The Immunological Landscape

There is no need to listen any longer. The man stopped making sense long ago. No one can follow his logic, except by some sort of leap of semantic faith that somehow one thing here leads to the next thing here through mysterious implicit hidden logical connections known only to true believers, or real patriots, or someone out there. But the man said this:

Former President Donald Trump claimed on Sunday that one of the reasons some people are unwilling to take the COVID-19 vaccine is because they “don’t trust the Election results” from November 2020.

Go ahead. Try to connect those dots. Donald Trump offered this:

The former president’s comments come after President Joe Biden’s administration failed to meet its vaccination goal to ensure 70% of the nation’s adults receive at least one shot by July 4. Still, 161 million people are fully vaccinated and 68% of adults have received at least one dose, according to the Centers for Disease Control and Prevention.

Trump has touted his administration did a “great job” in regard to handling the coronavirus pandemic through programs like Operation Warp Speed, which saw vaccine development and disbursement happen in record time. While he has encouraged people to get vaccinated, a large group of his supporters has erred on the side of caution surrounding the COVID-19 jabs.

“Joe Biden kept talking about how good of a job he’s doing on the distribution of the Vaccine… He’s not doing well at all,” Trump wrote, adding, “He’s way behind schedule, and people are refusing to take the Vaccine because they don’t trust his Administration, they don’t trust the Election results and they certainly don’t trust the Fake News, which is refusing to tell the Truth.”

That’s one righteous rant! Too bad it doesn’t make sense. But to some, it makes enough sense:

A new CBS News/YouGov poll of those Americans who are not vaccinated finds 74% of them would not get vaccinated even if their doctor recommended it, while another 16% said their doctor already has suggested it.

Just 10% would get vaccinated if their doctor recommended it.

Trump said trust no one. They trust him on that. Tucker Carlson says the same thing on Fox News. They trust him on that. Trust their own doctor? Never! Trump said so!

But there’s more to this new poll:

Six months into President Biden’s administration, Americans are less apprehensive about the year than they were at the start of it.

They think the battle against the pandemic is going somewhat well, though that’s tempered now by concern about the Delta variant. Most say their finances are okay, and most parents think the tax credit will help. On the personal front, Biden gets positive marks, particularly for his handling of the pandemic and how he handles himself.

The angry, who trust no one or anything, are few. Everyone else is see things looking up a bit, and see Biden as a sensible man doing good things that help, but not all is mellow and a bit hopeful:

People are feeling the effects of inflation. And as vaccination rates stall, despite the administration’s push, the remaining unvaccinated look more and more immovable in their decision – and even more politicized.

Those ranks of the unvaccinated look ever more dominated by those suspicious of the science, skeptical of the effectiveness, and distrusting of the government that’s urging them to get it. Half of the remaining vaccine hesitant are now those who say they “don’t trust the government,” up from where that sentiment was among the comparable group in June, and almost half don’t trust the science or feel it is still too untested.

Trump did what he had set out to do. They all know now. Trust no one but him. And never trust science. And of course that’s a class issue now:

The differences between vaccinated and unvaccinated Americans have long cut along educational and partisan lines – with the unvaccinated disproportionately non-college and also those who call themselves very conservative. We now see some partisan pushback against the wider effort, too, as most Republicans think the Biden administration is doing too much in urging Americans to get it.

They shouldn’t urge anything. That’s not the government’s business. That’s the word, even if that’s the sort of thing all governments do. But maybe that’s the problem:

Six months into his presidency, President Biden receives mostly positive marks on his approval of various issues, and six in ten like how he handles himself personally. His backers see things as steady, if not very exciting. A 55% majority of Democrats describe U.S. politics over the last six months as “steady” with fewer using words like “inspiring” (39%) or “exciting” (21%). Most Republicans describe the past six months as “worrying” (67%) or “frustrating” (61%).

Yes, they are frustrated. They don’t want to hear one more word about any vaccine. They’re not going to be vaccinated for anything now or ever again. There’s no need. Everything is fine, except for this:

The United States recorded 79,310 new cases of COVID-19 on Friday, according to Johns Hopkins University. The number is the highest in the world, exceeding recorded totals from Indonesia (54,000), the United Kingdom (51,949), and Brazil (45,591), and doubling that of India (38,079). The spiking case number matches the level hit in October 2020, a record at the time, though it would not remain so for long. Despite the effectiveness of multiple vaccines against the virus, vaccine hesitancy is fueling “a pandemic of the unvaccinated,” according to CDC Director Dr. Rochelle Walensky. The vast majority of all patients currently hospitalized with COVID-19 are unvaccinated, according to the CDC.

Trump is winning. Walensky is losing. We’re Number One! But only the virus is winning, The Washington Post’s Joel Achenbach covers that:

Maria Van Kerkhove, a World Health Organization epidemiologist, was in her Geneva office last weekend preparing for a keynote address when a simple phrase came to mind. She had been pondering the dismaying rise in coronavirus infections globally during the previous three weeks, a reversal of promising trends in late spring. The surge came as people across much of the Northern Hemisphere were moving around again in a suddenly freewheeling summer — as if the pandemic were over.

She wrote in her notebook: “The world needs a reality check.”

Van Kerkhove’s subsequent comments on Twitter pointing out the lack of social distancing drew predictable flak from the social media trolls, something she has gotten used to in the past year and a half. But she is not an outlier.

She’s just a realist:

Coronavirus infections are surging in places with low vaccination rates. SARS-CoV-2 is continuing to mutate. Researchers have confirmed the delta variant is far more transmissible than earlier strains. Although the vaccines remain remarkably effective, the virus has bountiful opportunities to find new ways to evade immunity. Most of the world remains unvaccinated.

And so the end of the pandemic remains somewhere over the horizon.

“We’re getting further away from the end than we should be. We’re in a bad place right now globally,” Van Kerkhove said.

In fact, we’re going backward in this:

Similarly dismayed is Francis S. Collins, director of the National Institutes of Health. Last summer, he watched cases in the United States spike, particularly in the Sun Belt, after what he felt was a premature end to spring restrictions. This summer, he is not surprised by the rise in infections across a country where many people haven’t gotten their shots and have returned to pre-pandemic behavior.

“It’s like we’ve been to this movie several times in the last year and a half, and it doesn’t end well. Somehow, we’re running the tape again. It’s all predictable,” Collins said.

So, here we go again:

Coronavirus infections in the United States rose nearly 70 percent in a single week, officials reported Friday, and hospitalizations and deaths rose 36 percent and 26 percent, respectively. Almost every state has experienced a rise in cases. Florida, populous and not highly vaccinated, is seeing a surge in cases. In hot spots such as Arkansas and Missouri, covid wards are opening up again in hospitals.

Los Angeles County this past week announced that it had to reinstate indoor mask requirements for everyone, regardless of vaccination status. Breakthrough infections among vaccinated people provide another reality check. Thursday night’s prime-time baseball game between the New York Yankees and Boston Red Sox was canceled when six Yankees players – most of them vaccinated – tested positive for the virus.

Yes, that happens:

The vaccines, though marvels of basic and applied science, do not form an impenetrable shield against SARS-CoV-2. They work as advertised, meaning they usually prevent severe illness and death, but they do not deliver what is known as “sterilizing immunity.”

The CDC issued a statement Friday saying the agency has multiple programs, working with state and local partners, to track vaccine effectiveness.

“COVID-19 vaccines are effective and are a critical tool to help bring the pandemic under control. However, no vaccines are 100% effective at preventing illness in vaccinated people. There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19. As with other vaccines, this is expected. As the number of people who are vaccinated goes up, the number of breakthrough cases is also expected to increase,” the CDC said.

That’s rare but that’s real, and this is no time to simply stop being careful:

The delta variant has mutations that significantly enhance transmissibility, and it is responsible for a majority of new infections in the United States as it outcompetes other strains. Mutations in the virus are inevitable and complicate forecasts of how the pandemic will play out. The world is in the midst of a global experiment in which a single virus is turning into a full Greek alphabet of distinct strains, each with its own suite of mutations.

And of course the angry Trump crowd, who refuse all vaccinations, has turned most red states, particularly in the Deep South, into giant petri dishes where the virus can muck about in a large unprotected population and mutate again and again into something that can never be stopped. But even so, those who actually were vaccinated help the general situation a bit:

The increase in hospitalizations has been less dramatic than the increase in reported infections. That’s because the vaccines – a tool the world lacked a year ago – usually prevent severe illness.

“The game-changer is if and when we see large numbers of vaccinated individuals returning to hospitals. But we are not seeing that,” said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia.

That’s a comfort:

This hints at how the pandemic may eventually play out: The virus would become endemic. It would not be eradicated – and would still cause occasional clusters of infection – but it would not ignite runaway outbreaks nor be nearly as lethal as when it emerged into the human population. That drop in lethality will be driven less by changes in the virus itself than by the changed immunological landscape.

But can Trump, by stoking anger and resentment, keep that immunological landscape from changing in our favor and keep this pandemic going and growing? If not, we get this:

For people with at least partial immunity, covid-19 could become more like influenza or even a cold, which are caused by viruses that are at least somewhat familiar to our immune systems. Four other coronaviruses are endemic in humans and are responsible for a significant fraction of colds.

This scenario – call it Scenario A – has been the general assumption or hope of many infectious-disease experts since the start of the pandemic. The dialing down of the lethality of the disease would be an example of history repeating itself: The 1918 influenza pandemic was caused by a virus that never vanished, but instead became the cause of the seasonal flu.

But the angry Trump crowd seems to be stopping that:

Janis Orlowski, chief health-care officer of the Association of American Medical Colleges, offers one version of Scenario B: “Delta goes on to epsilon which goes on to lambda, and that becomes another ugly virus. The virus mutates to a strain that we are not effectively vaccinated against – and that leads us into another ugly year.”

Expect that. The vast pool of the unvaccinated angry have made that likely. They have firmly established a large pool of unprotected Trump patriots where that virus will be totally free to do its thing,

That can’t be what Trump or anyone else intended. That makes no sense.

But maybe it does. Will Bunch, the Philadelphia Inquirer’s resident cynic, to some, or a realist, follows the logic of how it has come to this:

Tuesday will mark the 52nd anniversary of the date that an American was the first human to walk on the moon. It should be a moment not only to reflect on that historic high point, but to celebrate another scientific breakthrough that was also mostly born in the U.S.A. The record-time development of COVID-19 vaccines that have already saved thousands of lives and – under the best circumstances – could wind down the deadliest global pandemic in more than a century.

But this is not 1969.

There is, we are finding out rather painfully, a Democratic and a Republican way to do vaccines. Just travel to a place like Mountain Home, Arkansas – in a state where Trump got 62% of the vote last year – where the largest medical center is jammed with coronavirus patients, in a county where more than two-thirds of residents aren’t vaccinated and interest in the jab is low. (“It was just terrible,” a 68-year-old widow with chronic pulmonary disease told the New York Times of her COVID-19 ordeal – before adding she still won’t get vaccinated.)

In neighboring Tennessee, the top immunization official was fired last week under pressure from Republican lawmakers because she aggressively promoted vaccines for teens. “I am afraid for my state,” Dr. Michelle Fiscus said in a statement after she was sacked. Health officials in the GOP-dominated state immediately justified her fears by buckling under political pressure and stopping all vaccine outreach to teenagers – not just on COVID-19, but also for flu, measles, mumps, rubella, and human papillomavirus, or HPV, among others.

It was a stunning embrace of ignorance over science.

That may be what has changed:

“We probably would still have polio in this country if we had the kind of false information that’s being spread now,” Dr. Anthony Fauci, the nation’s top infectious-disease expert, told CNN’s Jim Acosta on Saturday. He’d been asked about the promotion of vaccine refusal, laced with medical falsehoods, on right-wing outlets like Fox News that has been embraced by GOP leaders like Florida Gov. Ron DeSantis, a leading 2024 White House contender. DeSantis’ political shop has even been selling T-shirts that proclaim, “DON’T FAUCI MY FLORIDA” – even as 20% of the nation’s new COVID-19 cases are coming from the Sunshine State.

But get used to that sort of thing:

If you’re thinking that something has radically changed in America in the 52 years since Armstrong bounded down the stairs of the lunar module to take “one giant leap for mankind,” you would be correct. A new Gallup poll released last week shows that confidence in science among Republicans has dropped by an astonishing 27% since 1975, shortly after NASA wound down moon exploration. During this same nearly half-century, faith in science has actually increased among Democrats and independents. The gap between the two parties over science is now wider than for all but a couple of American institutions.

Indeed, it’s remarkable how closely this stunning drop in GOP voter confidence in science – a high 72% in 1975, but just 45% today – tracks with America’s growing vaccination divide between “red states” and “blue states.” Likewise, almost 30% of Republicans said in a separate survey last month that they refuse to get the vaccine – a critical reason why experts now fear the United States can’t reach the herd immunity needed for the pandemic to peter out.

Bunch, however, sees the evolution of thinking that got us here:

It’s important to remember that in the largely upbeat (though also seriously flawed) America after 1945′s victory in World War II, there was a virtuous upward cycle of middle-class prosperity and technological breakthroughs – at the Pentagon (computers, rockets, and of course the A-bomb) but also in the home (TVs and dishwashers). American Exceptionalism and the nation’s scientific prowess were seen as inextricably linked, culminating with 1969′s big win in the space race.

Less than a year after Apollo 11 came the first Earth Day – scientists warning that industrial progress threatened environmental destruction – and also the massacre at Kent State, amid a backlash of the so-called “silent majority” against what was happening on college campuses where many researchers are employed. Just like the lunar module, distrust in modern science was engineered by humans – billionaire industrialists who funded pro-fossil-fuel think tanks, and right-wing talk radio and later cable TV ratings seekers who mocked effete “tree huggers.”

Indeed, wealthy capitalists and the politicians who aided the backlash and rode it to victories – Richard Nixon, Spiro Agnew, Ronald Reagan – were so successful that distrust in science and the conspiracy theories that flow from that distrust now spread as virally as COVID-19 itself, among everyday folks on social media sites like Facebook. Albeit with an occasional booster shot from the most cynical media celebrities like Fox’s Tucker Carlson.

Earth Day was the problem? No, the problem was that science also came with dire and quite uncomfortable warnings. Who knew? But no one was going to change, damn it! Americans liked their life just the way it was. Who did these people think they were? Down with science!

But only one group of Americans thought that way:

The masses are receptive to misinformation because America is increasingly divided not by its traditional fault lines, but by one huge determining factor: whether or not you attended college. As the U.S. increasingly cleaves into a Democratic Party composed heavily of college grads in cosmopolitan cities and suburbs, and a GOP foaming with anti-elite resentments, Republicans increasingly lack faith in our universities (their confidence dropping sharply from 56% to 39% just between 2015 and 2018) and their science departments. As more and more scientists denounced the right’s hero, Donald Trump, the gulf grew even wider.

And that’s that:

Now we are witnessing firsthand the consequences of a society that’s chosen to willfully ignore its leading climatologists and infectious-disease experts. The increasing reports from overcrowded ICUs in low-vaccine hotspots like the Ozarks of Missouri and Arkansas about people fighting – needlessly – for their lives on ventilators…

But there’s more:

News of growing wildfires and drought in the parched, overheated American West is just terrifying, a reminder of our failure to curb greenhouse-gas pollution fast enough. Or not – at least not to the conservatives who live in the smoky shadows of rural Oregon’s wildfires.

“Global warming?” one farmer dismissively asked a Washington Post reporter not far from the massive, uncontrolled Bootleg Fire, as one of his friends muttered, “Yeah, right.”

The ranchers and farmers of the rural Northwest are much quicker to blame pointy-headed federal bureaucrats than the global rise in temperatures, even after a heat wave that alarmed climate experts just killed at least 800 people in the region.

So here we are:

America is continuing to unravel in this long hot summer of 2021. And without the can-do spirit of the 1960s’ moon missions, it’s hard to see how we’re going to pick ourselves up off the drought-parched ground and make the tough-but-smart choices to turn things around.

That may be impossible now. Trump said trust no one. The election was fake. The news is fake. Science is fake. There are those who trust him on that. There are too many who do. There’s the virus. And the West is burning at the beginning of an endless drought that will end things there.

Is this how it all ends?

About Alan

The editor is a former systems manager for a large California-based HMO, and a former senior systems manager for Northrop, Hughes-Raytheon, Computer Sciences Corporation, Perot Systems and other such organizations. One position was managing the financial and payroll systems for a large hospital chain. And somewhere in there was a two-year stint in Canada running the systems shop at a General Motors locomotive factory - in London, Ontario. That explains Canadian matters scattered through these pages. Otherwise, think large-scale HR, payroll, financial and manufacturing systems. A résumé is available if you wish. The editor has a graduate degree in Eighteenth-Century British Literature from Duke University where he was a National Woodrow Wilson Fellow, and taught English and music in upstate New York in the seventies, and then in the early eighties moved to California and left teaching. The editor currently resides in Hollywood California, a block north of the Sunset Strip.
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