Living with Our Pandemic Trade-Offs


A boy throwing away a face mask in a garbage can already cluttered with masks.

 Dhruv Khullar September 18, 2022 New Yorker

Isaiah Berlin, the twentieth-century philosopher, spent much of his life arguing that we can’t have it all. In any weighty societal matter, worthwhile values invariably clash: liberty and equality, justice and mercy, impartiality and love. Such collisions, Berlin wrote, are “an intrinsic, irremovable element in human life,” and realizing some ends “must inevitably involve the sacrifice of others.” But he also argued that we can soften the impact of this “value pluralism.” Our aim should be to “maintain a precarious equilibrium that will prevent the occurrence of desperate situations, of intolerable choices—that is the first requirement for a decent society.”

During the pandemic, few issues have crystallized the trade-offs we face as the disruptions to education have. This month, more than a million children returned to New York City’s public schools. They joined students around the country who, for the first time since 2019, started the school year without major covid restrictions: no universal mask mandates, physical-distancing protocols, compulsory quarantines, or remote learning. But they are among a cohort that has experienced historic losses in educational achievement. According to data from the Department of Education, reading scores for the nation’s nine-year-olds declined this year by the largest margin in three decades; their math scores dropped for the first time on record. These findings are especially troubling in light of research showing that third-grade competencies have a pivotal influence on life outcomes, such as the likelihood of graduating from high school, the risk of being incarcerated, and the ability to earn a living wage.

Some of this decline was unavoidable—the result of a once-in-a-century virus. But our choices mattered. In the spring of 2020, nearly all American schools switched to remote learning, in an attempt to mitigate the worst of desperate situations—overrun hospitals, rationed ventilators, mass death. Since then, however, there’s been wide variation in how long and how frequently schools shut their doors. The result is clear: the more time students spent remote, the more their education suffered. According to an analysis from Harvard, the American In­stitutes for Research, and NWEA, children in “high-­poverty schools” who spent most of 2021 learning remotely lost more than half a year’s worth of instruction. The effects were most devastating for Black and Hispanic children and for those who were already struggling academically.

This was a trade-off we chose—mortgaging the quality of education in an effort to protect parents, teachers, communities, and (to a lesser extent) children themselves from the coronavirus. Now the U.S. seems to have arrived at another judgment: the value of normalcy exceeds that of caution. “covid no longer controls our lives,” President Joe Biden said this month, and most Americans agree. In a recent poll exploring which of fifteen issues voters feel are most important ahead of the midterm elections, the coronavirus ranked fifteenth. Even among Americans who identify as “very liberal”—the most covid-cautious political demographic—worries about the coronavirus have plummeted. Last week, Governor Kathy Hochul allowed New York’s covid-19 state of emergency to expire. (Connecticut and Rhode Island are the only states in the Northeast with ongoing emergency declarations.)

Part of this shift reflects a genuine reduction in the virus’s toll. With vaccines, boosters, antivirals, monoclonal antibodies, and more than eighty per cent of Americans having been infected, covid’s case-fatality rate has fallen significantly, and I.C.U.s once overflowing with coronavirus patients now care for a pre-pandemic variety of illnesses. But much of it simply reflects the passage of time—a once novel threat fading into the background.

Owing to a lack of congressional funding and a desire to move past the “acute emergency phase,” the Biden Administration is taking a less central role in managing the pandemic. It recently paused a program that sent out free coronavirus tests, and soon it will stop paying for vaccines and treatments. Instead, these products will be purchased by insurers, who will pass the cost on to consumers through higher premiums; people without coverage will have to purchase the products on their own. covid will become just another of the many diseases that afflict Americans—a circumstance that says more about our social and political choices than about our medical reality. The U.S. continues to suffer more than two thousand covid deaths a week; it records more than sixty thousand new cases every day, and these represent a fraction of the true number of infections. According to the Centers for Disease Control and Prevention, more than half the country has high or moderate levels of viral spread, and many experts anticipate another covid surge this winter, possibly alongside a brutal influenza outbreak. (Australia, which often acts as a bellwether for the U.S., just had its worst flu season in five years.) Meanwhile, it’s increasingly evident that infections can have lasting health and economic effects: by one estimate, covid-related illnesses have reduced the U.S. labor force by half a million people. And many elderly and immunocompromised people remain at risk for serious illness, even after immunization.

Last month, the Food and Drug Administration authorized a redesign of covid vaccines. The new “bivalent” boosters target both the original strain and the hyper-contagious Omicron subvariants BA.4 and BA.5. The updated shots should, theoretically, offer better protection against the versions of the virus currently circulating, but because they were authorized on the basis of data in mice, instead of in humans—a decision prioritizing speed over certainty—it’s unclear how much benefit they will provide in the real world. The White House signalled that, going forward, Americans will probably need only an annual booster that takes aim at the variant du jour; that recommendation, though, seems based less on rigorous data than on a wish to assuage a weary public.

For much of the pandemic, covid discourse assumed a stark political polarity. Conservatives advanced arguments rooted in freedom and autonomy; liberals focussed on health equity and communal well-being. For better or worse, the two camps seem to have coalesced around a shared understanding: the coronavirus is here to stay, and it’s up to individuals to decide how to live with it. But, still, there are no universal truths. The value pluralism that Isaiah Berlin identified in societies is now roiling within individuals. On some days, at some events, for some people, the risks feel worth it. In other moments, they don’t. These internal tensions are inescapable—part and parcel of our own precarious equilibriums. ♦

Published in the print edition of the September 26, 2022, issue, with the headline “Pandemic Choices.”

https://www.newyorker.com/magazine/2022/09/26/living-with-our-pandemic-trade-offs