In the film “Don’t Look Up” [spoiler alert], the earth is on the verge of being saved from a killer asteroid by missiles armed with nuclear warheads, when the world’s third richest man intervenes. As a technocratic visionary, head of the BASH corporation, and lavish campaign contributor, he has the President’s ear. There are rare minerals worth trillions of dollars on the asteroid. His company has a plan to mine them. He must be listened to. He has the science, the technology, and the belief in progress on his side. And he happens to have the bucks to make it happen.
It doesn’t. The mining operation fails and the earth is doomed.
But it seems that our visionary didn’t completely trust his own science, for he had a backup plan, namely, an interstellar spaceship that could hold 2000 human beings, including himself and the President. In other words, in spite of his assurances that the science would work, he knew that there was a risk of failure. In this case, he was gambling with the survival of our species.
Our visionary technocrat appears to have acted without peer reviewed studies of his plan, his science. This rightly upsets and then infuriates the Michigan State scientist who is trying to warn the world of the immense danger. However, the problem here is not only one of science improperly done. It is the absurd degree of risk that the technocrat is willing to take on for the sake of his goal, using the seductive promise of progress in technology and science to win others over.
Those behind “Don’t Look Up” saw it as a satirical allegory about the climate crisis. It can, however, also be viewed as a story about how science and progress have been used to obscure and sidestep ethical considerations in our response to the Covid-19 pandemic.
We continually hear from the CDC, the White House, and other economically and politically motivated parties about how much progress we’ve made in dealing with the virus. We even heard the President announce on national TV that the pandemic was over, while pointing to the unmasked at a car show as evidence for his claim. When these parties speak they often sound like mini-me versions of the crazed technocrat in “Don’t Look Up.” We’ve made progress. We will make more progress. We are in a much better position now than we were earlier in the pandemic because science has given us the tools to fight back, most importantly vaccines. The risks are much lower. Get your booster and enjoy gathering with relatives over the holidays, assuming you are not actively ill, etc. Trust us.
First small problem: people haven’t gotten their booster shots.
The CDC and the Administration know that the uptake of the new booster has been poor, and too many people are not in fact properly protected. No doubt part of the reason the uptake has been poor is their own happy talk about how much progress has been made by science in ending the pandemic. From an NPR story on December 28th:
Now, many have shrugged off the need to get updated boosters. Only 15% of people eligible for the COVID booster shot that targets the omicron variant have gotten it — a rate that is even lower than the perennially disappointing rates for flu vaccine uptake. Vaccine fatigue seems to have spread to other shots, too — including those to prevent measles and polio — according to a recent poll by the Kaiser Family Foundation.
This article drew its data about the booster from the CDC. The same CDC website, “COVID Data Tracker,” has the figure of 15.4% for January 5th. Hardly any gain during a period in which the virus was likely to spread. It’s obvious that the population is not properly protected, because the efficacy of earlier vaccines has waned, too few people are boosted, and there are very few mask mandates. It should come as no surprise where we are headed. The charts below are on the same CDC website. Notice the spikes in new hospitalizations in past Januaries and where we are at the very beginning of January 2023, on January 5th to be exact, at the end of the graph. Also, notice the warning at the bottom of the chart: “Due to potential reporting delays, data reported in the most recent 7 days (as represented by the shaded bar) should be interpreted with caution.”
New hospitalizations have gone up, especially for those 70 and older. As a matter of fact, it looks like we have exceeded all but the last two Januaries in new hospitalizations of the elderly in the period covered by the graph. Now throw into the mix a new highly contagious variant first seen in NY, the Kraken (XBB.1.5), which will likely spread to the rest of the country, and the odds are we will be seeing many more hospitalizations. New York has apparently exceeded all but two periods on the chart for all ages.
But not to worry. Because, you see, if you compare the present new hospitalizations to the highest peak on the chart for the whole country, then we are in good shape, down 70.4%. It’s right there on the chart, bottom left, along with the current figures and the peak seven day average of new hospital admissions. The march of science and progress. Be happy. It’s all over. Of course, we could play the opposite game, pick a couple of periods in which hospitalizations were especially low and talk about how much of an increase there has been. Or we could ask, why the hell are we still having periods in which there are many more hospitalizations than in others? Why haven’t hospitalizations permanently declined? (And hospitalization is clearly not the only risk. There are ongoing threats of long Covid and organ damage, not to mention death.)
The decision to go with this presentation of the statistics (on the left side of the graphs) over a more comprehensive approach by the CDC isn’t justifiable on scientific grounds, especially when cumulative illness over time may be comparable to a peak and when no one knows if a new variant may cause another extreme peak. (For example, why not also have shown on the right side of the graph the percent increase in new hospitalizations since the deepest trough?) What we have here amounts to advertising to sell the government’s success in battling Covid, as well as promoting the narrative that things are almost all better. Progress! (But you know, you can bleed to death quickly all at once, an extreme peak, or you can bleed to death over time, multiple smaller peaks. But in both cases, you die.)
It’s certainly true that fewer people are dying in proportion to the number of those infected because vaccines help reduce the odds of calamitous outcomes. They reduce risk. Science should be commended. But even if the science is exceptionally good and the presentation of data fair and comprehensive, science cannot tell us what is ethically the right thing to do. If we had a nuclear exchange with a hostile country last year that caused two million deaths and a recent one that caused only 400,000, because science had given us better treatments against radiation, this improvement would hardly be a reason for looking the other way regarding the 400,000 deaths, if you put a premium on the value of human life. And presumably we should not say, it’s okay to keep losing 400,000 each year because it’s not as bad as losing two million in one year (or it’s okay because it’s mostly old people dying). But this is not a scientific response. It is an ethical one. When we accept a certain amount of illness and death that is preventable, because we have competing interests (for example, freedom from masks), we are making an ethical decision, not a scientific one.
Unfortunately, what we have seen is not always science advocacy at its best. Instead what we have often seen is a form of scientific malpractice, especially because one of science’s obligations is to communicate its findings as best it can to the public. When its advocates downplay the number of people who are still becoming ill, or may become ill in the future, leading people to make poor decisions about their health and the health of others, it is a form of malpractice. And it is unethical. It is also manipulative because it uses attitudes toward progress and science to sidestep basic ethical questions, for example, what is the number of sick people we are prepared to accept as a society and why this number and not another?
Further, we keep hearing about how science has taught us to prevent infection and illness—through air filtration, for example—but these mitigation strategies are often spoken about as if they are already in place, when in fact they are not. We are told about potential techniques and technologies as if they are actually in use or will be in use very soon. Magical thinking about the uptake of the bivalent booster falls into this category.* And also schools. (How many times have we heard, we are able to protect students and staff by doing x, y, and z. Question: Has x, y, and z been done in all of our schools? Answer: Well, uh, we have model school districts we can show you…..) Medical science should not exclude actual conditions on the ground. It should seek to inform the ill-informed. It should not say to us: Don’t Look Up, or in this case, Don’t Look Around!
No less a personage than the White House’s coordinator on Covid, its Covid Czar, its face of science on Covid, failed to emphasize conditions on the ground when he recently made it sound as if people should gather for the holidays, assuming we did certain things, knowing that the vast majority of Americans hadn’t done one thing that was crucial from his own perspective, namely, getting a booster. From The Hill, December 18, 2022.
“People are gathering, as they should, because it’s really important to gather with family and friends,” Jha said on ABC’s “This Week” with host Martha Raddatz. . . .
Jha said he was not totally surprised by the rise in COVID-19 cases, given the return of colder air that spurred major waves in the two past winters as well as an increasing number of gatherings during the holidays.
“That combination is what is driving the increase,” Jha said on ABC.
“The good news here is that we can prevent those infections from turning into serious illness if people go out and get that updated bivalent vaccine,” he continued. “The updated vaccine is essential for keeping people out of the hospital. So we’re making the case that we’re at a point where it’s safe to gather, but you still have things to do. If we don’t do those things, obviously things can get much worse.”
So, a week before Christmas, we are told to do things, with the focus on getting vaccinated, knowing that the vast majority of Americans will not get boosted before gathering a week later. What Jha should have said, if he wasn’t abusing the science—because medical science and public health shouldn’t exclude actual conditions on the ground—is that people should not gather if they wish to reduce the risk to themselves and others unless they have taken certain measures. End of story. In addition to this failure to be emphatic, he didn’t even mention masks or masking! Martha Raddatz, the interviewer, had to raise them.**
Too many of those in charge would like people to believe that science has put us on top of the situation and therefore we don’t need to think about the ethics of what we are doing. The patina of progress and the rewards of science have been used rhetorically to obscure a situation that remains dangerous for too many. This has real risks. And not only of death and hospitalization, but of long Covid. These risks should not be dismissed by people who continually point to numbers showing great progress, especially when it’s quite obvious that we are not out of the woods.
*If there are any doubts regarding the Administration’s knowledge about people being insufficiently protected, here are exchanges from the actual interview. “This Week’ Transcript 12-18-22”
RADDATZ: More than 40 percent increase since Thanksgiving in Covid cases and hospitalizations. That is a very big spike.
JHA: It’s a – it’s a clear increase. It’s a substantial increase. We’re seeing it across 90 percent of the country. So, yes, Covid cases are rising across the country right now.
RADDATZ: And – and there was a statistic that really stood out to me from – from your White House briefing, less than half of nursing home residents have gotten their updated Covid – Covid vaccine, even though deaths are occurring mostly concentrated in people over 65. You say you’re talking to leadership, trying to get them vaccinated.
Why hasn’t this been happening?
JHA: Yes, so, you know, there’s — people are still, I think, learning about the new Covid vaccine, the updated booster. There are still a lot of people that are confused about whether they need one or not. We’re being very clear about this. If you’ve not gotten a vaccine in the last six months, it is essential to go out and get the new, updated bivalent.
This is an ongoing – this is ongoing work. But I actually think we’re seeing real increases in the last couple of weeks, and my hope is that that momentum continues.
It is not clear if the alleged momentum here refers to nursing home vaccinations or the country as a whole. When this interview took place, the country stood at 14% for the booster. We are now at 15.4%, more than two weeks later and after everyone has gathered. They knew the virus was spiking and that people were not properly protected. Perhaps they were praying for divine intervention, because there was no other way America would be properly boosted in time for the gatherings.
** From The Hill piece, once again:
Jha did not explicitly reference masking as a part of that strategy, although Raddatz mentioned masks during her questioning. Jha instead stressed the updated booster and COVID-19 tests to protect against the virus’s spread.
It’s absolutely mind-boggling how the Covid Czar could fail to mention masks, and yet not. From Biden to the press we have been led to assume that Americans are deeply opposed to masks. But according to this recent survey of likely voters, this simply isn’t the case. (See chart below.) As a matter of fact, cities with a high proportion of Democrats and POC look like they would be in favor of mask mandates. One can only wonder why in these places masks haven’t been mandated during Covid surges. After all, good science tells us that they can help. (Oh, right, but the President said that the pandemic was over and no one was masking at the car show. Let’s not remind ourselves that we are still in the pandemic.)
Illustration from “How the COVID-19 Pandemic Could End,” Scientific American, June, 1, 2020.