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Institutional COVID denial has killed public health as we knew it. Prepare to lose several centuries of progress.

Originally published: The Gauntlet on January 24, 2024 by Julia Doubleday (more by The Gauntlet) (Posted Feb 03, 2024)

If you live in a rich country, you’re probably not going to get cholera from your drinking water. The state accepts the responsibility of waterborne disease elimination as an obvious duty of governance, and the state and the collective then benefit from a healthier population, more able to participate in the economy and work.

Let’s say tomorrow the U.S. government decided to stop cleaning our water supply. President Joe Biden or one of his minions gets on TV and says “cholera has been defeated, it’s over, and we need to get back to normal. We can’t live in fear of cholera forever- we need to live our lives!” Massive cholera outbreaks ensue, and people are quietly told they can (pay out of pocket) for private water filtration systems. Those who do pay this burdensome individual tax are told they are living in fear and mocked by those who do not. People with cholera are pushed by their employers to come to work anyway, and CDC guidance reduces cholera isolation to one day, whether or not you’re still symptomatic or infectious.

If this all sound patently ridiculous, like a brutally misguided approach to “protecting the economy,” and like an extremely obvious way for the state to save money and shirk responsibility for collective good, congratulations! You now understand why so many on the left are aghast at the current state of the country and world’s COVID response (there is none.)

We can’t talk about how we got to total state abandonment on COVID without discussing the billions of dollars that went into disinformation campaigns, pushing people to think of public health as an individual responsibility. Sure, liberals were easily able to call out Trump-era minimizing and their subsequent anti-vaccination rhetoric. But what about the mild-mannered TV news-platformed “experts” and unqualified reporters who continually pushed lines like “personal risk tolerance”, “you do you,” “back to normal,” “we have to live life,” “only vulnerable people are at risk,” and that old chestnut, “we can’t live in fear”? (I truly can’t overstate how much demanding clean air and clean water is not “living in fear” but simply expecting the bare minimum of a democratic society to which we pay taxes and refusing to be a bootlicker for billionaire talking points.)

This propagandist narrative aimed to achieve, not just a practical outcome, but a philosophical, political victory. It aimed to individualize a collective good that has been entrenched as a basic human right in rich societies for at least a century. It aimed to reframe disease control as something that should be a choice for each person, rather than a publicly funded collective effort.

This victory is so thorough that many prominent leftists and progressive organizations remain silent as workers are continually sickened and disabled with zero legal recourse. Speaking to them, you will often hear the above talking points- which came from shadowy libertarian thinktanks- repeated word for word. It’s as if, in the course of four years, leftists suddenly decided they no longer believed in public transit, public libraries, public welfare programs, or public education. Except it’s, you know, way worse.

Imagine describing an unprecedented attack on and dismantling of public transit resources and a leftist telling you, “yeah, but what can we do? People can always buy a car.” That’s the situation we find ourselves in with COVID- not only are we not winning, we aren’t even fighting. Not only are we not protecting people, we aren’t even outraged. To engage with the reality of this crisis, we need to understand how adopting an individualist approach to public health is destroying decades of labor activism, human rights progress, and hard-won protections.

The history of public health in this country and around the world is the history of disease eradication, mitigation, suppression, and prevention. The name of the public health body currently pushing “you do you” as a strategy is the Center for Disease Control and Prevention, for God’s sake. It’s not the Center for Diseases Are Fine and Go About Your Day. It was initially founded in 1946 as the Communicable Disease Center with a mandate to eliminate malaria. Not ignore. Not “learn to live with.” Eliminate. A word that, four years into the disaster capitalist response that took neoliberal abandonment to new heights, cannot even be uttered aloud anymore.

Elimination is not considered a radical goal at all—or wasn’t—in the context of any other virus. Looking at public health projects globally, you will consistently see elimination and eradication listed as the top priorities of governments, NGOs and public health institutions. HIV/AIDS elimination. Malaria elimination. Measles elimination. TB elimination. Zero public health projects in the history of ever have had a stated goal of “ignore it because we have to live life.” It’s fundamentally antithetical to the very concept of public health.

And look at the way this logic of individualizing and ignoring disease has led to complete disuse of any of the so-called “tools” we supposedly have in our toolkit. We certainly hear the public complaining about illness after illness after illness, taking to twitter and Tiktok to marvel at the “new normal” of constant, lingering sicknesses and new onset health problems, yet they appear completely unaware that there are any measures that could prevent and reduce illness.

Partly, this is because of several years of misinformation and propaganda demonizing masks and bringing their efficacy into public doubt. Partly, this is because people see the wholesale public abandonment and feel it is pointless for them to individually attempt to reduce their individual risk- a feeling that is, to a degree, correct. Yes, I wear masks indoors and test and ventilate and filtrate. Yes, I still got COVID because a houseguest who stayed with me didn’t take precautions at a work event. Attempting to protect yourself from airborne viruses in a world with zero airborne infection control is as effective as trying to avoid cholera in a world without clean public water. Worth doing? Yes. Carries great financial and social cost and still won’t fully protect you? Also yes.

That’s why we need a strong, institutional response including new ventilation and filtration standards that would immediately and significantly reduce virus in the air and airborne viral spread generally.

Let’s talk about the short and long-term social outcomes of COVID normalization. Yes, masks and all other precautions are demonized to the point of being framed as indicative of mental illness, including on the left. But we also see this attitude bleeding into disease control generally. Another reason the public appears more willing- perhaps even eager- to spread disease- has to do with officially sanctioned misinformation being hurled at parents: that your kids are getting sick more often because of the “lockdowns” that occurred in 2020.

There are layers to how incorrect this talking point, known as “immunity debt”, is. Firstly, your immune system doesn’t need to encounter viruses to get stronger. Pathogenic microbes do not strengthen your immune system. That’s why, instead of giving kids cholera on purpose, we clean the water. Secondly, wearing a mask or doing other forms of disease mitigation does not damage your immune system. Prominent outlets, critical of Trump at the beginning of COVID, we quick to debunk this lie back in 2020. Now they promote it.

Worth mentioning that “immunity debt” is a spinoff of the “hygiene hypothesis,” which states that the body needs to encounter beneficial bacteria. It was never intended to encompass pathogenic microbes or viruses. Anti-vaxxers were the first to push the idea that getting sick is healthy for children. Now liberals incorrectly believe it.

What does damage your immune system is COVID infection.

Persistent complement dysregulation with signs of thromboinflammation in active Long Covid (Science)

Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection (Nature Immonology)—please note that 8 months was end of the study, not the end of the immune damage

Impaired function and delayed regeneration of dendritic cells in COVID-19 (PLOS Pathogens)

Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to 2 Years Following COVID-19 (MedRxiv preprint)

There is still debate about what proportion of people are being affected by post-COVID immune damage and how long it lasts, but what we know indicates that a significant number of people are affected indefinitely. Even minimizers are pivoting from claiming COVID doesn’t impact the immune system to the tautology and logical fallacy “it’s only hurting the immune system in people with Long COVID.” This is akin to saying “COVID only causes long-term harm to people who are long-term harmed by COVID.” It is circular logic.

For several years, when minimizers downplayed consistent findings of post-COVID immune damage, they stated that were we experiencing large-scale immune dysfunction, we’d expect to see spiking fungal infections, spiking bacterial infections, worsening viral outbreaks, pneumonias and other opportunistic infections. We are now seeing all of these effects internationally, yet minimizers continue to turn a blind eye and the press continues to push “your kid wore masks in 2020” as the explanation.

We are even beginning to see large resurgences of previously-eliminated-in-rich-countries viruses like measles. Lack of vaccination is a culprit; so is normalizing sending sick kids to schools, telling parents kids need to get sick to be healthy, denying people paid sick leave, and kicking kids’ immune systems in the teeth multiple times a year.

Suppression of pathogens like measles relies on a herd-immunity strategy. This means a large number of people in the community need to have a good amount of immunity to the pathogen. When kids are unvaccinated, they don’t have any immunity. When they have damaged immune systems or become immunocompromised, they may have weakened immunity or be unable to develop immunity at all. That means that broad-scale suppression of kids’ immune systems multiple times a year is also going to bring down that wall of herd immunity that previously protected the collective from outbreaks. Oh, and telling parents it’s good for their kids to get sick, and they should attend school sick? Yeah, that’s not going to help much either.

Unless we change course urgently- unless we fight back against the normalization of constant illness and the individualization of a critical public good- we are going to see a long, slow, across-the-board decline in health and life expectancy amid increasingly uncontrollable disease outbreaks and overwhelmed hospital systems. I haven’t even gotten into the damage COVID does to blood vessels, kidneys, livers, brains, and hearts, how it can trigger autoimmune diseases and reactivate latent pathogens; all of that information can be found elsewhere on this site. But the reality is that our kids will be continually reinfected with COVID while navigating the return of measles and other vaccine-controlled diseases, while being told there is zero technology that can protect them and zero reason to protect them, while contracting flu and RSV more frequently and with worse severity.

This is not 1824. It is 2024. We have the technology and knowledge to mitigate disease spread. Let’s fight for a future that is safer, better, and healthier than the world we grew up in, rather than sicker, crueler, and technologically regressed. If we don’t face reality and understand what we’re sacrificing right now, the next generation certainly will.

Julia Doubleday: International and domestic politics; Deputy Director, Committee LLC; co-host @committeepro.

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