Commentary: A UW Expert Just Called the End of the Pandemic. Why Is Nobody Celebrating?

Posted

When officials announced that the Spanish Flu pandemic was on the wane in Seattle back in 1918, people poured into the streets in celebration.

It happened to coincide with the end of World War I, giving double cause for joy. But the demise of the disease was a major part of the revelry.

"The Flu Ban is Lifted!" trumpeted a clothing store ad in the Seattle Daily Times, in November 1918, inviting everyone to come back downtown after weeks of lockdowns and quarantines.

"Seattle Now Unmuzzled" read a headline, above an article on how the public had "thrown its masks in the stove, piled the breakfast dishes in the sink and hit for town on the first available street car."

"The influenza masks were forgotten," the Times reported, "except that they were used instead to be waved from windows and doorways by cheering clerks."

Now that's how to end a pandemic. Send it out in a blaze, or a mass doffing of the mask.

The hitch, as we now know, is the pandemic hadn't really ended. Within a few months, Seattle had reinstituted a quarantine, locking more than 1,000 stricken residents inside their own homes, during a new wave of the Spanish flu.

I'm recalling all this because the other day, a top health official in Seattle said what we've been pining to hear during this two-year slog: That the great coronavirus pandemic is ending.

Christopher Murray, head of the influential disease-modeling Institute for Health Metrics and Evaluation at the University of Washington, said the virus is still circulating at high rates for now. But in a matter of a few weeks, it will be Seattle Unmuzzled once again — and for good this time.

"This is a watershed for the pandemic," Murray said. "The era of extraordinary governmental and societal interventions to control COVID-19 is essentially coming to an end. The pandemic, in the sense of that societal response, is over."

Over is a mighty strong and alluring word. Murray argued the vaccines and the rapid spread of the omicron variant are combining to end "the emergency crisis" period of the pandemic. The coronavirus will still circulate, but as a more manageable disease. It means, he said, that future government mandates to control its spread will be unnecessary.

These remarks were reported on TV news in Seattle, but passed without much comment, and did not draw all that much attention nationally. Certainly nobody burned their masks or danced in the streets.

Is it because we don't believe it? Last summer, many people, from me on up to the president, had premature "Mission Accomplished" moments. So some hesitancy would be understandable.

Or is it that society has already psychologically moved on? I've heard multiple people say lately: "I'm done with COVID." Meaning, I think, that the meteoric omicron makes it all uncontainable anyway, so beyond getting vaxxed, what more can you do?

How will our pandemic end? Will we even know it when we see it?

"This framing that the pandemic is ending is really unfortunate," said Jeff Duchin, the chief health officer for Seattle and King County, and also affiliated with the UW, when I asked him about the predictions.

First, he argues, hospitals are slammed to the brink of rationing care and nearly 2,500 people are dying per day nationally — an alarming 10 to 20 times the typical death rate of the seasonal flu. So by all measures we're in the thick of a major ongoing crisis.

Second, the thing that makes pandemics so challenging, as we all ought to know by now, is that they feature a novel, evolving pathogen.

"It's by its nature unpredictable," Duchin said. "We've just seen that evolving unpredictability, twice, since last summer" — the delta and omicron waves, which combined have killed nearly 300,000 more Americans.

"The key is having some humility about it. There's no reason to think another variant like that can't happen again."

One Murray prediction — which Duchin said he agrees with — is that we're about to go into a period similar to last summer, where COVID transmission recedes to relative lows. It likely means that masking and other public health restrictions could be dropped (again, like they were last summer). But after that?

"To say that we know that we're no longer going to need any of the strategies to control COVID in the future, such as masking or social distancing or vax verifications, it's counterproductive, and it's not true," Duchin warned.

It's maybe like 1918. They thought they were done with it, too. They wanted to be done so badly that they pushed ahead as if it were so.

Medical historians say that's typically how past pandemics have "ended" — murkily, with some gradual but mass cultural or psychological shift that maybe doesn't have all that much to do with scientific reality.

Past pandemics have tended to morph, through societal fatigue or amnesia, into becoming "someone else's problem," two historians, from Johns Hopkins and Exeter University, write in an essay "How Pandemics End."

"The social epidemic does not necessarily end when biological transmission has ended, or even peaked, but rather when, in the attention of the general public and in the judgment of certain media and political elites who shape that attention, the disease ceases to be newsworthy."

After two years of dashboards and epidemiological curves and political wars about everything from masks to deaths, this, amazingly, may turn out to be what matters at the end. Is coronavirus newsworthy anymore?

Here within this very column, we have two experts, one who says the end of the crisis is near, and the other not so fast. I don't know who's right — even the latter said he desperately hopes it's the former.

But what's powerful, and not being talked about all that much, is that the scientific debate, or even the real-world behavior of the virus, may not dictate the pandemic's end.

What matters is how much disease and death we're willing to accept as our new normal — concentrated though it may be among those who still, maddeningly, won't get vaccinated.

It's a bit like the mass shooting phenomenon: The real end of the pandemic may be marked by the moment we collectively choose we just can't do it anymore, and we look away.