States began shutting down most of public life back in the 3rd week of March. The economic impact of these measures has been staggering but as they drag on, the psychological impact is beginning to grow as well.
Spread of the disease in the US has slowed, but almost all of our overall decline has occurred in the NYC, New Orleans and Boston areas. Two months into this shutdown, six states (TN, ME, TX, ND, UT, AR) still have an R-value above 1, meaning C19 infections continue to grow. One of them, Texas, also has an enormous population giving the disease plenty of room to run. After two months of lockdown our per capita daily death toll from C19 remains fifth in the world behind only Sweden, UK, Brazil and Peru.
Lockdowns were never meant to end the pandemic. They are designed to buy time, a thin firebreak providing an overwhelmed government a pause to set in place the testing and tracing measures that contain a viral disease. Our lockdowns haven’t failed because people lost patience. Our lockdowns failed because our federal government has not done its job.
Our current CDC Director is an anti-abortion activist who blamed the HIV epidemic on a collection of right-wing scapegoats, including “single-parent households.” Under the leadership of a wider Administration filled with religious nuts, grifters and racists, our pandemic response has been a rolling disaster. However, Obama’s CDC Director, Tom Friedan, is doing what he can from outside the government to steer us toward the only solution.
Working with the Gates and Bloomberg foundations, and with help from Kelly Henning, the former Director of Epidemiology for New York City’s Health Department, they’ve published a guide to testing and tracing for morons accompanied by a New York Times op-ed.
Friedan’s very simple guide lays out the only solution that was ever available in a simple cartoon, using small words in bold type. This model was used for prior outbreaks, like the Ebola crisis in Africa, but it is uniquely effective for viral diseases. Viruses do not replicate outside their hosts. Identify all of the hosts, isolate them during their contagious phase, and the disease will die out. Fail, and the disease will continue to spread. That’s the whole, very simple story of a complex pandemic.
With or without effective treatments, and with or without a vaccine, testing and tracing is our only way out of this disaster. Yes, a vaccine would help, but for comparison consider what it took to (briefly) eradicate measles.
We had a cheap, reliable vaccine available for measles in 1968. We eradicated the disease (briefly) 32 years later in 2000, thanks to mass, mandatory vaccinations and an aggressive contact tracing campaign. 32 years of effort, even with a vaccine that imparts lifelong immunity.
By comparison, we have no reason to think that immunity to C19 lasts very long, and a great deal of evidence that it may be fleeting, perhaps as brief as 6 months. We’ve had influenza vaccines since WW2. How often have you had a flu shot and how often have you had the flu? Lifelong immunity is not available for every illness, and coronaviruses probably aren’t among them. Vaccines will not be enough.
Potential limitations in immunity also mean we can’t count on this disease to simply “burn itself out.” Nobody manages malaria, tuberculosis or meningitis by letting it run through the population and build up “herd immunity.” That’s not how you solve an infectious disease problem, it’s how you build one of those shithole countries that require a dozen painful injections for a visit.
Countries like South Korea and New Zealand which have nearly eradicated C19 have used limited lockdowns as opportunities to build their testing and tracing capabilities. We squandered that opportunity. Now the toll of the shutdowns, along with protests from ideological idiots, is forcing us to abandon even these weak measures. Prior to the lockdowns and mitigation efforts, C19 was spreading with an R-value around 3, meaning each infected person was infecting 3 additional people. Drop these mitigation efforts and we’ll likely see a return to these levels of spread within a few weeks. But what choice do we have?
Lockdowns alone were never going to stop the spread of C19. Lockdowns are not a cure and they cannot last forever. Our incompetent federal leaders did not do their job, allowing our window for implementing a relatively manageable testing and tracing regime to close. Now we’re going to do this the hard way, a painful reminder that politics is always a matter of life and death.