How has the US performed vis à vis COVID-19? Are we learning to do better?
Alas… no. No, we are not.
As evidence, consider below (1) the state of public health measures world-wide, (2) what the virus seems to be doing, and finally (3) what our crazy reactions have been.
The state of the world
Let’s look at how the COVID-19 pandemic has impacted human welfare, world-wide.
The first question that interests me is: are we still living as long as before, world-wide, or has COVID-19 made an appreciable impact on human longevity? Staying alive is, after all, one of the coarsest-grain measures of well-being.
Alas, the evidence is that apparently we are not:
Here we’re seeing the life expectancy at birth, stratified by region of the world, and shown over the last 70 or so years. A few facts stand out to me:
- The dip in all the curves starting around 2020 indicates that the COVID-19 death toll has been large enough to make average human lifespans shorter. I was worried that this would be the case in the US but not other developed countries, due to our vaccine refusal rate and higher death rate per capita (see below): one of the COVID-19 death risk factors is being an American. However, it appears to be a global effect, which is even worse.
- Then look at the disparity between regions of the world. Why did we build an economic and political system that shortens human lives by 15 years from the accident of birt of being an African? (And why do we continue to tolerate that?)
- Finally, compare the US and Europe. They were broadly comparable in the 1990s, but then Europe made improvements which the US did not. If we were to normalize lifespan by amount of healthcare spending, this would look even worse: the US spends astronomically more on healthcare for lesser results. Our healthcare system is shot through with the rent-seeking middlemen that capitalism seems to spawn frequently.
Via the indispensable Eric Topol, here is some evidence that the US has had the worst of the global COVID-19 deaths per capita: 337 per 100k people. That is significantly larger than most of the rest of the world:
Topol’s point is that the US is at the top of the list, a position he describes as “ignominy”. Sadly, we agree.
But while we’re checking his sources (which is part of what peer review is all about!) we might wonder why China is called out in red, and why it has 2 different values?
That’s because his source is a New York Times article.  It tried to tease apart the puzzle of Chinese COVID-19 statistics, generally woefully inaccurately reported by the Chinese government for political purposes. They use epidemiological models fit to other advanced countries to attempt an estimate of Chinese death rates, given that funeral rates, deaths of prominent academics which are reported internationally, and even crematoria lines are much bigger than would be consistent with the Chinese official statistics:
After China relaxed the world’s most stringent Covid-19 restrictions in December, the virus exploded. Hints of the surge were everywhere: Hospitals turned away patients. Crematories were overwhelmed with bodies. A wave of top scholars died.
But China’s official Covid death toll for the entire pandemic remains strikingly low: 83,150 people as of Feb. 9. That number is a vast undercount…
As you can see in the 2nd graphic, if one employs epidemiological models (based either on Shanghai where better numbers were available, or on travel patterns, or on the US death rates) one gets a picture much different from the official one. There should be 1.0 - 1.6 million dead, not just 83,150.
Indeed, even if one looks only at the official Chinese data, shown in the 3rd graphic of trailing 7 day death rate averages vs time, something fishy is going on. We believe their “COVID 0” policy probably did keep the numbers pretty low, but somehow the real data appears to have leaked out in the January wave. Either the high January data is wrong, or the preceding low data is wrong. They cannot both be right.
- The US has terrible per-capita death rates, arguably the worst in the developed world.
- The Chinese are consistently lying about their data, to no one’s very great surprise.
- Substantially all humanity has shorter average lifespans due to the COVID-19 deaths, with the effects of Long COVID-19 yet to be seen.
The state of the virus
Ok, that’s what the virus did to us in the past. What’s the virus doing now?
Laurie Garrett reports that the excellent GISAID database of SARS-CoV2 sequences observed in patients is all Omicron, all the time, all over the world. For Jan-Feb 2023:
- The pie charts at the top show 100% Omicron sequences all over the world.
- The array at the bottom shows, for 4 weeks before 2023-Jan-24, all over the world Omicron was growing and everything else is pretty much extinct.
So we pretty much have to deal with Omicron, which is why we’re glad here at Château Weekend we got the bivalent classic/Omicron booster last fall. There are a lot of Omicron variants, but XBB1.5 seems to be the current terror. We verified this using the US CDC’s nowcast of variants, shown here.
Yet here’s a video segment from the PBS News Hour broadcast of 2023-Feb-16, showing most Americans simply will not face this. (The video opens at 29:53, which is the segment on long COVID-19.)
- There are still about 2,000 deaths each week. More than 100,000 deaths/year, largely avoidable but for our refusal to face facts and act accordingly.
- Now Long COVID is impairing the lives of something on the close order of several million
Americans(exact number unknown).
- Often it’s hard to get doctors even to take you seriously!
- From one sufferer:
After having COVID the first time and recovering fine, I assumed that having it again wouldn’t be a problem, because I had been OK during my first infection. And I couldn’t have been more wrong.
- David Putrino, neuroscientist and physical therapist, is director of rehab innovation at
the Mount Sinai Health System in New York:
- The heartbreaking stories of people crippled, financially broken, and feeling like their lives are coming to an end are quite common.
- His clinic alone has seen over 3,000 Long COVID patients in the last 3 years.
- In an article in The Lancet, he reports ~200 symptoms associated, affecting
virtually every organ system. It’s a portfolio of conditions caused by an underlying
acute viral infection.
All we can do right now is symptom management. … But we’re not curing them. We’re getting them to the point where they may be a little more functional.
But what we understand very clearly is that … this is not a psychological illness. This is not a psychosomatic illness.
We need the public to understand that dying is not your only risk of serious life-changing effects from having an acute COVID infection. And we need the government to support a lot more in the way of infection prevention.
- An (uncited) article in Nature Reviews Microbiology estimates that there are about 65 million people world-wide with Long COVID. If we estimate the US at 4.25% of world population, that works out to 65 million * 0.0425 = 2,762,500 Long COVID cases in the US.
- The Omicron lineage is the terroir du jour, namely XBB.1.5 at this particular time.
- Long COVID is a severe danger which imposes disability for years, and currently afflicts about 6 million world-wide and about 2.7 million in the US (rough estimates).
Our crazy reactions, or: why our death rate is so high
Ok, that’s what the virus is doing. Are we reacting intelligently, or even slightly more intelligently than at the beginning of the pandemic?
Stupidity is always a capital crime when Nature is the judge. The whole point of civilization is to be less brutal than Nature, but we seem to be failing that test of civilization.
To wit, the following from neo-fascist America:
Idaho legislators propose to criminalize mRNA vaccines
Via the still-indispensable Eric Topol comes a story gleefully reported by the Fox ‘News’ Republican propaganda channel: a bill in the Idaho legislature to criminalize giving mRNA COVID-19 vaccines! 
Just because nobody should depend on the odious Fox ‘News’ for anything, we confirmed this with a parallel story in Talking Points Memo.  Even with one confirming source, that’s… well, pretty breathtaking. So we dug up the bill text , shown here. The relevant bits are in Section 18-296:
18-926. ADMINISTERING AN MRNA VACCINE. (1) Notwithstanding any other provision of law, a person may not provide or administer a vaccine developed using messenger ribonucleic acid technology for use in an individual or any other mammal in this state.
(2) A person who violates this section is guilty of a misdemeanor.
What is it about mammals: I can vaccinate my pet fish, but not my cat? Or is it a category error to attempt to make sense of this?
In particular, at least one of the legislators in question, Idaho Sen Tammy Nichols, owns up to this bill, and is proud enough of it to tweet about it with her own name attached:
Now, to be sure, this is proposed legislation, at a state level, and untested in court. Most proposed laws die in ignominious obscurity. The scary part is that this wasn’t laughed out of the legislature, and that it proposes all of us should also die in ignominious obscurity without vaccination.
I mean, just consider how bone-headed stupid you have to be to say this publicly, and put your name on it. (Were it a joke on Nichols perpetrated by another legislator, it would have been marginally funny. Especially the floor debate.)
Florida Republicans pass resolution to ban COVID-19 vaccines
Via PZ at Pharyngula comes news that the Florida, the Official Hell-Hole of the United States, Republicans passed a resolution giving the governor — the fascist Ron Desantis — the power to ban COVID-19 vaccines!
Now, let’s be fair: this is a resolution, not a binding law. And it’s the product of the Republican party at the Lee County level, not in general. But it does take the ideological temperature, and the reading is ugly. They don’t just want to push back on vaccine mandates, or refuse to get the vaccine themselves; they want to use state power to force the rest of us to remain unvaccinated in spite of clear medical findings to the contrary by the FDA and CDC.
The author is one Joe Sansone, who described his motivation as (emphasis mine):
The Lee County Republican Party is going to be on the vanguard of this campaign to stop the genocide because we have foreign non-governmental entities that are unleashing biological weapons on the American people.
Umm… what?! You think COVID-19 is a foreign bio-weapon, and you think the correct response is to ban vaccines so nobody will be protected? Pick a side, dude!
Or, in the words of Forbes:
Stop the genocide? Foreign non-governmental entities unleashing biological weapons? Holy space-laser-operating-lizard-alien-living-on-a-flat-Earth-with-a-5G-transmitter.
Apparently that’s not weird enough for Sansone, because he also claimed:
If you got this shot, you go home and hug your pregnant wife—she can have a miscarriage through skin contact.
So… he thinks we vaccinated people are somehow shedding paraproteins or something that puts unvaccinated people in danger, e.g., of miscarriage?
It gets worse. If you look at the close-up WINK News obtained of some of the text of the resolution, you can see some pretty claims that are not just wrong, but verging on psychotic delusions, making at least the following nonsensical claims:
- “strong and credible” evidence that both COVID-19 and the vaccines are bioweapons
- Pfizer’s clinical trial of their vaccine somehow had 1223 deaths (the real number is 0), as well as 158,000 adverse events (impressive, in a trial with only 43,548 participants!)
- “strong and credible” evidence that mRNA vaccines alter human DNA (truly, stupendously ignorant)
- massive government and corporate fraud across FDA, CDC, Pfizer, Moderna, media, tech companies all conspired together to lie about this (a classic schizophrenia delusion of persecution, especially given what we know about the lifetime of such conspiracies)
- the clinical trials constituted a “violation of the Nuremberg Code and therefore constitute crimes against humanity” (a classic schizophrenic delusion of grandeur)
I’m desperately hunting for some redeeming social value here, so let’s dig into this guy Joe Sansone a bit and see if he’s maybe a bit better than all this looks.
From his Psychology Today profile  we see that he’s a licensed psychotherapist, practicing in Florida. A few queasy feelings bubble to the top when we see that he strongly emphasizes hypnosis as his main therapeutic mode, that all sessions are in person, not by telehealth, and he prefers cash or credit card payments instead of insurance.
Ok, that’s a bit queasy, but… let’s give him the benefit of the doubt and look further.
What are his credentials? He has bachelors, masters, and doctoral degrees, which is pretty good. But his doctorate is from Sofia University (not the one in Bulgaria), of which I had never heard before. So… what’s that?
The front of the Wikipedia page on Sofia University warns us that it appears to be written as an advertisement, and the talk page warns the text is largely copied from the Sofia web site. It’s a private, for-profit university… which is kind of the last straw for me.
It grew out of something called the California Institute for Transpersonal Psychology. What’s that? Wikipedia helpfully informs us that transpersonal psychology “may be” a fringe theory, and the explanation even in Wikipedia may not give appropriate weight to the mainstream view.
Transpersonal psychology, or spiritual psychology, is a sub-field or school of psychology that claims to integrate the spiritual and transcendent aspects of the human experience with the framework of modern psychology. The transpersonal is defined as “experiences in which the sense of identity or self extends beyond (trans) the individual or personal to encompass wider aspects of humankind, life, psyche or cosmos”. It has also been defined as “development beyond conventional, personal or individual levels”.
Ok, that’s really the last straw. I’m a religious person myself, but one simply does not mix religion with medical therapy or psychotherapy. While my religion can inform me on why I need to practice with compassion and generosity, it does not override the science behind how I choose to do my work. I’m happy to explore the possibility of a spiritual side to humanity, but therapy is medical treatment, not spiritual advice.
Conclusion: This resolution is full of lunatic conspiracy theories, written by a person who practices psychotherapy emphasizing hypnosis and cash payments, with a degree from what is apparently a private/for-profit pseudo-university, and mixes his religious preferences with therapy on his clients.
Ladies and gentlemen, your modern Republican party.
Montana legislators propose to forbid the vaccinated to donate blood
I’ve now forgotten who showed me this; that’s good, because I’m pretty sure I don’t want to repeat the journey. It appears the Montana legislature has introduced House Bill 645, to prevent vaccinated people from donating blood. 
Do you remember how the unvaccinated took to calling themselves “purebloods”?  It’s a weird mash-up of the canard that mRNA vaccines alter your DNA making your “blood impure” (racist dog-whistle), and the “pureblood” magical families of the Harry Potter novels. Do they just not get the fact that the purebloods were the bad guys in those books? They were the racists of the magical world, the analog of Nazis demanding racial purity. (A good heuristic: once you identify the Nazis, pick the other side.)
Apparently in Idaho this extends to not wanting to “mix blood” (another racist trope) of the vaccinated and unvaccinated. If you have the stomach to wade through the intellectual sewage, I recovered the text of the bill  – and it’s about as bad as you think.
Extreme anti-vaxxers propose masking… around vaccinated people!
Usually vaccine conspiracy theories go along with stubborn refusal to wear masks. Oddly, some of the vaccine kooks are convinced, like Joe Sansone in the Florida bill above, that vaccinated people are somehow dangerous. So now they’ll be wearing masks to protect themselves from vaccinated people:
“Vaccine shedding”… of what, exactly? Paraproteins? Alien DNA? My mind is so thoroughly boggled, I’m getting boggle fatigue.
The Weekend Conclusion
Oh, good grief, as Charlie Brown used to say. As if there isn’t enough real crap in the world to worry about: Russian genocide in Ukraine, fascism revenant world-wide, Republicans trying to slash Social Security/Medicare/Medicaid, banning books from schools, arresting drag performers, and a litany of other woes.
Notice that all the delusional, coercive, and cruel things above come from red states in the US. They’re so hungry for paranoia, they have to make up things to fear.
This is not without historical precedent. Back in the Victorian period, when London began to introduce sanitation measures like clean water sources and sewage processing, people actually resisted. We are reminded of this by Kashif Pirzada, and emergency physician who spends his off hours in the honorable endeavor of fighting misinformation. Here he’s showing us extracts from the Times of London from 1848 - 1854:
That seems worth fact-checking, since it’s such a body-slam to compare vaccine resistance to the resistance against clean water, sewage processing, and just washing. So, we checked this in Snopes  and got a thumbs up: yes, this really was a thing.
It appears in the last nearly 2 centuries, conservative thinking has not evolved a bit. They resisted public health then, and they still do. The thing about “public health” is that you can’t omit the “public” – it really has to be a collective endeavor, or it won’t work.
The right-wing allergy to anything “collective” is sometimes lethal.
Now, you might reasonably accuse me of indulging a taste for schadenfreude pie (homage à Scalzi) here. Just looking at the examples above, there is some partial truth to that.
But it’s also true that I’ve got some personal skin in the game here, avoiding COVID-19. Consider what Delthia Hicks has to say here about the frequency and severity of Long COVID-19:
Now, here at Château Weekend we got COVID-19 last August, due to my forced confinement in close quarters with unmasked knuckleheads on a shuttle bus. We both recovered, thanks to paxlovid. But I got a rebound, and was basically incapacitated for a month.
Here we are, 7 months later. I still have some mild cognitive impairment. I can’t really multitask. It’s difficult to pick up new things, especially when spoken rapidly by people I don’t know. My writing is much slower:
- I used to take apart a scientific paper, get the data, reanalyze it, compare conclusions, and write up a critique in about 2 days.
- Now it takes me weeks to do the same thing, sometimes reading the same paragraphs 10 times without really getting it.
I started this post on 2023-Mar-03. It doesn’t contain any mathematical analysis, just reading and summarizing. But even so, it took me almost 2 weeks to get it up.
Much of my mind is not yet healed. While I know on some level that it takes 7-9 months for “brain fog” to clear up  , it’s nonetheless a difficult wait. Being able to use my mind effectively has been a huge part of my identity ever since childhood; COVID-19 has thus far taken that away from me.
I hope that since 7 months have elapsed, I should be returning to normal soon. But I have daily fears that I might not.
So yeah, it’s kinda personal with me.
Notes & References
2: K Morris, “Two Idaho lawmakers introduce legislation to criminalize giving out certain COVID-19 vaccines”, Fox ‘News’, 2023-Feb-17. ↩
5: BY Lee, “Lee County, Florida, Republican Party Passes Resolution To Ban Covid-19 Vaccines”, Forbes, 2023-Feb-24. ↩
6: M Hudak & T Wirtz, “Lee County GOP passes ‘Ban the Jab’ resolution to ban COVID vaccines in Florida”, WINK News (southwest Florida news station), 2023-Feb-21. ↩
7: C Alexander, “COVID-19 vaccination associated with 15% reduction in stillbirths in pregnant women”, Press releases of Royal College of Obstetricians & Gynaecologists, 2022-May-10. ↩
8: S Prasad, et al., “Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy”, Nature Communications, 13:2414, 2022-May-10. ↩
10: N Girten, “Bill banning vaccinated blood donations would ‘decimate’ blood supply, opponents say”, Daily Montanan, 2023-Feb-27. ↩
11: AC Gilbert, “Some unvaccinated TikTokers are calling themselves ‘pureblood,’ in latest concerning trend”, USA Today, 2021-Sep-16. ↩
12: G Kmetz, “(Montana) HB 645: AN ACT REVISING LAWS RELATED TO THE DONATION OF BLOOD AND TISSUES; PROHIBITING CERTAIN DONATIONS OF BLOOD AND TISSUES; PROVIDING A PENALTY; REVISING IMMUNITY PROVISIONS RELATED TO BLOOD AND TISSUE BANKS; CREATING AN EXEMPTION FROM THE PROHIBITION ON DISCRIMINATION BASED ON VACCINE STATUS FOR THE SCREENING AND TESTING OF BLOOD AND TISSUES; AMENDING SECTIONS 49-2-312 AND 50-33-104, MCA; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE.”, Montana Legislature, 2023. ↩
13: D Emery, “Did London Times Editorialize Against Being ‘Bullied into Health’ in 1800s?”, Snopes, 2023-Jan-15. ↩
14: H Davis, et al., “Characterizing long COVID in an international cohort: 7 months of symptoms and their impact”, The Lancet, 2021-Jul1-15. DOI: 10.1016/j.eclinm.2021.101019.
See § 3.3.1: 55.5% (CL: 52.5% - 58.8%) of patients still experienced “brain fog” in month 7, so that’s close enough for me to the median time to recovery. So, to my mind I say: see you in 2023-Feb. It’s very frustrating to hear people say “COVID’s over, man!” when the consequences to me personally are somewhat high. ↩
15: C Callan, et al., “‘I can’t cope with multiple inputs’: a qualitative study of the lived experience of ‘brain fog’ after COVID-19”, BMJ Open, 2022-Feb-11. DOI: 10.1136/bmjopen-2021-056366. ↩