The new world which emerged in Europe after the Black Death in the fourteenth century was very different from the world at the beginning of that century.  Among other things, the death of much of the laboring class left the survivors with a great deal of bargaining power, for a while, at least.  Income inequality diminished markedly.  Generally, some silver linings emerged, at least for a while.

I bring this up only as an excuse for posting this cool graph from Kevin Drum, which suggests that these silver linings will not be part of the post-COVID new world, even for a little while:

And, as Kevin notes, COVID's death toll is much higher among the much older, resulting in a smaller effect on the labor pool.  But that hardly matters; the new world will probably not be built on a new relationship between labor and management, as was true seven hundred years ago.

The Next Variant

The popular media is beginning to send a very annoying type of headline/article our way.  The headline says something like "What comes after the omicron wave?" and, after you've read the whole article, you realize that the answer is:  "We don't know."  Couldn't put that in the headline, could you?

It seems that it mostly depends on what tools the upcoming variants come equipped with and, of course, we don't know.  Some (very) preliminary research is suggesting that the BA.2 omicron variant* may have some very effective tools indeed:

The BA.2 virus -- a subvariant of the Omicron coronavirus variant -- isn't just spreading faster than its distant cousin, it may also cause more severe disease and appears capable of thwarting some of the key weapons we have against Covid-19, new research suggests... New lab experiments from Japan show that BA.2 may have features that make it as capable of causing serious illness as older variants of Covid-19, including Delta... And like Omicron, it appears to largely escape the immunity created by vaccines. A booster shot restores protection, making illness after infection about 74% less likely... BA.2 is also resistant to some treatments, including sotrovimab, the monoclonal antibody that's currently being used against Omicron.

If even one or two of these findings is accurate, we won't be reading as much about the new world soon.  What comes after this "final wave" is - the next variant.  Stay tuned.

 * - Now variants have variants.  Are we having fun yet?

COVID is Surging - Time to Open Up!

Here at The New World, we are concerned, among many things, with how long the pandemic will be with us.  Therefore, I submit for your approval a chart (science!  math!) which should help explain how to determine the pandemic's arc through the future:

                                                                                             - Cheryl Rofer via Balloon Juice

Perhaps the most common, most frequently-heard trope during the last two excruciating years has been:  "Positive test results and serious cases are surging, so let's open up and get back to normal!"  There is no reason to think this will change, which is why predicting the end of the pandemic is just about impossible.

Oh - and also, new variants, of course.  But that's a different topic.

Normal is How We Got Here

Something different today.  I'm just going to leave you with a Twitter thread I came across the other day, about our current favorite subject:

The new meaning of endemic that’s arisen during the COVID pandemic isn’t based in disease dynamics. Public health professionals, medical providers, journalists, and government officials are increasingly using the word endemic to mean some version of “getting back to normal”.

When people ask, “When will we get to endemic?”, what they really mean is, “When can we reopen?”, “When can the masks come off?”, “When will COVID be less disruptive?”, and maybe, “What amount of disease and death is acceptable to us?”

If we get to a point where COVID continues to devastate elders, immunocompromised people, and chronically ill and disabled people, will that mean it’s “endemic”?

If we get to a point where COVID is like HIV, where your privilege determines whether you get to ignore it, will that mean the pandemic is over?

What if we find a way to keep our healthcare system teetering just on the edge of collapse without quite falling over so that everyone who isn’t a healthcare worker can pretend the system is working fine, will that mean we entered the "endemic phase"?

What we need to be asking is, what is the “normal” that we’re trying to get back to? Whose deaths are acceptable to us? What level of disease are we willing to accept as normal or inevitable?

If we get to a point where we don't have an exponential increase in cases, that's great, but that doesn't mean exponential growth can't return - R-numbers are not fixed properties of infections. It doesn't mean people won't stop dying or that COVID is mild.

If individual cities like San Francisco think they're "getting to endemic", they should also remember that cities are connected to the rest of the world - this crisis won't be over until it's over everywhere.

And endemic does not mean we get to go back to normal. Normal is how we got here, and normal will continue to bring us new crises until we collectively decide to stop accepting it.

        Berkeley Free Clinic Outreach @BFCoutreach  Jan 31

For Some, the Pandemic Will Never End

As I'm sure you've noticed, there is, lately, a certain level of hopefulness regarding the end of the pandemic - the new world.  Even though everyone is getting the omicron variant, hospitalizations and deaths are, as a proportion of cases, a good deal lower.  Never mind that huge number of cases means that even a smaller percentage of serious illness still translates into a larger absolute number of hospitalizations and deaths.  Never mind that in the anti-vax-plagued US, deaths are higher than any point except last winter's surge, and a great deal higher than any other advanced nation.  As we've seen in the last few posts, nations are making plans for putting the pandemic behind them.

The pandemic, dear reader, will never be behind us.  Unless, of course, long COVID turns out to be temporary, which it has shown little sign of being.  I'd like to do some math that I've done before:  when we're comfortably settled in the new world, how many of us will not be comfortable?

As of right now, 384 million people worldwide have tested positive for COVID-19.  Estimates of the prevalence of long COVID range from one third to 42%.  Here's the math:  let's use, oh, 35% as the proportion of those positive for COVID-19 who will have long COVID.  Thirty five percent of 384 million people is *Googles math problem* one hundred thirty four million people.  Oh, wait - of those 384 million who contracted COVID, 5,700,000 died.  They won't get long COVID.  That makes about 378,300,000 who survived, leaving around 132,405,000, worldwide, who will need long-term, substantial medical care indefinitely.  In the US, the math brings us to around twenty six million who will need long-term treatment for long COVID.

That's a lot of medical care.  Are we ready for it?  

Sorry for the rambling post.  When I hear about how we're about to emerge and get back to normal, I always think about the millions for whom the pandemic will never end.

A Socially Critical Disease

Denmark has taken half a step into the new world, but a very different half than Thailand has taken:

Denmark took the European Union lead Tuesday by scrapping most pandemic restrictions as the Scandinavian country no longer considers COVID-19 “a socially critical disease.”

"No longer... a socially critical disease."  Is this the new criteria for the end of the pandemic?  If so, I suppose it would work better if we knew what it meant.  It strikes me that none of us would predict that Denmark would be vague, while Thailand would be precise.

At any rate, the media, at least, is starting to talk about lifting mitigating restrictions as the signal that the end is near.  The article about Denmark lists half a dozen European countries which have eliminated, or will shortly eliminate, all restrictions, without suggesting that they have announced the coming of the new world.  And all this in the midst of a surge, although:

Officials say the reason for the Danish move is that while the omicron variant is surging in the country, it’s not placing a heavy burden on the health system and Denmark has a high vaccination rate... The head of the Danish Health Authority, Søren Brostrøm, told Danish broadcaster TV2 that his attention was on the number of people in ICUs rather than on the number of infections. He said that number had “fallen and fallen and is incredibly low.”

Once again, one of the foundations of the new world is "a high vaccination rate," which means that many (most?) countries - oh, take the US as an example - are far from the sight of land.