The end of the pandemic is in sight

All pandemics come to an end.  All pandemics feel endless at their peak, but then they end just as suddenly as they began. Today the Covid case count is finally clearly down.  So Omicron has probably peaked in the USA nationally and it has already definitely been plummeting in the cities that it hit earliest like New York and Chicago.

Omicron is now nearly100% of US Covid cases and for boosted people it has been considerably less deadly than the ordinary flu, but right now there is much, much higher transmission rates right now so overall risk is currently higher than a bad flu season, but in a month from now the transmission rates will be like an ordinary flu season so we’ll basically be done with the pandemic unless a new variant evolves that evades prior immunity.  That gets less likely with every new wave of contagion so I’m optimistic that this is the last gasp of the pandemic. 

In retrospective, we’ve done amazingly well.  The economy and mortality took a much smaller hit than the 1918 pandemic which took three years to end and caused the biggest recession you’ve never heard of because it was overshadowed in the history books by the end of WWI and the pandemic itself.*  The only global recessions that were worse since then were the Great Depression (particularly in the US which suffered worse than average) and WWII which was a disaster globally, but an economic boom in the US.  Robert Barro and Jose Ursua’s research suggests that the flu pandemic caused a 12% drop in US GDP and a 6% to 8% fall in worldwide GDP between 1919 and 1921.  The coronavirus pandemic caused the deepest recession since the Great Depression in the US which was followed by the fastest recovery ever measured which has been so strong that we are now dealing with modest inflation and worker shortages!  That is a much better problem to have than a long stagnation and high unemployment.

This time we developed numerous new treatments in record time using new research that has changed science forever.  In particular, the mRNA vaccines were developed in days, tested starting in months and mass-manufactured in less than a year.  Nobody would have predicted that in 2018 because it couldn’t have happened in 2018 — the mRNA science wasn’t ready yet.  So the timing was incredibly lucky. The fastest previous vaccine took four years just for development.  And after that hurdle, vaccine manufacturing used to be very slow because it meant infecting living cells (sometimes chicken eggs) with a version of the virus that causes it to manufacture more virus and then extracting the virus and preserving just enough of it to cause an immune response but not the full illness.  That manufacturing process is hard to scale up rapidly compared with mRNA vaccines although the new adenovirus technique also made traditional vaccine manufacturing much faster too. Because the US led in mRNA technology, the US had the best vaccine production in the world. 

The story how the new mRNA vaccine science came together is really worth reading.  It was a series of happy accidents, many coming out of the failed efforts to develop an AIDS vaccine that combined seemingly unconnected research and all unexpectedly clicked into place last year and in less than two years after Covid-19 was first named, over 10 billion doses have been administered worldwide.  That is more than enough to give everyone in the world a dose, but of course, richer people have had three doses which means that poorer people mostly have none, but vaccine production has ramped up considerably over the past year and, we could easily see 20 billion more doses over the next year if there is the money to do it.  

76% of Americans have had at least one vaccination and that is already close enough to herd immunity to dramatically blunt the effects of the Omicron wave.  Omicron is delivering a ‘vaccination’ dose to most of the 24% of Americans who haven’t gotten a shot yet and a giving booster to lots of vaccinated Americans.  By March, the majority of Americans will undoubtedly have had Covid at least once.** 

The peak of US Covid hospitalization should come in about another week and the last peak of mortality another week or two after that, so we aren’t done yet, but I think we can start planning our spring Covid parties to celebrate the end of the pandemic. Although the infection rate is terrible now, it will just get safer and safer.  We just gotta get through a few more weeks of deepest darkness before the dawn.  After that, the virus will still always be with us, but it won’t be any more worrisome than the many other endemic viruses that we always have.  They too caused pandemics in the past.

Of course another variant could cause another spike at some point, but if so, then we will be even more prepared for it when it comes along.  I’m betting that we are already in the last pandemic wave because the next variant won’t be nearly as problematic as any of the pandemic waves so far and we’ll manage it more like we ordinarily manage a bad flu season.

*In 1918, every kind of disease was more deadly than today because medicine and public health were so primitive.  Even diarrhea was a major killer of Americans back then! So if the coronavirus had happened in 1918, the mortality rate would probably have been many times higher and more similar to the 1918 pandemic.  In 1918  medical science was so primitive that scientists didn’t even know that the flu was spread by a virus and nobody knew how it spread.  Some people correctly guessed that it was spread through the air, that wasn’t a widespread belief because they had little evidence and scientific confusion about airborne virus transmission continued right up through the first half of the Coronavirus pandemic (a monumental scientific mistake).  Doctors knew that the flu was an infectious disease and they focused on germs they could see (bacteria) rather than the germs they couldn’t yet see (the virus).  Bradley Schurman points out that ironically one of the main ways the 1918 flu pandemic transformed society was the promotion of toilets and cleaner water to prevent infections even though water-bourne bacteria had nothing to do with the flu.  The public had only recently become aware of bacteria and the pandemic focused attention on germs like never before.  The change in public sentiment caused water systems to proliferate despite their tremendous expense.  After only about two decades half of American homes had already achieved complete plumbing by about 1940!

**There is always much uncertainty about the precise number of Americans who have had Covid. The official count is 20% have had a confirmed case, but that is a dramatic undercount because most cases do not require medical care and do not get officially reported. All three of my three boys got it and none were included in the official count even though we tried to report them to the health department. The real number of cases is probably more than double the official count and one reputable estimate put the number at about 31% way back at the end of 2020! If that was correct, then the majority of Americans have definitely already been infected by now.