What happens if we don’t have a COVID-19 vaccine by early 2021? Or 2022? In other words, what might the world look like if the pandemic continues for several years?
Earlier this week I used this question to generate a scenario for 2023. That post covered a lot of ground, touching on economics, psychology, politics, society, architecture, and more.
Today I’d like to build on it. Readers and friends have already helped by adding their own thoughts through comments on the previous post and on Twitter (see below). Let’s see if we can glimpse that particular 2023 together with some more clarity.
To recap, how might a three-year pandemic happen? In the last Tuesday post I listed a series of necessary preconditions: no vaccine, no major therapy, continued virulence. Since then Ed Yong has published a diagnosis of the many ways America has flubbed pandemic response. If we keep following those behaviors COVID would well continue for years.
Given those underpinnings for this particular vision of 2023, we can trace some more ways it might play out.
COVID health conditions other than death While much attention now goes to people killed by the virus, and those who escaped its effects, there is also a population it injures. Damages to breathing, to the immune system, to the heart, to the brain and nervous system are some of the marks COVID-19 leaves on the infected. In 2020 a term has emerged for people thusly afflicted: long-haulers.
By 2023 there will be a number of pandemic survivors bearing medical conditions. What number? Let’s try a back of the envelope sketch. About 6 million Americans have been infected so far, after six months. If we wildly assume that rate persists, we have around 36 million United States residents who’ve hosted the virus by 2033. If 10% of them survive but end up with significant tissue damage, we could see three million or so of them, nearly 1% of the total population.
Worldwide, there are around 28 million infections (one source). By the same crude math there would be around 16 million injured survives. That’s a large amount of human suffering, not to mention demand on very strained health care systems, as well as losses of economic productivity for families and nations.
I imagine some with nicknames for their ailments: COVID heart, pandemic lung, ‘rona nerves, COVID fatigue. “I’ve been exhausted/had headaches/always sick with something since I had the demon virus.” “She used to manage asthma all right, but ‘rona lung is something you just can’t fix.”
We might expect some to pay attention to this as an ongoing dimension of the overall pandemic crisis. There are already citizen science efforts, coordinated online, which try to assist in recovery and mitigation. On the other hand, we might just grow accustomed to long haulers as part of society, as many nations did with polio.
In addition to the biological impacts of a plague lasting three years, brilliant Georgetown University Learning, Design, and Technology student Wesson Radomsky reminds us of the bad mental health dimensions.
I'm really worried about the implications of that isolation for mental and physical health — there's so much research showing the importance of social connections & support systems for health outcomes
— Wesson Radomsky (@WessonRadomsky) September 8, 2020
The advent of generation COVID. The very youngest of us have had their lives stamped by the pandemic. For example, science fiction and fantasy writer Catherynne M. Valente observes that
This baby is almost 2. He’s lived more than a quarter of his life under quarantine, & that quarter contained almost all of his first sentient impressions of the world.
Right now, for my son, dragons and restaurants have an equal probability of actually existing in real life.
by 2023 this child – who doesn’t remember pre-quarantine – will be old enough for kindergarten. Our homeschooled-under-COVID middle-schooler (and others like him) will be starting to look at colleges.
Relevant to this post (and maybe your next one): by 2023 this child – who doesn't remember pre-quarantine – will be old enough for kindergarten. Our homeschooled-under-COVID middle-schooler (and others like him) will be starting to look at colleges. https://t.co/g6SatwJVDB
— Alison-Hyphen-Furlong (@AlisonFurlong1) September 8, 2020
How does that experience mark these children as they grow into teens, then adults? Are they forever Generation COVID?
Inequalities Wesson Radomsky envisions today’s inequalities leading to certain effects by 2023, including on medical supplies and who isolates:
More hoarding of testing resources to facilitate parties in the Hamptons and private island getaways, a continued lack of accessible & affordable options for the rest of us, leaving households with essential workers and multi-generational households stuck isolating for years.
— Wesson Radomsky (@WessonRadomsky) September 8, 2020
In a blog comment Michael Flood concurs and adds:
VC firms are attaching new/higher value to immune or low-risk categories of the population. Meaning, firms may treat these populations with increasing benefit and find ways to eschew high-risk populations. Why start a business targeting the elderly or overweight in this environment? Would “certified immunity” come to exist as a credential with benefits? Or would insurance schemes attach risk-values to hiring practices that do/don’t take infection risk into account? Over time, would this lead to a new category fighting for anti-discrimination laws?
Radomsky connects this to technology as well, speculating on who gets to use which surveillance and protection technologies:
And 2) I’m really skeptical that we’ll see mass surveillance tech deployed here to manage COVID spread, but I am really curious to see what platforms emerge for opt-in tracking, again especially for those who are more well-off and looking to return to "normal".
— Wesson Radomsky (@WessonRadomsky) September 8, 2020
…which could migrate across other domains:
I’m also curious to see if the types of testing/tracking/self-reporting apps that colleges are using will become more prevalent in other settings— for work but also for music festivals, private social clubs, etc. — again, making access to social spaces more exclusive…
Acceleration toward the retirement of physical currencies as people transact ever less in person and when they do, prefer contactless transactions. Significant increase in digital crimes (of all types) as more and more economic activity moves online, staffing turnover continues (creating openings and weak longitudinal accountability), and law enforcement cannot compete for the in-demand tech workers. The need for increased digital security will eventually become a much larger economic sector of its own, including new types of personal/household level insurance with accompanying mandated practices for eligibility.
Politics I wrote up unrest in the last post, but perhaps that account was too mild. Flood offers this alternative:
Much more social unrest. If your 2023+ scenario holds, I do not see avoiding further increases in social unrest. What is today heated arguments in local places of business about masks or distance will become more agitated as more people can tie real losses (personal/death and economic suffering) to their views about the “other” side. Even outside of the realm of opinion on relative risk and preventative measures – the actual disproportionate impact of the economic changes will be substantial. Perhaps this buoys momentum toward Basic Income schemes – demanded by the destitute and begrudgingly accepted by the wealthy as insurance against civil disorder or a (real) class war…
We could go further. The details of this recession could drive political desperation. Think, for example, of newly homeless people (if the United States fails to act on evictions) who have lost so much. They turn to an already overstretched social safety net. How many of them will find political extremism, conspiracies, or militias appealing as meaningful and active responses to their experience? How many will turn to various forms of crime, which can overlap with political unrest in American culture? We know from history that unrest can breed more unrest, especially when authorities crack down and inspire new rebels.
Just how unstable will nations be in 2023?
Social tensions Three years of pandemic means three years of quarantine and other restrictions. Sociologist Randal Collins examined changes in American life during this summer in some detail, then concluded:
People are culturally quite malleable, but if that means that after a period of acclimation, we can get used to anything, it does not follow that we can do so without paying a price. If people are deprived of embodied interactions, it is a likely hypothesis that they will be more depressed, less energetic, feel less solidarity with other people, become more anxious, distrustful, and perhaps hostile. [emphases added]
Culture In addition to what I wrote previously, I’d like to add that I’m curious about how culture represents the pandemic. Two very marginal cultural sectors have already engaged. In horror movies there’s already an emerging subgenre. (The name “quar-horror” is hideous and should be crushed.) Host (2020), for example, does a good job of squeezing frights out of lonely people on a low budget, and all on Zoom. And quarantine porn is a thing.
How else will other cultural areas grapple with three years of pandemic? I’m curious about highbrow and mainstream literature, pop music, and computer gaming. What does COVID fashion look like? Or rather, by 2023 how many epochs of pandemic fashion will we have gone through?
Travel Flood offers this interesting focus:
I fear that closed borders are a bigger reality and problem. Systems will emerge for “trusted travelers” and everyone else turned away. The resulting lack of international and intercultural interaction may lead to increased distrust, lower understanding, and more political isolation/nationalism. The main offset to this is the digital world. We may yet be on the cusp of major increases in global interaction forced by increasingly global online platforms. Watch for signs of inflection for this – we need better/faster/easier real-time translation tools.
Which leads us back to national and international politics.
I’d like to explore what higher education looks like in such a 2023, but that deserves its own post. That’s coming up next.
In the meantime, what do you think year three of COVID would look like?
(thanks to jbackon, Tom Elliot. and Vanessa Vaile; thanks, too, to Ray McClintock, Kyle Erlenbeck, and Michelle Baldwin for reading; thanks to Rob Henderson for eagle-eyed correction; thanks in particular to my wife for talking me through this with her own special vision)