From the NY Times Coronavirus Newsletter for March 12th:

Jonathan Wolfe: So you said we might return to something close to normal in May, but when do you think we’ll be back to 2019 levels of normal?

Ezra Klein: I have an exchange in my latest podcast with Dr. Ashish Jha, a health policy researcher at the Brown University School of Public Health, where he says something like there’s no going back to 2019 normal. And I’ve heard something like that a lot. But I think there are two versions of “things will never go back to 2019 normal” that people mean. There’s one version where what people are saying is it’s never going to be safe to do certain things again. And that doesn’t seem true.

EZ: On the other hand, as Dr. Jha says, pandemics change societies. So I think remote work is going to be more common. He was saying that he thinks there will be fewer 500-person lecture halls. It may take a long time for people to feel comfortable with activities that have once again become safe — there will be trauma and PTSD on a societal level from all this. So there may be social reverberations from this that may last longer than people think. That said, they also may not. I always think people underestimate the human animal’s ability to adapt and to snap back to an equilibrium.

I've never really understood the "never go back to 2019 normal" stuff either. Of course we're going back to normal, and quickly. For better and mostly worse, you couldn't stop a snap back to normal with a black plague.

Many are already back to normal and have been for months, against, I believe, any critical thinker's better judgement. Why in heaven's name would you eat indoors at a restaurant now? The risk/reward ratio is so high, and not just to you but everyone in your community. I mean, one Sunday morning I drove past a brunch place in town and it was jam packed. You couldn't tell we were, as a society, in pandemic mode.

We're so eager to be social and feed ourselves that we can't stop feeding our bodies to this virus.

Some kids have been in school since August. Many have played sports. Many adults have gone to bars without masks, and many states, including mine, haven't even proscribed doing so. Every time I go to the store, I see people leaving with a handful of items. Why did you bother? Why can't you stop yourself from feeding your body and your neighbors to this virus?

What's the difference between 2021 normal and 2019? The difference is that our oldest have died and will continue to die. If there was no vaccine, we'd simply have a much lower life expectancy. And many of us would get a hellish flu several times (maybe?) over the course of our lives. And some small percentage would have "long-haul" symptoms for years, perhaps.

With a vaccine, those repercussions drop by a factor of 100, don't they? You can't even sanely argue against going back to normal at a point that seems to be just a few months in the future, mutations be damned.

Because aside from having less of it for those who live longest, life would be and, again, for many already is, "normal". There would just be one very nasty extra "natural cause of death" culling our oldest generation -- and a sizeable, but small, percentage of our middle-aged and younger dying with them.

There will be fewer but not zero, not even 50% fewer, 700 person lecture halls in two years. I may not eat out very often for years, but most will. Most are. People may work remotely, but not because of COVID-19. Rather it will be because companies have seen, "When the workers stay home, they drop productivity by 5%, but we recoup it all spending less on facilities!" and, "If we can keep the top 30% most productive workers right now at home, we save 30% on rent and gain productivity!" and these selfish savings, for better or worse, will be lain on COVID, not the bean counters who deserve the praise or blame.

Life will be more dangerous than without this virus for the near future. But this virus morphs slowly and mRNA vaccines adapt quickly. In the richest countries, it seems likely that we will shove it into a corner quickly and, perhaps, will be able to eradicate it from the globe in decades, not centuries, if we have half a mind to.

The real lesson, and the difference I hope I see in the coming years, is that we take the to heart the real possibility that the next outbreak won't be nearly so (and it's painful to even conceive of COVID-19 like this) treatable. One might come that kills 20%, not 2%, of those it touches. It may spread through contact, not "just" sustained, shared respiration. It may mutate at 10x, 100x the speed of this one. We may not be able to contain it. It may kill our youngest with abandon instead of our oldest, causing anguish we haven't seen since the first Passover.

And then, if they don't learn the lesson and are as laissez-faire about their outbreak as we were about ours, when that future society gets back to 2019 "normal" (because if there's one thing we learned about human nature in 2020 it's that humans won't stop doing what they want to do now; normal always comes back) it will forever be paying a gruesomely higher price than we will.

Labels: covid, Other Stuff

I've wondered about this before, last time deciding we could get COVID twice, it's not chickenpox2020, and we need a vaccine or treatment asap.

Then a recent NYT newsletter told me this:

Separately, we spoke to experts who were comforted that three major Covid-19 trials were recently paused for safety considerations. And yes, you can be reinfected, but it’s extremely unlikely.

Which got me wondering if that's not the case with chickenpox too -- maybe you can get it twice, but it's just as unlikely.

Turns out that's close to the truth. Here's one random site:

Second infections with chickenpox occur in immunocompetent individuals, but are uncommon. Such second infections are rarely severe. A soundly-based conjecture being carefully assessed in countries with low prevalence of chickenpox due to immunization, low birth rates, and increased separation is that immunity has been reinforced by subclinical challenges and this is now less common. 

COVID has, from the first, made me wonder, almost hope, its ceiling would be a nasty, horrible chickenpox redux. I'm not as young as I once was, but for almost everyone under 30, it looks like you catch it and you're done. I wonder if "extremely unlikely" to catch it again means "six months after the first time you had COVID" or "for the rest of your life after you've had COVID". 

Worst part is we won't really know anything definitively until we get that far out. As I've told those stuck near me before, "You can't know the side effects of a vaccine that appear two years after you take it before, yep, it's been two years since people started taking it." And even then, you won't know for sure you're not a special case for a while. The same goes for this virus. We don't know what it'll do, what its shingles equivalent is, for instance (shingles representing "unknown stuff that it'll do to you later, after 'recovery'"), until we get there.

Regardless, if that's immunity is a lifetime of "extremely unlikely", even if it's not as hard and fast as chickenpox lifetime immunity, strangely Trump's plan (insert maniacal laughter about the misuse of the word "plan" here) isn't as wrong as some are painting it. We want to back the virus infection faucet down from where we are now so that the hospitals are at 50%, not 100%, capacity, which the White House completely ignores. We want to slow it even further than that so that we can develop some better treatments for those whose disease goes sideways. But if, on recovery, those who do recover get anything close to lifetime immunity, we might want (we don't not want?) folks who will recover to get sick and recover as soon as possible.

Chickenpox, again, if I remember correctly, could be really serious for older people. That bastion of accurate knowledge, wikipedia, currently says, "Chickenpox is rarely fatal, although it is generally more severe in adult men than in women or children." (Sound familiar?) You wanted to get your kids sick at an age when you could be reasonably certain they could recover fairly easily. It wasn't perfect, but it was a livable world. Wonder when chickenpox "started"... Looks like no later than the 1500s. So we'd long ago taken our "first bout" deaths that we're experiencing now. Chickenpox, I wonder, might have been a lot more fearsome when it started.

Anyhow, lotta ifs. I'm a little surprised we don't have more answers. Any way you slice it, this virus is kicking our collective butts, and I'm still crossing fingers we have a good vaccine sooner than later.

Labels: covid, Other Stuff