COVID In The Rearview Mirror: Could We Really Have Done Things Differently?

It was four years ago this week that COVID-19 was declared a global pandemic, setting off a chain of events unlike I ever experienced in my life and unlike anything I had mentally prepared myself to deal with.  Even when global markets began crashing in late February 2020 because of an expectation of vastly diminished economic output, I never expected it would come to months of closed-down stores and stay-at-home mandates for the majority of American workers.  And even by the second week of March, when Italy, among other European nations impacted by the pandemic before us, began locking down to reduce viral spread, it still didn't seem conceivable that the same fate awaited the United States only a week later.  It felt positively surreal wheeling my office chair out of the building on March 17, 2020, preparing to work from home for the foreseeable future and having no sense of what the world would look like on the other side of the lockdown.

Well, here we are four years later and on the other side of those lockdowns initiated in the spring of 2020, and the consensus opinion seems to be that our national response was an overreaction.  Anybody with a basic understanding of human nature could predict that the social isolation, the cessation of education, and abrupt disruption of commerce would have catastrophic downstream consequences, but preservation of human life was deemed the priority and that we would all have to be in it together to sacrifice for the common good.  Was it the right call?  And what did we obviously get wrong that we can learn from if there's a next time?

Looking at it as objectively as possible, I have to acknowledge that few things are particularly obvious and I can't envision any counterfactuals where the worst outcomes of COVID-era lockdown disruption could have been averted.  I've been critical in the past of the epidemiologists for telling half-truths or outright lies on everything from the utility of masks to the efficacy of the vaccine, but it's also hard not to acknowledge that there was a common good to the national psyche for trying to project calm and in attempting to sell a light at the end of the tunnel, even if it required some sleight of hand.

The first such sleight of hand came with the slogan "15 days to flatten the curve", sold by the epidemiological community in March 2020 as something of a vacation for most workers when viral spread was expected to really accelerate.  There was plenty that was not known about the virus when that line was deployed, but everybody in the medical community knew that it would be much, much longer than 15 days before we could even think about getting back to normal.  Should they have been honest with us and told us that from the outset?  Maybe, but I think we've proven ourselves too immature as a people to have dealt rationally with that information.  Indeed, less than a month after the lockdowns began, public protests were already being held demanding that they be lifted.  If people had any sense in mid-March that the lockdowns would extend as long as they did, a public uprising would likely have arisen at the very time when it would have been the most costly in terms of viral spread.

As for masking, the messaging from the epidemiological community was even more incoherent.  For at least a month, they discouraged masking, insistent that no good could come from it.  Instead, we were walking around the supermarket mask-free but then scrubbing the groceries when we got home to "get the virus off". Then at some point in the second half of April, an abrupt and awkward pivot began where the same people who had shrugged off masking began to aggressively embrace it, ultimately to the point of recommending mandates for the very accessory they assured us was useless only a month or so earlier.  As sketchy as this seemed, it may still have been defensible as mask supply in March 2020 was nowhere near what the demand would be if the virologists had told us from the outset that masks were useful.  Was it better to count on the lockdown itself limiting viral spread during the interim period where mask supply was shored up, and thus allowing the masks to be readily available at the time when the world started to open up a little?  Probably, but with a considerable qualifier that trust lost is hard to get back, a theme that kept repeating throughout the pandemic.

As the spring of 2020 progressed, some patterns became clear on the demographics of people who were most vulnerable to the virus, and children and young adults were not among them.  Many of them were becoming understandably restless and wondered aloud why they were on indefinite house arrest as opposed to simply protecting people at greatest risk of the virus.  The explanation we always got was that it would be impossible to shield the vulnerable securely enough if the virus was running rampant among all demographics.  This was indisputably true, but the longer the lockdown went on, the tougher it became to sell that cost-benefit assessment, particularly as it applied to schoolchildren going multiple months without in-person education. 

This remains the hardest aspect of the COVID era to parse one way or another when reflecting upon our response.  On one hand, even though the virus didn't prove as deadly to as many people as originally feared, there were more than a million deaths linked to it!  That was a considerably larger number than the worst of our fears in March and April 2020, rendering any attempt to downplay the severity of the virus to be dubious hind-sight. On the other hand, would things really have been worse if we'd green-lit younger and healthier people to live freely and frontload the spread of the virus?  Would more people have ultimately died amidst steeper spikes of viral spread?  Or did all of the people who would have died earlier ultimately end up dying later since the virus outlasted all lockdowns?  

It would be helpful if there were any consistent numbers, at home or abroad, to quantify whether a looser or tighter lockdown yielded better results, but there aren't.  States and nations with the most aggressive approaches ended up having no better or worse outcomes that states and nations with the most relaxed approaches. With that in mind, it's easy to decry in retrospect that the lockdowns were all for nothing, particularly with the diminished educational outcomes and the epidemics of crime and mental health credibly connected to the prolonged isolation for jurisdictions with the strictest lockdowns.  I'm not fully convinced though.  

Recall that during the hospitalization spikes, our emergency response systems were taxed well beyond their limit in dealing with the tidal wave of sick people coming their way.  If those systems had been taxed even further with even greater numbers of sick people coming all at once, there's reason to believe that in addition to vastly more deaths, it would have done irreparable harm to our already fragile health care system.  Would that have ultimately wrought more societal wreckage that incubating a generation of mental health decline among young people by isolating them and failing to educate them?  Most people are pretty confident that they know the answer either way, but I'm not one of them.

And that brings us to the vaccine, which predictably became just as controversial as every other part of the pandemic if not necessarily for the reason I anticipated.  The epidemiology community sure made the public believe that, in a matter of months, a miracle cure had become available that would abruptly generate "herd immunity" and end the pandemic.  I recall visiting my doctor in November 2020 and being assured that "by next year at this time the pandemic will be over".  As it turned out, there was no such thing as a miracle cure or herd immunity.  I suspect epidemiologists knew that when they were pleading with us to get vaccinated, and it became obvious to the rest of us just a few months later when viral spread began to once again surge.  Were we bamboozled?  Yes.  Was it worth it for us to be bamboozled?  Probably.

By convincing hundreds of millions of people that unrestrained freedom and a complete return to normalcy awaited for those willing to spend 30 seconds getting stuck by a needle full of miracle medicine, they were able to reduce incidence of fatalities and hospitalization and help contain a pandemic that at any point could have mutated into something deadlier.  Indeed, the highly virulent omicron virus that took hold in the fall of 2021 could conceivably have been devastating if not for two-thirds of Americans getting vaccinated and reducing the impact of their infections.

Still, it wasn't supposed to work that way.  The vaccine was supposed to be a fire extinguisher on COVID, rendering the vaccinated individual incapable of catching the virus or transmitting it to others.  Sure, we might need to get a booster every year, but we walked out of those vaccine appointments feeling like Superman, sneering at the fools and rubes that refused to get the vaccine and blaming them for prolonging the pandemic.  Perhaps we deserved to be humbled, and we certainly were by July 2001 when the same epidemiologists ensuring us the vaccine ended our problems dramatically revised their assessment and informed us we were no less likely to receive and transmit the virus than we were six months earlier.

Once again, a steep price will be paid for the scientific community having misled us on the efficacy of the vaccine, and it will manifest itself for a generation and in seemingly infinite ways, including but not limited to vastly diminished incidence of traditional childhood vaccinations and the potential health emergency waiting when those medieval diseases return.  But putting myself in the shoes of the epidemiologists at the time, I ask myself if I'd have done anything differently given the circumstances, and it's doubtful that I would.  They can only deal with one crisis at a time rather than try to predict what the downstream effects of the hypothetical next health emergency will be, and in the winter of 2000-2001, there was no greater emergency than COVID risk reduction.  Even a vaccine with only modest efficacy was monumental in reducing risk, and managing the virus's mutation and eventual decline was far less perilous with so many Americans having that first layer of protection.  With luck, the scientific community will have time to rebuild public trust before the next inevitable pandemic rears its head.  It's a gamble, but probably one worth taking.

So is there anything we definitively learned from our COVID response?  The only one entirely obvious is the one that should have been obvious all along.....don't put infected patients into nursing homes.  Even that's probably more complicated than speculating outsiders would like to admit.  At the dawn of the pandemic, there probably weren't any credible alternatives to house the patients while still giving them access to the necessary care.  With that in mind, we should definitely vastly increase the square footage of overflow emergency care for patients in the event of future health crises.  

Beyond that, don't defer to political correctness so easily.  For more than a year, the scientific community clung to a far-fetched storyline of this global pandemic originating because someone ate a bat sold at a wet market.  More than a year was wasted breathlessly defending this narrative and shooting down more credible alternatives, including the most obvious one:  that the virus originated at a virology lab right there in Wuhan, China.  Furthermore, don't tell us that viral spread is no big deal if you're protesting on behalf of racial justice and expect to ever taken seriously on anything again.

Ultimately though, no two viruses in history are alike, so those who insist they've cracked the code and have the whole virus response protocol figured out for next time are comically naive.  The next virus that triggers a pandemic will undoubtedly behave much differently than this one.  Expect an abundance of caution to be taken when the time comes just as it was in March 2020.  If it isn't, an all-out plague could be triggered if the demographics impacted by the next virus are different than those impacted by the last one.  

I really hope to never endure another pandemic footing again in my lifetime.  History indicated that pandemics typically bring out the worst in people just as wartime does, and even the relatively mild one we muddled through certainly proved that to be the case.  But whether the next one comes in one year, 10 years, or 100 years, I suspect the only consistency to be that the risk potential will be infinitely higher if the scientists are not listened to than if they are.  Especially if the next pandemic happens sooner rather than later, before COVID memories are fully memory-holed, people will be rightfully skeptical of some of the conclusions reached by the "experts", but they're more likely than not going to be sorry if they don't take those conclusions seriously and respond accordingly.