COVID update

As I’ve mentioned before, pandemics end in the sociological sense when people start ignoring them, not when they end in strictly epidemiological terms.

Something I hadn’t realized about the Spanish Flu pandemic of 1918-1919 is that, at least in the United States, it didn’t really end in 1919: there was a pretty bad further outbreak that caused a lot of deaths in 1920. The difference was that essentially none of the public health measures that were adopted in the two previous years were maintained, so in that sense the pandemic was “over:”

The 1918 pandemic—which is estimated to have killed at least 50 million people worldwide, though accurate data are hard to come by—is often described as having three waves. The first came in the spring of 1918, followed by a notoriously deadly second wave that fall and then a third, wintertime wave in early 1919—with cases eventually subsiding by the summer of that year. But [John] Barry [author of The Great Influenza: The Greatest Pandemic in History] says a new variant emerged in 1920 and effectively caused a fourth wave. This wave killed more people in some cities than the second one, even though there was widespread immunity to the virus by then. Although many cities and public institutions imposed restrictions during the second and third waves, virtually none did so during the fourth. By 1921, the flu death toll had returned to prepandemic levels. But moving on too soon was a mistake, Barry says.

The COVID pandemic may end up following a roughly similar pattern in the USA. Right now, COVID statistics nationally are pretty similar to last summer’s two-month lull: the seven-day average daily death rate is the lowest it’s been at any point in the pandemic except for six weeks from mid-June to late July of last year, and the hospitalization rate is at its lowest point since it began to be tracked in the summer of 2020.

Cases are ticking up, however: the seven-day moving average has gone up about 50% from its early April low. But the really striking parallel with the previous pandemic is what happened in the first three months of this year, when 155,000 Americans died of COVID during the Omicron wave, which represents a considerably higher average daily death rate than we’ve seen during the pandemic as a whole. What happened was, if not exactly nothing, something very similar to the pattern in 1920: with no public appetite for continuing restrictions, there was very little in the way of reinstatement of old restrictions, and indeed existing restrictions tended to be loosened or dropped altogether during this wave of the pandemic. For example, at the University of Colorado we taught remotely for the first two weeks of the semester in January, but then went back to in-person teaching for the rest of the semester, even as the Omicron wave peaked (Deaths peaked in early February, by which time we had been back in the classroom for three weeks. My sense is that what happened at CU was fairly characteristic).

At this point, the percentage of the US population that is immunologically naive to COVID must be pretty small: 82% of everyone five and over has been at least partially vaccinated, and surely a large percentage of the other 18% has had some strain of COVID at least once. So we’ve got that going for us I guess, but what we clearly are not going to have going for us going forward are any significant mitigation measures, unless some really terrible variant arises that pushes death totals to levels far higher than we saw this winter, when at one point close to 3,000 people per day were dying.

So in that sense, it’s over, for now, even though even under the best of circumstances we’re going to see death totals from COVID in the USA in 2022 that would have been considered a catastrophic public health emergency three years earlier, but which have since become the way we live now.

There are no conditions to which a person cannot grow accustomed, especially if he sees that everyone around him lives in the same way.

Anna Karenina