Tomorrow: David Wallace-Wells
New York magazine|February 15–28, 2021
Imagining a COVID Endgame “Should we be satisfied with just slightly speeding up the status quo?”

SINCE ALMOST THE BEGINNING of the pandemic, Harvard’s Michael Mina has been among the country’s most outspoken epidemiologists, urging the public-health apparatus toward a more responsive and creative approach to managing the crisis. In particular—despite maddening resistance from the medical Establishment—he has advocated for mass deployment of rapid tests, similar to home pregnancy tests, to help curb the spread of the virus. We spoke in mid-February with vaccine distribution in full swing—and the threat of new strains on the horizon.

How do you see the state of things? I’m having a hard time juggling the bad news about strains versus the good news about vaccines. My personal feeling is we are seeing the benefits of seasonality hit, which I know some of my colleagues don’t necessarily agree with. But it’s not uncommon for coronaviruses to essentially start dropping around now. Most of the known coronaviruses have something on the order of a three-month window where they’re really infectious. We don’t fully understand why seasonality works like this, but if the trajectory stays this way and we also start to achieve some level of herd effects or herd immunity, I think the next few months could start to offer a reprieve. Ideally, that will last through the summer until we get into next fall when we’ll probably have another wave.

You didn’t mention the vaccines. I’ve been very, very disappointed at how the vaccine rollout has gone thus far.

Because of the slowness? Because of the extremely medical-centric view of prioritizing doctors and health staff. In the hospitals, they were vaccinating 20-year olds who are sitting behind a computer and don’t even see patients. And there are patients in the same hospitals who are 65, at very high risk, who have to wait. Vaccines are now starting to get to the more vulnerable populations, and that’s going to start quickly changing the risk-benefit ratio. We’ll see hospitalizations drop. From there, we need to have a hard discussion about “Okay, what is our endgame here?”

What is the endgame? I still to this day have not heard a goal for testing and for vaccination. More broadly, are we trying to get covid to zero, or are we trying to get covid to a point where it’s palatable for society, it’s not overburdening the hospitals, and it’s essentially looking like flu? Those are really different things.

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