Bryan Alexander

Der Tod eines Menschen: das ist eine Katastrophe. Hunderttausend Tote: das ist eine Statistik!
(The death of one man: that is a catastrophe. A hundred thousand deaths: that is a statistic!)

-Kurt Tucholsky, 1925

It looks like COVID-19 has now killed about 800,000 Americans.

Here’s the latest dashboard result from Johns Hopkins University:

800,945 dead.  I wrote “about” because American COVID data is so varied and unreliable.  On the lower side the CDC currently posts 796,010.  COVID Act Now estimates 797,000.  On the other side Worldometers thinks 821,444 while the World Bank has 800,043.

I also hedged my language because enough sources argue that published stats undercount COVID deaths worldwide, including in America.  The usual way for determining this is to track total deaths over recent, pre-pandemic years, then project them into our COVID time, checking to see how many more deaths occurred than expected. Some researchers see the real number at 20% higher, and higher still in black and Hispanic populations.  IHME calculated that actual world deaths are around double the official number, and that American deaths are more than 50% higher than the CDC’s figures.

And so many of those deaths were preventable.  Stupidly, infuriatingly preventable, because vaccines are safe, provide protection, are free, are widely available, and have been so for a while. According to the Kaiser Family Foundation:

We also estimate that 163,000 COVID-19 deaths could have been prevented by vaccination since June 2021, when safe and effective COVID-19 vaccines were widely available to all adults in the U.S.

Only around 60% of the population is fully vaccinated, according to Mayo, and that includes people whose last shot was long enough ago that its protections have weakened to some degree.  Maybe 20% have received a booster, according to CDC.

So now: at least 800,000 dead in the United States.  COVID-19 has probably killed a million.

It’s a terrifying number to grasp.  I suspect many people shy away from it.  Statistics are unintuitive for some.  Others may avoid the fact for political reasons: Republicans, embarrassed that Trump didn’t scotch the thing during his last year; Democrats, who hoped Biden would bring it under control by now.

The emotional impact isn’t something most people are used to dealing with.  Not at this scale.  The last medical emergency to strike America was AIDS, which we didn’t handle well, and whose deaths COVID already exceeds, and in a far shorter period of time.  The Great Influenza around 1918 is barely a historical presence, absent from the popular imagination.  The closest the United States has suffered in raw numbers and time is the 750,000 dead of the Civil War, although in a smaller population.  The point is, we don’t have much practice in collectively processing massive deaths.

It’s also a hard number to visualize because the deaths are hard to see – literally. There are very few visual depictions of COVID deaths. We see little evidence of people breathing their ragged, terrible last in emergency rooms, or struggling through ECMO – and for good reasons, including privacy and HIPAA.  It’s a kind of medical echo of the military’s push to not share images of dying and dead soldiers.  The result is similar.  For a culture well trained to experience the world visually, these stories of deaths are off the screen.  We’re living through (among other things) a major visual storytelling failure.

COVID deaths are also hard to grasp because they mostly hit senior citizens.  Here’s a New York Times visualization, finding 75% of fatalities among those over 65 years old:

Simple ageism means we can set these deaths aside. Dying elders are less dramatic, even more expected than younger people expiring.  (COVID killed 1 out of every 100 senior in America so far.  1%!)

On top of this is COVID fatigue. It’s something the study of historical precedents caused us to expect. Every plague is exhausting to the survivors for obvious reasons: extra work for precautions, maybe additional labor for some, and the terrible emotional toll.  When I mention this point every audience has nodded, wearily, in recognition. Heading into the pandemic’s third year, we are bone weary of it. Ian Bogost has recently written movingly on the topic, if you’d like a good sample.

I see this in small personal actions when I “travel” – i.e., visit local groceries stores or train into DC and back. There was the young woman on a Metro car who, sitting with friends, fiddled with her mask (getting at jewelry?), then simply let it drop, her mouth and nose bare.  (The Metro requires masking for all passengers.) There are the nearly gas stations where it’s about a 50-50 chance that fellow shoppers – inside the store – will be masked.  There was a cheerful shop owner in his 60s, maybe older, who simply went unmasked.

One more point: while eight hundred thousand is a very round number, it might not be appealing enough.  The first hundred thousand was a major milestone.  Perhaps it’ll take one million to shock us into discussion, or maybe even action.

So what does the death roll and our reaction to it mean? What does this signify for the future?

Extrapolation, always a sketchy tool, suggests we should watch the butcher’s bill continue to build.  There’s no sign of COVID quickly falling below pandemic levels. Nobody’s trying to utterly eliminate the virus.  It’s possible that Omicron and successor variants could be far less fatal *and* rapidly outcompete Delta in the human race, but I think that would take at least a few months.

The next few months: IHME currently forecasts a range of possibilities. For the global total they project six to seven million, depending on public health behavior.

For the United States, a mere 815,000 if we wake up and get serious about vaccination and masking. The worst case blows past one million by March.

As I’ve said elsewhere, Omicron’s arrival can change things up. Early studies find it to be more infectious, spreading more rapidly than prior strains. (one example) (another) It is too early to tell its lethality. It may prove more fatal, in which case the numbers end up approaching the upper bounds of those IHME charts.  The opposite is also possible.

Our collective desire to not look very hard at the death toll should probably continue.  All of the reasons mentioned above – privacy, exhaustion, invisibility, ageism, statistics – seem likely to remain in play.

Now, extrapolation is sketchy, as I’ve said. It misses changes in volume and new developments. It’s possible a rogue storyteller is even now assembling horrifying footage of deaths and editing them into a gripping, viral narrative.  America could suddenly have a reckoning with ageism, perhaps if something happens with our elderly president Biden or, more importantly, a celebrity.  I don’t think these are likely, but I could well be wrong.

Political changes could occur. We can see strong political dimensions in who gets vaccinated, as this Kaiser tracker shows:

Republicans and independents could experience a change of heart, depending on events.  Men, black people, those without college education, and those aged 18-49 could see political shifts that make getting shot more appealing.  I’m not sure this is likely, but American politics famously has the power to confound expectations.

We may also more hatred of the unvaccinated (the vaccine-hesitant, the vaccine-skeptical, the -resistant, etc.) from everyone else. There’s an easy political way to think of this, with Democrats hating Republicans. That leaves out the political complexity of anti-vax behavior, but does contain a chunk of it.  This hatred can take many forms, from seething social relations online and off to driving punitive policies or vigilante action to simple shunning.

Meanwhile, our lousy vaccination and booster rates suggest a nation with plenty of vulnerable people to house the virus.  Unless we change those rates massively Americans will be riddled with COVID.

Further ahead, I wonder if we’ll push hard to consign the past few years to formal memory, especially if the virus drops below pandemic levels. Public statuary in physical or virtual forms (augmented or extended reality) could appear as a way for us to process the events. I’m not sure of this. A century ago American society turned its back on that great influenza very decisively, deliberately trying to not memorialize it, so we have a memory hole precedent.  But perhaps an aging society will try to commemorate the suffering of its elders.

Let’s keep an eye on this.  And what are you seeing for the pandemic’s next phase?

PS: get your vaccines and boosters!

What might we expect from the COVID-19 pandemic’s third year?

Yes, that’s where we are now in this December 2021, running out of the virus’ second year while all indicators are blinking GO! for a third.  Technically, the third COVID year should start in March 2022, since WHO declared the pandemic in March 2020. In fact, Chinese doctors first diagnosed a case of the virus two years ago last week, so we’re in year three of the creature’s overall career nestling within and successfully leaping between human bodies.

In fall 2020 – which feels like a decade ago – I blogged about what a Pandemic Year Three might look like, inspired by Josh Kim. * In this post I’ll update that vision, based on what we’ve learned and experienced since.  In the next I’ll turn to implication for higher education.

To begin with, imagining how the virus spreads and acts through 2022 is difficult.  Many nations, including the United States, gather and share data badly, so our understanding of where COVID stands now is flawed. Worse, we have just detected the Omicron variant. It will take at least a week for us to get an early sense of how it interacts with bodies and vaccines, due to how long it takes to culture samples etc., so there isn’t much we can reasonably speculate upon.  Omicron could outcompete Delta and dominate the (epidemiological) world, or it won’t.  It might spread more rapidly than its priors, or not. It could be more lethal than the rest of COVID strains, or less.

We could see the pandemic rage through 2022 at 2021 levels.  The virus will keep mutating, so we might see some mutations bestride the world: variants Pi, Rho, and so on, each with distinct characteristics and dangers.  Or it could decline in infection rates, dropping out of pandemic status into being merely endemic.  One popular endgame that I and others have imagined is COVID becoming like the seasonal flu.

It kills and sickens people at levels we deem low enough to be acceptable. We take updated shots to reduce our risks.

In short, a huge asterisk hangs over any attempt to forecast about the virus per se.

What we can do with somewhat more confidence is examine what the virus has done to us so far, then study human reactions.  From these we can identify trends, which sketch out one cloudy, contingent vision of 2022.

To begin with, where do things stand now, to the best of our shaky knowledge?

There have been 266,944,804 COVID cases worldwide, according to the Johns Hopkins dashboard (above). JHU also counts 5,268,667 killed by the virus.

  The World Health Organization’s numbers are similar: 265,194,191 cases and 5,254,116 deaths.  In the United States alone the Centers for Disease Control numbers 49,198,746 infections (about 15% of the whole national population) and 787,064 deaths.  In Britain, COVID became the leading cause of death this year.

I can find no reliable numbers of those suffering from Long COVID, partly because of disagreements on definition and diagnosis. If 1% of infected people suffer from that chronic condition, that yields nearly 3 million people suffering for months or years, worldwide.

Again, these numbers are not great right now.  It’s obvious that there are reporting undercounts, thanks to national, local, and cultural reasons. When some researchers compare these stats against pre-COVID death rates, it looks like the real numbers may be 10-20% higher.

To sum up: the pandemic has been a horrendous human catastrophe, killing upwards of 5 million people and sickening – injuring – a much larger number.

How has humanity reacted?

Extrapolation from trends

Our response has been mixed. On the one hand we’ve developed an amazing vaccine – a vaccine platform, really – in an incredibly short period of time. We’ve also produced vast numbers of the stuff and distributed it to some populations.  Billions of people have also learned and practiced public health measures which have changed over time, from social distancing to masking, hand-washing, etc.  Health care professionals and public health workers have done heroic, largely invisible work with awful costs at times. Shut-downs and quarantines have taken place at huge scale and warped individual lives.

On the other… there is broad and international resistance to the vaccines, for a fascinating range of reasons.  The pre-COVID antivax movement plays a role, as do various religious beliefs, suspicion of medical and author authorities, economic fears, not to mention political concerns and conspiracy thinking. In the United States the Kaiser Family Foundation tracks vaccine uptake and resistance, and you can see quite a variation by race, political party affiliation, age, and education:

Beyond the vaccine, a good number of people are evading the other public health measures.  I’m sure readers can share stories of meeting people who semi-mask or just go maskless, or the many cases where social distancing is nonexistent. I experience this myself when I trek across blue counties to Georgetown University (where I teach) and back.

A new Axios poll adds some data to those stories, showing majorities of Americans not bothering with most measures:

Our social and commercial desires win out, it seems.

So there are two opposing trends. One of extensive and intensive research, medical, and public health engagement against another which disengages from these efforts and institutions to varying degrees.  Both sides are dug in with many people passionate about their views and actions. Looking ahead we should expect these two forces to persist and collide, grinding against each other as people try to navigate the pandemic’s third year.  The shifting nature of culture and politics (think about the Q-Anon ferment) means that friction could drive more cultural and political mutation. Taken together, it means humanity will continue to provide some fertile grounds for the virus to till.

A hybrid form of life has emerged, and not only in the sense of those two major attitudinal forces often located together within individual communities.  The pandemic hauled a chunk of the human experience online, deepening digital immersion and drawing some energies away from the in-person realm.

It’s not enough to say “we’re more online than ever,” although that is true, even while tech criticism is mainstream and growing.  It’s not only that online and offline worlds are increasingly intertwined. It’s that we’ve normalized that hybridity.

Think of in-person restaurants. Some have QR codes for menus or augmented reality layers attached for local color, while others have shifted their business out of dining rooms and into delivery (typically organized by digital delivery services). Or think of homes, where digital entertainment occurs in social rooms, and digitally-ordered Amazon boxes thunk on doorsteps. An Uber driver, hailed by mobile app, navigates traffic with eyes, hands, feet, and Google Maps while her passenger Facetimes a friend.  A group of people on a bus or train, masked and (maybe) distanced, avoids conversation in favor of smartphone interactions.

This hybridity isn’t new. It began in a quiet way with the networked digital world in the 1970s and took off with mobile devices in the 1990s.  It describes a digital layer laminated onto the analog world. COVID accelerated its adoption, deepened its uses, and made it mainstream.  From now on we should expect any in-person meeting to be just one visible component of a two-level engagement. On our devices we’ll expect to be able to peer out into other locations and engage with them. Increasingly when we describe a physical space we have to account for its digital layer, with the two ever more intertwined.

Those physical spaces may change as well through 2022.  Since 2020 I’ve been expecting changes to the built environment: more windows and doors, bigger windows and doors, fewer interior rooms without outside exposure, and so on. Architecture can strive to help us combat the virus. I’m not sure to what extent this has been realized so far.

Our interior spaces have also been theaters of combat, and the mental toll exacted has been intense.  Think back to the numbers cited earlier.  The millions dead mean millions more hit by those deaths.  Some of those hundreds of millions infected suffer mentally as well as physically from the encounter; hundreds of millions more had to grapple with that. The economic whirlwinds of 2020 gave many more people fierce stresses of unemployment and financial survival.  The many perceived errors of public health sapped some public faith in the process, yielding uncertainty and fear on top of the overarching dread such a widespread disease inspires.

Years of pandemic psychological stress will yield several effects over the next year.  We should expect more people to be burned out, either on the disease’s front lines or otherwise. Some will turn inwards, away from people, perhaps increasing the proportion of people scoring as introverts.

  Demand for mental health services should boom.

This doesn’t describe everyone, of course.  Some folks batten on crisis. Some viewed themselves as too healthy and virtuous to be negatively impact (my wife can tell stories from her public health work, oh yes). On a related note, others took comfort in culture, religion, or politics and weathered the storm. Some just didn’t get hurt.  And the conservative dislike of psychotherapy, as old as Freud, persists.

To repeat: these are trends from recent history and the present. In the preceding I described them as persisting through the next year on a basic, largely unmodified level.  This is just a starting sketch, since it is likely each development will behave in at least a slightly different way, given the fierce creativity of billions of human beings interacting on a civilizational scale.

What 2020 thought of 2022

As a futurist I routinely examine my older forecasts. This isn’t navel-gazing, but the opposite. It’s a way of checking my work, looking for strengths to maintain and errors to correct.  It should be a professional mandate.

So what did my September 2020 post think of 2022?  Let’s pull out some points.

1. People moving out of crowded cities into the country, or just aiming for less populated spaces. It seems like this was overstated and that urban areas remain powerful social magnets overall.
2. Intergenerational relations becoming more intense. This, too, might be overstated, appearing only in the form of younger folks refusing vaccines etc. because they are very unlikely to be sickened. (Never mind the greater danger of spreading an infectious disease!)
3. Older folks becoming more segregated for safety’s sake.  I am not away of good studies on this.  Anecdotally I can confirm that I had to pass through more hoops this year than in 2019 to see my 90-year-old father in assisted living or rehab.
4. Will the American character change?  I brooded: “I’m not sure if decreased face-to-face contact will confirm Americans in our individualism through isolation or, conversely, stoke our longing for norms, belonging, and conformity.” This seems very hard to quantify or otherwise measure.  I do know it’s popular in the progressive world to criticize individualism. Did COVID boost this line of thought?
5. Americans becoming more religious.  I haven’t seen good evidence for this in terms of established faiths yet. But I was right to assess marginal faiths as taking off and getting creative.  I wish I’d anticipated “pastel Q.”
6. Some businesses suffering, others booming.  Check.
7. Labor market in recession: I clearly missed this one.
8. Supply chains in flux: got it.
9. Left-wing populism rising: I’m not sure about this one.  On the one hand, the Democratic party looks likely to keep up the Biden balancing act between the party’s left, right, and center. On the other, the “great resignation” and talk of strikes suggests some kind of leftward current.
10. Punishment being meted out to those perceived as guilty of pandemic mistakes and crimes: so far this hasn’t really happened.  It was sexual harassment which cost New York’s governor his job, not his COVID mistakes and the coverup thereof. Trump remains a free, if Twitter-less, man. I haven’t seen any vigilante justice.
11. More surveillance and policing: generally yes. Yet I didn’t anticipate that “defund the police” would be as popular as it was in 2020.
12. US-China Cold War deepening: yep.
13. A cultural boom: that seems to be under way. TV continues to be enjoying a renaissance.  Movies are trying to recover. People are reading.  Analog and digital games flourish.
14. Automation expanding: yes.
15. The techlash (popular criticism of Silicon Valley etc.) persisting: check.
16. The climate crisis building: oh yes.

That’s an uneven forecast.  It looks like I was stronger on technology, culture, some economics, and geopolitics than on justice, labor, and generations.  Duly noted for my future work.

Putting all of these strands together yields a richer sketch, from economics to psychology and pop culture.

Yet it leaves out novelty. What new developments should we anticipate?  This, I invite readers to consider and share.

(“Ohne Titel 2022,” by Michi Schwaiger)

*Link fixed.  Thanks, Cogdog!