When is the pandemic over?

¯\_(ツ)_/¯

In a epidemiological sense, with over 300 people still dying a day, clearly not yet.  But, in how virtually everybody I know is living their lives… oh, yeah.  You know I’ve been a person to generally take things pretty safe, but when I saw the articles about keeping your Thanksgiving safe with Covid my initial reaction was, “we’re still doing that?”  

Katelyn Jetelina and Jeremy Faust have been two of my favorite voices on these issues, so it was a real treat to have them come together in one of Faust’s posts.  After a nice discussion of assessing Covid through excess mortality, I especially liked this part:

Jetelina: I mean, it makes sense to me. But I think the other really interesting discussion we need to have on a national level regarding excess death is that we have a new disease now. What is acceptable excess death? Because we are going to see death. Is it truly zero? Should we strive to what was pre-pandemic? What is it now?

Faust: What’s our new sea level?

Jetelina: Yeah, and that’s a discussion; it’s a tough one to have. I think that’s also what we’re trying to really decide as a nation right now is where is that new sea level and what do we find acceptable, right? We do that with flu. We prevented, what, 60,000 deaths from the flu or whatever because of a lockdown. We can prevent that many deaths, but that’s not what we, as a culture, accept.

So I don’t know, I think it’ll be really interesting and I don’t think anyone has the right answer, but this is what is basically happening in real time as we’re all discussing and deciding as a culture where this lays.

In short, whenever Covid is “over” we are simply going to have more mortality than before because there’s a new deadly disease out there in the world (just like influenza is out there and not going away) and there’s no putting that genie back in the bottle.  Obviously, we can mitigate extensively with vaccines and treatments, but it seems safe to say that, at least till some genuinely new bio-technological developments, excess mortality is going to remain permanently about pre-Covid levels.  That’s just our world now.  Is 300/day too high?  I think so, probably.  But, if we wait for this to get down to 0, this pandemic may never be over, and that’s not realistic.  

Meanwhile, David Wallace-Wells had a really nice piece on the state of Covid a few weeks ago that I had meant to write about.  And, these days, a 3-week old Covid piece is actually still relevant:

The Covid pandemic still isn’t over, but it has gone remarkably flat.

It’s been nearly a year since Omicron was discovered in South Africa and Botswana, and no new variant of concern has been declared since then by the World Health Organization. That’s a notable interlude, since five were declared in the previous year.

There have been plenty of new variants of Omicron, of course — so many lineages that all but the most conscientious or neurotic Americans have probably lost track of them. And each new subvariant (XBB, BQ.1 and BQ.1.1, to name three recent ones of note) has produced a small flurry of worried coverage about immune evasion and transmissibility, with some producing small surges in infection as well.

But all of them are part of the same family, and though some are quite distant relatives of the original Omicron subvariant, none have meaningfully changed the big-picture story of the disease. The third anniversary of the pandemic is around the corner, and we remain in the quasi-endemic steady state that has characterized things since the early spring: Infections are very common, and deaths are distressingly high, but without another Omicron, new subvariants really don’t seem to matter all that much.

Even just a few weeks ago, there was some worry about what these new Scrabble variants might mean, and some alarms flashed abroad…

But pretty quickly, the tide turned, making the ultimate impact of the new subvariants hard to see unless you were squinting…

The Economist’s excess mortality data, which uses a slightly different methodology, tells the same story: relatively steady, comparatively little excess mortality since April.

Compared with what, though? Four hundred deaths a day add up to almost 150,000 deaths a year. If we avoid a major surge in the next two months, the Covid death toll for the full year will stay below 300,000. That isn’t quite as horrific as the 350,000 deaths the country registered in 2020 or the 475,000 it registered last year. But it’s still tragic. It’s just normal now, too.

And there you have it, I think.  It is tragic that we have a disease that’s going to likely be killing 6-figures of Americans a year for the foreseeable future, but, Covid is simply with us now, and yes, it is and will be “normal.”

And, oh, yeah, have we massively dropped the ball in not having a Warp Speed 2.0 for next generation vaccines and treatments.