COVID Won’t End Up Like The Flu. It Will Be Like Smoking.
Description
Hundreds of thousands of deaths, from either tobacco or the pandemic, could be prevented with a single behavioral change.
The end state of this pandemic may indeed be one where COVID comes to look something like the flu. Both diseases, after all, are caused by a dangerous respiratory virus that ebbs and flows in seasonal cycles. But I’d propose a different metaphor to help us think about our tenuous moment: The “new normal” will arrive when we acknowledge that COVID’s risks have become more in line with those of smoking cigarettes—and that many COVID deaths, like many smoking-related deaths, could be prevented with a single intervention.
The pandemic’s greatest source of danger has transformed from a pathogen into a behavior. Choosing not to get vaccinated against COVID is, right now, a modifiable health risk on par with smoking, which kills more than 400,000 people each year in the United States. Andrew Noymer, a public-health professor at UC Irvine, told me that if COVID continues to account for a few hundred thousand American deaths every year—“a realistic worst-case scenario,” he calls it—that would wipe out all of the life-expectancy gains we’ve accrued from the past two decades’ worth of smoking-prevention efforts.
The COVID vaccines are, without exaggeration, among the safest and most effective therapies in all of modern medicine. An unvaccinated adult is an astonishing 68 times more likely to die from COVID than a boosted one. Yet widespread vaccine hesitancy in the United States has caused more than 163,000 preventable deaths and counting. Because too few people are vaccinated, COVID surges still overwhelm hospitals—interfering with routine medical services and leading to thousands of lives lost from other conditions. If everyone who is eligible were triply vaccinated, our health-care system would be functioning normally again. (We do have other methods of protection—antiviral pills and monoclonal antibodies—but these remain in short supply and often fail to make their way to the highest-risk patients.)Countries such as Denmark and Sweden have already declared themselves broken up with COVID. They are confidently doing so not because the virus is no longer circulating or because they’ve achieved mythical herd immunity from natural infection; they’ve simply inoculated enough people.
President Joe Biden said in January that “this continues to be a pandemic of the unvaccinated,” and vaccine holdouts are indeed prolonging our crisis. The data suggest that most of the unvaccinated hold that status voluntarily at this point. Last month, only 1 percent of adults told the Kaiser Family Foundation that they wanted to get vaccinated soon, and just 4 percent suggested that they were taking a “wait-and-see” approach. Seventeen percent of respondents, however, said they definitely don’t want to get vaccinated or would do so only if required (and 41 percent of vaccinated adults say the same thing about boosters). Among the vaccine-hesitant, a mere 2 percent say it would be hard for them to access the shots if they wanted them. We can acknowledge that some people have faced structural barriers to getting immunized while also listening to the many others who have simply told us how they feel, sometimes from the very beginning.
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