Year: 2023

Commentary, COVID-19

The end of the emergency

When I first heard that President Biden was going to announce the end of the COVID-19 state of emergency, I was not happy.  I was similarly uncomfortable about my employer lifting mask and test mandates.  Hospitalization and death rates were still very high, in the United States and worldwide.  They could have stayed high, and the end of the state of emergency would have been a disaster.  Fortunately, they didn’t, so the emergency does seem to be ending, for now at least, in the United States.

Death rates are now at their lowest since agencies started reporting numbers, in my hometown of New York, across the United States and worldwide.  Hospitalization rates are also at their lowest since the hospitals first started filling up.

There’s even more good news: the US Centers for Disease Control and Prevention hosts a web page called RESP-NET that allows you to compare current rates of hospitalization for SARS-COV2, influenza and Respiratory Syncytial Virus (RSV), from the current “season” (October through May) with rates from previous seasons going back to 2018-2019.

In the week of March 11 of this year, RESP-NET shows that the combined hospitalization rate for all three dropped below the peak combined rate for flu and RSV in 2018-2019.  Hospitalization rates for all three respiratory diseases have continued to drop since then.  If that trend continues, we could wind up the way we ended flu seasons in previous years, with hospitalization rates below 4 people per million per day.

We did get close to those hospitalization rates in June of 2021 and April of 2022, but in each of those cases there was a new wave of COVID right after that.  We have to be vigilant, and we have to be prepared to reinstitute emergency procedures if the hospitalization numbers start rising again.

I’m pleased to say that my family and I are starting to wind down some of our own state of emergency, which we’ve maintained since our government started loosening restrictions.  Until this week we have tried to wear masks in indoor public spaces whenever possible.  With very limited exceptions, we have not eaten in indoor public spaces, and we have avoided vocal and wind instrument performances, and anywhere there are likely to be large numbers of unmasked people.

A trio of jazz performance students (singing, guitar and upright bass) perform at a staff party at the New School, May 4, 2023

From now on we will start dropping some of these precautions.  We have stopped wearing masks in our building hallways, and yesterday I attended a social event at work where there was food and live music.  We plan on attending more events, and traveling more.  I plan on organizing in-person karaoke events.

We are in no rush to get back to normalcy.  My mother is 84 years old and has multiple risk factors,  The rest of us have health issues which make us a bit more vulnerable than the average American.  We’ve read that airplanes are particularly high transmission sites, especially when on the ground.  And we like eating outdoors!

We also want to minimize our involvement in spreading COVID.  There are still billions of unvaccinated and under-vaccinated people.  New York is a global port city, and we regularly encounter people from all over the United States and the world.  On Monday I had breakfast with cousins from Georgia who were leaving on a transatlantic cruise.  My mother has several Medicaid-supplied home health aides, most of whom are from different countries all over the world, and who travel home periodically to visit family.

My family and I live in the epicenter of the first COVID outbreak in Spring 2020, and we saw how it hit our poorer, immigrant, nonwhite neighbors harder than us and our more privileged neighbors.  I also have several friends who are immunocompromised in various ways, and who have seen their lives restricted because others refuse to make spaces and events safe for them.

I thought back to times when I had upper respiratory infections before COVID.  Nobody ever suggested wearing a mask or eating outdoors when I was sick, and if people talked about staying home, it was usually for my own recuperation.  I have memories of sneezing on the subway, coughing in restaurants, and even singing karaoke while battling a sinus infection.

The author wearing a KN95 mask on a Long Island Railroad train.  The destination sign reads "Grand Central."

I’ve decided that in the future I want to be more careful about spreading infectious diseases, particularly influenza, colds and of course COVID.  I plan on doing the following for the rest of my life: 

  • Wearing an N95-type mask in medical settings, including pharmacies
  • Monitoring outbreak warnings
  • Monitoring hospitalization rates for COVID, the flu and RSV
  • Getting tested regularly during outbreaks

And when I’m sick or during an outbreak, 

  • Staying home as much as possible
  • Wearing an N95-type mask in indoor public spaces
  • Eating outdoors
  • Organizing events online/outdoors

The bottom line is that COVID is not over.  We have so far failed to eradicate it.  It can come back at any time.  And I do not want to be complicit in spreading it to vulnerable people.  If it becomes necessary, I plan on reinstating the precautions I’ve been taking for the past few years.  It will be inconvenient and annoying, but it’s a small price to pay for saving so many lives.

Commentary, COVID-19

Now it ain’t so neat to admit defeat

There are three kinds of attitudes towards the spread of a disease like COVID-19. You can be indifferent to the suffering of others, you can be in favor of eradication, or you can give up. Recently I’ve noticed that more and more of the people I know have given up. At first I was puzzled that so many people refused to talk about our failure to eradicate the disease, but over time I’ve come to understand that this is just what most people do.

First, I want to talk about how we’ve failed on COVID. And when I say “we” I mean all of humanity, but specifically the United States, and more specifically New York State and New York City.

Before I get to our failures, I want to give a nod to our successes. Shutting down non-essential in-person businesses in the spring of 2020 allowed us to “flatten the curve” of hospitalizations. Our hospitals were under severe strain, but we did not get to the point where we needed to use the Javits Center or the Navy hospital ship. After that, the restrictions on indoor dining and avoidance of other indoor in-person activities helped us to keep hospitalizations and even deaths relatively low until the vaccine rollout.

Our record after that has been pretty dismal. Over 800,000 people have died of COVID in the United States since the first vaccine was administered on December 13, 2020, more than twice as many as had died before. Thousands of people have been reinfected with COVID again. Thousands suffer from long COVID. We have failed them.

Our worst failure, of course, is the failure to completely eradicate COVID. We live in an era where humans have eradicated smallpox from the world, eliminated polio and guinea worm from most countries, and are aiming to eliminate malaria and other diseases. We have successfully eliminated the first SARS coronavirus, the cause of the 2002–2004 outbreak, and have made progress against MERS. We had the power to eradicate COVID, and we failed.

I hope that one day we will eradicate COVID, and many of the other diseases that cause misery to humans and other animals on this planet, including diseases that we have not yet encountered. But for COVID, the possibility of eradication gets harder with every new variant.

The result is that many political and institutional leaders have told us we’ll be “living with the virus,” in ways that ensure that thousands will be dying with the virus for many years. The “reopening” of institutions to unmasked indoor activities is a cruel joke to immunocompromised people who are unable to participate. More than a billion people around the world are still unvaccinated or undervaccinated, most through no choice of their own.

What baffled me for months was the inability of almost everyone I know to acknowledge this failure.

Of course, people are plenty willing to acknowledge the failures of others. Here in New York, lots of people are willing to heap well-deserved blame on Donald Trump and his enablers. Some are willing to blame Andrew Cuomo, who deserves at least as much blame, and on other Democrats like Bill de Blasio, Joe Biden, Kathy Hochul and Eric Adams. But I have yet to hear someone acknowledge their own failures.

Remember in 2020 how we were all in this together — wearing masks, socially distancing, getting tested, even washing our hands? Of course, a lot of this was a fiction, but many of us felt like we were contributing to the effort to stop the spread of the disease. I know lots of people who for months, if not years, were diligent about eating outdoors, wearing masks, working from home, avoiding indoor entertainment.

I know some people who have continued to this day with careful measures to avoid spreading COVID. As of this writing, my family and I are still avoiding eating in indoor public spaces, foregoing in-person concerts, and wearing N95-type masks when necessary. But many others just stopped at a certain point. And what struck me was how quietly they all did it.

I’ve seen some people on social media — and on mainstream media, and even in person — announce that they were going to their first party “since COVID,” or maybe attending their first concert or conference, or giving their first interview. Some have even gotten visibly emotional about it, and talked about feeling nervous. But nobody talked about why they decided to start attending parties or conferences, or performing in theaters. Nobody acknowledged that this meant they had stopped taking precautions to avoid spreading COVID.

Some people have parroted the bullshit put out by the Centers for Disease Control and Prevention — that COVID is now “endemic,” and we have to start “living with the disease.” But they pivoted awfully quick from “we have to stop COVID” to “we’ll never stop COVID,” without going through the stage of “we have failed to stop COVID.”

What I eventually figured out — and only recently — is that people just don’t like to admit defeat. Some people are okay with acknowledging setbacks — we’re retreating to the hills, but we will be back! But colossal, catastrophic defeat, the kind that means that a million more people will die, that we may see many thousands die every year for the rest of our lives? That’s something people don’t want to think about.

The key to my understanding this was a Mastodon post I made about the recent fad of Large Language Models. I had noticed a similar pattern: that some people who were typically critical of new technologies had started incorporating LLMs into their work. I posted a critical response to an LLM post from someone I considered a friend, and was shocked that he basically told me to shut up with the criticism.

An older woman in black stands at the front of a stage and looks towards the audience. A man about her age looks at her. Behind them, a group of people dressed in gray and yellow watch them. Everyone in the group is wearing bright yellow shoes.
A 2014 production of The Visit at the Theater of St. Gallen, Switzerland. Photo: Tine Edel

I recognized this pattern from other trends I’ve studied as well. It reminds me of a scene from Friedrich Dürrenmatt’s play The Visit (Das Besuch der alten Dame), where the character Alfred finds the entire population of his village turning against him. He realizes this when he sees them wearing new shoes, which are yellow, and in most productions of the play they are bright yellow. I’ve never seen the play performed, but my high school English teacher described Alfred seeing first one neighbor wearing yellow shoes, then another, and then looking across the stage and seeing everyone wearing bright yellow shoes. The image has stuck in my mind for decades.

I’ve also been listening to the History of Byzantium podcast, and the recent episodes focus on the capture and sack of Constantinople by the Fourth Crusade. I thought about the people of the city, seeing several emperors killed in quick succession, the harbor filled with Venetian ships, and Frankish knights parading through the streets.

It was too late to flee. What could they do but swear to serve their new lords? And once you decide to serve the new lords, why take the risk of pissing them off by showing insufficient enthusiasm?

On the television, anchor Kent Brockman speaks to the camera.  In the upper left hand corner of the television, a man lies on the ground raising his hand as an insectoid with human legs cracks a whip over him.
Screenshot of the “Deep Space Homer” episode of the Simpsons

In my Mastodon post I compared the new large language model fans to Kent Brockman, the news anchor from the Simpsons who, spooked by a magnified image of an ant crawling across the camera, immediately announces, “I, for one, welcome our new insect overlords.” What I realized recently is that the only thing Brockman does differently from real people is to react a little more quickly.

It’s important for me to acknowledge here that I don’t think that these people gave up fighting the spread of COVID, or the imposition of large language models, because they stopped caring. I think that tomorrow if they thought there was as much chance of eradicating COVID as they thought there was in 2020, they’d mask up again and stop eating in indoor restaurants.

Clearly, they don’t think that wearing a mask again will do much. And they can see that most of our leaders and the institutions they control have come down against eradicating COVID. They’ve gotten their orders from the Centers for Disease Control and Prevention, or from the boss telling them to show up at work in person.

They’ve seen the announcements for in-person conferences and job fairs, with food and drink provided indoors. They don’t want to miss out on those opportunities while less scrupulous competitors take advantage of them.

So why do I care? Why did I expect anything else? Why do I think it’s important to acknowledge failure?

I’ve worked in tech support on and off for most of the past 28 years, either as a direct support technician or as a developer responsible for fixing bugs as they are found. One thing I’ve found to be essential to providing good support is acknowledging and documenting failure. If we don’t understand why we failed, we’re just going to keep making the same mistakes again.

Normal conditions great need

America's present need is not heroics, but healing; not nostrums, but normalcy; not revolution, but restoration; not agitation, but adjustment; not surgery, but serenity; not the dramatic, but the dispassionate; not experiment, but equipoise; not submergence in internationality, but sustainment in triumphant nationality.
An excerpt from Warren Harding’s “Readjustment” campaign speech, June 29, 1920

I remember my eighth grade Social Studies teacher telling us how in 1920 the American people were so hungry for “A return to normalcy” that they voted for a cretin like Warren Harding. But he only told us that they craved an end to involvement in World War I; I don’t remember hearing or reading anything about the flu epidemic in that class.

We need to talk about what happened: the people who wanted to sacrifice the vulnerable to preserve their profits organized and won. We need to remember how they did it and figure out how to overcome that. And we need to preserve that knowledge so that the people who are looking out for humanity in the next pandemic can be prepared.

We won’t be able to do that if we continue to live in denial.