McArdle Asks Questions

In her Washington Post column Megan McArdle asks questions:

The problem is that life happens not in theory but in practice. Poorer countries probably won’t be fully vaccinated for years — and, for that matter, the United States might not be, either. Fewer than half of U.S. nursing home workers got vaccinated in the first round of on-site distributions at their facilities. What might resistance rates look like among Americans who don’t work with our most vulnerable? What if only 50 percent of Americans get vaccinated, about the share of people who get flu shots? What if it’s even fewer?

In that case, our best hope is probably that vaccine skeptics who assume that they’ll be immune after they get infected realize their mistake when another wave materializes. They might opt to take their chances on vaccination rather than risk a third bout of covid-19. In this situation, many people would die. But it’s almost certainly better than other possibilities.

For vaccine skeptics might dig in, creating reservoirs of infection in which new variants can arise — for example, by spreading to immunocompromised people whose infections could function as laboratories where the virus effectively experiments with ways to evade immune defenses. And since we clearly won’t keep locking ourselves down forever, we might decide, as a nation, to accept greater death rates rather than doing what it would take to actually shut down transmission.

Alternatively, we could get tired of all the dying and take the kinds of strenuous steps that have so far been off the table in the United States: making it near-impossible to live and work without proof of current vaccination. Require people to show their card before boarding a plane or cruise ship, attending a concert or movie; make such evidence mandatory for occupations as varied as nursing assistants and waitresses. And use a central, instantly checkable database so the certificates can’t be forged.

It’s not clear to me which of these outcomes is more likely. What’s obvious is that they’re all terrible. Yet it also seems clear that at least one possibility is even worse.

For some reason she neglects to consider the endgame I have long suggested would ultimately be accepted. What if COVID-19 becomes endemic in the population (practically certain) just as seasonal flu is? In my view any notion that we’re going to inoculate the entire global population and keep inoculating once a year, multiple times a year, forever is nonsense. As far as we can tell right now the mortality due to SARS-CoV-2 is about an order of magnitude higher than for seasonal flu. That’s still lower than many other diseases that used to be highly prevalent in the bad old days before antibiotics and multiple vaccinations. Life went on. But not the life that we had before 2020.

Let me ask another question we don’t want to ask. What if there’s another pandemic of equal or greater virulence to SARS-CoV-2 right around the corner? And another and another and another? I think that the lesson is that globalization, at least in the form it has taken for the last 30 years, bears risks far in excess of any conceivable benefit.