America Has Decided It Went Overboard on Covid-19
The New York Times (archive.ph)
By David Wallace-Wells
2023-03-18 01:23:26GMT
Ibrahim Rayintakath
In both the United States and Britain, there is suddenly a front-and-center debate about the very earliest days of the pandemic and how each country responded. Did mitigation measures imposed in the spring of 2020, amid great anxiety and uncertainty, actually work? And considering the costs, were they worth it?
In the United States, that conversation was precipitated by a Department of Energy leak about Covid-19’s origins and by a flood of hearings initiated by the Republican House majority into those origins and the American response: the impacts of shelter-in-place guidance and school closures, vaccine development and mask guidance, and more. In Britain, it was precipitated by a leak of more than 100,000 ready-for-the-tabloids WhatsApp messages between Matt Hancock, the secretary of state for health and social care for the first 15 months of the pandemic, and other senior figures of the British government, including Prime Minister Boris Johnson, who at one point, misreading the number of decimal places in a fatality-rate estimate, appeared to conclude that Covid was only 1/100th as deadly as it was. “If you are over 65 your risk of dying from Covid is probably as big as your risk of falling down stairs,” Johnson wrote to his team in August 2020. “And we don’t stop older people from using stairs. What do you think?”
It’s telling that the British scandal centers on Hancock, who reached the highest levels of public notoriety when he was caught disobeying his own social-distancing orders to visit his aide with whom he was having an extramarital affair. It’s also telling that the scandal has come about because the ghostwriter Hancock hired to help him cash in on that infamy, herself apparently a lockdown skeptic, eventually turned on him and, shortly after the book’s publication, sent the messages to The Daily Telegraph. That’s because, for much of the pandemic in England, the country’s leaders came under fire for incompetence to some degree but especially for their hypocrisy. (Johnson’s own top adviser Dominic Cummings kept memorably comparing him to an out-of-control shopping cart, but he was forced to ultimately resign over fallout from parties held during periods of social distancing.)
By contrast, to the extent Americans vilified their leaders over the course of the pandemic, it was not primarily for hypocrisy (remember Gavin Newsom’s French Laundry dinner party?) but for harshness. In Britain, the WhatsApp leak has been narrativized by the British press as a cartoon of feckless leadership. In the United States, the equivalent leak was the “Twitter files,” when internal company deliberations over pandemic messaging were examined by contrarian quasi-journalists deputized by Elon Musk shortly after his takeover of the company. The rhetorical emphasis was to hype public health guidance as near-totalitarian, as though those pursuing restrictions regarded severity as something like an ideological end of its own.
Given how panicked and supportive of mitigation measures Americans were in the spring of 2020 — and how much infection and death lay just ahead — the idea that pandemic response was largely defined by excess and overreach may seem extreme. But in its softer form the belief is no longer confined to the skeptical margins of social media’s anti-establishment.
Last weekend, The Times published a survey of pandemic recommendations from experts considering the possibility of another outbreak, and it looked to me as though in nearly every case even those taking the more aggressive side of the argument endorsed mitigation measures that were no stronger and often weaker or more caveated than those that had been put in place in 2020. They did so even though the hypothetical disease they were considering was both more transmissible and more deadly than the new coronavirus (and even though it also affected children and adults equally). That is, faced with a disease that would spread more quickly than Covid, kill more of those infected than Covid, with a mortality burden, compared with Covid’s, markedly rebalanced toward the young, they would vote, in general, to do less.
This isn’t a question limited to abstract, virtual-reality-style debates on op-ed pages and social media. In at least 30 states, The Washington Post reported last week, legislatures have already passed laws limiting public health powers in the wake of the pandemic. Most of the states are in Republican control, but not all, and the restrictions legislated so far are quite intrusive: in many cases, extending outright bans against health officials or governors from issuing mask mandates, closing schools or businesses, restricting large gatherings in places like churches, or testing or vaccine protocols. But what is most striking is how little consideration they give to the particular attributes of future outbreaks — treating a future disease that spreads like measles but kills one in five kids it infects the same as one that spreads like swine flu and doesn’t kill anybody. And stopping public health authorities from doing anything about any of them.
Stop and think about that for a second: As the country emerges from three years of death, disruption and suffering, dozens of states have decided not just that future mitigation measures should be carefully targeted and calibrated, or that they should be time-limited, or that they should always integrate trade-offs and cost-benefit calculations from the beginning. They have decided that the best way to prepare for those future diseases is to tie our hands ahead of time.
Is this the lesson the country should be taking from its experience with Covid-19? More than a million Americans died, and several hundred more continue to each day, keeping the country on a path to more than 100,000 Covid-19 deaths annually. Polls continue to show significant public support for mitigation measures like masking, believe it or not. These kinds of surveys are notoriously unreliable and may well significantly overstate such support, but last fall’s elections tell something of the same story: Candidates who were Covid hard-liners weren’t punished for their policies any more than skeptical or hands-off governors. These dynamics may shift again, as the country pulls past exhaustion toward some real pandemic perspective — which many of the installments of Opinion’s Next Pandemic series attempt to provide. But for now, at the level of policy and public discourse, a striking American consensus seems to be hardening: When Covid-19 hit, the country did too much.
The epidemiologist Katelyn Jetelina calls this “a new phase of the pandemic — revisionism.” To me, it looks almost like brain fog, with the deadliest public health crisis in a century already so out of focus in our collective memory that we find ourselves talking at the level of abstract principles as though they bear no relationship to the brutal reality of the early pandemic, producing talking points so disconnected from real history they can be put to any narrative purpose that suits.
This is not to say that the early months of the pandemic represent an eternal mitigation ideal, or even that they were as well calibrated as they might have been. But I am sure that any potential infection delayed until mass vaccination was a public-health win and that we can’t just retroactively cut-and-paste the social preferences we’ve settled on post-Omicron — after years of vaccination, disease spread and natural immunity, and mass death — onto our memories of 2020 as though we’re rebooting a pandemic video game now knowing how best to play it. And yet instead of thinking carefully about how the game has changed and how different circumstances require different responses, we seem to be modeling policy for future pandemics based on the world we inhabit now rather than the one we did when the virus first began spreading. Most of the time, no one really seems to notice that presentist legerdemain, perhaps because so few of us actually remember the experience of 2020 all that clearly and are clinging to hastily imposed narratives instead.
Consider the story circulating now — through essays, columns, podcasts and commentary on the pandemic’s geopolitical context — about China. Beginning in the fall — first with protests against the country’s “zero Covid” policies and then with news of its abrupt end — foreign observers, including me, warned about the humanitarian disaster the country was steering toward. Given more than a billion people with almost no exposure to the virus itself and a vulnerable elderly population that was disproportionately unvaccinated, the unmitigated spread of some extremely transmissible Omicron variants was projected to produce more than a million deaths in short order. When that brutal wave came, Western commentators were quick to declare a kind of debate-club victory and call China’s stubborn Covid-containment policy, for so long a global outlier, an obvious failure.
The data tells a more complicated story and illustrates that these questions are rarely binary or one-size-fits-all. According to estimates published last month by The Times, probably one million Chinese — and perhaps as many as 1.6 million — died when the country relaxed its Covid restrictions. That is a harrowing toll, especially in just two or three months. But it would mean that China’s per capita death toll through the whole pandemic was still less than a third of America’s.
And that may well understate the gap. The Economist maintains what is probably the single best database of global excess mortality throughout the pandemic, and the enormously wide range of its China estimate is telling — we simply know much less about the ultimate cost of the disease there than in almost any other country. But the very highest end of The Economist’s estimate for China, 220 excess deaths per 100,000, represents a pandemic death toll that is barely half the very lowest end of the U.S. estimate, 390 deaths per 100,000. If you take the median estimate for each country, the American per capita death toll would be four times as high. Which is to say that, to judge by excess mortality, if China failed the pandemic, the United States failed four times as hard.
Of course, mortality is not the only way to judge pandemic response. But while many other aspects are difficult to measure directly, economic performance is one decent proxy for how much the pandemic disrupted the day-to-day life of each country.
The United States has, by global standards, an enviable record. Thanks in large part to unprecedented federal relief spending, the country stands out. It is alone among its peer countries in not just recovering from the initial pandemic shutdown but also, as soon as late 2021, surpassing the levels of economic growth forecast for that quarter before the pandemic even hit. But even on this metric, China’s economic record is better, with Chinese G.D.P. growing, according to the I.M.F., from $14.3 trillion in 2019 to $18.32 trillion in 2022 — growth of about 28 percent. American G.D.P., by contrast, has grown from $21.4 trillion to only $25 trillion — 17 percent. Of course, Chinese data is notoriously unreliable, and the countries were on different growth trajectories heading into the pandemic, which means it isn’t exactly fair to compare them so simplistically. But it also makes it hard to look at China’s record and think simply, “disaster.” Over three years, the country’s people died a lot less and the country grew a bunch more.
What, then, is the precise nature of the Chinese “failure”? One answer is the lockdowns and “zero Covid” policy itself. The problems with vaccination rollout are especially striking to me, considering how much higher rates were among the young and the middle-aged than the elderly and infirm. Another might be that the error was essentially a matter of sequence: that the ultimate mistake of China’s pandemic response was to endure its most catastrophic wave not when the planet was almost paralyzed by panic but when the rest of the world had decided the disease was no big deal.
But here the experience in China is striking, too, at least as well as it can be observed from abroad — a sign that three years in, the Chinese are happy to trade unmitigated transmission for some freedom from pandemic restrictions, too. Remember, though economic headwinds surely played a role, “zero Covid” was brought to an end in part by unprecedented nationwide protest. There has been no evident equivalent protest against the hands-off approach that followed, no visible upswelling of outrage over the possibility of a million deaths and the indifference of Xi Jinping and the Chinese Communist Party to that carnage. “Can a million Chinese people die and nobody know?” Michael Schuman asked in The Atlantic last month, wondering about how little those outside the country had heard about the recent deaths within it. But the domestic fallout, or lack thereof, is even more striking — that a million people might die without the country really caring. Or perhaps it shouldn’t be striking so much as a sign of global convergence — that three years on, the whole world has acquiesced. Even the longest holdouts are normalizing mass death now, too.
The New York Times (archive.ph)
By David Wallace-Wells
2023-03-18 01:23:26GMT
Ibrahim Rayintakath
In both the United States and Britain, there is suddenly a front-and-center debate about the very earliest days of the pandemic and how each country responded. Did mitigation measures imposed in the spring of 2020, amid great anxiety and uncertainty, actually work? And considering the costs, were they worth it?
In the United States, that conversation was precipitated by a Department of Energy leak about Covid-19’s origins and by a flood of hearings initiated by the Republican House majority into those origins and the American response: the impacts of shelter-in-place guidance and school closures, vaccine development and mask guidance, and more. In Britain, it was precipitated by a leak of more than 100,000 ready-for-the-tabloids WhatsApp messages between Matt Hancock, the secretary of state for health and social care for the first 15 months of the pandemic, and other senior figures of the British government, including Prime Minister Boris Johnson, who at one point, misreading the number of decimal places in a fatality-rate estimate, appeared to conclude that Covid was only 1/100th as deadly as it was. “If you are over 65 your risk of dying from Covid is probably as big as your risk of falling down stairs,” Johnson wrote to his team in August 2020. “And we don’t stop older people from using stairs. What do you think?”
It’s telling that the British scandal centers on Hancock, who reached the highest levels of public notoriety when he was caught disobeying his own social-distancing orders to visit his aide with whom he was having an extramarital affair. It’s also telling that the scandal has come about because the ghostwriter Hancock hired to help him cash in on that infamy, herself apparently a lockdown skeptic, eventually turned on him and, shortly after the book’s publication, sent the messages to The Daily Telegraph. That’s because, for much of the pandemic in England, the country’s leaders came under fire for incompetence to some degree but especially for their hypocrisy. (Johnson’s own top adviser Dominic Cummings kept memorably comparing him to an out-of-control shopping cart, but he was forced to ultimately resign over fallout from parties held during periods of social distancing.)
By contrast, to the extent Americans vilified their leaders over the course of the pandemic, it was not primarily for hypocrisy (remember Gavin Newsom’s French Laundry dinner party?) but for harshness. In Britain, the WhatsApp leak has been narrativized by the British press as a cartoon of feckless leadership. In the United States, the equivalent leak was the “Twitter files,” when internal company deliberations over pandemic messaging were examined by contrarian quasi-journalists deputized by Elon Musk shortly after his takeover of the company. The rhetorical emphasis was to hype public health guidance as near-totalitarian, as though those pursuing restrictions regarded severity as something like an ideological end of its own.
Given how panicked and supportive of mitigation measures Americans were in the spring of 2020 — and how much infection and death lay just ahead — the idea that pandemic response was largely defined by excess and overreach may seem extreme. But in its softer form the belief is no longer confined to the skeptical margins of social media’s anti-establishment.
Last weekend, The Times published a survey of pandemic recommendations from experts considering the possibility of another outbreak, and it looked to me as though in nearly every case even those taking the more aggressive side of the argument endorsed mitigation measures that were no stronger and often weaker or more caveated than those that had been put in place in 2020. They did so even though the hypothetical disease they were considering was both more transmissible and more deadly than the new coronavirus (and even though it also affected children and adults equally). That is, faced with a disease that would spread more quickly than Covid, kill more of those infected than Covid, with a mortality burden, compared with Covid’s, markedly rebalanced toward the young, they would vote, in general, to do less.
This isn’t a question limited to abstract, virtual-reality-style debates on op-ed pages and social media. In at least 30 states, The Washington Post reported last week, legislatures have already passed laws limiting public health powers in the wake of the pandemic. Most of the states are in Republican control, but not all, and the restrictions legislated so far are quite intrusive: in many cases, extending outright bans against health officials or governors from issuing mask mandates, closing schools or businesses, restricting large gatherings in places like churches, or testing or vaccine protocols. But what is most striking is how little consideration they give to the particular attributes of future outbreaks — treating a future disease that spreads like measles but kills one in five kids it infects the same as one that spreads like swine flu and doesn’t kill anybody. And stopping public health authorities from doing anything about any of them.
Stop and think about that for a second: As the country emerges from three years of death, disruption and suffering, dozens of states have decided not just that future mitigation measures should be carefully targeted and calibrated, or that they should be time-limited, or that they should always integrate trade-offs and cost-benefit calculations from the beginning. They have decided that the best way to prepare for those future diseases is to tie our hands ahead of time.
Is this the lesson the country should be taking from its experience with Covid-19? More than a million Americans died, and several hundred more continue to each day, keeping the country on a path to more than 100,000 Covid-19 deaths annually. Polls continue to show significant public support for mitigation measures like masking, believe it or not. These kinds of surveys are notoriously unreliable and may well significantly overstate such support, but last fall’s elections tell something of the same story: Candidates who were Covid hard-liners weren’t punished for their policies any more than skeptical or hands-off governors. These dynamics may shift again, as the country pulls past exhaustion toward some real pandemic perspective — which many of the installments of Opinion’s Next Pandemic series attempt to provide. But for now, at the level of policy and public discourse, a striking American consensus seems to be hardening: When Covid-19 hit, the country did too much.
The epidemiologist Katelyn Jetelina calls this “a new phase of the pandemic — revisionism.” To me, it looks almost like brain fog, with the deadliest public health crisis in a century already so out of focus in our collective memory that we find ourselves talking at the level of abstract principles as though they bear no relationship to the brutal reality of the early pandemic, producing talking points so disconnected from real history they can be put to any narrative purpose that suits.
This is not to say that the early months of the pandemic represent an eternal mitigation ideal, or even that they were as well calibrated as they might have been. But I am sure that any potential infection delayed until mass vaccination was a public-health win and that we can’t just retroactively cut-and-paste the social preferences we’ve settled on post-Omicron — after years of vaccination, disease spread and natural immunity, and mass death — onto our memories of 2020 as though we’re rebooting a pandemic video game now knowing how best to play it. And yet instead of thinking carefully about how the game has changed and how different circumstances require different responses, we seem to be modeling policy for future pandemics based on the world we inhabit now rather than the one we did when the virus first began spreading. Most of the time, no one really seems to notice that presentist legerdemain, perhaps because so few of us actually remember the experience of 2020 all that clearly and are clinging to hastily imposed narratives instead.
Consider the story circulating now — through essays, columns, podcasts and commentary on the pandemic’s geopolitical context — about China. Beginning in the fall — first with protests against the country’s “zero Covid” policies and then with news of its abrupt end — foreign observers, including me, warned about the humanitarian disaster the country was steering toward. Given more than a billion people with almost no exposure to the virus itself and a vulnerable elderly population that was disproportionately unvaccinated, the unmitigated spread of some extremely transmissible Omicron variants was projected to produce more than a million deaths in short order. When that brutal wave came, Western commentators were quick to declare a kind of debate-club victory and call China’s stubborn Covid-containment policy, for so long a global outlier, an obvious failure.
The data tells a more complicated story and illustrates that these questions are rarely binary or one-size-fits-all. According to estimates published last month by The Times, probably one million Chinese — and perhaps as many as 1.6 million — died when the country relaxed its Covid restrictions. That is a harrowing toll, especially in just two or three months. But it would mean that China’s per capita death toll through the whole pandemic was still less than a third of America’s.
And that may well understate the gap. The Economist maintains what is probably the single best database of global excess mortality throughout the pandemic, and the enormously wide range of its China estimate is telling — we simply know much less about the ultimate cost of the disease there than in almost any other country. But the very highest end of The Economist’s estimate for China, 220 excess deaths per 100,000, represents a pandemic death toll that is barely half the very lowest end of the U.S. estimate, 390 deaths per 100,000. If you take the median estimate for each country, the American per capita death toll would be four times as high. Which is to say that, to judge by excess mortality, if China failed the pandemic, the United States failed four times as hard.
Of course, mortality is not the only way to judge pandemic response. But while many other aspects are difficult to measure directly, economic performance is one decent proxy for how much the pandemic disrupted the day-to-day life of each country.
The United States has, by global standards, an enviable record. Thanks in large part to unprecedented federal relief spending, the country stands out. It is alone among its peer countries in not just recovering from the initial pandemic shutdown but also, as soon as late 2021, surpassing the levels of economic growth forecast for that quarter before the pandemic even hit. But even on this metric, China’s economic record is better, with Chinese G.D.P. growing, according to the I.M.F., from $14.3 trillion in 2019 to $18.32 trillion in 2022 — growth of about 28 percent. American G.D.P., by contrast, has grown from $21.4 trillion to only $25 trillion — 17 percent. Of course, Chinese data is notoriously unreliable, and the countries were on different growth trajectories heading into the pandemic, which means it isn’t exactly fair to compare them so simplistically. But it also makes it hard to look at China’s record and think simply, “disaster.” Over three years, the country’s people died a lot less and the country grew a bunch more.
What, then, is the precise nature of the Chinese “failure”? One answer is the lockdowns and “zero Covid” policy itself. The problems with vaccination rollout are especially striking to me, considering how much higher rates were among the young and the middle-aged than the elderly and infirm. Another might be that the error was essentially a matter of sequence: that the ultimate mistake of China’s pandemic response was to endure its most catastrophic wave not when the planet was almost paralyzed by panic but when the rest of the world had decided the disease was no big deal.
But here the experience in China is striking, too, at least as well as it can be observed from abroad — a sign that three years in, the Chinese are happy to trade unmitigated transmission for some freedom from pandemic restrictions, too. Remember, though economic headwinds surely played a role, “zero Covid” was brought to an end in part by unprecedented nationwide protest. There has been no evident equivalent protest against the hands-off approach that followed, no visible upswelling of outrage over the possibility of a million deaths and the indifference of Xi Jinping and the Chinese Communist Party to that carnage. “Can a million Chinese people die and nobody know?” Michael Schuman asked in The Atlantic last month, wondering about how little those outside the country had heard about the recent deaths within it. But the domestic fallout, or lack thereof, is even more striking — that a million people might die without the country really caring. Or perhaps it shouldn’t be striking so much as a sign of global convergence — that three years on, the whole world has acquiesced. Even the longest holdouts are normalizing mass death now, too.
