Editor’s note: This year-end reflection is by digital editor Mike Dougherty, who has helped lead VTDigger’s Covid-19 coverage since March 2020.
Of all the experts I’ve interviewed about Covid-19 over the past two years, none has proved to be as prescient as Alex Navarro.
A medical historian at the University of Michigan, Navarro is a scholar of the 1918 flu. When we first spoke in May 2020, it was still accurate to say that Covid-19 was the deadliest pandemic since 1918, when the flu claimed more than 600,000 American lives.
Now, with more than 800,000 dead from Covid, that ranking has flipped.
Still, Navarro said some key lessons held true. His research into “escape communities” — locations such as Fletcher that dodged flu cases and deaths — proved that now-familiar public health measures worked. “Nonpharmaceutical interventions” such as masking, social distancing and targeted closures made all the difference in 1918. But they had to be applied in sometimes unpopular ways.
“Early, layered and sustained” was how Navarro put it. Policies must be proactive, not reactive. No policy is airtight, so several must be in place at once.
And, crucially, they must be kept in place even after it seems like the danger has passed. When policies were lifted too early, the virus reliably resurged.
Navarro pointed to Denver’s experience with the 1918 flu. The city lifted its pandemic restrictions on Nov. 11 that year. Citizens jumped at the chance to gather once again, and cases quickly shot up. Health officials convinced the mayor to issue a new set of restrictions on Nov. 22.
The public was caught by surprise. Enraged business owners quickly formed an ad hoc “amusement council” and stormed City Hall. They convinced the mayor to rescind the new policy just hours after it was enacted.
Days later, new cases and deaths in the city hit record highs.
“I think it’s important to note that there are sort of two competing definitions of what an epidemic is,” Navarro told me last year. “There’s the epidemiological, scientific definition. But then there’s also the social definition. And if people simply say, ‘This isn’t a big deal anymore, and we just have to live with this,’ the epidemic is, for all intents and purposes, over — at least socially, at least politically.”
More than 18 months since we spoke, Navarro’s words seem more relevant than ever. Across the country, and certainly in Vermont, the defining question for much of this year has been: Is this thing over or not?
It seemed, in June, that it was. Not only were the three Covid vaccines in the U.S. miraculously protective, but Vermont had actually done the work to utilize them effectively. Our state government got shots in arms more quickly than any other. Gradually, but decisively, rates of cases, hospitalizations and deaths dropped to near zero.
It was no surprise. Vermont had led the nation in mitigation efforts throughout the pandemic’s first year. “Early, layered and sustained?” We had the first two down pat.
The concept of maintaining restrictions past the spring vaccination blitz, though, seemed far-fetched. Gov. Phil Scott announced that when 80% of adults had begun vaccination, all remaining measures would be lifted — and there was broad agreement that it would be safe to do so.
Some experts, though, urged caution. There was no real science behind using 80% as a threshold, some noted, and vaccines for children were still several months away.
The Covid-19 transmission rate would provide a better benchmark than the vaccination rate, especially if new variants arose. That’s what Aditya Khanna, an epidemiologist and behavioral sciences professor at Brown University, told me in April.
“If vaccine deployment is going up, yet transmissions are going up too, then does it really make sense to stick with the original plan just based on vaccine rollout?” Khanna said. “I don’t think so.”
In August, that hypothetical scenario became reality. The newly arrived Delta variant was driving a surge in cases and deaths, while vaccinations had slowed to a trickle.
Experts ramped up calls for Scott to move beyond a vaccine-only strategy. He resisted, at times mocking those calls, and the virus moved into its deadliest phase yet.
Delta stormed Vermont when the state was averaging about five new cases per day. The even more contagious Omicron variant is taking hold when our baseline is topping 400.
[Looking for data on breakthrough cases? See our reporting on the latest available statistics.]
Returning to Navarro’s “competing definitions” of an epidemic, we’re still in one, scientifically. What about socially?
Scott appears to believe it’s over for most Vermonters, as evidenced by his repeated assertions that there’s no public appetite for reinstating mitigation measures. “I’m not willing to move us backwards,” he said on Nov. 23.
The public’s stance is hard to discern. Local opinion surveys from as recently as November signal approval of the governor’s approach, yet national polls also show an openness to masking rules. See also: the Black Friday-like run on Vermont’s limited supply of rapid Covid tests before the holidays.
A controversial essay in The Atlantic earlier this month suggested that, yes, it’s time to call it. “Many, if not most, Americans are leading their lives as if Covid is over, and they have been for a long while,” wrote conservative journalist Matthew Walther.
That same week, Colorado Gov. Jared Polis, a Democrat, made national news for declaring that the Covid emergency was done. In an interview with Colorado Public Radio, Polis compared people’s choice to not wear masks to not wearing winter coats in freezing weather: “If they get frostbite, it’s their own darn fault.”
Public health experts have warned against this kind of fatalism, arguing that there is still a collective obligation to use the tools we have to save lives.
Reached in Michigan last week, Navarro said he believed the public’s waning attention to the pandemic, at least in many regions and communities, was unfortunate but true. Months of whipsawing circumstances have blunted people’s ability to properly assess their own risk.
“We are human beings,” he said, “so we’re prone to cognitive dissonance of various sorts. And I also think that as this thing has dragged on, we see more and more people who are just tired of it — including people like me, who are otherwise very safe.”
The Omicron variant of Covid-19 may prove to be the most contagious disease in recorded history, Navarro said. For it to arrive when much of the public has tuned out means that a serious wave is inevitable.
“We are now at the point where, at least in terms of disease, basically everyone is either going to be sick or get vaccinated before this really starts to die down,” he said.
As always, Navarro returns to the lessons of 1918.
Skepticism of public health measures became entrenched then, too. The first round of restrictions “flattened the curve,” he said, but they didn’t eradicate the disease. The public thought, “ ‘Well, what good was it, doing any of these measures?’ Not fully understanding that, in fact, you’re not going to prevent a pandemic by doing that. But you’re going to help. They thought it was sort of an all-or-nothing.”
Navarro has spent the Covid-19 pandemic trying to promote the simplest takeaways from his research: that nonpharmaceutical interventions work, and that they must be kept in place until the pandemic is over — scientifically, not socially.
“I think we have failed to learn those lessons,” he said last week. “And I don’t foresee us learning them now at this late stage of the game.”
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