Kin Cheung/AP
Medical workers help residents get tested for the coronavirus at a temporary testing center in Hong Kong, on March 14, 2022. A surge of infections in the city has caused a medical crisis.
The world just can’t catch a break. As Vladimir Putin’s war on Ukraine wreaks havoc among civilians and creates yet another massive refugee crisis, the coronavirus pandemic is once again rearing its head. Hong Kong is suffering one of the worst surges of COVID-19 deaths of any city in the world over the last few weeks—and mainland China looks likely to be next in line.
It’s a reminder that America could totally use another major vaccine push. Liberals in particular need to get their booster shots and vaccinate their children if they haven’t done it yet. And Democrats in Congress need to do whatever it takes to restart the flow of funding for vaccines, tests, and other anti-pandemic measures, which they failed to pass last week in a truly criminal act of negligence.
First, what’s going wrong in Hong Kong? As I have previously written, the omicron variant is arguably the most contagious virus in history, and the city’s zero-COVID systems are simply crumpling under the assault. Masks, lockdowns, and test-trace-isolate systems have halted previous variants, but they have not done so against omicron in any country once community spread was established.
I was quite surprised by how bad the death toll has been, as the city’s overall vaccination rate is quite high. But it turns out that Hong Kong’s vaccination rate is inversely correlated with age. As the Financial Times reports, when the omicron variant hit the city, 88 percent of people in their forties had gotten at least two doses of vaccine—but that was true of just 52 percent of people in their seventies, and a meager 24 percent of people over 80. Vaccination rates are climbing fast as people are getting their shots in a panic, but for many it’s too late. Because COVID-19 is most deadly for the elderly, this has meant an absolute tsunami of sickness and death.
Apparently, this failure is due to some combination of bad messaging raising unfounded fears about vaccine side effects among the elderly, general vaccine hesitancy, and complacency about Hong Kong’s success at stopping the virus thus far. But whatever the reason, it’s a flabbergasting failure. It never occurred to me that any government on Earth would let that happen. The city expended an ungodly amount of money and effort on its zero-COVID strategy, but it didn’t even seize the time this bought to vaccinate its most vulnerable population. Even the American government was sensible enough to prioritize the elderly.
Making things worse, much of that vaccine coverage is with China’s Sinovac, which is not as good against omicron as the mRNA shots. It does provide some protection against hospitalization and death, but not as much as the Pfizer/BioNTech or Moderna doses, and very little protection against infection.
In New Zealand, by contrast, which did vaccinate over 96 percent of its seniors, and mostly with the Pfizer shot, omicron is also spreading out of control—but the death rate is something like 0.2 percent that of Hong Kong.
Mainland China is not in much better shape. Like Hong Kong, it has inexplicably failed to prioritize vaccinating its elderly. Only about half of over-80s are fully vaccinated, and practically all of them with China’s domestic vaccines. The Chinese government has thus far resisted employing the extant mRNA shots, it seems on nationalist grounds, and been unable to produce its own version. So once again, it is locking down cities and closing factories—but I suspect this time it’s not going to work.
That said, Americans should not be sitting on their heels. Our vaccination rate among over-80s is better than China’s, but we are pathetic failures compared to real overall champions like Portugal, Denmark, or Cuba—particularly when it comes to booster shots. Some of that is because of a sociopathic propaganda campaign from right-wing media, which has cemented anti-vaccine views among a large fraction of the conservative base (and killed tens of thousands of them in the process), but many others simply haven’t gotten around to a third dose.
Just 36 percent of New York City residents—where Joe Biden got well over three-quarters of the vote in 2020—have gotten a third shot. I suspect this is mainly because when boosters were being discussed, a handful of public-health bureaucrats decided to argue (incorrectly) that they weren’t necessary for most people, apparently in an effort to divert vaccine supply to poorer countries. The argument didn’t actually move supply to those countries, but it did horribly screw up President Biden’s planned booster rollout, and sowed mass confusion around the issue.
In particular, there appears to be a broad impression that a third shot is nice to have rather than a vital necessity. I have personally heard from more than two dozen people, most of them educated professionals, who were jolted into scheduling a booster appointment only when I posted a chart on Twitter showing that three doses provided much better immunity than just two. That’s evidence of a massive messaging failure.
A further problem is with children. Only about 27 percent of American kids aged 5–11 have gotten two doses, and only 56 percent of those aged 12–17.
Once again, I think this is down to poor messaging. The FDA’s dithering for months around vaccine approval for kids (which inexplicably continues for under-fives), and widespread media coverage of rare side effects, have made the shots seem risky for younger people. Meanwhile, repeated misleading arguments from people like Emily Oster that COVID is not that bad in kids have created an impression that children aren’t harmed by the virus.
Getting COVID is far, far more risky than getting the vaccine, no matter one’s age, and a full course of vaccine doses will cut one’s risk of serious illness almost to nothing.
Those two narratives have obscured the core truth that getting COVID is far, far more risky than getting the vaccine, no matter one’s age, and a full course of vaccine doses will cut one’s risk of serious illness almost to nothing. The main side effect from mRNA shots—moderate and non-life-threatening heart swelling—is something like a 2 in 100,000 risk at worst. Common over-the-counter medications like Tylenol or aspirin are more dangerous.
Moreover, a case of COVID carries a much greater risk of the same heart swelling, and in a more severe form, along with dozens of other potential complications. The virus is less dangerous for kids, but it can still be very serious. About 900 American children have died of COVID, and many more have long-term complications.
Meanwhile, Europe is experiencing another wave of the virus, thanks to waning immunity and relaxed protections. They’re in far better shape than China, but it’s likely that another surge of infection is coming to the U.S. at some point.
But it’s not too late to take action. The key thing to remember is that because the coronavirus is established in multiple animal reservoirs, it is now totally impossible to eradicate, and much like cold viruses, it will circulate for the foreseeable future. Countries that sustained zero COVID are falling one by one to omicron. It follows that virtually everyone will be exposed to the virus sooner or later. The key task for nations now is to build up their population immunity as high as possible.
Anyone who got one or two doses of vaccine should get a booster immediately. Anyone who has not vaccinated their kids should do it immediately, and school districts should add COVID shots to their list of mandatory vaccines. Rather than removing vaccine requirements for businesses, as Philadelphia and New York have done, they should be restored, and the definition of “fully vaccinated” should be changed to mean three, not two, shots.
Finally, Democrats simply must restart funding of vaccines and tests. It’s the only way to blunt the next wave, and the one after that.
