Nancy Lane/AP Photo
A protest against coronavirus restrictions in Boston
This article appears in the November-December print issue of the Prospect.
Just as the numbers came in on the presidential vote, the numbers went up in the pandemic, soaring past 100,000 new COVID-19 cases a day and setting new daily records for hospitalizations in the two weeks after the election. Even as encouraging reports broke about the vaccine trials by Pfizer and Moderna, the immediate reality was the “dark winter” that Joe Biden warned about during the campaign. The White House had given up—“We are not going to control the pandemic,” White House chief of staff Mark Meadows had told CNN in late October. It was what it was. The country was locked on course for spiraling increases in illness and what will likely be the pandemic’s tragic, final climax: a wave of winter infections and deaths before a vaccine can bring the disease under control sometime in 2021.
This is the prospect that Biden faces: a likely horrific toll leading up to the inauguration and at the beginning of his term; a daunting rollout of one or more vaccines; and potentially the easing of the crisis later in his first year. In a rational political world, what would the American people and the government do in this situation? The people would agree to make short-term sacrifices and comply with public-health protections, while the federal government would provide economic aid to get us through this winter’s valley of suffering.
But we cannot count on either of those happening. Trump and the Republicans have thoroughly politicized public-health protections. It’s not just refusing to wear a mask that Republicans have elevated into a symbol of personal autonomy; as an article in The Journal of the American Medical Association reports, resistance has apparently risen to testing for the virus. People don’t want to face the inconveniences of testing positive, such as isolating themselves. In the party that calls itself “pro-life,” freedom has become an argument for the right to remain ignorant and pass on a deadly infection to your grandmother.
Early in 2020, we needed strong, unified national leadership to promote social distancing and wearing masks and to organize and finance testing, isolation of the infected, contact tracing, and quarantine of the exposed. Under Trump, we didn’t have that effort—in fact, Trump undermined it—when it could have kept the pandemic at much lower levels. Now it will be difficult for Biden to overcome the oppositional thinking that has become ingrained among Republicans, who, like their leader, have come to equate their rights, indeed, their very understanding of America, with the narrowest conception of self-interest.
Unless Democrats win the two runoff Senate races in Georgia, Biden will also likely face Republican obstruction in Congress on the economic aid to workers, companies, and states and local governments needed to get through this winter. Without that aid, many people will see public-health measures that interfere with their businesses or work as a threat to their economic survival. Republicans will not be unhappy if they do.
Despite Biden’s victory, the election should be taken as a cautionary lesson on the pandemic. It wasn’t as devastating to Republicans as it might have been. When political leaders fail catastrophically—for example, when they have been defeated in war or had the economy collapse on their watch—they usually face retribution from the voters at the polls. Trump deserved to lose, but he deserved to lose by much bigger margins than he did. And instead of being held accountable for enabling Trump, congressional Republicans did surprisingly well.
The pandemic may not have produced a backlash against Republicans because of voters’ worries that Democrats would impose a new economic lockdown. Biden said that wasn’t his intention. During the second presidential debate, when he warned of a “dark winter,” he also said he wanted to “shut down the virus, not the country.” But he didn’t make clear that the primary focus can and should be targeted measures to stop transmission.
Despite Biden’s victory, the election should be taken as a cautionary lesson on the pandemic.
The early lockdowns were partly a reflection of how little was known last winter and spring about the epidemiology of COVID-19. Research since then has shown that risks come mainly from close and prolonged contact in crowded indoor venues and from contact without facial coverings. Large indoor gatherings have repeatedly been shown to have been superspreader events. We don’t need to close down transportation or much retail business. Except where the pandemic is raging, we shouldn’t be closing schools across the board, especially not primary schools. We should instead be paying restaurants, bars, and similar venues to stay shut for the winter and barring gatherings of ten or more people in confined spaces (including homes and churches), emphasizing that these are temporary sacrifices necessitated by an out-of-control disease. Lockdowns in the form of general stay-at-home orders should be a last resort.
Since the Trump administration has abandoned the field, Biden’s coronavirus advisory group—not Biden himself—should try to provide the missing scientific leadership in the dangerous weeks ahead. The opposition even to targeted measures will be fierce. But state and local officials need a reference point for policy, and if the federal government will not provide it, the government-in-waiting should try to fill the void insofar as it is possible without formal authority.
WHILE TRUMP AND HIS AIDES have encouraged resignation to the immediate course of the pandemic, they have also created the opposite problem about a vaccine: unrealistic certainty about how quickly and completely it will end the crisis. As of mid-November, according to The New York Times vaccine tracker, 12 vaccines were in Phase 3 trials, with dozens of others in earlier stages of development. This effort has no historical precedent, but the history of vaccines urges care and caution. Some promising vaccines have failed in the past; some successful ones have had problems in manufacturing and distribution affecting their safety. We can rely on vaccines only because the methods for developing, testing, and reviewing and regulating them have been so rigorous. A failure in this case would endanger public confidence in vaccinations of all kinds.
The November announcements by Pfizer and its German partner, BioNTech, as well as by Moderna, that their vaccines were proving 90 percent or more effective was certainly good news, but they were only press releases about Phase 3 trials, not yet full publication of scientifically reviewed findings. If the vaccines are shown to be both safe and effective, the rollout will pose staggering logistical challenges. Pfizer’s will be particularly demanding since it must be stored at minus 94 degrees Fahrenheit until shortly before being administered, and those receiving it will need a second dose three weeks after receiving the first.
Countries with well-organized public-health systems and high levels of public trust will be able to handle the vaccination campaign. Unfortunately, the United States is not one of those countries. What may make things especially difficult is that health care facilities are already under stress from the surge of COVID cases, and states and local governments are under financial stress and haven’t received sufficient federal support for the vaccination effort. We know who stands at greatest risk of being overlooked in our system: people with low incomes and others who do not have a regular source of medical care and live in minority and rural communities. Like systemic racism, systemic neglect of public health is a built-in obstacle to both justice and good health in America.
Assuming that the Pfizer, Moderna, and possibly other vaccines are rolled out within the next several months going into the spring, important questions will probably remain unresolved at the point we are being asked to make crucial decisions about our families and ourselves. We will not know how long protection lasts. We are unlikely to know how well different vaccines perform with the particular age and risk factors we face. None of the vaccines will yet have been tested on children. We may not know whether a vaccine that protects us against getting ill with COVID-19 (functional immunity) also prevents us from spreading the virus to others (sterilizing immunity). If a vaccine does still allow transmission, people may let down their guard, stop wearing face masks, abandon social distancing, and cause new COVID outbreaks.
If the vaccines are shown to be both safe and effective, the rollout will pose staggering logistical challenges.
The Pfizer vaccine has side effects that could deter many people from taking it. As Kaiser Health News reported, “Scientists anticipate the shots will cause enervating flu-like side effects—including sore arms, muscle aches and fever—that could last days and temporarily sideline some people from work or school.” In a country where many low-wage employees lack paid sick leave, that will be a significant deterrent for people who are expected to show up for work every day and may lose their jobs if they don’t. An emergency authorization for paid sick leave for people suffering side effects from the vaccine ought to be part of the vaccination campaign.
All the many uncertainties about the vaccine increase the chances of legitimate confusion as well as misinformation and conspiracy stories. Put together this past year’s COVID “infodemic” with the miasmas now likely to emanate from the anti-vax, QAnon, and other fever swamps, and the Biden administration will likely have its hands full getting accurate information to the public.
But let us imagine that despite all these obstacles, the vaccine campaign succeeds and the end of our dark winter also closes this dark chapter in our history. What will it be like coming out of the crisis?
This past year has been a year of loss: loss of lives, loss of close contact with family and friends, lost jobs, lost progress for kids in school, loss of peace of mind. Just having the anxieties of the past year lifted should bring an immense wave of relief.
But the economy is not going to return to its pre-pandemic state. As a result of increased use of technology, some jobs are gone for good. Some shopping malls and downtown business areas have been dealt blows that they are not going to recover from quickly. The country faces a long-term challenge in economic reconstruction together with all the other urgent needs for social investment deferred during the Trump years. If Democrats had won a decisive victory in congressional races, they would have been able to start that reconstruction. It is going to be a struggle to get it going now. Mitch McConnell and other Republicans in Congress would like nothing better than to stop Biden from doing anything so that they can accuse Democrats in 2022 of doing nothing.
This battle is inevitable, but there is one partially compensating possibility. The pandemic has seen a rise in savings rates among the employed, who haven’t spent money on restaurants, travel, entertainment, and other activities outside the home. So there should be a lot of pent-up consumer demand, which could provide the kind of stimulus the American economy received after World War II. If the worst of the pandemic is behind us by 2022, the economy could be rebounding, and Biden and the Democrats might enjoy some attendant goodwill. I realize that’s a rosy scenario, but it could turn out to be important as we go into the midterm elections. As this dark winter unfolds, we are entitled to dream about spring.
