Michael Lewis On Covid And Grieving

Michael’s latest book, The Premonition, spotlights a band of dissenting doctors that battled the inept government response to Covid-19.

You can listen to the episode right away in the audio player embedded above, or right below it you can click “Listen in podcast app” — which will connect you to the Dishcast feed. For three clips of my conversation with Michael — on how we should approach Covid right now, on why Americans in particular are so vulnerable to viruses, and on the profound grief of losing a child — head over to our YouTube page.

The Covid-related conversation from our main page continues below. This first reader sums up many of the dissents from parents:

I enjoyed your perspective last week on the virus, masking, and lockdowns, but you made a major mistake: Children who can’t get vaccinated and the societal costs of long COVID behoove those of us who are vaccinated to work together to protect others. There is also the evolutionary biology, which you do touch on, but more infections mean more mutations and a more complex vaccination strategy going forward. So I think indoor masking for now in areas above public-health threshold levels of infections are important. Yes, the recalcitrant and stupid should get vaccinated. But a really important demographic (children) can’t yet, so it’s not fair to pursue policies that we know will unfairly penalize them. I am not a parent, but when I talk with those who are, they are terrified.

“Terrified” is not a reasonable response to the reality, even though, of course, it’s understandable. And if taking these measures, we keep slowing down the trajectory of the pandemic, we also extend the time for the virus to mutate and evolve again. There isn’t a perfect solution. But I don’t think my trade-off is reckless.

From a parent:

I agree wholeheartedly with your assessment of the path forward on the COVID front — i.e., not delaying any longer the point at which this virus is no longer novel to significant elements of humanity. But there’s one important caveat: kids. I know that children generally don’t face the same level of risk as do adults (this guest essay on Zeynep’s stack explains why), and I’m biased by being the father of two young girls, but I think it’s reasonable to think about bringing back some NPIs [non-pharmaceutical interventions] over the next bunch of months until we have vaccines approved for children.

Notice I am *not* saying the same thing about the severely immunocompromised, for whom the vaccines may be truly ineffective. Unfortunately, it seems to me that that population may have to continue to avoid high-risk settings and/or wear high-filtration masks until the pandemic has truly subsided and case rates have come way down — and we’ll be there sooner if we “let it rip,” as you say.

Let’s hear from a reader who is immunocompromised:

I must say that I am quite taken aback by your prescription, Andrew. You see, I’m a responsible person who eagerly got doubly vaccinated as soon as I could. Like all my friends, family, and colleagues, I was excited and relieved to be protected against an insidious virus.

However, unlike my friends, family, and colleagues, I am immune-compromised with a very rare disease that, without medication, would leave me blind and paralyzed. That medication, I have come to find out, leaves me unprotected against Covid-19. So, unlike you and your friends in Ptown, if I get infected, there’s a relatively good chance I will have more than a brief period of the sniffles, feeling sick and missing the chance of having a great night out. In fact, you and I live with this virus in a crucially different way: there’s a good chance that I would require hospitalization, suffer serious consequences, and die if I were exposed to it. 

But that is what you gladly foresee and accept by allowing natural forces to take over, right? 

I cannot put myself in your shoes of living with HIV, so I don’t know what you’ve gone through over the years. But please put yourself in mine. Vaccinated people can be effective passive carriers of the highly-contagious delta variant. 

That being the case, I still need to sequester myself in my apartment, with very limited person-to-person contact for about a year and a half. Would that I could go to a bar or any indoor place. I wasn’t able to be with my elderly mother in her final days to comfort her, nor was I able to attend her funeral or burial services. 

What do we do in the meantime while the vaccine-deniers reach their moment of awareness? I’m sorry that you feel that taking sensible institutional measures to protect the continued vulnerable is unfair and constraining. But it is the last line of a defense that, I hope, others can provide me. After all, aren’t we all in this together? Or are the immune-compromised expendable? 

You wrote, “And this seems to me to be the key question here: do we really want to get back to living? I do.” Yeah, so do I.

But again, slowing the pandemic down won’t help you. It will actually extend the period you have to be sequestered from the world. Another vulnerable reader takes the opposite approach to Covid:

It’s striking how resonant your column was to me, a 36-year-old double lung transplant survivor of 20+ years. The odds were 9 to 1 against me at the time, and to this day I battle with chronic rejection and pulmonary hypertension secondary to two decades on borrowed organs. I have a fraction of a healthy person’s breathing reserve, and any infection that is even moderately severe would likely take me out.

Yet I find myself of your same mindset. People like us are acutely aware of the paradox inherent in the efforts to STAY alive while also … living. I’ve become so sensitive to the tradeoffs myself that, reasonably or not, it feels a moral indignation when others can’t seem to process mortality *as part of* living. You articulated well the almost incontrovertible fact that Covid, in some form, will become endemic, and that any notion of wiping it completely from Earth is nothing short of hubristic. Such an achievement, at least in the short term, would be genuinely miraculous.

In case it’s not obvious, I am vaccinated. But I’m glad you pointed out that “in a free society, coercion is not an option.” If the cost of liberty is the consequences of our personal decisions, then it is a fair price and a just bargain every time. Freedom, and all the baggage it has, is what makes life simultaneously beautiful and tragic. As one of the “vulnerable,” all I’ve ever expected from society was a fair shot at survival, which all the initial mitigation efforts were there to accomplish. In a post-vaccine world, all that can reasonably be done already has been, and I know that my unique burdens are back to being my own to bear. Life has to go on, unencumbered, unless a singularly virulent threat re-emerges.

I’m also maddeningly frustrated with the general illiteracy of the public (at the hands of the media) as it pertains to most of this topic — everything from vaccine science to the limits of masks to appropriately sizing up Delta. The belligerence and conspiratorial activity on the right, as you wrote, will sort itself out in a grim Darwinian way. But poor comprehension and misinformation from left of center is particularly asinine because it’s accompanied by the usual self-righteousness: The “party of science” routinely gets science wrong or zeroes in on things like Provincetown to the exclusion of the big picture that demonstrates cases have become decoupled from hospitalization and death. The split realities along partisan lines are growing increasingly divergent.

So on that note, thank you as always for being the signal through the noise.

You’re welcome. And I think you’re right that living for decades with a potentially fatal virus shifted my perspective. Another reader goes into more detail about our depressing new normal:

You make a compelling case as always, and I’d love to get on board, but I can’t stop thinking about our local healthcare systems and their ability, or lack thereof, to deal with a resurgent Covid outbreak. It’s not a matter of just letting the vaccine/mask hesitant deal with their own choices — all that s**t rolls downhill.

Last year, as you will recall, the lack of available beds in many locales due to hospitals being at or near capacity with Covid cases led to many “important but not urgent” medical procedures to be postponed, sometimes for six months or more.  This led to great suffering for many, and at worst, appears to have led to some additional needless deaths because many of those procedures, while they could be put off for some amount of time, certainly do not have an unlimited timeframe for delay.

But the more pressing concern revolves simply around the people who man our healthcare system. Knowing what our nurses, doctors, PAs and everyone else involved in that sector went through last year, especially in hard hit areas, I have to believe there are many who would be ready to hang it up and just find another career rather than deal with that again, especially when they know it’s all so preventable at this point.

What’s going to happen if many of those folks stop showing up for work? We already can’t find workers for much easier jobs than being a nurse in an ICU.  And it won’t be just folks with Covid who are left sitting outside hoping to see someone, anyone. It’ll be the rest of us too. Maybe you break a bone, or maybe you get strep and you need to see someone … hurry up and wait, and hope it doesn’t get worse.

I actually agree that the best way for the recalcitrant to get on board is to let them see and experience the suffering. As you said, that’s proven. But I don’t agree that we can just let the experiment run freely with NO other mitigations. There’s A LOT of risk in that strategy. As I said, s**t rolls down hill.

Lastly, an impassioned dissent from a vaccine holdout:

According to USAfacts.org’s US Coronavirus vaccine tracker, as of July 31, 2021, exactly half of the population has been fully vaccinated. I think we can safely assume that a significant percentage of the unvaccinated feel so uncomfortable with the shot that they are willing to risk the virus instead of the shot’s potential side effects. Simply put, they do not trust the vaccine.

Why, you might ask? Well, I invite you to google “What are the long term side effects of the COVID19 vaccine” and reply to me directly with any concrete answers you manage to uncover. You really can’t. Because it’s not there. Sure, we can find some vague opinions by nameless experts on the CDC’s website [link unavailable], such as the following:

Regarding Long Term Side Effects: Because all COVID-19 vaccines are new, it will take more time and more people getting vaccinated to learn about very rare or possible long-term side effects.

Unfortunately this still doesn’t answer the question. What are we up against in the future? No one can say with concrete evidence. You might argue, that’s because there is nothing to worry about. Well, I don’t buy that. I know people in my own circle who have experienced heart issues, long-term fevers, menstrual changes and frequent illness since being vaccinated. That’s within months, imagine years.

You may tell me to “listen to the science” — to Tony Fauci and whomever he deems “expert” enough to impart knowledge. We aren’t presented with a diverse panel of doctors with varying views on the subject, despite knowing other opinions are out there and they do exist. No no no. Those alternate opinions are quickly censored so that we are subject ONLY to the information that the White House chooses not to wipe clean from the internet. A generic panel of “doctors and experts” with the same exact viewpoint as the man/women/x/y/z sitting next to them. All approved by one institution that a large part of the country, make that the world, does not trust.  

I am not vaccinated. Clearly. I have no intention of getting vaccinated. Clearly. And do you want to know why? Not one person from the CDC or otherwise has compassionately addressed the very real fears that many of us have surrounding this shot. Not one “expert” has given any feedback or concrete evidence regarding the hesitations that are plaguing the un-vaxxed. At least, no one has done that from a place of respect and understanding that I have been made aware of.

Not at all. We have been attacked and vilified for it. Sounds a little like, oh I don’t know … cancel culture? I know how much you like that!

Have you considered that your fears around the virus are just as debilitating as mine are around this shot? Look at what I am willing to give up to avoid this injection: ease of travel, visits with COVID-obsessed grandparents, a movie in Paris, a new job … do you think I am doing this to be selfish? To be as “delusional and deranged” as you so eloquently put? To “live in denial”? Why do you assume I have “somehow convinced myself that the virus is a hoax or a deep-state plot or a function of white supremacy or whatever…”?

Because you are a bully. Because you are selfish. Because you haven’t bothered to put yourself in the shoes of those of us on the other side. Because you don’t care about MY health even though I am supposed to care about YOUR health. Because you, like much of vaccinated society, has decided that I am a monster, that I am unrealistic, that I am a conspiracy theorist, that I am “not nearly as smart” as POTUS thought I was because I am not at all comfortable with the possible repercussions of this shot.

Perhaps I am just real, I am human, having a human experience. Perhaps I have fears like you do — my fears just happen to be about something else, something you cannot relate to. Why does this put me in the category of “deranged” human being? I have very legitimate questions! My questions are NOT being answered. My fears are NOT being addressed with the data I would require to make this decision. And until they are, I will hold on to my sovereignty and my right to CHOOSE the trajectory of my health without being openly bullied by someone who doesn’t value it as I do.

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