The final retrospective
“And now to sum up,” as Virginia Woolf has one of her characters in The Waves say (not recommended reading, incidentally – it is quite a dreary novel). The Public Health Emergency that was declared over three years ago when COVID first burst onto this country officially ends at midnight. In practical terms the financial burden on the government will lessen: it will no longer supply COVID tests gratis, and Americans will have to coordinate with insurance companies to obtain vaccines. The burden on our health care system has been gradually diminishing, as hospitalizations become less frequent and treatment has become more effective. The story of COVID is far from being concluded, but the story of COVID as a pandemic is.
What have been the effects of COVID since the pandemic first began?
The first one is fairly obvious: over one million Americans dead from the disease, a much greater amount than what had been initially predicted when the pandemic began and, it may be said in passing, representing about 17% of out of the total number of COVID-related deaths around the globe, even though we represent a bare 4% of the world’s population. The United States ranks 58th among the nations in frequency of COVID infections among its population, but 15th in mortality rate – not exactly a record to be proud of.
As to the number of those who have contracted the disease and whose health has been greatly reduced in consequence – the sufferers from long COVID, in fact – it is impossible to obtain anything like accurate data. A hopeful note appears to be sounded, insofar that the rates are declining and that even those who contract COVID are recovering more quickly than they have been in earlier months. In very approximate terms, about 15% of all American adults have reported symptoms of long COVID, but such symptoms have lasted not more than a year for the majority of cases.
The great strain that our health care system underwent during the earlier phases of the pandemic has been alleviated long ago, but the system has been weakened by the onslaught: not so much from the disease itself, but from the damage inflicted by those who sought to deny its severity or even its existence. Many health care professionals became tired of the abuse they were receiving from those whom they treated, particularly from those who refused to take the vaccines and who then berated the doctors and nurses when they became ill. The most experienced among them have retired early and the younger ones have turned to other occupations. According to one poll of 1,000 health care workers conducted in September 2021, 18% had quit their jobs during the 19-month since February, 2020. By 2025, the U.S. is estimated to have a shortage of approximately 446,000 home health aides, 95,000 nursing assistants, 98,700 medical and lab technologists and technicians, and more than 29,000 nurse practitioners.
There are other consequences that could not have been predicted when the disease first manifested itself. Remote work – the practice of working in a location apart from a corporate office – has increased dramatically and, while some corporations are requiring their employees to return to the office, quite a number of them are content to enable their employees to work from home, thereby enabling them to economize on office space. This trend is bound to have far-reaching consequences. Traffic congestion will become less of an issue in the larger urban areas. Social interaction among workers, on the other hand, will sharply decrease. Several people in the past formed their closest friendships from a selection of their colleagues, but that will be less likely to occur when people work from their homes all day and rarely come into close personal contact with any of their co-workers.
Education has been similarly affected. Even if students are now returning to the classroom, home schooling has increased in popularity, with students learning from the Internet rather than from face-to-face encounters with teachers and classmates. It is unclear how children will deal with such isolation. It is not a new situation by any means; until government-mandated schooling originated in 16th-century Germany, many men (and, less frequently, women) were educated at their parents’ homes by tutors. But up to this point we have not seen home-schooling as so large a scale as in recent years, and currently its long-term results can only be a matter for speculation.
Depression is now more common among young people than it was in the past. Research from the Walton Family Foundation indicates that members of Generation Z (those born in the year 1997 or later) are nearly twice as likely to fall into depression as those who are 25 and older: 42% of their group as opposed to 23% of the latter. One in four of them have a close friend or relative addicted to drugs, and one in five is connected with someone who died by suicide. Even before the pandemic began, depression was on the increase: according to the CDC, suicide rates for people ages 10 to 24 increased almost 60% between 2007 and 2018. Emergency department visits for suspected suicide attempts among adolescents rose 31% from 2019 to 2020. Nearly 90% of Gen Z members believe their generation is not set up for success and 75% feel they are at a disadvantage in comparison to previous generations (such as the Baby Boomers or Gen X) who are at least 42 years old in 2022.
I think that they are right. The younger generation is dealing with economic pressures that members of my generation never experienced. Our country is currently due to be unable to meet its debt obligations by June 1st – a bare three weeks from now – and, unlike the political parties of previous decades, neither the Republicans nor the Democrats have the faintest inclination towards fiscal responsibility. Currently the U.S. is the industrialized country with the fourth highest debt-to-GDP ratio. Only Japan, Italy, and Greece have higher ones. In addition, the national debt is forecast to be double the United States’ GDP by 2051.
The events associated with the pandemic have highlighted the fact that Americans are, as a nation, not especially healthy. To an extent this reflects well on our medical community: many people who in earlier times would have succumbed to diseases resulting from compromised immune systems are now able to survive and even to lead reasonably unrestricted lives as a result of the strides we have made in therapeutic medicine. But most of us continue to be far too sedentary in our habits, to eat too much, and to venture out of doors too little. At the beginning of the pandemic there was a flurry of outdoor activity, but that for the most part has subsided. Obesity continues to affect four out of every ten Americans, and indeed the obesity rate climbed over 3% during 2020 and 2021, the early years of the advent of COVID. Obesity has played a role during the pandemic, tripling the chances of being hospitalization. Nearly 20% of American children and adolescents are obese, indicating that as Generation Z matures this issue will worsen.
On a more parochial level it may be noted that Washington DC is doing relatively well in this respect, with an obesity rate of 24.7%: much too high, to be sure, but considerably better than most other regions of the country.
Less directly, the pandemic affected this country’s political administration. In all probability Trump would have won the 2020 election if it had not been for the intervention of the COVID pandemic. Not all of his decisions were bad. He certainly showed greater sense than Biden has done with respect to border control: allowing thousands of undocumented people to enter a country while a pandemic is raging is as thoroughly misguided a policy as harassing health officials and ignoring the advice of the medical organizations appointed to implement appropriate measures of control during times such as these. The frantic efforts of the Trump administration to deny the reality of the disease when it first appeared and then to advocate quack remedies such as hydroxychloroquine and ivermectin were primarily responsible for the populace as a whole becoming disaffected with him; before the hospitals became overburdened with patients on ventilators and mortuary became overburdened with corpses, the independent voters inclined more towards him than towards any of his Democratic rivals. Thus Trump’s defeat and the subsequent assault on the Capitol might be said to be among the unpredictable side-effects of COVID.
But it would be misleading to end on so hopeless a note. My own experience during the COVID years showed that it was possible to lead a quiet and reasonably satisfying life despite the difficulties we have experienced during this time, and I venture to hope that others have done so as well. Here, then, is a final retrospective of the COVID years:
My own personal health remains good. I continue my active habits; on my most recent hiking trip I covered about 70 miles, much of it on challenging terrain. I cannot say for certain at this point whether I will complete 2000 miles for the entire year, but I should at any rate get within striking distance of that goal by the end of December.
I still bring a facemask with me (either on my person or in the car) whenever I leave my house. It remains an instinctive habit now, just like checking to ensure that I have my keys in my pocket before I close the house door. Yet I must admit that I have been laxer about using them, and I daresay I will become laxer still as COVID recedes to the background. In England I did not bother with facemasks after arriving at the Lake District, despite the numerous bus rides I took there. No one else was wearing one, and so I became careless in turn. Here I wear one while using public transit, going to stores (although I’m not always consistent about this), and in enclosed areas such as theaters. But I no longer wear them in restaurants or in private homes, where indeed they appear to be me to be a pointless exercise.
Social life and convening in crowds are nearly back to the levels that they have been in pre-pandemic years. Private visits, restaurant dining, going to museums, sitting through theater performances – I have indulged in more of all of these during the first few months of 2023 than in the entire period from mid-March of2020 to the end of December, 2022, and my experience is probably indicative of how people are behaving as a whole.
I am detecting a decrease in physical activity. It is becoming more frequent now to wander on the trails without encountering others. Still, my experience varies. On certain hikes, such as the Trillium Hikes that I did last weekend, I saw many outside of the group I was with. On others I was nearly on my own, which was generally was not the case in 2021 and 2022.
Travel likewise no longer is attended with the difficulties imposed during the earlier phases of the pandemic. It is no longer necessary to carry proof of vaccination or to undergo testing before returning to the country. As for travel within the country, any restrictions have disappeared long ago: people have to strain their memories to recall a time when inter-state travel was curtailed on a state-by-state basis.
I conclude by posting statistics for the last time. Flawed though they may be, they should be savored while they are still obtainable. The end of the Public Health Emergency means that states are no longer required to report their COVID data to the CDC. The CDC will have to perform estimates from hospital admissions (for hospitals still must report to the CDC even if their state does not) and wastewater analysis, which obviously are going to be less accurate.
Today’s statistics as of 9:00 PM – # of cases worldwide: 688,119,252; # of deaths worldwide: 6,873,389; # of cases U.S.: 106,790,393; # of deaths; U.S.: 1,162,693.
And, as we say at the end of the Passover seder:
CONCLUDED AND DONE