When Will This Pandemic End? When We As a Society Can Accept Risk Again

Nothing has been the same since the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. Not only have we seen the worst pandemic since the Spanish Flu, we have also seen the worst economic downturn since the Great Depression. The recession is officially over, yet we are dealing with issues of unemployment, inflation, and out-of-whack supply chains. On top of that, we have managed to politicize the pandemic, whether it has been lockdowns, masks, the vaccines, or the severity of the disease itself. Throw the social unrest and mental health issues caused by the pandemic and you realize how much of a train-wreck the past nineteen months have been. People are fed up. I am sure we are all wondering "When will this pandemic end?"  

As I see it, there are four ways a pandemic could plausibly end. One is extinction of the human race. I bring up the most dire example, not to placate the fear-mongering portion of our society, but to rule it out in the case of the COVID-19 pandemic. The COVID-19 data we have on the existing strains do not support such an outcome in this pandemic, although a future pandemic could theoretically make that a possibility (also, the Bubonic Plague wiped out 30 to 60 percent of Europe, so it is possible to have such a deadly disease....but again, that is not COVID-19...not by a long shot). Moving on, the second possible outcome is eradication of the disease. Historically, the only human-borne disease we have eradicated is smallpox. Our track record on the matter makes eradication unlikely in the case of COVID. The third possibility is that of herd immunity. Herd immunity is the combination of natural immunity and vaccine immunity that greatly reduces the probability of transmission of a disease. Given the rate of transmission of the Delta strain and the levels of vaccine hesitancy, I would surmise that herd immunity is out of reach, at least in the short-term. 

This leads to the fourth possibility: endemicity. What is mean when a pandemic becomes endemic? This is tricky to define. The Centers of Disease Control and Prevention (CDC) defines it as "a constant presence and/or usual prevalence of a diseases or infectious agent in a population within a geographic area." So when it is endemic, it could be construed as constant, lower levels with occasional outbreaks. One could think of the transition from pandemic to endemic is when a disease becomes more manageable. In that sense, herd immunity is a subset of endemicity because herd immunity means it is more manageable or exceptionally manageable. In the cases of herd immunity and endemicity, the disease does not disappear. Take the Spanish Flu as an example. The virus did not disappear. The virus mutated enough times, became weaker, and it faded into the background as the seasonal flu. As that happened, the human race went on with life. Survivors of the Spanish Flu have even been shown to still have strong immunity upwards of about ninety years after the pandemic (Yu et al., 2008). The fact that there have been multiple pandemics and the world eventually came out on the other side should give us hope. 

I think there could be some agreed upon figure of when hospitalization or death rates are low enough to consider COVID-19 as endemic. However, I think there is a component during this pandemic that was not as rampant as in past pandemics. In the case of the COVID-19 pandemic, it has nothing to do with the properties of the disease itself. It has to do with the fear. 

From the onset of the pandemic, politicians and media peddled fear. Even as we learned more about COVID-19 and found that the disease was nowhere near as deadly as early models predicted, the fear was propagated. This was especially pronounced in U.S. media. According to an Ivy League study published by the National Bureau of Economic Research, "Ninety-one percent of stories by major U.S. media outlets are negative versus fifty-four percent for non-U.S. major sources and sixty-five percent for scientific journals (Sacerdote et al., 2020)." Even when we were making progress on treatments and vaccines, the media spin continued to be decidedly negative.

What happens when people are consumed by fear? As we have seen throughout this pandemic, reason goes out the window, panic ensues, and life becomes dystopian. Let's start by looking at what happened to the goalposts and metrics throughout the pandemic. We started this pandemic by saying "two weeks to flatten the curve." We then said "wait a little longer to help out the hospitals with capacity." The mantra then became "let's hold off until we have vaccines." We then miraculously produced a vaccine within a year, but then Fauci said that we need at least 60 percent vaccinated. After looking at survey data, Fauci, upped that number to 85 percent. Last month, Biden continued to shift the goalposts by saying we need up to 98 percent vaccinated to go back to normal. Nothing beyond the fantasy of perfection seems to satisfy the fear-mongering politicians. 

This mentality of trying to shift towards the delusion of zero-COVID played out in behavior, as well. People are viewed as vectors of disease instead of fellow human beings. Parties and celebrations were cancelled. Children in the United States were forced to do online learning, although children in multiple European countries went to school (especially primary school) during the pandemic without causing super spreader events. Many developed a compulsion to fastidiously clean surfaces, an ineffective practice I am confident that will go down in history books as a superstition akin to using leeches as a cure-all. Travel bans still dominate the friendly skies, even though they only, at best, slow the spread at the onset of a pandemic to give hospitals a bit of more time to prepare for the inevitable. Onerous lockdowns that deprive millions of a livelihood and cause considerable mental health issues are implemented. Forget that there was no rationale for lockdowns before the pandemic and they have since been shown to be ineffective and harmful. 

We have readily-available vaccines, and yet Montgomery County, Maryland and Dane County, Wisconsin, which are some of the most vaccinated counties in the United States, still have mask mandates. In July, Iceland's leading epidemiologist said that COVID restrictions in Iceland could last for another 15 years, even in spite of vaccination rates being over 85 percent and a fatality rate that was at 1 in 11,000 at the time. 

This is the sort of thinking and policy that take place when fear becomes the predominant value in our society. I'm not here to say that COVID was a hoax or was "nothing more than the seasonal flu" because neither one of those statements is true. Throughout this pandemic, I did my utmost to make sure I neither under-exaggerated nor over-exaggerated the disease burden or severity of COVID. I always expressed concern about COVID, but at the same time, I thought that the fears were overblown. I thought that last year, and I think that it is even more the case now that vaccines are readily available. While not 100 percent effective, the vaccines have remained very, very effective at preventing severe COVID and COVID-related deaths (Scobie et al, 2021). According to an analysis of CDC data from the Right-leaning Heritage Foundation (Dayaratna and Michel, 2021), the vaccines have been so effective that a vaccinated individual is more likely to die from a bee sting than they are from COVID (see below). 

From the beginning of the pandemic, one of my major gripes has been how governments did away with standard risk management. For those in power, the only thing that mattered was COVID, damn everything else. That is not a proper risk assessment or cost-benefit analysis. The existence of vaccines makes the one-sided calculus even more foolhardy. For one, COVID vaccines are very effective. The flu vaccine was 45 percent effective in 2020. In the past decade, the flu has killed anywhere between 12,000 and 52,000 annually in the United States (CDC), yet people did not feel unease participating in daily life during a flu season like many of the vaccinated have felt even after being vaccinated (Morning Consult).  

This point about risk management can be made with multiple examples beyond other respiratory diseases. As the data above show, the vaccinated are more likely to die from a dog attack, but we don't mandate dog muzzles or order that all dogs be put down to avoid any deaths related to dog attacks. There are nearly 4,000 drowning deaths in the United States (CDC), but we do not ban swimming or bathing. There are 5,000 people that die from choking (NIH), but we do not mandate puréed food. Heart disease is the leading cause of death, but we do not mandate exercise, ban fatty foods, or require five servings of fruit and vegetables a day to prevent heart disease. Automobile accidents kill over 30,000 people a year (NHSTA), but we do not ban automobiles or limit the amount of traffic on the road. I could go on, but the point I am making here is that do not take such extreme measures in other areas of life both because of their absurdity and because there are more important things in life than caring about health as an absolute. We have accepted risks in other areas of life. We should be able to do the same for COVID, especially given the low risk of dying from COVID, vaccinated or not.    

In previous pandemics, a pandemic ended when it became endemic because our ancestors knew how to accept the fact that life is not risk-free. On an individual level, I got over whatever fears I had early on in the pandemic because I knew if I didn't, fear would consume me and it would take a long while for me to adjust back to something resembling a pre-pandemic normal. At the same time, I realize that too many people internalized fear during the pandemic. They have been conditioned to fear COVID above all else. As such, it is why I strongly believe that this pandemic will continue after the pandemic technically becomes endemic because people have clung to a mentality of overblown fear. The pandemic will end when people stop being scared. It will end when "we, the people" have had enough of the fear-mongering and learn to live with it, such as Singapore's strategy shows. It will end when we abandon the idea that we can eliminate the inevitable, much like zero-COVID poster child New Zealand did when it recently abandoned its zero-COVID policy. It will end when we realize the risk of being scared of COVID is actually greater than COVID itself, much like Denmark did. Only when we surpass the fear and learn to live our lives once more will this pandemic come to an end.