Think You're Done With COVID? COVID Doesn't Care WHAT You Think-- & Neither Do The Airlines

I’ve given up on the dark fantasies about all the Trump voters in unvaccinated counties around the country catching COVID and dying. What a better place America would be! But it just isn’t happening. Still could, I guess… but it hasn’t. There aren’t that many states left where less than 25% often people aren’t vaccinated— just 23 backward Trumpist hellholes— the MAGA Counties of America… greatest places to go if you want to catch COVID. Otherwise… not so much.

These are all 23— along with what percentage are fully vaccinated and what percentage voted fro Señor Trumpanzee in 2020 (quite the correlation!):

• Slope Co., ND- 11% (89.0% Trump)

• McPherson Co., NE- 15% (91.1% Trump)

• McCone Co., MT- 18% (84.7% Trump)

• Holmes Co., OH- 18% (83.2% Trump)

• Cameron Parish, LA- 18% (90.7% Trump)

• Harding Co., SD- 19% (92.0% Trump)

• Loving Co., TX- 20% (90.9% Trump)

• Garfield Co., MT- 20% (94.0% Trump)

• Arthur Co., NE- 20% (91.2% Trump)

• Billings Co., ND- 21% (85.2% Trump)

• Grant Co., NE- 21% (93.3% Trump)

• Winston Co., AL- 22% (90.3% Trump)

• Gaines Co., TX- 22% (89.3% Trump)

• Logan Co., NE- 22% (90.4% Trump)

• Long Co., GA- 22% (62.3% Trump)

• Crowley Co., CO- 22% (72.6% Trump)

• Moore Co., TN- 22% (81.6% Trump)

• McKenzie Co., ND- 23% (82.7% Trump)

• LaGrange Co., IN- 23% (76.3% Trump)

• Storey Co., NV- 23% (66.3% Trump)

• Powder River Co., MT- 23% (85.4% Trump)

• Grant Co., ND- 24% (82.9% Trump)

• Douglas Co., MO- 24% (83.2% Trump)

Writing at dawn for the Washington Post today, Joel Achenbach repeated what anyone with two lie brain cells to rub together already knows: America has decided the pandemic is over. The coronavirus has other ideas. “The latest omicron offshoot, BA.5, has quickly become dominant in the United States,” he reported, “and thanks to its elusiveness when encountering the human immune system, is driving a wave of cases across the country.”

Eric Topol, a professor at Scripps Research who closely tracks pandemic trends, told Achenbach the number of new cases per day might be as high as a million right now and that antibodies from vaccines and previous covid infections offer limited protection against BA.5, leading Topol to call it “the worst version of the virus that we’ve seen.”

Other experts point out that, despite being hit by multiple rounds of ever-more-contagious omicron subvariants, the country has not yet seen a dramatic spike in hospitalizations. About 38,000 people were hospitalized nationally with covid as of Friday, according to data compiled by the Washington Post. That figure has been steadily rising since early March, but remains far below the record 162,000 patients hospitalized with covid in mid-January. The average daily death toll on Friday stood at 329 and has not changed significantly over the past two months.

There is widespread agreement among infectious-disease experts that this remains a dangerous virus that causes illnesses of unpredictable severity— and they say the country is not doing enough to limit transmission.

Restrictions and mandates are long gone. Air travel is nearly back to pre-pandemic levels. Political leaders aren’t talking about the virus— it’s virtually a nonissue on the campaign trail. Most people are done with masking, social distancing, and the pandemic generally. They’re taking their chances with the virus.

Two of my friends—one very severely— and the wife and daughter of another friend, all pretty careful people, double vaccinated and boosted and mask-wearers, all came down with COVID in the last week or two on airplane flights in which basically no one else was masked. If people who got sick were able to sue the airlines, sensible airplane mandates would be in place and far fewer people would be getting sick. I feel this is, in good part, an airline-borne disease now. And neither the industry nor the incompetent federal government are doing anything about it. You've got to be insane to get on a plane that doesn't enforce mask mandates at this point. (Thanks to some brain-dead Trump judge, no U.S. airlines are required to have mask mandates, so none do. As far as I have been able to discover, the airlines that still have mask mandates are Air Canada, Quantas, Iberia, Lufthansa, Air New Zealand, TAP Air Portugal, Aeromexico, ANA, Turkish Airlines, Singapore Air. Roland flew on JAL last week and said everyone on his flight was masked but that there was no mandate. Their website puts it like this: "We kindly ask that our guests wear masks while in the airport and on board. Please prepare one before arriving at the airport." That could be Japanese for "mandate."

“It’s the wild west out there,” said Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis. “There are no public health measures at all. We’re in a very peculiar spot, where the risk is vivid and it’s out there, but we’ve let our guard down and we’ve chosen, deliberately, to expose ourselves and make ourselves more vulnerable.”

Angela Rasmussen, a virologist at the University of Saskatchewan, would like to see more money for testing and vaccine development, as well as stronger messaging from the Biden administration and top health officials. She was dismayed recently on a trip to southern California, where she saw few people wearing masks in the airport. “This is what happens when you don’t have politicians and leaders taking a strong stand on this,” she said.

The CDC said it has urged people to monitor community transmission, “stay up to date on vaccines, and take appropriate precautions to protect themselves and others.”

Nearly one-third of the U.S. population lives in counties rated as having “high” transmission levels by the CDC. Cases are rising especially in the South and West.

Many people now see the pandemic as part of the fabric of modern life rather than an urgent health emergency. Some of that is simply a widespread recalibration of risk. This is not the spring of 2020 anymore. Few people remain immunologically naive to the virus. They may still get infected, but the immune system— primed by vaccines or previous bouts with the virus— generally has deeper layers of defense that prevent severe disease.

But the death rate from covid-19 is still much higher than the mortality from influenza or other contagious diseases. Officials have warned of a possible fall or winter wave— perhaps as many as 100 million infections in the United States— that could flood hospitals with covid patients. Beyond the direct suffering of such a massive outbreak, there could be economic disruptions as tens of millions of people become too sick to work.

“It feels as though everyone has given up,” said Mercedes Carnethon, an epidemiologist at the Northwestern University Feinberg School of Medicine.

Carnethon said she also isn’t as cautious as she used to be. She wears a high-quality mask on airplanes, but doesn’t wear a mask at the gym. She is worried that she’ll contract covid again — she caught it during the omicron wave last winter. But she doesn’t think a “zero covid” strategy is plausible.

“I feel there is a very limited amount that I can do individually, short of stopping my life,” Carnethon said. “It’s risky. I’ll be catching covid at an inconvenient time. I can hope it is milder than the first time I caught it.”

…Population-level immunity is one reason the virus remains in mutational overdrive. The risk of reinfections has increased because newly emergent subvariants are better able to evade the front line defense of the immune system, and there is essentially no effort at the community level to limit transmission.

Al-Aly, who is also chief of research and development at Veterans Affairs St. Louis Health Care System, has scoured the VA’s vast database to see what happened to the nearly 39,000 patients infected with the coronavirus for a second or third time. What he found was sobering. In a paper posted online last month, but not yet peer-reviewed or published in a journal, Al-Aly and his co-authors reported that people with multiple infections have a higher cumulative risk of a severe illness or death.

It’s not that the later illnesses are worse than, or even as bad as, earlier cases. But any coronavirus infection carries risk, and the risk of a really bad outcome— a heart attack, for example— builds cumulatively, like a plaque, as infections multiply.

“Reinfection adds risk,” he said. “You’re rolling the dice again. You’re playing Russian roulette.”

…Omicron blew through the largely vaccinated population last winter with stunning ease, and since then the subvariants have arrived in rapid succession, starting with BA.2 and BA.2.12.1 in the spring, and now BA.5 and its nearly identical relative BA.4.

Vaccines are based on the original strain of the virus that emerged in Wuhan, China in late 2019. The Food and Drug Administration has asked vaccine makers to come up with new formulas that target BA.5 and BA.4. Those boosters could be ready this fall.

But there is no guarantee that these latest subvariants will still be dominant four or five months from now. The virus is not only evolving, it’s doing so with remarkable speed. The virus may continually outrace the vaccines.

“I worry that by the time we have a vaccine for BA.5 we’ll have a BA.6 or a BA.7. This virus keeps outsmarting us,” Al-Aly said.

…Akiko Iwasaki, a professor of immunology and expert on long covid, said in an email that she believes the world is not sufficiently vigilant about the disease anymore. She is often the only person masking in a crowd, she said.

“I understand the pandemic fatigue, but the virus is not done with us,” she said. “I fear that the current human behavior is leading to more people getting infected and acquiring long covid. I fear that this situation can lead to a large number of people with disability and chronic health problems in the future.”

The precocious nature of the virus has made infectious-disease experts wary of predicting the next phase of the pandemic. Topol warns that a new batch of variants could come out of the blue, the same way omicron emerged unexpectedly last November with a stunning collection of mutations already packaged together. Omicron’s precise origin is unknown, but a leading theory is that it evolved in an immunocompromised patient with a persistent infection.

“Inevitably we could see a new Greek letter family like omicron,” Topol said. “There’s still room for this virus to evolve. It has evolved in an accelerated way for months now. So we should count on it.”