The Road goes ever on and on ... Day 131 (631)

I have a couple of pages of notes on the stricter restrictions being put in place by various countries, mostly European ones. I was ready to start summarizing those but found an article in The Guardian that while actually dated in October is relevant today and will be relevant for quite some time. What will it take to make the current pandemic endemic? There's actually no easy answer, which makes sense given how different the conditions are in different parts of the world. One objective criterion is that an infectious disease becomes endemic when the rate of infections has more of less stabilized across years (seasonal changes are to be expected). Under this rubric, R0 is stably at one; each person who is infected will infect only one other person. This is far from the whole picture, though, keeping in mind that the R0 of measles is around 18, and WHO has declared it not only endemic but also eliminated in the US. 

On a more subjective level, a pandemic becomes endemic when health experts, global governmental bodies, and the general public are all okay with the level of illness or death that is occurring as a result of the disease. So, what is an "acceptable" level of mortality? Influenza kills 12,000 to 52,000 Americans each year according to the CDC. Some experts say that that is too high, but we as a society seem to have accepted it. With the coronavirus, though, there is covid and there is long covid, which has been recognized as a disability under the Americans with Disabilities Act. One epidemiologist summarizes the situation as, "What you want is to get to a stage where you don't have to worry about disruption because of Covid. The pandemic is over when the crises stop--not just when we get to a certain level of death."

When will the crises stop? It's probably best to consider just which aspects of our current state are crises and which are inconveniences. Clearly some that I would call an "inconvenience" are, to others, a "crisis." After two years, I wonder why we did not do what the Japanese do sooner and wear a mask when suffering from a cold. Those who won't wear a mask see wearing one as an infringement of a basic liberty. And some that I would call a "crisis" are to others a fact of life, not just an inconvenience. I see the high number of Americans who will not get vaccinated as a crisis. The vaccine-resistant see the situation as "they won't get vaccinated" period full stop. 

Assessing the current situation of the pandemic is made more difficult by the other, very different things that have happened during it. Think George Floyd, Black Lives Matter, Ahmaud Arbery, Climate Change, the Big Lie, the January 6 insurrection, and the ex-POTUS whose name I don't want to type. All of those swirl around and at times leave me not clear as to how one affected the other(s). How many people stayed home rather than joined a protest because they were avoiding crowds? How might things have gone if all those people had shown up? So much was bound together or pulled apart because everything happened in the context of the pandemic. Was this a good thing or a bad thing or will we just never know the answer?

I wish I could express my thoughts here better. I start to type one thing and another butts its way in demanding to be considered. Pandemic to endemic. Crisis to inconvenience. Thoughts to words. Transitions that may happen or may never happen. I'm just along for the ride.