Issue of the Week: Disease, Population, Human Rights, Ecomomic Opportunity, Personal Growth
Five years of Covid, The Atlantic, The New York Times, March 2025, Illustration by Ben Hickey
Five years ago, the Covid pandemic hit in full force. It’s abated enough to seem slghtly more like history, even though it still is taking lives and is in a kind of limbo as to what happens next.
What will happen next for sure is another pandemic, worse, that we are not prepared for, that we even bring on, by reckless and increasingly inhumane health policies.
Two years ago, we posted the following, as it appeared the pandemic may be winding down:
Three years ago this month, the Covid pandemic hit with full force. Today, the first day of March, 2023, we begin year four.
We’re looking back. We’re still in it. We’re looking forward.
We don’t know where we are.
We don’t know what hit us.
How could we?
Nothing like it has ever happened.
Worse plagues and calamities of various kinds?
Yes.
But never in this age of all things connected in so many ways from personally to globally.
Never a consciuosly shared experience by all humanity at once quite like this.
And the impact on us, from personal, to physical, to emotional, to cognitive, to ecomomic, to social, to political, to historical, to spiritual–impossible still to fully disect for any of us.
The news is full of where did it start and how was it covered up. It has been before and will be again. Just as it has been and will be again on the millions infected and killed. And the myriad medical questions, answers and realities of the disease. And the inter-related dynamics in an inter-related world of the causes and effects of pandemics, which may be the end of us as likely as anything.
But now we all are, and hopefully in the future will be, survivors.
Which starts with focussing, the seemingly most impossible thing to do.
Nothing has done a better job of helping us to do so, which means to survive in any meaningful way, than the cover story in last Sunday’s New York Times Magazine.
The first words are from 2020:
“March is such a blur”
On the first day of March, 2023, it still is.
Here’s the article:
After you’ve finished, fast forward two years to this March,
to now,
with two remarkable articles from The Atlantic and The New York Times:
WHY THE COVID DENIERS WON
Lessons from the pandemic and its aftermath By David Frum, The Atlantic, March 2025
Five years ago, the coronavirus pandemic struck a bitterly divided society.
Americans first diverged over how dangerous the disease was: just a flu (as President Donald Trump repeatedly insisted) or something much deadlier.
Then they disputed public-health measures such as lockdowns and masking; a majority complied while a passionate minority fiercely resisted.
Finally, they split—and have remained split—over the value and safety of COVID‑19 vaccines. Anti-vaccine beliefs started on the fringe, but they spread to the point where Ron DeSantis, the governor of the country’s third-most-populous state, launched a campaign for president on an appeal to anti-vaccine ideology.
Five years later, one side has seemingly triumphed. The winner is not the side that initially prevailed, the side of public safety. The winner is the side that minimized the disease, then rejected public-health measures to prevent its spread, and finally refused the vaccines designed to protect against its worst effects.
David A. Graham: The noisy minority
Ahead of COVID’s fifth anniversary, Trump, as president-elect, nominated the country’s most outspoken vaccination opponent to head the Department of Health and Human Services. He chose a proponent of the debunked and discredited vaccines-cause-autism claim to lead the CDC. He named a strident critic of COVID‑vaccine mandates to lead the FDA. For surgeon general, he picked a believer in hydroxychloroquine, the disproven COVID‑19 remedy. His pick for director of the National Institutes of Health had advocated for letting COVID spread unchecked to encourage herd immunity. Despite having fast-tracked the development of the vaccines as president, Trump has himself trafficked in many forms of COVID‑19 denial, and has expressed his own suspicions that childhood vaccination against measles and mumps is a cause of autism.
The ascendancy of the anti-vaxxers may ultimately prove fleeting. But if the forces of science and health are to stage a comeback, it’s important to understand why those forces have gone into eclipse.
from march 2020 to February 2022, about 1 million Americans died of COVID-19. Many of those deaths occurred after vaccines became available. If every adult in the United States had received two doses of a COVID vaccine by early 2022, rather than just the 64 percent of adults who had, nearly 320,000 lives would have been saved.
From the January/February 2021 issue: Ed Yong on how science beat the virus
Why did so many Americans resist vaccines? Perhaps the biggest reason was that the pandemic coincided with a presidential-election year, and Trump instantly recognized the crisis as a threat to his chances for reelection. He responded by denying the seriousness of the pandemic, promising that the disease would rapidly disappear on its own, and promoting quack cures.
The COVID‑19 vaccines were developed while Trump was president. They could have been advertised as a Trump achievement. But by the time they became widely available, Trump was out of office. His supporters had already made up their minds to distrust the public-health authorities that promoted the vaccines. Now they had an additional incentive: Any benefit from vaccination would redound to Trump’s successor, Joe Biden. Vaccine rejection became a badge of group loyalty, one that ultimately cost many lives.We want to believe that somebody is in control, even if it’s somebody we don’t like. At least that way, we can blame bad events on bad people.
A summer 2023 study by Yale researchers of voters in Florida and Ohio found that during the early phase of the pandemic, self-identified Republicans died at only a slightly higher rate than self-identified Democrats in the same age range. But once vaccines were introduced, Republicans became much more likely to die than Democrats. In the spring of 2021, the excess-death rate among Florida and Ohio Republicans was 43 percent higher than among Florida and Ohio Democrats in the same age range. By the late winter of 2023, the 300-odd most pro-Trump counties in the country had a COVID‑19 death rate more than two and a half times higher than the 300 or so most anti-Trump counties.
In 2016, Trump had boasted that he could shoot a man on Fifth Avenue and not lose any votes. In 2021 and 2022, his most fervent supporters risked death to prove their loyalty to Trump and his cause.
why did political fidelity express itself in such self-harming ways?
The onset of the pandemic was an unusually confusing and disorienting event. Some people who got COVID died. Others lived. Some suffered only mild symptoms. Others spent weeks on ventilators, or emerged with long COVID and never fully recovered. Some lost businesses built over a lifetime. Others refinanced their homes with 2 percent interest rates and banked the savings.
We live in an impersonal universe, indifferent to our hopes and wishes, subject to extreme randomness. We don’t like this at all. We crave satisfying explanations. We want to believe that somebody is in control, even if it’s somebody we don’t like. At least that way, we can blame bad events on bad people. This is the eternal appeal of conspiracy theories. How did this happen? Somebody must have done it—but who? And why?
Compounding the disorientation, the coronavirus outbreak was a rapidly changing story. The scientists who researched COVID‑19 knew more in April 2020 than they did in February; more in August than in April; more in 2021 than in 2020; more in 2022 than in 2021. The official advice kept changing: Stay inside—no, go outside. Wash your hands—no, mask your face. Some Americans appreciated and accepted that knowledge improves over time, that more will be known about a new disease in month two than in month one. But not all Americans saw the world that way. They mistrusted the idea of knowledge as a developing process. Such Americans wondered: Were they lying before? Or are they lying now?
In a different era, Americans might have deferred more to medical authority. The internet has upended old ideas of what should count as authority and who possesses it.
The pandemic reduced normal human interactions. Severed from one another, Americans deepened their parasocial attachment to social-media platforms, which foment alienation and rage. Hundreds of thousands of people plunged into an alternate mental universe during COVID‑19 lockdowns. When their doors reopened, the mania did not recede. Conspiracies and mistrust of the establishment—never strangers to the American mind—had been nourished, and they grew.
the experts themselves contributed to this loss of trust.
It’s now agreed that we had little to fear from going outside in dispersed groups. But that was not the state of knowledge in the spring of 2020. At the time, medical experts insisted that any kind of mass outdoor event must be sacrificed to the imperatives of the emergency. In mid-March 2020, federal public-health authorities shut down some of Florida’s beaches. In California, surfers faced heavy fines for venturing into the ocean. Even the COVID‑skeptical Trump White House reluctantly canceled the April 2020 Easter-egg roll.
And then the experts abruptly reversed themselves. When George Floyd was choked to death by a Minneapolis police officer on May 25, 2020, hundreds of thousands of Americans left their homes to protest, defying three months of urgings to avoid large gatherings of all kinds, outdoor as well as indoor.
On May 29, the American Public Health Association issued a statement that proclaimed racism a public-health crisis while conspicuously refusing to condemn the sudden defiance of public-safety rules.
The next few weeks saw the largest mass protests in recent U.S. history. Approximately 15 million to 26 million people attended outdoor Black Lives Matter events in June 2020, according to a series of reputable polls. Few, if any, scientists or doctors scolded the attendees—and many politicians joined the protests, including future Vice President Kamala Harris. It all raised a suspicion: Maybe the authorities were making the rules based on politics, not science.
The politicization of health advice became even more consequential as the summer of 2020 ended. Most American public schools had closed in March. “At their peak,” Education Week reported, “the closures affected at least 55.1 million students in 124,000 U.S. public and private schools.” By September, it was already apparent that COVID‑19 posed relatively little risk to children and teenagers, and that remote learning did not work. At the same time, returning to the classroom before vaccines were available could pose some risk to teachers’ health—and possibly also to the health of the adults to whom the children returned after school.
David Frum: I moved to Canada during the pandemic
How to balance these concerns given the imperfect information? Liberal states decided in favor of the teachers. In California, the majority of students did not return to in-person learning until the fall of 2021. New Jersey kept many of its public schools closed until then as well. Similar things happened in many other states: Illinois, Maryland, New York, and so on, through the states that voted Democratic in November 2020.
Florida, by contrast, reopened most schools in the fall of 2020. Texas soon followed, as did most other Republican-governed states. The COVID risk for students, it turned out, was minimal: According to a 2021 CDC study, less than 1 percent of Florida students contracted COVID-19 in school settings from August to December 2020 after their state restarted in-person learning. Over the 2020–21 school year, students in states that voted for Trump in the 2020 election got an average of almost twice as much in-person instruction as students in states that voted for Biden.
Any risks to teachers and school staff could have been mitigated by the universal vaccination of those groups. But deep into the fall of 2021, thousands of blue-state teachers and staff resisted vaccine mandates—including more than 5,000 in Chicago alone. By then, another school year had been interrupted by closures.
by disparaging public-health methods and discrediting vaccines, the COVID‑19 minimizers cost hundreds of thousands of people their lives. By keeping schools closed longer than absolutely necessary, the COVID maximizers hazarded the futures of young Americans.
Students from poor and troubled families, in particular, will continue to pay the cost of these learning losses for years to come. Even in liberal states, many private schools reopened for in-person instruction in the fall of 2020. The affluent and the connected could buy their children a continuing education unavailable to those who depended on public schools. Many lower-income students did not return to the classroom: Throughout the 2022–23 school year, poorer school districts reported much higher absenteeism rates than were seen before the pandemic.
Teens absent from school typically get into trouble in ways that are even more damaging than the loss of math or reading skills. New York City arrested 25 percent more minors for serious crimes in 2024 than in 2018. The national trend was similar, if less stark. The FBI reports that although crime in general declined in 2023 compared with 2022, crimes by minors rose by nearly 10 percent.
People who finish schooling during a recession tend to do worse even into middle age than those who finish in times of prosperity. They are less likely to marry, less likely to have children, and more likely to die early. The disparity between those who finish in lucky years and those who finish in unlucky years is greatest for people with the least formal education.
Will the harms of COVID prove equally enduring? We won’t know for some time. But if past experience holds, the COVID‑19 years will mark their most vulnerable victims for decades.
the story of covid can be told as one of shocks and disturbances that wrecked two presidencies. In 2020 and 2024, incumbent administrations lost elections back-to-back, something that hadn’t happened since the deep economic depression of the late 1880s and early 1890s. The pandemic caused a recession as steep as any in U.S. history. The aftermath saw the worst inflation in half a century.In truth, the story of COVID is a story of strength and resilience.
In the three years from January 2020 through December 2022, Trump and Biden both signed a series of major bills to revive and rebuild the U.S. economy. Altogether, they swelled the gross public debt from about $20 trillion in January 2017 to more than $36 trillion today. The weight of that debt helped drive interest rates and mortgage rates higher. The burden of the pandemic debt, like learning losses, is likely to be with us for quite a long time.
Yet even while acknowledging all that went wrong, respecting all the lives lost or ruined, reckoning with all the lasting harms of the crisis, we do a dangerous injustice if we remember the story of COVID solely as a story of American failure. In truth, the story is one of strength and resilience.
Scientists did deliver vaccines to prevent the disease and treatments to recover from it. Economic policy did avert a global depression and did rapidly restore economic growth. Government assistance kept households afloat when the world shut down—and new remote-work practices enabled new patterns of freedom and happiness after the pandemic ended.
The virus was first detected in December 2019. Its genome was sequenced within days by scientists collaborating across international borders. Clinical trials for the Pfizer-BioNTech vaccine began in April 2020, and the vaccine was authorized for emergency use by the FDA in December. Additional vaccines rapidly followed, and were universally available by the spring of 2021. The weekly death toll fell by more than 90 percent from January 2021 to midsummer of that year.
The U.S. economy roared back with a strength and power that stunned the world. The initial spike of inflation has subsided. Wages are again rising faster than prices. Growth in the United States in 2023 and 2024 was faster and broader than in any peer economy.
Even more startling, the U.S. recovery outpaced China’s. That nation’s bounceback from COVID‑19 has been slow and faltering. America’s economic lead over China, once thought to be narrowing, has suddenly widened; the gap between the two countries’ GDPs grew from $5 trillion in 2021 to nearly $10 trillion in 2023. The U.S. share of world economic output is now slightly higher than it was in 1980, before China began any of its economic reforms. As he did in 2016, Trump inherits a strong and healthy economy, to which his own reckless policies—notably, his trade protectionism—are the only visible threat.
In public affairs, our bias is usually to pay most attention to disappointments and mistakes. In the pandemic, there were many errors: the partisan dogma of the COVID minimizers; the capitulation of states and municipalities to favored interest groups; the hypochondria and neuroticism of some COVID maximizers. Errors need to be studied and the lessons heeded if we are to do better next time. But if we fail to acknowledge America’s successes—even partial and imperfect successes—we not only do an injustice to the American people. We also defeat in advance their confidence to collectively meet the crises of tomorrow.
Perhaps it’s time for some national self-forgiveness here. Perhaps it’s time to accept that despite all that went wrong, despite how much there was to learn about the disease and how little time there was to learn it, and despite polarized politics and an unruly national character—despite all of that—Americans collectively met the COVID‑19 emergency about as well as could reasonably have been hoped.
The wrong people have profited from the immediate aftermath. But if we remember the pandemic accurately, the future will belong to those who rose to the crisis when their country needed them.
This article originally misstated the U.S.’s gross public debt in 2017 and early 2025. It appears in the March 2025 print edition with the headline “Why the COVID Deniers Won.”
ABOUT THE AUTHOR
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David Frum is a staff writer at The Atlantic.
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“Covid’s Deadliest Effect Took Five Years to Appear”, The New York Times
March 10, 2025
By Siddhartha Mukherjee
Dr. Mukherjee, a physician and scientist, is the author of “The Emperor of All Maladies” and “The Song of the Cell.”
Listen to this article · 15:35 min Learn more
By Siddhartha Mukherjee
Dr. Mukherjee, a physician and scientist, is the author of “The Emperor of All Maladies” and “The Song of the Cell.”
February 2025. A blustery morning. I alight, a little breathless, from the subway at 168th Street and walk the oddly deserted blocks toward the hospital where I work. I hear a distant cough. A windblown plastic bag tumbles along the sidewalk and lodges itself in the skeletal branches of a tree. The familiar, insistent whine of an ambulance rises in the distance.
It has been five years since the world was blown into the tumult of a lethal pandemic. Back then, deserted streets and distant coughs, to say nothing of ambulances docking into hospitals, would have carried a very different meaning. But as Proust wrote, the moments of the past do not remain still. We have metabolized a global trauma — millions of deaths, nations brought to their knees, a generation scarred by grief, isolation and loss — so rapidly that it seems, at times, not to have happened at all.
As the pandemic rose, I saw my patients get sick and in some cases die, including a 42-year-old mother of two young children whose loss is seared into my soul. As it receded, I served on then-Gov. Andrew Cuomo’s commission to rebuild New York’s health infrastructure. Back then, the overwhelming public sentiment was: never again. Today, it seems: never what?
But Covid didn’t just change billions of individual lives. It changed our country’s basic approach to public health, in fundamental ways that are becoming fully visible only now — and that the Trump administration looks likely to render irreversible.
It was sometime in the thick of the pandemic, in January 2021, that I reread John M. Barry’s superlative book “The Great Influenza,” which tells the story of the 1918 pandemic and the birth of public health as a discipline in the United States. Before that, shielding the population from disease was primarily the domain of either individual heroic doctors such as John Snow (who solved London’s 1854 cholera epidemic by tracking its epicenter to a contaminated water pump — and, so the story goes, breaking off the handle) or civic interventions such as the new sewer system that London installed to address the Great Stink of 1858.
That ad hoc approach changed in October 1918, when William Welch inaugurated a school of public health at Johns Hopkins University in Baltimore. Its trainees would learn to dissect patterns of disease in populations, just as a pathologist might perform an autopsy on an individual patient. They would confront future epidemics and health crises systematically, through public institutions, issuing mandates, dispensing carefully vetted information and managing the surveillance and containment of contagion — tools that, as Mr. Barry notes, lack the drama of individual heroism but have saved countless millions of lives.
Mr. Barry has written no fewer than five afterwords for his book, the most recent in 2021, while the world was still adjusting to the novel coronavirus. In it he wrote that one of the great lessons of the 1918 pandemic is that “public health measures — the nonpharmaceutical interventions of social distancing, proper ventilation” and so on — “work.” I’ve seen it myself, at times of crisis and times of calm, in New York, across the country, around the world.
It came as a surprise for me, then, when Dr. Céline Gounder, an infectious disease doctor and a member of President Joe Biden’s Covid-19 Advisory Board, said that public health was nearly dead. It was October 2024, and we were seated in a chilly tent at the National Academy of Medicine meeting in Washington.
Dr. Gounder was referring to what she calls the “unglamorous public infrastructure” — the interlocking institutions that function constantly and invisibly and don’t depend on private enterprise or personal decisions. Yes, we conquered Covid, but “if we are inclined to think of our victory against Covid as a public health success,” she warned me, “we should really reconsider.”
What seemed to succeed, instead, was a deployment of private enterprise (backed by state subsidies): the invention of vaccines by pharmaceutical companies; their delivery in significant measure through private hospitals and clinics; the ascendancy of private decision making by individuals, schools and businesses; and the surveillance of the pandemic by private institutions.
Covid was a privatized pandemic. It is this technocratic, privatized model that is its lasting legacy and that will define our approach to the next pandemic. It solves some problems, but on balance it’s a recipe for disaster. There are some public goods that should never be sold.
Dr. Gounder checked off the basic mechanisms by which public health experts confront a pandemic: They create systems to understand and track its cause and spread; they identify the people most at risk; they deploy scalable mechanisms of protection, like air and water sanitation; they distribute necessary tools, such as vaccines and protective gear; they gather and communicate accurate information; and they try to balance individual freedoms and mass restrictions.
In the case of Covid, each of these responsibilities became increasingly relegated to the private sphere. In one of President Trump’s first national speeches about Covid, he told the nation, “You’re going to be hearing from some of the largest companies and greatest retailers and medical companies in the world.” And so we did.
As the new administration engulfs Washington, we are witnessing the further, and perhaps final, phase of this retreat. In its first weeks, the Trump administration announced far-reaching cuts in the Centers for Disease Control and Prevention as well as reportedly severe restrictions on the kind of research its employees can conduct. It moved to dismantle the U.S.A.I.D., even though the agency funds crucial health efforts around the world, including an early detection system for epidemics. The president proposed slashing funding for medical research at universities. And of course, to lead the Department of Health and Human Services, he chose Robert F. Kennedy Jr., who might have done more than anyone else alive to recast the miracle of vaccines as a dark and dangerous conspiracy.
The mechanisms that Dr. Gounder identified may no longer function at all. Their time of death will be this chaotic political moment. But the illness set in during the pandemic.
Let’s begin with vaccination. The fight against Covid has been repeatedly told as a technological story and a story of corporate heroism. In record time, four major pharmaceutical companies — Pfizer, Moderna, AstraZeneca and Johnson & Johnson — created the vaccines that were used most to vaccinate the world. Pfizer’s and Moderna’s, in particular, are triumphs of science: Building on the prior work of academic scientists, they established the use of mRNA as a platform for vaccination. Drew Weissman and Katalin Karikó deservedly shared the 2023 Nobel Prize in Medicine for their research on mRNA; it is notable, however, that while they receive wide mention in the story of vaccine development, the decades-long funding of their science by public institutions such as the National Institutes of Health (which has also funded some of my research) is often left out. The “Moderna vaccine” is as much the “N.I.H. vaccine.”
The first Trump administration deserves fair praise for accelerating the development of these vaccines through Operation Warp Speed, a public-private partnership. But it was the private sector that prevailed and will be remembered.
In the United States, vaccines were delivered through an often ad hoc and chaotic system managed nominally by the government — but almost entirely run by private hospitals, clinics, pharmacies and district-run vaccination centers that relied on private-public partnerships. There was no federal system for scheduling the shots. Instead, countless different systems bloomed, many created by enterprising software companies, each seeking to simplify, but overall contributing to more chaos. Vaccine-hunting felt, at times, like a “Hunger Games” challenge, replete with illusory hopes and disappearing screens. In New York City, you stayed up late in order to pounce when the next tranche of appointments opened up. Then just as you clicked to claim a spot, it vanished — presumably to someone who had hit it a nanosecond before you had.
And remember the early days of testing? Public testing sites could take a couple of weeks to offer results. Anything quicker might require booking an appointment at a private facility, some of which charged hundreds of dollars. Other options arose, and soon the streets of major cities were lined with custom-outfitted vans and tents, the innovation of quick-thinking entrepreneurs who rushed in to meet a public need.
The collection and dissemination of facts during a pandemic is typically considered an essential public good and therefore best controlled through validated, state-endorsed channels. But it took three months for the Centers for Disease Control and Prevention to produce a national testing database. Rick Bright, the former head of the Biomedical Advanced Research and Development Authority, or BARDA, told me that the most important surveillance data “were generally reported by universities, such as Johns Hopkins, or the Covid Tracking Project, a private project coordinated by The Atlantic. The U.S. eventually adopted these dashboards, as did most news and media outlets, over any efforts that the government tried to produce.”
As for the responsibility to provide more than data at a moment of mass panic and obfuscation, many Americans looked to the government for answers. Dr. Anthony Fauci, the former director of the National Institute of Allergy and Infectious Diseases, became for many a hero for shouldering the near-impossible task of dispensing information in the midst of a sandstorm of unknown unknowns. It was dangerous work. But as Zeynep Tufekci wrote here in June, “under questioning by a congressional subcommittee,” officials later “acknowledged that some key parts of the public health guidance their agencies promoted during the first year of the Covid-19 pandemic were not backed up by solid science. What’s more, inconvenient information was kept from the public.”
The lack of consistent messaging left ordinary people looking for answers elsewhere. They got them, or believed they did, from private echo chambers, conspiracy theorists, social media influencers and home remedy peddlers. All of a sudden, Joe Rogan and Dr. Fauci were seemingly equal authorities on virology, immunology and vaccine efficacy. That shift has had the lasting effect of greatly diminishing public trust in scientific authorities and science as a whole.
What does this mean for future pandemics? The good news is the pharmaceutical companies have already demonstrated that they can develop effective vaccines in record time. But it’s not hard to imagine downsides of giving corporations total control of this arena.
When the government withdraws from the private-public partnerships that have produced recent vaccine innovations, it also diminishes its ability to negotiate prices. High consumer cost would deepen health care inequities and decrease compliance. As the virus multiplied in unvaccinated people, it would get more chances to mutate, further endangering everyone, even those who got the shot. Private companies might well “donate” some number of doses or negotiate a lower price — but that would be a decision left to executives trying to optimize the shareholders’ interests, not to people making choices in the public’s interest.
And as imperfect as our distribution and reporting system has already proved to be, the government-run Vaccine Adverse Event reporting system has been an invaluable repository of nationwide reports that can be rapidly cross-searched by physicians and public health agencies. The degeneration of that vital infrastructure, or its transfer to private management, would have cascading effects. Imagine an adverse-event reporting system managed by the suppliers of vaccines. For a public already suspicious of the process, a conflict of interest like that could be a fatal blow to trust.
The same goes for the surveillance of pandemics. The C.D.C. monitors diseases worldwide and publishes the Morbidity and Mortality Weekly Report, a publicly accessible report that acts as a weather vane of the status of diseases across the United States. Will it continue to do so? Infectious disease surveillance companies abound, and Google Trends and Apple Health have a lot more money to throw at this project, if they choose to, than Congress would be likely to allocate.
But training matters, and low-tech networks, built and nourished over decades, are powerful. In March 2023, the Marburg virus — an extraordinarily deadly contagion similar to Ebola — broke out in the Kagera region of Tanzania. The news of an unknown infection reached a local C.D.C.-trained health worker named Vedestina Shumbusho through a group chat. She informed the Tanzanian Ministry of Health, which swiftly moved to test and isolate the sick patients. A potential international disaster was averted. I don’t think that the patients were sitting at home on their iPhones, searching “What do I do when I have Marburg virus?”
The shift of surveillance to privately owned, profit-minded subscription services (with stated commitment to the public good but obvious obligations to the bottom line) should also raise alarm. Would premium clients get early access to surveillance data? Would they, or the company itself, use it for private gain? Could these sources always be trusted not to put a finger on the scale? What if one of their major funders is a big pharmaceutical company? A private entity looking to break into a new market might want to skew a country’s data to curry favor with its government. A company might even be incentivized to dramatize a far-off danger to increase user engagement on its platform.
Is this what we really want — handing off increasing levels of decision-making power to the private sphere? Americans may not agree about much, but it’s clear they are angry about the degree to which corporations constrain our choices about our health and our bodies. (Look, for instance, at the gleeful response to the coldblooded murder of a health insurance executive.) But just when we should be demanding more public accountability and reliability, we seem to be turning away from the idea that health is a collective endeavor, a public good at all, and retreating into the rhetoric of personal responsibility. The deeper message is that we’re all on our own, fighting our private battles. I fear we will come to regret it.
Later that afternoon, as I returned home to Chelsea, I walked past the triangular park that marks the AIDS memorial. I doubt New York City will build a Covid memorial park any time soon, but if it does, it will probably be “sponsored.” Perhaps some of the “largest companies and greatest retailers” would chip in, and maybe they’d charge admission (with a percentage no doubt donated to a good cause of their choosing). No names of the deceased would be carved in stone. The memorial sculpture would be some rendition of a strand of mRNA. Or a great glass bubble representing, simultaneously, the lipid nanoparticles within which some of the vaccines were suspended and the ultimate separation of the public air outside and the private air inside.
‘We Tire Very Quickly of Being Told That Everything Is on Fire’
I Was a Whistle-Blower Under Trump. Here’s What’s at Risk for Public Health.
The False Premise Shaping Trump’s Public Health Picks
Siddhartha Mukherjee, a physician and scientist, is the author of “The Emperor of All Maladies,” for which he won a Pulitzer Prize. His latest book is “The Song of the Cell.”
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