Things We Didn't Do

A partial list of COVID failures to adapt

The United States made a bunch of costly mistakes early in the pandemic, most prominently requiring the use of a CDC-approved test that simply didn’t work. As a consequence, COVID got a strong foothold in America despite the fact that we had more time to prepare than Europe did as well as more resources. Once it had such a foothold, the prospects for truly crushing the virus were pretty poor, even if we had stood up a proper test-and-trace infrastructure (which we never did). And then subsequent mutations that made the virus more infectious (Beta, Delta, Omicron) put the idea of zero COVID truly out of reach.

Most of these lists stop there, and focus on how we could have prevented the pandemic in the first place. Those lists are extremely worth examining; the fact that we’re doing so little to prepare for the next pandemic (which will come, inevitably) is a scandal.

But we’ve also done way too little to adapt to the pandemic we have, and to the fact that it isn’t simply going to “end.” By May of 2020, it was already clear that the pandemic was going to have to be managed for the long haul. And as a society, we did make a number of adaptations to enable something like normal life to resume, even before vaccines were available. Restaurants expanded outdoor seating, and bought heaters so that seating could be used in the winter. Film and television production developed protocols to make it possible to resume shooting without triggering outbreaks among cast and crew.

There’s so much more, though, that we could have and should have done—and still could do. For example:

We didn’t provide the cheap and easy at-home testing that is available in much of Europe. This began as a regulatory failing: We were slow to approve the tests because they weren’t as accurate as the PCR gold standard. But processing of PCRs is also much slower, and gets slower still as demand ramps up. Those delays make them much less useful, particularly for Omicron which goes so quickly from infection to infectiousness. Cheap and easy tests would not stop the pandemic, but they would make it much easier for families to congregate safely with older and more vulnerable relatives. Instead, we have more isolated individuals and more people taking risks that could land them in the hospital or dead. They would also make it much easier for people who have been exposed to COVID but don’t have symptoms to continue to work as long as they test negative (a “test-and-stay” protocol). Instead, we’re going to see lots of institutions simply shut down because of the number of people who have been exposed.

We didn’t improve ventilation in schools. By the late spring of 2020, it was already very clear that the virus was airborne, and that therefore good ventilation would dramatically reduce risk in indoor spaces. Retrofitting buildings with windows that don’t open isn’t cheap or easy, but lots of school buildings wouldn’t require an overhaul, and HEPA filters are not particularly expensive. If states across the country had made a commitment to opening schools in the fall of 2020, and the federal government had prodded and supported that decision by promising money—and it wouldn’t have taken that much—for ventilation upgrades and daily rapid testing, we could have saved our education system and a generation of children. Instead, we established the awful precedent that zero tolerance for COVID justified inflicting vastly greater harm on a huge population, a precedent that is being used now to justify new closures that will do nothing whatsoever to slow the spread of Omicron.

We didn’t stand up COVID treatment centers. Early in the pandemic, one of the things I worried about was that the regular presence of COVID in hospitals would deter people from seeking proper medical care. This did turn out to be an issue, but the bigger issue was that hospitals regularly became overwhelmed during COVID waves and simply couldn’t take patients. Now, with Omicron, I worry additionally about the percentage of healthcare workers likely to be infected (even if the infections are mild) and therefore unable to come to work. All of these problems might have been alleviated if we had recognized that we were going to have wave after wave of hospitalizations, and needed overflow capacity specifically to handle COVID patients, and in which health care workers who test positive could continue to work (if asymptomatic). There’s been some interest in sanatoria for COVID long-haulers, and the National Guard has been mobilized in emergencies, but I’m not aware that there’s been any systematic effort to expand emergency capacity system-wide. I’m sure doing so would have been expensive—but since our other control measures are all ultimately justified by the need to protect the healthcare system, it feels like spending a bunch of money to shore up our capacity to handle COVID surges would have been well worth it. Instead, we’re once again facing the prospect of an overwhelmed health-care system. It’s as if, after repeated breaches of a sea wall, we simply accepted catastrophic seasonal floods rather than build the wall higher.

I could go on, but I won’t. The common thread between our failures is that we have largely refused to think of COVID as something we were going to have to live with. And for the record, this is a problem across the political spectrum. The Trump administration repeatedly fantasized about the virus simply vanishing, and when they talked about “living with” the virus what they meant was basically ignoring it. But the Biden administration’s actions from the beginning only make sense if you assume they thought COVID would go away pretty much by itself by the summer of 2021 thanks to the availability of vaccines. Vice President Harris’s interview comments that the administration did not anticipate the rise of new variants like Delta and Omicron is pretty much an admission of what was already obvious from their actions. They didn’t want to think about living with COVID; they just wanted to get through it.

This is a huge societal problem in America with respect to the pandemic. It’s going to be a much bigger one with respect to climate change, a much larger disruption that is simply going to happen, and that we are going to have to learn to live with even as we decarbonize so as to prevent the worst scenarios from materializing.