Dealing with a changing pandemic

Covid-19 is now almost entirely a problem only for the unvaccinated.  Within the US, roughly half the population is now vaccinated, yet 99.5% of covid-19 deaths are occurring among unvaccinated people, as are over 90% of hospitalizations.  Even when a vaccinated person gets the disease, it is far less likely to result in death or serious symptoms than in an unvaccinated person.

At the same time, due to the spread of the delta variant, covid-19 is becoming more dangerous to the unvaccinated than it was earlier in the pandemic.  More young people are developing serious cases, and people are dying faster.

So the US population is now bifurcated into two groups among whom the pandemic is following opposite trajectories.  Among the vaccinated, it is petering out and disappearing.  But among the unvaccinated, it is resurging and becoming deadlier than ever, including among younger people who previously were at much lower risk.

Moreover, which group a person is in is now almost entirely a matter of choice.  The vaccines are easily available in great abundance all over the country.  In most cases, people stay unvaccinated only because they choose to be so (there are a few exceptions such as illegal aliens who shun contact with anything they associate with government authority, or legal minors whose freedom of choice is overridden by anti-vax parents).  In most cases the rejection of vaccination is rooted in willful refusal to accept the known facts about the dangers of covid-19 and the efficacy of the vaccines, which in turn is rooted in political or religious ideology.  Anyone who regularly reads right-wing blogs and "news" sites knows that that camp's opposition to vaccination is firm and truculent.  In one recent notorious case, the audience at CPAC actually cheered news of the country's failure to reach its vaccination target.  Making covid-19 vaccination compulsory would fail for the same reason alcohol prohibition failed and sex-work prohibition fails and gun prohibition would fail.  It's not possible to enforce laws which a large part of the population, including many of the people who would need to do the enforcing, simply don't accept as legitimate.

So, the militantly unvaccinated are pretty much unreachable.  The government has done what it can.  It's time to accept that that element of the population has chosen to leave itself vulnerable to disease and death, and leave them to face the consequences of their decision, since doing so no longer poses much threat to the vaccinated.

(Also, to be blunt, the kind of people who reject science in favor of ideology, who threw tantrums at the minor inconvenience of wearing masks to protect others, who cheer at the failure of a public-health campaign, who mostly voted for Trump and continue to embrace the hateful bullshit he represents -- these are the kind of people the country would better off with fewer of, anyway.)

The objection is sometimes made that allowing covid-19 to fester endemically in a large sub-population will facilitate the continuing appearance of new variants, perhaps eventually one which would be resistant to the existing vaccines and thus threaten the vaccinated population.

Here's the critical thing to remember about that point, though.  To the extent that this is a possibility, it makes no difference whether the unvaccinated people you're talking about are inside the United States or outside it.  The delta variant originated in India and spread very rapidly all over the world, just as the original covid-19 itself originated in China and did the same.  This will be the case with future variants as well.  National borders have proven pretty much irrelevant to the spread of this disease.  If you are a vaccinated American worried about unvaccinated populations fostering the rise of a new variant which could defeat the vaccines, then an unvaccinated individual in Bengal or Ethiopia presents exactly the same risk to you as an unvaccinated individual in Florida or Missouri does.

The differences between the two cases are (a) most unvaccinated Americans have already decided to reject the vaccine and any further efforts to get them to accept it are likely to be futile, whereas most unvaccinated people in Asia, Africa, and Latin America do want the vaccine but cannot obtain it due to supply problems; and (b) the unvaccinated population in Asia, Africa, and Latin America is far larger than the unvaccinated population in the US, so the risk of a dangerous new variant arising there is correspondingly greater.

So, even if you care only about the security of our own country (and I would hope that most people reading this do also care about Asians, Africans, and Latin Americans for their own sake), the most effective course of action now is to do all we can to increase the supply of vaccines to countries where many people want those vaccines but cannot get them.  This could involve suspending the patent-law obstacles which now inhibit more widespread vaccine manufacturing, and/or increasing our own production so that we can provide greater supplies to other countries.  We're already doing this to some extent, but far more is needed.

The US is not an island, and 96% of the world is outside the US.  That point must always be front and center of all our thinking about global problems like pandemics and climate change.  Nature pays little heed to human-drawn lines on maps.