Photo: Susan Walsh/Getty Images
Life can only be understood backward, but it must be lived forward, the philosopher Søren Kierkegaard once asserted. And so it goes with public policy. It’s easy, in retrospect, to criticize any particular decision and express exasperation with the experts who handed down their decrees. A full five years has come and gone since the coronavirus began infecting and killing Americans. It was exactly this week, in 2020, when COVID officially entered the mass consciousness: The NBA suddenly canceled its season, Tom Hanks announced he had tested positive for the new virus, and Donald Trump delivered a disorienting Oval Office address.
As much as we would like to pretend otherwise, we all carry COVID scars. More than 1 million Americans are dead. We’ve either lost loved ones or know those who have suffered mightily. We’ve all, inevitably, had COVID ourselves, and some iterations of the virus were far from mild. Children, teenagers, and young adults lost some of their most formative years to Zoom screens. Remote work hollowed out the downtowns of many cities. The inflation that the pandemic at least partially triggered lingers to this day. In 2019, few were talking about a nationwide housing crunch or the hefty cost of groceries. Life today is far better than it was during the depths of the pandemic: Tourism roared back, restaurants filled again, and the economy is far stronger than it was in the spring of 2020, when many feared a second Great Depression was upon us. But we can’t undo the loss of life nor the loss of time.
What could have been done differently? With five years of hindsight, what sort of decisions should politicians and public-health officials have made? What were the worst avoidable mistakes? There are no easy answers. But given that we now live in a period of surging anti-vaxx sentiment and distrust of the public-health Establishment, it can be reasonably argued that several messaging and policy failures helped power the return of Trump and the installation of Robert F. Kennedy Jr. as the secretary of Health and Human Services.
First, it’s important to establish what the public-health Establishment — and liberals, broadly — got right about COVID. The coordinated citywide and regional lockdowns in the early weeks of the pandemic were successful at averting mass death. In King County, home to Seattle, and the Bay Area of California, local leaders worked closely with governors to communicate effectively with the public and rapidly close down any venues where mass gatherings might occur. The coronavirus arrived earliest there and it was little-heralded leaders like Jay Inslee, then the governor of Washington, who took the pandemic seriously and helped to keep his state’s death rate among the very lowest in America over the next several years. When vaccines were unavailable, early action was pivotal. California, too, would suffer through subsequent COVID waves, driving its death rate up, but it still lost fewer lives, relative to its population, than other states that were ravaged at a comparable time.
As governor, Andrew Cuomo was initially celebrated for his pandemic leadership, delivering press briefings that were watched by millions. Several scandals would subsequently dent that popularity, including his alleged manipulation of the death-toll data in nursing homes and his decision to accept more than $5 million to write a pandemic memoir, but it’s been mostly forgotten that Cuomo, in the earliest weeks of COVID’s appearance in the U.S., was likening the virus to the common flu and downplaying its potential devastation. Cuomo, who is now running for mayor, actually dithered over locking down New York City, blocking his political rival, Mayor Bill de Blasio, from initially issuing a shutdown order. Public-health researchers found this delay might have led to many thousands of deaths as COVID tore through the region.
In hindsight, though, certain kinds of lockdowns lasted too long. It was sensible to close schools in March 2020 and let children learn remotely for the rest of the school year. But the decision, in certain big city and suburban school districts, to institute remote learning for the entirety of 2020 and 2021 proved disastrous. Children themselves, and young people broadly, were far less likely to die of COVID and could have, in most instances, safely gone to school to learn and socialize. Teachers were more vulnerable, but relatively few of them belonged to the most threatened cohort of Americans: the elderly and the immunocompromised. There’s mounting evidence to suggest that school closures contributed to devastating learning loss and stunted social development. Some students dropped out and never returned.
Public-health officials and politicians greatly erred, too, in shuttering parks, playgrounds, beaches, and other outdoor spaces where people could have clustered more safely. The padlocking of playgrounds was as absurd as shaming Floridians for heading to the beach. The public-health Establishment should have been honest with Americans: The pandemic was going to be a multiyear endeavor, and this meant that it was unsustainable to curtail human interaction indefinitely. Go outside and wear a mask was simple enough messaging. Absolutism did not work, and only provoked backlash. There was a fantasy, in the first months of COVID, that millions of people, acting together, could collectively will the pandemic away. No country could do this — not even those, like China and New Zealand, that implemented extraordinarily aggressive lockdown measures.
Neither political party knew how to talk about the COVID vaccine sensibly. After taking credit for Operation Warp Speed, which quickly funded the development of the Pfizer, Moderna, and Johnson & Johnson vaccines, Trump pivoted to strenuous vaccine skepticism because that’s where Republicans had migrated during Joe Biden’s presidency. Conservatives pitched ineffective alternative cures and cooked up lies about the vaccine, blaming it for every sudden death or claiming it could alter a person’s DNA. In poorer, rural states, which are now disproportionately Republican, the decision of some conservatives with comorbidities to refuse vaccination probably contributed to the mass deaths there. The states with the highest COVID death rates — including Kentucky, West Virginia, and Mississippi — overwhelmingly backed Trump.
But Democrats — and the left-leaning public-health officials they staunchly supported — peddled what would be, in retrospect, their own misinformation. In early 2021, the COVID vaccines were sold as a miracle cure that could stamp out the pandemic for good. Public-health officials like Dr. Anthony Fauci promised that vaccinated individuals would be much less likely to spread the virus. The idea was wrongheaded, if straightforward enough: Get a COVID vaccine and you’d no longer be a vector for the coronavirus. This would prove wildly untrue as 2021 dragged on and new variants of COVID, like Delta and Omicron, appeared. Should public-health officials be blamed for not foreseeing any kind of COVID mutation? Probably. Or, if they’re spared, they can certainly be accused of failing to adjust their messaging once it became obvious the vaccinated and unvaccinated could equally infect others.
Perhaps no policy did greater damage to the cause of vaccination in America than the vaccine mandates that mostly Democratic mayors and governors imposed in 2021 and 2022. If they did spur an uptake in vaccination rates, they also alienated millions of Americans, many of them working class, who could not understand why the status of their employment was now bound to their personal medical decisions. Teachers, sanitation workers, and military personnel were all fired for refusing the vaccine, and the unvaccinated were barred in certain Democrat-run states and cities from a wide range of jobs and greater public life. The political fallout, for the left, was severe: formerly liberal individuals driven rightward, the deep reddening of Florida, and the rise of RFK Jr., who rode decades of anti-vaccine activism to Washington, D.C.
A more effective and humane approach would have been to heavily market the COVID vaccine to the elderly and the immunocompromised. Vulnerable populations needed protection. Forcing the vaccine on children and teens made less sense, however, and bred long-lasting suspicion of public-health authorities. Entirely downplaying the reality of vaccine injuries — a small percentage of the population experienced adverse side effects, like myocarditis — only further fanned the flames of conspiracy. And not every vaccine manufacturer produced a sterling product: Both the AstraZeneca and Johnson & Johnson vaccines were eventually pulled from the market altogether, with the former causing rare, fatal blood clots. If vaccine injuries, like the possibility of COVID’s origin in a Wuhan lab, were discussed and debated more honestly from the beginning, enormous gaps would not have opened up for misinformation and conspiracy to take root.
What the federal government should be doing now — and tragically will be doing little of, thanks to Trump — is investing significantly in vaccine research, especially as bird flu becomes a greater threat and makes the leap to infecting humans. Luckily, bird flu is far less contagious among humans than the coronavirus. In the future, though, new pandemics might arise, those that combine the transmissibility of COVID with a virus that has a higher fatality rate. The federal government should invest in new hospital capacity or at least have a working plan to immediately assist states with providing excess beds in the event hospitals rapidly fill up. Decades of consolidations and closures have left cities and rural areas alike bereft of functioning hospitals. In New York City, hospitals were immediately overwhelmed, and lives might have been saved if some of the old hospitals in the outer boroughs that were shuttered decades ago were still able to receive COVID patients.
In the interim, public-health authorities should reckon with where their messaging went awry — and the policies they championed that proved counterproductive. Americans craved honesty and consistency in a terrifying time; they didn’t often get it. It’s hard to know how the nation would react if another pandemic appeared tomorrow. We can only hope it never does.
