Character and Covid

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Does our uniquely American character doom us to failure in the fight against Covid?

It certainly seems so. On a per-capita basis, we are among the global “leaders” in cases and deaths worldwide, although part of our “leadership” may be due to better and more honest reporting. We hold this unenviable position despite being among the first to develop, produce and approve effective vaccines, despite our highly-praised biomedical R & D, and despite being generally recognized as the wealthiest nation on Earth.

Now, as the new omicron variant spreads worldwide, our economy and our lives are again becoming precarious. It’s worth some effort to analyze why.

Our “American pastime,” baseball, is a rare national game. To my knowledge, it’s the only one in which you can “steal” victory. If the pitcher or base players aren’t paying attention, a runner can “steal” a base. A runner can even “steal” home base for a point or for victory. Imagine a football player winning a goal without putting the ball into the net or (in the American version) over the goal line or between the posts. It can’t happen.

Arguments are not unique to our nation. But they certainly are characteristic of our national tribe. The players huddle around a besieged umpire, shouting and gesticulating, arguing over a close play. Sometimes a close call even produces a brawl. Instant-replay helps, but only a bit. As long as there are different points of view and different opinions, there will be vehement conflict among us.

That’s why we have umpires, and that’s why their jobs are so hard. And the same facet—dare I write “defect”?—of our national character makes the US by far the most litigious country on Earth. Right now we have dozens of lawsuits ongoing, all over our country, about what, if any, measures various levels of government, public-health services and even private business can take to protect us against Covid-19. Everybody has an opinion, regardless of medical knowledge or expertise; no one is shy about asserting it.

But the virus that causes Covid-19 is not a human ball player. It’s not an umpire or a judge. Although it can force human cells to reproduce itself, it’s an inanimate biomechanical instrument of sickness and death.

You can’t beat it, as if stealing a base, by escaping its attention or by arguing with authority. You can’t “steal” your health back once it gets in your lungs, your heart, your kidneys or your brain. And as we know now, this virus is capable of infecting and ruining almost every organ in your body. In some so-called “long-haulers,” it can produce long-lasting, even lifelong, suffering that makes life a living Hell.

The virus is an equal-opportunity destroyer. It can infect vaccinated people. Even if it doesn’t make them very sick, it can make them carriers who pass the virus on to others. Then they can get sick, especially if unvaccinated.

The virus is also a relentless changeling. It’s genome consists of 29,903 RNA base pairs (nucleotides). Of those, 3,831 encode for the so-called “spike” protein—the genetic “key” that admits the virus into human cells. In the latest or “omicron” viral variant, more than 30 of those base pairs have changed. That’s about 1% of the spike-encoding genome.

What causes these random changes? Physics, chemistry and biology. Random thermal fluctuations, cosmic rays and various chemical effects cause “errors” as the virus reproduces in human or animal cells. As noted in an earlier post, this mutation is an automatic, inescapable and unstoppable process.

The more people and animals the virus infects, the faster mutations arise. The speed of mutation is roughly proportional to the number of infected bodies. The more infections we allow, they greater the risk of another devastating variant.

That’s why the vaccination and infection rates in the global south matter to us in the global north. The more people who get infected globally, the greater the chances of Covid-19 morphing from a difficult pandemic into a global death plague comparable to the Black Plague of the Middle Ages. Every new infection brings that potential catastrophe a tiny bit closer to reality. For every thousand additional infections, the roulette wheel of suffering and death spins faster.

At the moment, vaccines are our best measure of protection. But the best vaccines—Pfizer’s and Moderna’s mRNA vaccines—have a weakness. They teach our bodies to produce antibodies against the spike protein, which unlocks our cells’ walls and lets the virus in.

That kind of vaccine was a brilliant scientific development. Unlike old-fashioned “killed-virus” vaccines, it contains no other part of the virus. In particular, it contains none of the genomic material that lets the virus force our cells to reproduce itself. So there is absolutely no way—even in theory—that an mRNA spike-protein vaccine can itself cause Covid-19. (It can, in theory, cause unrelated side effects, such as myocarditis, but actual experience shows these effects are extremely rare. They are orders of magnitude lower than similar side effects of vaccines routinely given for other diseases.)

Yet this feature of the mRNA vaccines is a two-edged sword. While it means the vaccines themselves can’t possibly cause Covid-19 or anything like it, it also gives the virus an evolutionary opening. If the virus mutates to change its spike protein so as to avoid the antibodies that these vaccines teach our bodies to produce, the mutated spike protein can still enter our cells. Then the mutated virus might evade the mRNA vaccines’ protection, or at least make them less effective.

Even then, all is not lost. The beauty of the mRNA vaccine technology is that it makes vaccine development a bit like programming a computer. No matter how the virus mutates, scientists can sequence its spike-protein genome, copy it, and make a vaccine that will produce antibodies to the mutated protein. According to news reports, they can do this in less than 100 days. The rest is up to the regulators, who must insist that even modified vaccines be tested for side-effects and other unintended consequences.

So here’s the big picture. As the virus unstoppably mutates, it creates a game of vaccine “whack-a-mole.” Air travel may be one of the greatest miracles of human civilization, but it’s also the fastest means our species has ever developed to spread infectious disease around the globe. So air travel gravely accelerates the game of “whack-a-mole.”

Already air travel is a big reason why many experts think it’s too late to stop the new omicron variant from spreading as widely and as disastrously as did the delta variant before it. It takes less than a day to fly halfway around the world. But the virus’ incubation period is from five to eight days. So before you know it—before passengers themselves can even suspect it—the omicron virus might be in your city. Recently 61 people tested positive for Covid-19 on two flights from South Africa. They were being tested for the omicron variant, which requires more careful genetic sequencing to detect.

What’s the solution? There’s no magic bullet, no single solution. Of course our already overworked biomedical researchers should get to work preparing an mRNA vaccine for the omicron variant. Of course our regulators should consider ways to expedite approval of new-variant vaccines while maintaining the assurance of safety and effectiveness that’s the linchpin of the whole vaccine system.

But we also have to get back to basics. We have to use all the tools at our disposal: (1) masking whenever among strangers, (2) social distancing, and (3) testing, contact tracing and quarantining/isolation. Most of all, we have to stop trying to “steal bases” against an implacable and ever-changing enemy. We have to stop arguing with the umpires (our biomedical and public health experts) and get serious about Covid discipline. If we don’t, the omicron variant could devastate our lives and our global economy once again, just as did the original virus and the delta variant now dominating the globe.

Our much-vaunted primate brains are supposed to make us more adaptable than other species and therefore better able to survive. But so far, we have been extraordinarily slow to learn from experience with Covid-19. The divergent reactions of cruise lines and airlines illustrate just how slow.

My wife and I recently took a short five-day ocean cruise. It was our first more-than-overnight joint vacation since the pandemic began. We chose this particular cruise because we could easily drive to and from it, without getting on an airplane. We felt safe because of the Covid precautions that our cruise line (Princess) took. Those precautions are rapidly becoming a cruise-industry standard.

Each and every passenger and crew member had to be vaccinated before boarding. All had to show original evidence of vaccination, either an original CDC vaccination card (not a copy) or an official online record. Every passenger also had to have a negative Covid test taken within 48 hours of boarding plus third-party documentation of that test (eliminating self-administered tests). Everyone on board also had to wear masks in public areas, except when eating or drinking. (The crew enforced this rule especially in food-dispensing areas, as I learned when I forgot my mask one time. I felt safer for the reminder and thanked the attendant for reminding me.)

As far as I could tell, the cruise line also had made some effort to increase the distance between tables in restaurants and bars. Best of all (for the passengers’ safety, not the line’s income), the number of passengers on board was less than half the ship’s rated capacity. Management apparently accommodated this reality by reducing the ship’s staff and closing several common areas, including certain dining rooms and bars.

Contrast these admirable safety precautions with what the airlines have done or, more to the point, what they still have not done. To my knowledge, no domestic airline requires passengers to be vaccinated at all. (Qantas does on trans-Pacific flights Down Under.)

A few airlines, including United, require crew to be vaccinated. But what good does that do passengers, whose interaction with crew is momentary and sporadic? What about the six or so surrounding passengers, who may be complete strangers, sitting well within the recommended six feet, and eating or drinking with no masks or letting their masks slip down below their noses?

And how, pray tell, can you get away from a mask scofflaw who “just knows” he or she won’t get Covid, on a full plane? (I’ve actually met two people who said that: their blind faith did not impress me, except as a mark of their ignorance of medicine and biology.) On a big cruise ship, it’s easy to walk or sit away from people whose actions show they don’t take the virus seriously.

In contrast to cruise lines, airline management has been about as unresponsive to the pandemic as it’s possible to be. And so we have the third dangerous variant in less than two years (original, delta and omicron) spreading unstopped around the globe at a little less than the speed of sound, courtesy of an industry that still doesn’t get it.

No doubt the clueless airline CEOs wonder why all those unused aircraft are still sitting out in the middle of the Mojave desert gathering dust and producing no revenue. The only way to get them back in the air is to take every reasonable precaution against Covid and let prospective passengers know, by means of consistent safety requirements strictly enforced. Then maybe people like me, and millions of others, will feel safe to fly again.

Russian peasants have a saying. When gardening, you might step on the short end of a rake, so that the long handle rises up and hits you in the head. If you do that once, it can be a sign of bad luck. If you do it twice, it’s a sign of stupidity. At least so goes the saying.

So far, we have suffered two serious variants of Covid-19, the original one and the delta variant. Each time, we Americans have stepped on the short end of the rake, hoping that the virus would bypass our economy without us having to accept the rules and discipline required for masking, distancing, testing-tracing-and-isolation and, eventually, near-universal vaccination. Each time, we’ve experienced localized and regional infection spikes, overwhelmed hospitals and public-health systems, and consequent drops in those oh-so-precious economic indicators.

Now the third dangerous variant, omicron, is upon us. I wonder whether we’ll finally get smart. If not, I wonder what a good Russian peasant would say about us as we step on the short end of the rake for the third time.

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