Thursday, October 20, 2022

Our Third COVID Winter Is Coming. America Isn’t Ready.

Our third American COVID winter is at hand. In the months ahead—with students back in school, temperatures dropping, social life moving indoors, and holiday travel commencing—not to mention the emergence of new and increasingly immune-evasive variants—we can count on another seasonal surge of infections and deaths.

With the experience of last year’s record-breaking Omicron wave, American leaders should now—at least, in theory—be very well equipped to deal with what’s ahead. Health agencies should be preparing clear, actionable messages on COVID measures for the holiday season. Masks, COVID tests, and treatments should be plentiful and accessible to all Americans. And indoor air quality should be improved by upgraded ventilation in schools, workplaces, and other public settings.
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Yet these essential steps are not in place. The CDC has issued no updated guidelines to the public. Though new bivalent boosters are available, uptake so far has been shockingly low. Even more seriously, recent federal funding cuts have ended programs providing free COVID tests, vaccines, and treatments—all crucial for protecting American communities and, particularly, vulnerable groups. Because of these cuts, COVID testing labs and manufacturers are reducing their operations. In mid-October, with little warning, the CDC announced the end of its program providing free N95 masks to the public. As the end of the year approaches, it is highly likely that Americans are about to be blindsided by another wave. Without renewed funding to cover these basic necessities, the U.S. could be facing another very dark pandemic winter.

At the same time, many of our political leaders—having capitulated to their sense that the pandemic is a lost cause—are defaulting to toothless and self-defeating messages. In May 2022, the CDC introduced its new “Community Levels” metric in a not-so-subtle effort to downplay the reality of continued high national levels of COVID transmission, generating reassuring maps colored mostly mint green. Since July 2021, Biden has repeatedly stated that “COVID no longer controls our lives”—at this point, a claim that is nearly Kafkaesque, given our enormous national death toll and high rates of reported Long COVID. In September, New York state produced a public service announcement for the Metropolitan Transit Authority showing face masks being worn incorrectly, accompanied by the message “you do you.”

The administration has had many opportunities to improve its COVID messaging over the past two years, but there is little sign that they’ve learned anything. Last December, the Biden administration repeatedly warned the unvaccinated of a “winter of severe illness and death”—a message that overlooked the importance of testing and masking and also, inadvertently, addressed a threat to children under the age of 5 and the immunocompromised. But at least that verbiage conveyed some sense of urgency. More recently, Biden’s comments on the months ahead have been far more tepid, such as the President commenting simply in September that “winter is not that far away.”

In other words, winter is coming. Earlier this year Biden officials warned of the winter COVID surge that lay ahead, predicting the possibility of 100 million infections, or nearly one-third of the population. But with funding held up by Republican obstruction in Congress since summer, Democrats seem to be trying to stand down. The administration has spent much of its efforts putting the best possible public-relations face on the pandemic—minimizing the seriousness of our continued predicament and presenting bad news as if it were good. In so doing, Democrats have compromised their case for Congressional pandemic funding.

In particular, the administration has had less and less to say about COVID deaths, though hundreds of people continue to die of COVID each day. This past July, Ashish Jha stated that “We are now at a point, I believe, where we can prevent nearly every COVID death in America”—a hubristic assumption that will be seriously tested this winter. Indeed, as fatalities continue, it might seem that leaders are betting that the public will simply become inured to ongoing losses. CDC head Rochelle Walensky suggested as much in March when, at the bitter end of the Omicron surge, she predicted that Americans will ultimately “have a coronavirus that leads to death in every season, that we will tolerate in some way.”

Most recently, the administration has touted annual COVID boosters as a panacea, comparing the COVID vaccine to a flu shot. Certainly everyone should get boosted if they are able to—but doubling down on a vaccine-centric strategy is the wrong move, particularly given that national vaccine uptake rates are approaching the absolutely lowest levels of the past two years, perhaps owing at least in part to “back-to-normal” rhetoric and insufficient funding for vaccine and booster rollout.

Furthermore, treating pandemic management as fundamentally a matter of vaccination builds in room for the administration to blame future deaths on the unvaccinated—to whom the administration has repeatedly attributed its less than optimal outcomes. In addition, overreliance on vaccination without sufficient use of other mitigation measures may speed up the emergence of variants that are less responsive to treatments and vaccination. In other words, our approach to pandemic control must be better diversified in order to be effective.

When he called the pandemic “over” last month, Biden tempted fate, risked political humiliation, and misled the public about how safe we are. Worse, his administration’s failure to push for better pandemic measures will cost the lives and health of many Americans. It’s not too late to walk these decisions back and pivot to the many good ideas in his campaign promises for managing the pandemic: expanded access to tests and personal protective equipment, mask mandates, and hiring thousands of community health workers to support vaccination and testing programs. There would be no time like the present to reset our national goals in public health and start putting these measures into practice. The administration and its allies should be fighting hard for the funding that would make them possible—not glossing over the truth of what lies ahead.



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