omicron

It is rapidly becoming apparent that most people don’t understand dealing with a pandemic, or the transition from pandemic to endemic illness. The odds of crushing this out the way that SARS or MERS were dealt with in the past are nonexistent now – C19 is with us to stay. The flip side is that with the omicron variant, we are seeing a less deadly form, which is what evolution would predict – after all, an organism that kills its host hasn’t got long to live itself. C19 was not “just like the flu” in its original forms, but it is becoming more like the flu – which is to say, we have a vaccine against it, and we have treatments for it if you catch it, and it is still deadly to those with underlying health issues or compromised immune systems, but it should not be lethal for the majority of the population if properly dealt with.

At least, that’s what could be the case. We would still need the Pfizer treatment to be as cheap and effective as, say, tamiflu. And we would need the vaccines to remain efficacious or quickly updatable, with the expectation that you’ll get the shot every year, same as a flu shot. And some people will get it, but it will be treatable with bed rest and hot liquids and the tamiflu equivalent, and it will not tax the health care system for them to recover at home.

Because all along, that has been the principal limiting factor: does the health care system have the capacity to absorb C19 patients? It has the capacity to absorb flu patients, and if C19 becomes the flu, that capacity is still there. If hospital ICUs and ERs are still filling with patients who require intubation and monoclonal antibodies and extreme care, then it is not the flu yet and we still have a problem that requires extreme measures. At this point, it’s not about wiping out C19, it’s about eliminating the need for these extreme measures.

And right now that is not a difficult proposition. Wash your hands, wear a mask, ESPECIALLY wear a mask if you think you might be coming down with something – which people in Asia and Asian people in the Bay Area have done for decades, seeing people in face masks at the farmer’s market in winter was a totally unremarkable event before 2020 – and either create social distancing indoors or require a mask in environments that are crowded and conducive to spreading colds, like aircraft for instance. I can’t remember a flight I took between 2005 and 2016 that didn’t have a sinus infection concerned in it somewhere after. 

It’s not about making C19 go away, that ship has sailed. Now it’s about lowering the impact on public health, such that fewer people get it badly enough to require hospitalization and that the people with other things – stroke, heart attack, broken leg, transplant, cancer – aren’t driven out of the hospital by the volume of C19 patients. We should probably stop using percentage positive as the metric for remediate measures and start using “percentage of area excess hospital capacity available”. If all the hospitals within 100 miles of you are full up, it’s mandatory masks everywhere and we’re gonna play games in empty arenas until it throttles back down. 

And above all, it’s time to make the vaccine pass a thing. If you have three shots, you can pretty much go anywhere. If you don’t, you’re going to have to take extra measures and there may be limits on where you can sit and what you can do. Probably not forever, possibly not even for very long, but the evidence has proven so far that when you force people to get vaccinated or lose their job, 99% of people will (and let’s face it, there’s no org that’s not better off losing the most recalcitrant 1% of their staff). In a world where you need a measles shot to start college and you need a license and insurance to drive your car and you have to have a blood test to get married, mandating a C19 vaccination for the duration of the pandemic is not outrageous or unreasonable.

Because the objection to the vaccine is in bad faith all the way around. A few years ago, when antivax was mostly the province of Marin hippie parents , conservatives fell about themselves to trumpet the value of the measles shot and demand that students not be able to come to school sick, because it was something to bash their enemies with. Now it’s become a shibboleth of fidelity to stupid-worship, which is all that being a Republican means any more: the worship of stupidity over everything and anything else. It’s long past time for private business to do what governments can’t or won’t: proof of vaccination or you aren’t riding Space Mountain. Proof of vaccination or you can watch the Cowboys and the Bucs on TV. Proof of vaccination or your kids will make you FaceTime instead of bouncing the grandchild on your knee. 

The fundamental flaw of the 21st century is that we gave up on any idea that living in a society requires responsibility and that you can’t do whatever you want, whenever you want. If people wouldn’t sacrifice in the face of the Pentagon and the World Trade Center, they certainly won’t give way for a virus when all the cable news assholes encourage them to believe the Facebook bullshit. And the conservative governments  in the UK and elsewhere aren’t calling it fake and throwing open the doors. This is American exceptionalism at its worst, and it’s making me really wish I could get that Irish passport somehow.  

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