Doc Sandoz
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Not in control7/30/21 |
Consider these Covid-19 mysteries: |
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How do we solve these mysteries? Michael Osterholm, who runs an infectious disease research center at the University of Minnesota, suggests that people keep in mind one overriding idea: humility. |
“We’ve ascribed far too much human authority over the virus,” he told me. |
‘Much, much milder’ |
Over the course of this pandemic, I have found one of my early assumptions especially hard to shake. It’s one that many other people seem to share — namely, that a virus always keeps spreading, eventually infecting almost the entire population, unless human beings take actions to stop it. And this idea does have crucial aspects of truth. Social distancing and especially vaccination can save lives. |
But much of the ebb and flow of a pandemic cannot be explained by changes in human behavior. That was true with influenza a century ago, and it is true with Covid now. An outbreak often fizzles mysteriously, like a forest fire that fails to jump from one patch of trees to another. |
The experience with Alpha in the Midwest this spring is telling: |
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Even Osterholm said that he had assumed the spring surge would spread from Michigan and his home state of Minnesota to the entire U.S. It did not. It barely spread to nearby Iowa and Ohio. Whatever the reasons, the pattern shows that the mental model many of us have — in which only human intervention can have a major effect on caseloads — is wrong. |
Britain has become another example. The Delta variant is even more contagious than Alpha, and it seemed as though it might infect every unvaccinated British resident after it began spreading in May. Some experts predicted that the number of daily cases would hit 200,000, more than three times the country’s previous peak. Instead, cases peaked — for now — around 47,000, before falling below 30,000 this week. |
“The current Delta wave in the U.K. is turning out to be much, much milder than we anticipated,” wrote David Mackie, J.P. Morgan’s chief European economist. |
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True, you can find plenty of supposed explanations, including the end of the European soccer tournament, the timing of school vacations and the Britain’s notoriously late-arriving summer weather, as Mark Landler, The Times’s London bureau chief, has noted. But none of the explanations seem nearly big enough to explain the decline, especially when you consider that India has also experienced a boom and bust in caseloads. India, of course, did not play in Europe’s soccer championship and is not known for cool June weather. |
‘Rip through’ |
A more plausible explanation appears to be that Delta spreads very quickly at first and, for some unknown set of reasons, peters out long before a society has reached herd immunity. As Andy Slavitt, a former Covid adviser to President Biden, told me, “It seems to rip through really fast and infect the people it’s going to infect.” The most counterintuitive idea here is that an outbreak can fade even though many people remain vulnerable to Covid. |
That’s not guaranteed to happen everywhere, and there probably will be more variants after Delta. Remember: Covid behaves in mysterious ways. But Americans should not assume that Delta is destined to cause months of rising caseloads. Nor should they assume that a sudden decline, if one starts this summer, fits a tidy narrative that attributes the turnaround to rising vaccination and mask wearing. |
“These surges have little to do with what humans do,” Osterholm argues. “Only recently, with vaccines, have we begun to have a real impact.” |
No need for nihilism |
The most important step has been the vaccination of many older people. As a result, total British deaths have risen only modestly this summer, while deaths and hospitalizations remain rarer in heavily vaccinated parts of the U.S. than in less vaccinated ones. |
But Osterholm’s plea for humility does have policy implications. It argues for prioritizing vaccination over every other strategy. It also reminds us to avoid believing that we can always know which behaviors create risks. |
That lesson has particular relevance to schools. Many of the Covid rules that school districts are enacting seem overly confident about what matters, Osterholm told me. Ventilation seems helpful, and masking children may be. Yet reopening schools unavoidably involves risk. The alternative — months more of lost learning and social isolation — almost certainly involves more risk and greater costs to children. Fortunately, school employees and teenagers can be vaccinated, and severe childhood Covid remains extremely rare. |
We are certainly not powerless in the face of Covid. We can reduce its risks, just as we can reduce the risks from driving, biking, swimming and many other everyday activities. But we cannot eliminate them. “We’re not in nearly as much control as we think are,” Osterholm said. |
A programming note: Starting Monday, I’m taking my annual summer break from writing this newsletter. While I’m gone, an exciting rotation of Times journalists will be coming to your inbox. Up first, on Monday: Vivian Wang, reporting from China. I’ll be back on Tuesday, Aug. 24. |
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