The Pandemic Is Over, Yet Death Is Still Here

How the end of the CDC’s indoor masking recommendation may go down in history

Justin Feldman
Medium Coronavirus Blog

--

Photo by Michael Jin on Unsplash

Historians may come to see May 13, 2021, as the effective end of the coronavirus pandemic in the U.S. The date isn’t a milestone in a downward trend of deaths or disease. In fact, that week saw about 4,300 Covid-19 deaths, equating to about 225,000 deaths if the rate were maintained over a year. Nor is the date significant because the U.S. reached a particularly high rate of vaccination — about two-thirds of the population are not yet fully vaccinated.

But pandemics don’t end when public health goals are achieved. Instead, historians tell us, pandemics end when a disease has become “an accepted, manageable part of normal life in a given society,” when there is a “return to normal life” and to “normal business practices.”

Since the beginning of the pandemic, some public officials have urged a “return to normal” by denying the severity of the disease. Others acknowledged the risks but, in rhetoric and policy, shifted responsibility for public health protections onto individuals.

Even so, it’s important to recognize that there was a state of exception that allowed for the passage of important public health measures. Some states enacted time-limited nonessential business closures and required masks in certain settings. Some schools shifted to fully or partially remote instruction. At the federal level, Congress expanded unemployment insurance and Trump’s Centers for Disease Control and Prevention restricted residential evictions (protections remained until a judge overturned the order in May 2021).

The public largely supported these public health measures and many wanted the government to go further in protecting them.

Then on May 13, 2021, the CDC gave its blessing for vaccinated people to stop wearing masks indoors with the exception of some particularly crowded settings.

One can debate the risks of infection and transmission among the vaccinated, but that is beside the point. While CDC guidance does not have the force of law, the authority that it carries can shape policy for all levels of government and for private institutions. In this instance, the guidance is a powerful push in the direction of eliminating indoor mask mandates while leaving it up to individuals to make choices about when to wear masks.

We are already seeing the effects. On the same day as the CDC announcement, Washington Governor Jay Inslee announced an end to state indoor mask mandates and private businesses like Trader Joe’s quickly followed suit.

With the new CDC guidance, it’s hard to imagine that the occupational health regulation meant to protect workers from Covid-19 (which has already been delayed for months) will ever see the light of day. It’s hard to imagine that measures like pandemic unemployment assistance will be extended beyond their sunset dates in the coming months. The state of exception is over.

It doesn’t have to be this way. Federal and state governments can make a major push to expand vaccination before the “return to normal” by going door to door and workplace to workplace. It’s worth noting here that most of the unvaccinated are not “hesitant”, and that they tend to be people of color and lower-income.

Governments can also give more time for adolescents to be vaccinated, as 12–15 year-olds have only been eligible for a few days. And it’s worth noting that countries like the U.K. and Israel had shutdowns that lasted until they’d vaccinated a large portion of their populations. We could have done the same.

What I’m really worried about right now is the normalization of mass illness and death in perpetuity. The U.S. could easily end up in a place where we have tens of thousands of Covid deaths each year (if not more) on top of tens of thousands of deaths from influenza and other resurgent respiratory viruses. These deaths will largely be among people who are old, disabled, and working-class people of color.

In fact, up to March 2021, there were fewer than 5,000 Covid deaths among college-educated white people under age 65 in the U.S., which is likely why it has been so easy for those in power to downplay the severity of the crisis.

What I think we need, in the long term, is a regulatory framework that reduces death from respiratory viruses. Not by modifying individual behavior, but by mandating multibillion-dollar investments in ventilation in workplaces and other high-risk institutions. By creating stronger disease monitoring systems that can trigger policy shifts like work-from-home periods when the incidence of a particular disease exceeds a given threshold. And by providing every human being with guaranteed, single-payer health care.

The pandemic is over in the U.S. because we have returned to normal — the mass death of Black, Indigenous, and disabled people has always been normal in this country — normal, unacceptable, and unjust.

--

--

Justin Feldman
Medium Coronavirus Blog

I’m a social epidemiologist and Health & Human Rights Fellow at the Harvard FXB Center.