Science

Americans Need to Be Nudged Out of the Pandemic

Orignally published on 2021-11-24 12:16:56 by www.theatlantic.com

Perhaps you’ve figured this out already: The pandemic will not have a discrete end. The coronavirus will not raise a white flag. There will be no peace treaty, no parade, no announcement from the CDC that the United States is done worrying about COVID. You will not get closure. The signs remain too mixed. The virus continues to spread, even as widening vaccine eligibility, booster shots, and improved medical treatments limit the damage the virus can do. The death rate has been declining since late September, but more than 1,000 Americans have perished each day for most of the past two weeks. A minority of Americans are still acting irresponsibly; a smattering of people would even prefer to lose their job than take a free, lifesaving vaccine.

But America remains in limbo for another reason: The Biden administration has yet to come out and say that the emergency is ending. To even contemplate it seems disrespectful to the nearly 800,000 dead. The Delta variant and vaccine resistance scuttled President Joe Biden’s hopes of declaring a “summer of joy” this past Fourth of July. Yet even though the threat still exists, the country needs to be nudged into the recovery phase—and only elected leaders can provide that nudge.

Biden and his party pledged to “follow the science” in dealing with the coronavirus. Their embrace of professionalism was a point of distinction between them and former President Donald Trump, who in the early days of the pandemic denied the seriousness of the viral threat and refused to help states acquire essential supplies.

Yet the question of when a crisis is over isn’t an objective matter that Anthony Fauci or any other scientific expert can decide. What is an acceptable trade-off between preventing infections and promoting the resumption of pre-pandemic routines? Should employers and school districts base their policies on the expectations of the most risk-averse people or those who have a higher tolerance?

Meanwhile, the perception that the emergency has not ended, and perhaps will never end, has consequences too. Some Americans who are acting cautiously—for instance, by routinely masking outdoors, even after being vaccinated—seem more worried than they should be. In areas with high vaccination rates, schools that extend mask mandates longer than necessary or reinstate rigid socializing rules after a few positive tests risk damaging students’ education with marginal benefit to public health. Americans need not throw out all precautions; indeed, efforts to promote vaccination, whether through gentle cajoling of vaccine refusers or overt pressure on employers, are essential to ending the emergency. We must focus urgently on our recovery—and assess how cautious we should be when the virus becomes endemic but widely available vaccines radically reduce the possibility of hospitalization and death.

In a normal disaster-management framework, an immediate harm—such as a terrorist attack, an ecological catastrophe, or an earthquake or a hurricane—triggers a multifaceted initial government response: search and rescue, mass sheltering, and emergency medical care. Firefighters, police, health officials, and other professionals step in to protect people who cannot protect themselves. But this period gives way to a recovery mode, in which the focus shifts to mourning the dead, rebuilding damaged physical and social infrastructures, and revitalizing the economy. The first responders who take command in the early days are replaced over time by builders and city planners who, in consultation with the public, chart a long-term plan to get systems running again. Many of the decisions that have to be made in a recovery are judgment calls—mere guesses about the best uses of resources. Indeed, one might call them political.

I was working at the Department of Homeland Security when a BP oil rig exploded in the Gulf of Mexico in 2010. The Coast Guard oversaw the immediate efforts to deal with the spill, America’s largest-ever marine oil disaster. But to oversee the recovery, President Barack Obama tapped a politician: the Navy secretary and former Mississippi governor Ray Mabus. Mabus’s job wasn’t to pick up tar balls on the seashore. It was to oversee the billions of dollars in recovery funds that BP had put up to support rebuilding efforts in the fishing and oil industries, the cleaning of marshlands and beaches, and the equitable distribution of funds to Native American and Black communities harmed by the spill.

Likewise, after Hurricane Sandy in 2012, Shaun Donovan, the secretary of housing and urban development, organized the government’s recovery efforts. He wasn’t saving people from drowning; other professionals had handled the initial phase. Donovan’s mandate was to distribute post-Sandy relief in order to better prepare communities for the future. These roles require not specialized technical expertise but an ability to mediate between competing values and priorities.

Similarly, the enormous challenges of America’s pandemic recovery—lost learning and lost staffing in schools, the great exodus from the workforce, and a profound disruption of office life—have no scientific solutions. We must own the political nature of this recovery, and it’s not anti-science to recognize that not all decisions are matters of science.

Elected officials do science no favors by putting fundamentally political decisions in the hands of technical experts. The recent local and state pushback against the federal government’s original limited guidance on eligibility for booster shots underscores the problem. Biden himself was pushing for boosters. He clearly understood that, in the face of organized vaccine resistance, many Americans who had been rigorously observing safety protocols for a year and a half would want to maximize their own immunity before resuming travel, in-person work, and other activities. Many public-health experts, in contrast, expressed skepticism about offering boosters to American adults rather than sending vaccine doses overseas. Two top FDA vaccine regulators resigned in protest over what Politico called “Biden’s top-down booster plan.”

In September, the FDA and the CDC authorized booster shots only for certain high-risk groups. But the agencies’ task arguably should have been limited to assessing whether boosters were safe and would help the people to whom they would be administered; the answer on both counts was obviously yes. After even Democratic mayors and governors balked at limitations on booster shots, the FDA and the CDC finally opened up boosters to all adults.

The muddle was avoidable. Elected officials must make political decisions without hiding behind scientific advisers’ white coats. Doing so forthrightly will, in the end, protect the integrity of science.

The coronavirus arrived like a tidal wave, but its worst effects are now ebbing, at least for vaccinated people. The United States has entered a phase that I have previously described as an adaptive recovery, a long period in which the virus persists but Americans figure out how best to manage it. The choice now facing the U.S. is whether to acknowledge the progress we’ve made—and the subjective, political, nonscientific nature of the value judgments that face us.

Orignally published on 2021-11-24 12:16:56 by www.theatlantic.com

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