Pandemics Don’t Really End—They Echo

The public health emergency related to the COVID-19 pandemic officially ended on May 11, 2023. It was a purely administrative step. Viruses do not answer to government decrees. Reported numbers were declining, but then started coming up again during the summer. By August, hospital admissions climbed to more than 10,000 a week. This was nowhere near the 150,000 weekly admissions recorded at the peak of the pandemic in January 2022.

The new variant is more contagious. It is not yet clear whether it is more lethal. Nor is it clear whether the recent rise is a mere uptick or foreshadows a more serious surge. More than 50,000 COVID-19 deaths have been reported in the U.S. in 2023. Somehow, this has come to be seen as almost normal.

Even while health authorities are keeping their eyes on new “variables of concern,” for much of the public COVID has been cancelled. The news media have largely moved on to other calamities. The pandemic is over. Is it?

History shows that pandemics have ragged endings. Some return again and again. The Justinian Plague that swept through the Roman Empire in the 6^th century returned in waves over the next 200 years. The Black Death that killed half the population of Europe between 1347 and 1351 came back more than 40 times over the next 400 years.

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The effect of the COVID-19 pandemic will be felt long after the last rapid test comes back positive. Millions today are still suffering from “long COVID”—a range of medical conditions that can appear long after the initial infection. This concept can be applied to the whole of society.

Pandemics have always frayed the social fabric, disrupted economies, deepened social divides, and intensified prejudices, leaving behind psychological scars—all of which have lasting political repercussions.

Angered by the British crown’s attempt to restore the inequalities of the pre-pandemic feudal system, which had been weakened by the massive depopulation caused by the plague, English peasants marched on London and nearly brought down the king. Repeated waves of cholera in Europe during the 19^th century increased social tensions and contributed to growing class warfare. A sharp increase in labor strife followed the 1918 flu pandemic.

Today, society seems similarly on edge and quick to violence, an observation that was also made about medieval society following the plague. The U.S. homicide rate in 2020 and 2021 increased by nearly 40 percent. It appears to have come down in some cities, but violent crime remains above pre-pandemic levels. Mass shootings have hit an all-time high, while random unprovoked aggression has increased in public spaces. The pandemic is not entirely to blame, but it has likely been a contributing factor.

Many Americans quit their jobs after the pandemic. Others are refusing to give up working from home. The so-called great resignation appears to be ending, but the labor militancy that featured in post-pandemic societies continues.

While the COVID-19 pandemic comes nowhere near the depopulation effects of the plague, it emptied the sidewalks in many major American cities. Office buildings have fewer workers. Restaurants have lost business. It is not uncommon to see rows of boarded up retail shops. COVID does not get all the blame. The rise in crime in many city centers keeps many away. Urban geography may be permanently altered.

As it often did after past pandemics, pessimism pervades the post-pandemic moodscape. Its explanation lies beyond the pathogens. A Biblical host of natural and man-made disasters—pestilence, war, famine, floods, drought, fire, contribute to a sense of foreboding.

The 1918 flu pandemic left a legacy of distrust in institutions and each other, which was passed down to children and grandchildren, COVID may have similar long-term effects.

Americans are a cantankerous lot, increasingly suspicious of malevolent motives behind anything government does. Partisan news outlets look for conflict and stoke outrage. In past pandemics, conspiracy theories flourished, often blaming immigrants and Jews. So too, some COVID conspiracy theories suggest that the virus was designed to kill Whites or Blacks, while sparing Asians and Jews. Nothing changes.

Some believe the government created the pandemic hoax or deliberately misled the public about the seriousness of the situation. They argue that needless lockdown orders and business shutdown ruined the economy; providing financial relief to businesses and families opened the way for massive corruption and left the country with insupportable debt; mask and vaccine mandates were assaults on personal liberty for the benefit of big Pharma profits. Some still claim that the vaccines themselves rivaled the virus in their lethality. Defiance has been elevated to patriotism.

Owing to response measures, improved medications, life-saving procedures for treating critically-ill patients, and the rapid availability of a vaccine, the outbreak did not replicate the death tolls of previous pandemics.

Although it sounds perverse, saving lives ended up contributing to the controversy. Simply put: The pandemic was not deadly enough. The 2^nd century Antonine Plague killed a quarter of the Roman Empire’s population. The 6^th century Justinian plague killed half the population of Europe. According to some historians, the first wave of the plague in the 14^th century again wiped out half of Europe’s inhabitants.

COVID has killed more than a million Americans, roughly a third of one percent—or about the same percentage of the population killed in World War II. As a percentage of the total population, the 1918 flu was twice as deadly.

The demographics of the death toll are important. The 1918 flu killed many younger people—those 25-40 years old accounted for 40% of the fatalities—while COVID killed mainly older Americans, as three-quarters of the dead were 65 or older. Those under 40 accounted for just 2.5% of the fatalities.

Some questioned why the country’s well-being should be jeopardized to save the elderly, many of whom already had other afflictions anyway. Expressed in the cruelest terms, nature was culling the herd. Indeed, some of the same groups that during earlier debates about national health care expressed outrage at the prospect of death panels “pulling the plug on grandma” suggested during the pandemic that the elderly would be willing to die to save the economy.

The COVID pandemic lacked visual impact. Except for those directly affected, COVID’s toll remained abstract. There was no modern equivalent of town criers calling “Bring out your dead” accompanied by carts making the rounds to collect corpses. Had COVID led to bodies piled in the streets, shared dread might have outweighed our differences. As it turned out, we had the science to address the pandemic. What we lacked was the social accord.

Discord continues in the political arena. The tradeoffs between preserving individual rights and protecting the public are legitimate areas to explore, but rather than looking for lessons to be learned, some politicians appear determined to settle scores. Pandemic disputes will almost certainly feature in the 2024 presidential election.

Any future outbreak of disease will likely again see cable news, the internet, and social media play major roles in shaping the information individuals choose in their decision making. This will inevitably make emergency control measures more difficult to impose. COVID’s biggest political casualty may be governability itself.

We are unable to join hands to remember the more than a million Americans that have succumbed to the virus—that are succumbing still. We cannot express a nation’s gratitude to the scientists, public health officials, and heroic frontline health workers, thousands of whom died saving lives during the pandemic. Stuck in the well-worn paths of previous pandemic prejudices and conspiracy theory re-runs, we cannot come together to mourn our losses and celebrate our survival.

There will be no collective thanksgiving, no elegies, no closure. As we have seen time and time again throughout human history, pandemics do not end—they echo.