COVID, COVID, COVID

Even though Covid-\infty is going to be with us forever, I actually think on the whole the pandemic turned out better than expected, and I mean that in the technical sense. If we were to rerun the pandemic over and over again, I think our universe will end up with fewer deaths than average. That is not to say we haven’t done anything wrong. We’ve botched up many things of course but given that the human default state is incompetence, we botched less than we could have.

The main mistake in my opinion was the rhetoric on masks in March of 2020. Most of the major Western health agencies recommended against wearing masks at that time because they 1) there was already a shortage of N95 masks for health care workers and 2) they thought that cloth and surgical masks were not effective in keeping one from being infected. Right there is a perfect example of Western solipsism; masks were only thought of as tools for self-protection, rather than as barriers for transmission. If only it was made clear early on that the reason we wear masks is not to protect me from you but to protect you from me. (Although there is evidence that masks do protect the wearer too, see here). This would have changed the rhetoric over masks we are having right now. The anti-maskers would be defending their right to harm others rather than the right to not protect themselves from harm.

The thing we got right was in producing effective vaccines. That was simply astonishing. There had never been a successful mRNA-based drug of any type until the BioNTech and Moderna vaccines. Many things had to go right for the vaccines to work. We needed a genetic sequence (Chinese scientists made it public in January), from that sequence we needed a target (the coronavirus spike protein), we needed to be able to stabilize the spike (research that came out of the NIH vaccine center), we needed to make mRNA less inflammatory (years of work especially at Penn), we needed a way to package that mRNA (work out of MIT), and we needed a sense of urgency to get it done (Western governments). Vaccines don’t always work but we managed to get one in less than a year. So many things had to go right for that to happen. The previous US administration should be taking a victory lap because it was developed under their watch, instead of bashing it.

As I’ve said before, I am skeptical we can predict what will happen next but I am going to predict now that there will not be a variant in the next year that will escape from our current vaccines. We may need booster shots and minor tweaks but the vaccines will continue to work. Part of my belief stems from the work of JC Phillips who argues that the SARS-CoV-2 spike protein is already highly optimized and thus there is not much room for it to change and to become infectious. The virus may mutate to replicate faster within the body but the spike will be relatively stable and thus remain a target for the vaccines. The delta variant wave we’re seeing now is a pandemic of the unvaccinated. I have no idea if those against vaccinations will have a change of heart but at some point everyone will be infected and have some immune protection. (I just hope they approve the vaccine for children before winter). SARS-CoV-2 will continue to circulate just like the way the flu strain from the 1918 pandemic still circulates but it won’t be the danger and menace it is now.

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