The Vaccines' Race Against Time

As the virus adapts, these months may be the hardest of them all.


One strange aspect of plagues is that they often finish strong. I learned this the hard way last time around. Many people have a general sense of AIDS being terrible in the 1980s and then slowly petering out in the 1990s, as treatments improved. It’s intuitive to think this way, and even to remember things this way. But, in reality, the worst ever year for deaths from AIDS in the US was 1995 — over a decade after the first deaths in America — and just before the arrival of the cocktail therapy that turned everything around. The virus killed more people in America in the year right before the medical breakthrough than in any other previous year.

I remember this vividly because a very close friend of mine died that September. Like me, he had been diagnosed two years earlier, but his infection was much more advanced than mine. He’d soldiered through humiliating opportunistic infections, his body contorted into agony as it turned into a living skeleton, covered in lesions, struggling to breathe, slowly starving, as microbes ate his food before his body could.

Two years was an almighty, courageous slog through this indignity, and so it was agonizing to watch him finally surrender to the virus just as the breakthrough treatments emerged on the horizon. He was 31. It was like watching a fellow soldier killed on the last day of the war. There was something poignantly devastating about the timing. 

It comes back to me now because we seem to be in the same, awful moment with Covid19. The medical puzzle has largely been solved — the vaccines clearly work, and more are arriving. And yet the deaths mount — in some places, exponentially. And they are mounting in many parts of the world because of new, mutating variants, from 30 to 70 percent more transmissible and perhaps deadlier than those we have become used to. I don’t think we’ve quite absorbed that reality. This virus was very easily spread in the first place. Now it’s far easier. In other words, we are much more likely to get infected now than at any previous time in the pandemic.

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In Britain, the death rate has tripled since December, as the B.1.1.7 strain takes hold. As Ezra Klein notes, in Portugal, “daily confirmed deaths have shot from about seven deaths per million in early December, to more than 24 per million now. Denmark is doing genomic sequencing of every positive coronavirus case, and it says cases involving the new variant are growing by 70 percent each week.” In Spain, the number of new cases is double what it was in the second wave and four times as bad as the first wave — as Madrid suspends all new vaccinations because the EU has run out of the supply. The strain that is becoming dominant in South Africa is measurably more resistant to some existing vaccines. In Brazil, the city of Manaus was hit hard by the virus last May, killing 348, the highest monthly toll in 2020. But in the first three weeks of January this year, with the new viral strain P.1. gaining momentum, 1,333 have died. It’s as if a Category 3 storm has been updated to a Category 5.

In the US we’re now accustomed to a daily death toll of 4,000. It’s amazing how easy it has become to live with mass death. Yes, we just saw the sharpest decline in new cases since the pandemic began — but that’s off a record high, remains far higher than last spring, and if new strains emerge, as they will, infections will surely rise again. A virus is a dynamic target; and time matters. Covid19 can elude us; and adapt to us. It can kill millions even in retreat. If we do not keep on top of it, and act quickly, and restrict its spread now, we could go backward.

All of which, it seems to me, makes the case that this plague, like many others, could become worse yet before it suddenly turns the corner. The next couple of months may be the most fatal of the entire pandemic — even as freedom from this virus is within sight. There’s a special agony to those deaths, as there will be for all those human beings who will die of a virus for which a vaccine already exists.

This makes fast, effective vaccination essential. Nothing matters more in government right now. Apart from that, we have our own work to do. So I’ve made a special effort to batten down the hatches. I see almost no one any more; I wear three masks everywhere. I binge on streaming services (currently “The Bureau,” perhaps the best miniseries I’ve ever watched). I get groceries delivered. However isolated I was before, I am more isolated now. I’m lucky — yes, privileged to be able to do this. But if you can, you should. In epidemics, a large number of small decisions can make a massive difference.

And yes, I have some PTSD about this — and not just about losing my friend right at the finishing line of AIDS. I got infected myself years before. The patterns of safety I had relied on failed me. I can’t recall any moment where I fucked up, but obviously I did. I wasn’t vigilant enough, even though I thought I was. And I’m determined not to make that mistake again.

In this plague, among others in history, the exhausted cliché is actually true. It is getting much darker just before the dawn. From a survivor of one plague, I just want to say: don’t let your guard down now. Don’t be the last one to die. 

(Note to readers: This is an excerpt of The Weekly Dish. If you’re already a subscriber, click here to read the full version. If you’re not subscribed and want to read the whole thing, and keep independent media thriving on Substack, subscribe now! This week’s issue includes: a bunch of reader dissents over Biden’s equity push (including a dissent from Susan Rice herself); my take on the “insurgency” on the Republican right; my defense of nationalism in combatting Covid19; a podcast conversation on the unintended consequences of the Civil Rights Act; more window views from readers; more recommended reading; the Face of the Week that is keeping me sane during lockdown; a Mental Health Break from the Grateful Dead, and, of course, the results of the View From Your Window contest — with a new challenge. Some of this week’s issue is excerpted below. Subscribe for the full Dish experience!)

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New On The Dishcast: Christopher Caldwell

Chris is an old friend and, in my view, one of the sharpest right-of-center writers in journalism. A senior fellow at the Claremont Institute and contributing editor to the Claremont Review of Books, his latest book, The Age of Entitlement, is a constitutional narrative of the last half-century that is indispensable — especially for liberals — in understanding the roots of our polarization. Here’s a great primer from Sean Illing:

Caldwell doesn’t defend racism or the apartheid system the Civil Rights Act dismantled; rather, he argues that the civil rights movement spawned a whole constellation of other liberation struggles — for immigrants, for gay and transgender rights, for sexual freedom — that Americans did not sign up for and did not want. And the result of this steady encroachment is what Caldwell calls a “rival Constitution” that is incompatible with the original one and the source of a great deal of social unrest.

It’s a challenging way to understand our tribal divide. To listen to two excerpts from my conversation with Chris — on the exodus of elites from Middle America; and on the dearth of intellectuals on the Republican right — head over to our YouTube pageListen to the whole episode here. That link also takes you to my response to some reader comments on last week’s episode with David Frum.


Dissents Of The Week: Biden’s Culture War Aggression

In response to last week’s issue, a reader doesn’t buy my interpretation of Biden’s definition of “equity”:

Biden requires “fair, just, and impartial treatment” — he says absolutely nothing about outcomes or adjusting anyone’s share of anything. You’re completely misrepresenting his words. Treating someone fairly takes nothing away from anyone. Biden’s definition simply cannot, logically, be read to require “giving the named identity groups a specific advantage in treatment,” as you torture us with your “less tortured English” definition.

Susan Rice, responding to the Dish on NewsHour, wasn’t convinced of my argument either, and she made her case to Judy Woodruff. Let’s see if Rice can help us divine the meaning of the word “equity”. First up, according to her: it’s not the old equity policy of Obama; it’s something “quite different and unprecedented.” What would she mean by that, do you think?

(Read my full response to Rice and many other reader dissents here.)


Counter-Insurgency In America

The description of the January 6 mob and their connected organizations as a kind of domestic terrorist “insurgency” sure grabs the attention. We tend to think of such insurgencies in foreign, failed states, like Iraq or Afghanistan. Or we think of places, like Northern Ireland, whose population is so divided by the question of core legitimacy that government is effectively paralyzed. The idea that a similar kind of insurgency could exist in the US in 2021 seems, at first blush, more than a little trolly. 

But it contains an essential truth, doesn’t it?

(Read the rest of the post here.)


Could Covid19 Kill Off The EU?

One of the more frustrating aspects of reading the American press is that virtually every outlet treats the European Union as a self-evidently unalloyed good. That’s why it has been close to impossible to read any reporting on something like Brexit that tries to explains why on earth a small majority of Brits voted for it — apart, of course, from racism, populism and xenophobia.

So I wonder if the Covid19 vaccine experience might open some eyes on this question.

(Read the rest of the post here.)


In The ‘Stacks

  • The latest indispensable voice to join Substack: John McWhorter. He’s serializing his book on the Great Awokening, The Elect, over five months. Subscribe here for the first installment, on “Neoracists Posing as Antiracists and Their Threat to Progressive America.”

  • In a different sort of serializing, Colin Wright fisks the first of eight chapters in the book The Spectrum of Sex — a non-binary concept that Wright calls pseudoscience, but he aims to be “as charitable as possible” in his review.

  • Welcome Will Wilkinson! Old-school bloggers of the world unite!

  • Bob Wright gets apocalyptic — subscribe!

(More recommended reads here.)


The View From Your Window Contest

Where do you think it is? Email your entry to contest@andrewsullivan.com. Please put the location — city and/or state first, then country — in the subject line. Proximity counts if no one gets the exact location. Bonus points for fun facts and stories. The winner gets the choice of a VFYW book or two annual Dish subscriptions. If you are not a subscriber, please indicate that status in your entry and we will give you a three-month sub if we select your entry for the contest results (example here if you are new to the contest). Happy sleuthing!

The results for the last week’s window are coming in a separate email to subscribers later today.

As always, keep the dissents coming, along with anything else you want to add to the Dish mix, such as a view from your own window (please include part of the window frame): dish@andrewsullivan.com. If we pick your window, we will send you a free six-month subscription. Please try to be concise with dissents: the new format of The Weekly Dish is much more constrained than The Daily Dish, so it’s more difficult to include your smart criticism when it stretches into many paragraphs.

See you next Friday.