Death Panel podcast co-hosts Beatrice Adler-Bolton, Artie Vierkant, Phil Rocco, Jules Gill-Peterson and Abby Cartus present their 2023 year in review, taking a look back at the last year of major social and political developments that worked to normalize covid in 2023.

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[Chime]

Joe Biden (Clip): "The pandemic is over. If you notice, no one’s wearing masks, everybody seems to be in pretty good shape."

Ashish Jha (Clip): "I mean, the notion that you could cut respiratory infections, there’s no study in the world that shows that masks work that well."

Eric Adams (Clip): "We’ve gotten so used to the mask that we don’t realize there’s a large volume of people that are wearing it, not because of covid, because they’re criminals."

Anthony Fauci (Clip): "You’ll get some people, mostly the vulnerable, the elderly, and those with underlying conditions … will fall by the wayside, they’ll get infected, they’ll get hospitalized, and some will die."

Joe Biden (Clip): "I mean, look at what’s happened. I sometimes underestimate it, because I stopped thinking about it. But I’m sure you don’t."

[Intro music]

Beatrice Adler-Bolton  00:01:02

Welcome to the Death Panel. Patrons, thank you so much for supporting the show. We couldn't do any of this without you. To support the show, become a patron at patreon.com/deathpanelpod. You'll get access to our second weekly bonus episode and entire back catalogue of bonus episodes. And if you'd like to help us out a little bit more, share the show with your friends, post about your favorite episodes, pick up a copy of Health Communism at your local bookstore, preorder Jules's new book, coming in January, called A Short History of Trans Misogyny, or request them both at your local library and follow us @deathpanel_. So I am really excited today. Actually, well, I'm feeling nearly as much excitement as I am dread.

Artie Vierkant  00:01:46

Trepidation.

Beatrice Adler-Bolton  00:01:46

Yes. Because, you know, this is the first time since Abby and Jules joined the show in September of 2022 that we have all been on a recording together all at once.

Artie Vierkant  00:01:57

Hell yeah.

Abby Cartus  00:01:57

Yay!

Beatrice Adler-Bolton  00:02:00

And I'm feeling dread, you know, but also excitement, because today we are here to record our annual COVID year-in-review episode. So, without any further ado, welcome to "Covid Year Four."

Artie Vierkant  00:02:13

Yeah.

Beatrice Adler-Bolton  00:02:15

I'm Beatrice Adler-Bolton, as usual, and I'm here with all of my Death Panel co-hosts today. First we have Artie Vierkant.

Artie Vierkant  00:02:22

Hello.

Beatrice Adler-Bolton  00:02:23

Artie will be leading us today. This episode is a massive lift. So thank you in advance, Artie. Next we have Phil Rocco.

Phil Rocco  00:02:31

Hey.

Beatrice Adler-Bolton  00:02:31

And Abby Cartus.

Abby Cartus  00:02:33

Hello.

Beatrice Adler-Bolton  00:02:34

And finally, Jules Gill-Peterson.

Jules Gill-Peterson  00:02:36

Hi.

Beatrice Adler-Bolton  00:02:37

So, we have a lot to get to. You know, I'm always kind of in a state of numb shock when we start these COVID year-in-review episodes. It's kind of this, like, overwhelming feeling where time is just fucking with you. So, you know, why don't we just dive right in? Artie, I'll pass it to you.

Artie Vierkant  00:02:53

Yeah. Okay. Welcome to Covid Year Four, everybody.

Jules Gill-Peterson  00:02:55

[ groans ]

Abby Cartus  00:02:56

Dun dun dun.

Artie Vierkant  00:02:58

I was gonna say, and so I think before I get into—if you've heard one of these before, you know I'm gonna probably do a timeline. That is the case for this year. Before I get into that, though, let's just start with those words. "Covid Year Four."

Beatrice Adler-Bolton  00:03:12

Mm. [ sighs ] I kind of can't say anything different than I have another years, which is that it both feels like it's been 10 years and three months. And I can't believe that it can feel that way for so long of a period of time. And that's kind of what I'm struggling with this time around.

Phil Rocco  00:03:31

I mean, this time around feels different in the sense that—and I'm actually kind of fascinated, not having known how you put this together, Artie. But this actually does feel like the first year in which the entire apparatus of following the pandemic, the sort of social prostheses have been entirely gone.

Jules Gill-Peterson  00:03:52

Yeah.

Artie Vierkant  00:03:52

Yeah. Gutted really, yeah.

Phil Rocco  00:03:52

And so like, it's—I feel like it must have been more work for you to put together just the, you know, all of the documentation this year.

Artie Vierkant  00:04:01

You have intuited correctly. [ All laugh ] Unfortunately. Yeah.

Jules Gill-Peterson  00:04:07

I mean, if we want to try and make one silver lining, I guess we don't have to follow along the, like, spasms of Atlantic thinkpieces from beltway people—

Beatrice Adler-Bolton  00:04:20

That is true.

Jules Gill-Peterson  00:04:20

—you know, just kind of guiding us along as a kind of, you know, funeral dirge. Sorry, that's very macabre.

Abby Cartus  00:04:28

I kind of miss those spasms, though, because—

Jules Gill-Peterson  00:04:30

I know, I was just thinking that as I was saying it!

Abby Cartus  00:04:33

Yeah, like, we've been talking about this a lot. And I've been thinking about this a lot, those spasms were kind of like the whetstone that I could sharpen myself against.

Artie Vierkant  00:04:44

Absolutely.

Abby Cartus  00:04:45

You know, like, without that I have felt—I don't know, I feel pretty adrift in like the COVID coverage this year. So it'll be very interesting to see what Artie has put together.

Artie Vierkant  00:04:56

Yeah, well, we'll return to that point, because that's actually kind of pretty similar to something that I'm going to kind of bring in as we're getting towards the end. I guess the one thing that I would just say, too, about Covid Year Four. I mean, it is—it is pretty staggering just to think about those words in themselves. It's also just really interesting to think, like, as Bea was kind of saying it's, you know, feels like 10 years, but also feels like three months. But really, I mean, four years. You know, from, let's say like when it was first discovered, fall 2019 until now. Those four years, it's actually just—when you really think about it, that's such a short amount of time, too.

Beatrice Adler-Bolton  00:05:30

Yeah.

Artie Vierkant  00:05:30

Like that's actually a really, in the grand scheme of things, that is such a remarkably short timeline in terms of especially how quickly it's been normalized. So. In any case, I'm gonna get started. First, I just have a couple of quick things that I wanted to say, right out the gate, which is: if you haven't heard one of these before. So this, as Bea mentioned, this is our kind of COVID year-in-review. This is the 2023 edition in a sort of informal series of episodes where we try to recap the year in COVID normalization. Or, to put it another way, where we try to chronicle what we have been calling "the sociological production of the end of the pandemic." In other words, how rhetoric, major policy decisions, the redistribution or termination of resources, and various actions of US government officials have led to a premature notion that the pandemic is over, even as COVID continues to spread, people continue to die, and people continue to get long COVID. So this series is comprised of this and a few other episodes, which I'll put links to in the description. But I'll also mention just briefly right here at the top. So Covid Year Two was released in December 2021 and was explicitly focused on correcting a notion that was, I think, much, much more prevalent at the time that it was recorded, at least, which is the idea that Biden had been doing a super good job on COVID and that he couldn't be blamed for the virus running rampant. [ Bea and Abby laugh ]. Covid Year Three was released last year, December 2022, and ran through what was a very aggressive year of COVID normalization. That one also had an offshoot, kind of second full conversation, which was called How Liberals Killed Masking, that also kind of went back into 2021 stuff, that was released around the same time looking at how the Biden administration had kind of put policies—or kind of undone policies of universal masking throughout the United States and led to that normalization of anti-mask sentiment among liberals. You'll notice there's no "Covid Year One," or at least no episode by that exact name. In 2020 we hadn't come up with the idea to do a year end recap yet, I suppose? Though, when we decided to do Covid Year Two we did name it after an earlier episode, Covid Year Zero, which was released on—and this gave me a sense of vertigo to look back up—March 15th, 2020.

Beatrice Adler-Bolton  00:05:30

What?

Jules Gill-Peterson  00:05:46

What!

Artie Vierkant  00:05:48

Yeah, March 15th!

Beatrice Adler-Bolton  00:06:01

We recorded that one then? Woah. Fuck.

Artie Vierkant  00:07:07

Yeah. So that one isn't a recap episode. Instead, it was something we recorded as we all had, you know, gone into isolation. We talked through what we knew and didn't know about COVID at the time—

Beatrice Adler-Bolton  00:08:06

That one features our old co-host, Vince Patti, as well.

Artie Vierkant  00:08:10

Mhm. I haven't revisited that episode in a while. But my memory of it is that we called it "Covid Year Zero" because at the time a lot of politicians and media figures in the US were saying, you know, COVID is gonna be over in two or three weeks, or whatever.

Phil Rocco  00:08:22

By Easter or something.

Abby Cartus  00:08:22

Yeah, by Easter. [ laughs ]

Beatrice Adler-Bolton  00:08:24

Yeah. We were like, yeah, right. [ Abby laughs ] Let's see some evidence of that.

Artie Vierkant  00:08:30

We spent a lot of time in 2020 being like, hey, guys, if you look at the history of past plagues, uhh.. it might take a while, so. Anyway.

Beatrice Adler-Bolton  00:08:37

Hey, guys, we're pretending to know the answers to questions that we haven't even asked actually. [ Bea and Jules laugh ].

Artie Vierkant  00:08:45

This year, we also have something of a companion episode. So last week, we released a discussion where we talked about how concrete data on COVID, from tests to deaths—death statistics—has become increasingly abstracted and harder to come by over the course of the last few years, leaving us knowing less than we ever have about the true state of things. So if you haven't heard that, that's kind of like a preamble to this conversation. Anyway. Without further ado. "Covid Year Four."

Artie Vierkant  00:09:15

This year's episode has a lot of moving parts, but I'll share some of the big themes before we get to the timeline. 2023 in the COVID response was the year the Biden administration really turned most of the lights out. With so much of its pandemic policies, from public health protections to social safety net supports and funding, already clawed back by the end of 2022, this year was the year they came for really anything that remained. The COVID Public Health Emergency was sunsetted in May 2023, which many people then conflated with the end of the pandemic itself. Millions of people have been kicked off of Medicaid, about 11 million by now, as of this recording. Masking was dropped even in healthcare settings. And a lot more happened that we're going to talk about in the next couple of hours. Meanwhile, COVID is very much still around. And around all the time. It's not merely that we have waves and seasons of COVID, or something like that, even though that's how it's often talked about. My favorite illustration of this comes from two headlines that I want to contrast right at the top of the show that I will be mentioning again, I think, when we get to that part in the timeline. But so for example, here's a headline from Fortune Magazine from July 28, as a summer surge was underway in the US. Quote, “Has COVID-19 become a summer illness? Cases and hospitalizations are on the rise again.” And, to contrast this again with this headline from a few months later, October 25 in the New York Times—again, October 25—quote, “It’s Covid Season. What Are the New Rules for Staying Safe?” So. Anyway, I think these are fascinating because if you look at the metrics, it's kind of always COVID season.

Jules Gill-Peterson  00:10:49

Yeah.

Beatrice Adler-Bolton  00:10:49

It is.

Abby Cartus  00:10:50

Yeah, it's always COVID season.

Artie Vierkant  00:10:51

But by the headline in October, you know, it's basically the same wave as being reported on in July. But I think we're so far into this idea of the end of the pandemic now that these totally contiguous surges are portrayed as anomalies.

Abby Cartus  00:11:05

I'm sorry, Artie. It's not a "wave," uh, it's an "uptick." [ Bea and Jules laugh ] It's looming uptick.

Jules Gill-Peterson  00:11:09

[ sighing ] That damn word.

Artie Vierkant  00:11:12

"A little bump."

Beatrice Adler-Bolton  00:11:13

I mean, let's be real, like, the way that everyone conceptualizes illness and time has been so thoroughly fucked up by the media representation of COVID.

Jules Gill-Peterson  00:11:25

Mm.

Artie Vierkant  00:11:25

Absolutely.

Beatrice Adler-Bolton  00:11:25

It's like, I think we're gonna see this kind of temporal minimization of disease just like applied to so many things going forward.

Artie Vierkant  00:11:34

Yeah. So I'm gonna start the timeline now, because we got plenty to review. Just a final disclaimer: this is by no means exhaustive. There's plenty we either won't be getting into today, or that we'll only be addressing in brief. What we will be getting into has been kind of selected to tell at least one story about what's happened in the last year.

Artie Vierkant  00:11:53

So. Part One. I think, as is our custom at this point, we're going to start our timeline for the last year not in 2023 but in the fall of 2022, which should let us get some context of what was happening as COVID's third year came to a close. It's also, I think, necessary because one of the things we tend to do in these year end episodes is focus on events that we have some more distance from so we can make connections we might not have thought of in the moment. But also because as we get towards the end of these episodes, I tend to put slightly less details into more recent months, because we've often just talked about the events that occurred, on the show. So, this will take into account things that kind of had less detail in Covid Year Three. This year, we're actually going to start a little earlier in the fall than usual because when you look at what we were all talking about at the beginning of the fall, it's striking just how quickly things have advanced.

Artie Vierkant  00:12:45

So, it's fall 2022. Mitigations? None really. Mask mandates? Haven't heard that name in years. [ Abby and Jules laugh ] However, vaccines and treatments are still free, for now. Though, at the same time, a program that HHS had been—uh, Health and Human Services—had been running to pay for COVID treatment for the uninsured, including and especially the cost of hospitalization, was no longer around, having been unceremoniously killed in March 2022. There still isn't anything like it anymore. That's just gone. Along with almost every other piece of the Public Health Emergency-related social safety net expansions, like expanded unemployment insurance. That program, that paid for things like hospitalization for uninsured people, is so thoroughly forgotten, in fact, that it's almost like it never happened. Except it did happen. Unlike things that never materialized during the Public Health Emergency like universal paid sick leave, or COVID specific OSHA protections for workers or, you know, the list could go on.

Abby Cartus  00:13:46

Vaccine outreach programs.

Artie Vierkant  00:13:47

Single payer, I don't know—[ laughs ] Yeah, vaccine outreach.

Artie Vierkant  00:13:51

Our COVID data picture is beyond murky. As we talked about last week, testing and vaccination centers are almost universally closed. This means a couple of things. One, there isn't good reporting anymore on how many actual COVID cases there are. The best we have is wastewater data, which shows alarming spikes. But wastewater data is only available in the few areas of the country that actually collect that data. Testing by fall 2022 is almost exclusively the domain of at home rapid tests which, while convenient, have a couple of big issues. The first issue with at home tests is reporting. There's just no way of knowing how many people are testing positive anymore, because the tests are done in private. The second issue is the cost: rapid tests typically cost $20 or more. They're supposed to be covered by private insurance. But as everyone knows, "supposed to" be covered by insurance comes with a lot of asterisks [ Bea and Abby laugh ] in the United States, which can sometimes include a lot of administrative burdens that decrease use. I don't know why I said sometimes. Typically do. Always do.

Artie Vierkant  00:14:50

In the fall of 2022, the Biden administration responds to pressure over this exact issue by putting up a new round of free mail order COVID tests, as they also recently did this year. But they didn't bother to do this until December 15, the very end of the year. So from December 15, anyone who went to COVIDtests.gov could get a grand total of four home rapid tests. Per address, or per household. That's not a lot, especially when you consider the third issue with at home COVID tests—rapid tests—which is that false negatives are common. So common, in fact, that the FDA guidance on how to use the tests properly is to test once, test a second time within 48 hours, and if both of those are negative test yet a third time shortly after that in order to get accurate results. So effectively, on December 15, the Biden administration says each household is entitled to about one and one third at home rapid tests.

Beatrice Adler-Bolton  00:15:47

I love all the people that clapped and were like, yes, look at what Biden is doing!

Artie Vierkant  00:15:51

Well they should be sending them, it's just, they should send a lot more if they're gonna—if that's what they're gonna do.

Beatrice Adler-Bolton  00:15:55

I know but when you lay it out relative to the actual usage of the tests and how far that gets one family, right, it was a ridiculously small, insultingly small amount.

Artie Vierkant  00:16:06

So all this is to say, as we've said time and time again, as of, you know, let's say mid-2022, we simply have no fucking idea how many COVID cases are happening anymore. That being said, as we'll talk about in a little bit, that's not to say we don't have any data in fall 2022. Until October, for example, CDC is still doing daily reporting on the number of positive COVID tests that it is capturing. Except on October 6, the CDC announces it will no longer report daily COVID cases, moving to weekly reporting instead. This will become a theme. In terms of normalization of COVID, or what we've called "the sociological production of the end of the pandemic," there are a couple of other events we have to keep in mind. We'll only run through a couple of the big hits just to make sure we all have the context—I promise this will be relevant later. But September 19, Joe Biden tells 60 minutes the pandemic is over—quote, "the pandemic is over." The context is he's giving an interview at the Detroit Auto Show. And he goes on to say quote, "if you notice, no one's wearing masks, everyone seems to be in pretty good shape. And so I think it's changing. And I think this is a perfect example of it." Unquote.

Beatrice Adler-Bolton  00:17:15

First of many raises of my blood pressure during this recording as you said that.

Phil Rocco  00:17:18

"You folks look wonderful from here." [ All laugh ]

Artie Vierkant  00:17:23

Of course, as we pointed out at the time, his administration has quite a lot to do with why people were not wearing masks at that event. So. That's what we call a tautology, I suppose.

Beatrice Adler-Bolton  00:17:34

Please see our episode How Liberals Killed Masking.

Artie Vierkant  00:17:37

Yep. Speaking of masking, one thing I think we only maybe briefly touched on in Covid Year Three: on September 23, four days after Biden's comment at the Detroit Auto Show, the CDC quietly updates its masking guidance late on a Friday afternoon—also known as the best time to bury things. They update their guidance to clarify they no longer recommend universal masking in healthcare settings. This will be very important to our timeline this year. As far as the discourse around masking as a whole, it's bleak. By the end of 2022, as we've documented elsewhere, the Biden administration position, as well as general liberal sentiment, is more or less in line with, to quote David Leonhart, as he famously put it: "masks work but mandates don't." We've done some episodes, including recently, on why this is wrong. And why a policy of one way masking is not sufficient—you know, a sufficient way to deal with a population level health threat. So I'm not gonna go into too much detail to rebut that. But again, I'll put like a link in the description. I will say that as of fall 2022, the Biden administration does start to shrug off the utility of universal masking much more blatantly. That's not to say that their many guidance changes over the years weren't blatant, but to say that their tone is more explicit. This is perhaps best illustrated by a comment that White House Coronavirus Response Coordinator Ashish Jha says in a Philadelphia Inquirer livestream on December 15 of 2022 that quote, "the notion that you could cut respiratory infections, there is no study in the world that shows that masks work that well."

Abby Cartus  00:18:15

He is such a fucking clown. Such a fucking clown.

Artie Vierkant  00:19:15

Quote, "you're never going to get the kind of benefit from mandatory year round masking as you would from making substantial improvements to indoor air quality." Somewhere, in the ether—

Jules Gill-Peterson  00:19:26

Which we're totally doing. [ Artie laughs ]

Beatrice Adler-Bolton  00:19:27

And you can only ever pick one.

Abby Cartus  00:19:30

Joseph Allen, take me out to dinner, please! [ laughing ]

Artie Vierkant  00:19:33

I was just gonna say, somewhere, out there, Joseph Allen is clapping. So again, you know, first of all, this is wrong. And a hell of a thing for the White House COVID Czar to say. Second, though, just to allow myself to be a little glib, I guess Ashish Jha doesn't read the New England Journal of Medicine because his comments came just a couple  weeks after the journal released a big study by, among others, Ellie Murray, former guest of ours and a number of, again, other co-authors, showing pretty definitively that mask mandates work.

Beatrice Adler-Bolton  00:20:03

Mhm.

Artie Vierkant  00:20:03

And that's one thing that we can say definitively about what we've "learned from the pandemic."

Abby Cartus  00:20:08

Yeah, there's no way Ashish Jha reads the New England Journal of Medicine. Like, there's simply no way. [ laughing ]

Artie Vierkant  00:20:14

I know, just allow me to be petty. What else? In the fall, the Biden administration and the media [were] also leaning in on a reframing of the fall as a catch-all "respiratory disease season." The term "Tripledemic"—

Abby Cartus  00:20:31

Tripledemic!

Artie Vierkant  00:20:31

—Was thrown around a lot, as it has been this year. As we set it at the time, and to borrow a specific point from Abby, actually, Abby, you said something last fall to the effect that the idea of syndemics—in other words, multiple overlapping epidemics or pandemics—is pretty common in epidemiologic literature. What isn't common and what was novel was the idea of a syndemic being invoked in order to minimize the severity of all three constituent epidemics [ Abby laughing ]. So. To move off from the Biden administration for the moment, this idea of the "tripledemic" overlaps with one of the other big pieces of discourse swirling in the media in fall 2022, which is, of course, the idea of "immunity debt."

Beatrice Adler-Bolton  00:21:15

Mm.

Artie Vierkant  00:21:15

If that sounds familiar, or you feel like you've been hearing a lot about that phrase recently, I'll just say: remember this concept as we'll certainly be returning to it much later. We didn't get into this too much in last year's year in review, because we had just done a whole episode about the concept of immunity debt. But I'm just gonna summarize the concept and its history really, really briefly and we can maybe return to it much later. I'll read from what I think is an indicative description. So this is an article on CNN's website from October 28, 2022 describing the idea of "immunity debt" and uncritically repeating it as truth. Quote,

The measures that helped keep us safe from Covid-19 over the past 2½ years – lockdowns, physical distancing, wearing masks, washing hands – also helped limit the spread of other viruses. As people return to school and work and take off their masks, those viruses, including respiratory syncytial virus [RSV] and flu, are back in full force.

That “immunity gap” [or "immunity debt"] from the last few years is probably behind the “unprecedented” early surge in RSV infections this year, scientists say – and it has thrown other seasonal respiratory viruses out of whack around the world.

Abby Cartus  00:22:26

I love how Protestant it is. [ Artie laughs ] Which I might have even said on the show before, but I love this. Like "you're gonna pay for it someday." Like the—

Artie Vierkant  00:22:36

We love debt here. Yeah.

Beatrice Adler-Bolton  00:22:37

Yeah, if you didn't suffer now, you'll suffer later, motherfucker.

Abby Cartus  00:22:41

[ laughing ] Exactly.

Artie Vierkant  00:22:42

Just to be clear, as many people have said, said at the time, are saying now—even, there's, like, a pretty widely circulated Financial Times piece from the fall of last year that people are also reposting now—this is not how the immune system works.

Beatrice Adler-Bolton  00:22:57

No.

Artie Vierkant  00:22:57

This is not how it works. This is instead something that is I think best understood on an ideological level.

Beatrice Adler-Bolton  00:23:02

Yeah, that's basically taking like the idea of how your muscles build themselves and applying it to your immune system. Just, you know.

Abby Cartus  00:23:09

A good cautionary tale about the uses of metaphor in scientific discourse.

Jules Gill-Peterson  00:23:14

Mhm.

Beatrice Adler-Bolton  00:23:14

Turns out parts of the body that are different, like, work differently?

Phil Rocco  00:23:17

—work differently. Who knew!

Artie Vierkant  00:23:18

Yeah. You can't skip flu day. You know? [ all laughing ]

Artie Vierkant  00:23:24

Anyway, so, on an ideological level, you can see where this is going, though, which is what I think is the most important thing about "immunity debt" to say really explicitly. Which is first of all, it is a very blatant rhetorical cudgel against the idea of lockdowns, or masking, or really doing anything about the pandemic. Longtime listeners will no doubt see, probably already know, even, the connections that can be made to the ideas of the Great Barrington Declaration, the so-called "focused protection" strategy, stuff like that. And in terms of social reproduction, it does two things. First, it suggests we did too much, not too little, to stop COVID. And second, by extension, one can assume the takeaway is supposed to be that, if we did "too much" to combat COVID, then if another pandemic happens in the future, which it almost certainly will, we should all remember that lockdowns "hurt us in the long run," or something. Or that masking hurt us in the long run, and we should all not do it. We'll get back to that, because people say this explicitly.

Beatrice Adler-Bolton  00:24:22

We should just embrace the "Beyblade" next time.

Abby Cartus  00:24:23

I also just want to say before we move on that there is a function of individual stigma that this carries, as well to—I think, further stigmatizing people who are still taking, you know, COVID precautions for whatever reason as, like, "debtors," you know?

Artie Vierkant  00:24:42

Yeah.

Abby Cartus  00:24:42

As people that are, like, "deficient" and that owe the rest of us something, or like, owe some payment to the great Moloch I guess of, like—of respiratory viruses or something. I just wanted to flag that before we move on.

Beatrice Adler-Bolton  00:24:56

That's a very good point, Abby.

Jules Gill-Peterson  00:24:57

Yeah I mean, it's 19th century eugenics, actually!

Abby Cartus  00:25:00

Yeah!

Artie Vierkant  00:25:00

Yep.

Jules Gill-Peterson  00:25:00

You know? Yeah, if we—if we do anything to intervene and mitigate the spread of disease, we're "messing with nature's plan for us," which will, you know, "ultimately always call from the human species." Such a rosy picture.

Abby Cartus  00:25:14

I know. Immunity pauperism, a huge social problem. [ Laughter ]

Jules Gill-Peterson  00:25:19

No, it's. Oof. Yeah.

Beatrice Adler-Bolton  00:25:21

Well, it reminds me of that Charles Darwin screed where he goes out against vaccinations [ Jules laughs ] saying that it's going to potentially, like, "ruin" all of the progress made by the human race during the early years of the Industrial Revolution to protect people from, you know, very basic things like smallpox.

Artie Vierkant  00:25:41

Yeah.

Jules Gill-Peterson  00:25:41

Now he could have worked in the Biden administration. [ Beatrice laughs ]

Artie Vierkant  00:25:45

The other final thing to know about "immunity debt" that I just want to put in here is that it is a novel term introduced into this pandemic.

Abby Cartus  00:25:55

Mhm. Yeah.

Artie Vierkant  00:25:55

It's not a pre-existing thing in scientific literature, though there are some that I don't listen to that claim it's a similar idea to immunity gap, which is something that is a distinct idea, actually.

Beatrice Adler-Bolton  00:25:56

And so different.

Artie Vierkant  00:26:01

But as far as I can tell, it's an idea that was introduced in one paper in France in spring 2021. And then it filtered its way into popular discourse after that paper was picked up by the Wall Street Journal for a piece that ran in June 2021. So, ideological to its core. Anyway. On October 20, 2022, Pfizer tells an investor call that when the Biden administration stops purchasing vaccines for the public and kicks them to the regular health care market Pfizer intends to charge between $110 and $130 per dose for its vaccine. This is something that's bad enough in and of itself, but will also be important later. Moderna would follow suit, announcing on January 9 that it will also seek a price between $110 and $130 per dose for its vaccine. Just a couple other things we need to know about the fall. We lose Evusheld, a monoclonal antibody treatment for COVID. Research shows essentially that COVID's evolutionary drift—spurred on, I would add, by the, as Bea mentioned earlier, Beyblade strategy, the—

Beatrice Adler-Bolton  00:27:12

"Let it rip."

Artie Vierkant  00:27:13

—The "let it rip" strategy. Spurred on by that, COVID's evolutionary drift had gone so far that Evusheld was no longer effective in propping up the immune response to strains that were circulating, now and then. And now, basically, Evusheld was the last—like, a number of other monoclonal antibody treatments had already fallen and Evusheld was the last to go. We also got some long expected sort of confirmation that repeat infection of COVID compounds risks from COVID, not just in the sense of having a bad or deadly acute infection, but risks of developing long COVID or various types of organ damage.

Artie Vierkant  00:27:51

We're almost done with the main context for the end of 2022. But before we move on to the bigger picture, we would be remiss not to mention a masterful hit piece on COVID organizing that ran in the New Yorker, at the very end of the year, December 28.

Abby Cartus  00:28:03

Oh, yeah! [ laughing ]

Jules Gill-Peterson  00:28:04

Mm.

Artie Vierkant  00:28:05

Yep. Uh, who could forget? I'm talking of course about the New Yorker's article, "The Case for Wearing Masks Forever" by Emma Green, the author of another piece we talked about, I believe in Covid Year Two, which was called "The Liberals Who Can't Quit Lockdown." For those who don't remember this, the title, quote, "The Case for Wearing Masks Forever," is supposed to be a joke. The joke is supposed to be something along the lines of, look at these dysgenic freaks who still want us to mask, et cetera, et cetera. The piece itself is a hit piece on the specific COVID advocacy group, the People's CDC, but it hits broad enough that it's really supposed to be a takedown of political speech about COVID as a whole. We had a whole episode on this called "The Case for Covid Gaslighting Forever," which I would recommend if you missed it. But I'll just briefly read some highlights. So this is from the piece in The New Yorker, from the very end of December.

Artie Vierkant  00:29:01

The group has quote, "made it their mission to distribute information about the pandemic—what they see as real information, as opposed to what’s circulated by the actual C.D.C. … they [talk] about quote unquote "science"—science is in scare quotes—

They [talk] about science as proof that the members' position is correct, when in reality they're making a case for how they wish the world to be and selecting scientific evidence to build their narrative. It's a kind of moralistic scientism—a belief that science infallibly validates lefty moral sensibilities.

Abby Cartus  00:29:35

Yeah, okay. But like, let's talk about the real CDC, though. You know? Like, "follow the"—you know what I mean? I don't know. Actually just cut this out. I'm not trying to get this mad about the CDC this early.

Artie Vierkant  00:29:48

And then, of course, just to make sure that I read this on this episode, too. Who could forget another thing buried later in the article, quote,

All the talk [from the group] about empire-building and capital accumulation—a key component of Marxist economic theory—made me wonder whether “the people” in the People’s C.D.C. are those people.

Abby Cartus  00:29:48

Dun dun dun.

Artie Vierkant  00:29:49

Yeah. You know, we're not affiliated with People's CDC, but, you got us, Emma. Some of us, uh, some of us are "those people." Filthy communists, or whatever. [ Laughter ].

Abby Cartus  00:30:23

I know, my initial reaction to that headline, you know, like, "The Liberals Who Can't Quit Masking"—I guess that's the earlier one—was like: I'm not a liberal!

Artie Vierkant  00:30:33

Yeah.

Abby Cartus  00:30:33

You know what I mean? Like, I'm not a fucking liberal. [ Laughter ].

Artie Vierkant  00:30:37

Anyway, this is all very funny, but the reason I'm bringing it up is because by the end of 2022, advocacy around COVID had gone from a thing that your stock liberal could easily get behind to, I guess, something of a punch line. When people talk about what Biden has or hasn't done in office, we can, I think, never forget about this in particular. Because if you think about that, in the span of about two years, from Biden's inauguration in January 2021 until the end of 2022, COVID went from you know, something that liberals were furious at the bad Orange Man for fucking up on to something where when you point out that their guy, Biden, is doing active harm by undoing COVID protection, liberals will, you know, really write a whole article about how you're "moralizing" them. So, you know, obviously, that process didn't take a whole two years, but this seems significant to me. So. All right. We have one last thing to look out for December, and we'll move on to the actual, you know, 2023. But I should note that in the calendar year 2022, according to the CDC's data—which, I'll mention this a couple more times over the course of this, most of our data is going to be drawn from CDC, but we should assume that these are probably undercounts. But according to CDC data, about 250,000 people—243,936—died of COVID, just in 2022.

Artie Vierkant  00:32:02

So this brings us to the end of 2022, and quite possibly the most important development. In fact, I'm just gonna basically blend components of the end of 2022 with the beginning of January 2023 here, because there's a lot of overlap and things happened quite quickly. Throughout 2022, for all of the normalization and downplaying of COVID, the US government still had in effect a Public Health Emergency, often shorthanded as "PHE," tied to COVID. This meant a few things. First and foremost, it was the biggest public signpost that we are all still indeed in a pandemic. But it also meant that the federal government was still on the hook for paying for all COVID vaccines and treatments. The public health emergency also spelled out certain data reporting requirements that we'll touch on briefly later, that helped us get a picture of what's going on with COVID. And there are some other things. But, you know, finally, a few of the remaining pandemic social safety net programs were tied to the end of the public health emergency, most notably, the Medicaid continuous enrollment requirement, which is the policy that was ensuring millions of people got to keep some form of health insurance coverage over the course of the Public Health Emergency.

Artie Vierkant  00:33:15

Now, let's say you're the Biden administration, and you want to wrap up the Public Health Emergency. You've got a couple of problems. Let's say you want to end the Public Health Emergency, in part because a big part of your pitch for your administration was that you wanted to end the pandemic. There's your first problem. You haven't ended the pandemic. You just kind of arranged things so that people think that the pandemic isn't their problem anymore, or a problem for them anymore. The other problem is all the things that are part of the Public Health Emergency for COVID that some of the public may have taken for granted about the pandemic itself, or the pandemic response itself. For example, the COVID vaccines and therapeutics, or antivirals, being free: that's good. People like that. It has a material effect in the world. Right? It definitely makes it so that more people use them than would otherwise. Though it's not perfect, because to get them, you still have to interact with some other elements of the US healthcare system, which is entirely pay-to-play and built to squeeze profit out of the stone. So you're still deterring a lot of people from using "the tools," as they're called, just by virtue of the design of the healthcare system in and of itself, as a capitalist healthcare system.

Beatrice Adler-Bolton  00:34:29

Mhm.

Artie Vierkant  00:34:30

But as long as "the tools," quote unquote, are free, it seems like the federal government is at least a little more active or more serious about COVID. It appears, right? You know, look, they care enough that they made it free. Well, you know, free for only a while, as we'll see. The other problem is that you've got millions and millions of people whose health care coverage depends on either the Public Health Emergency staying in place or on Medicaid expansion being made permanent. If you're the Biden administration, or Democrats generally, and you're thinking about ending the Public Health Emergency, I don't know, tomorrow, or 60 days from now, you have to be thinking: if I do this, the message is clear. You run the risk of having all the headlines about this read some variation of, you know, "Joe Biden announces the end of the Public Health Emergency, putting the health care of millions in jeopardy." That's not great. So what do you do? Apparently, you take these two things that are inconvenient to what you want to do politically, and you try to deal with them one at a time as if they were separate issues, rather than dealing with them all at once. Even better, you let Democrats in Congress do some of that work of decoupling them for you. There's some good reporting on this. And the one I've referenced most often in the last year is a piece from Politico from December 19, 2022, called "Why Democrats warmed to severing Medicaid eligibility from the Covid public health emergency." While this piece doesn't spell out a role that Biden administration itself played in the move, we do know that the administration was meeting frequently with members of Congress about things related to the Public Health Emergency, Ashish Jha spoke quite a bit it in 2022 about meeting with Congress toward kicking COVID Care to the private market, which we talked about in Covid Year Three. And one thing that is mentioned in this report that adds an interesting wrinkle is the following. I'm just going to read this brief quote, and then pause to let you all have a collective groan. Quote,

Artie Vierkant  00:36:21

“Republicans pushing for [a] deal [on Medicaid] have also been reminding Democrats that their original Build Back Better legislative package — which ultimately became the Inflation Reduction Act and passed this year after being significantly whittled down — included a wind-down of the public health emergency as a pay-for.”

Phil Rocco  00:36:40

Yeah. It was—it is really, really important to think about the administration's, you know, what seemed like an absurd position for an administration that sort of ran on expanding, you know, "expanding" quote, unquote, like "access to health care," to, you know, preside over this gigantic, you know, what is it now? 11 million person unwinding. But it is important, and I think we've talked about this on previous episodes that they didn't, number one, have a plan for what a different Medicaid expansion would look like. Two, if they were going to, you know, retain this aura of "fiscal restraint"—which was absurd, because of the scale of the Inflation Reduction Act as a spending package, just like don't—fiscal restraint is not your brand here. And it's not even what people want. So why bother even trying to do that? But third, I think one thing that undermined—would have undermined—anything that they had tried is that one of the counter arguments that you get, when you talk about unwinding is that oh, well, they, you know, you have the: "are there not exchanges?" [ Laughter ]. You know, "are the exchanges not open?" And it's like that's what they focus—any sort of change to the ACA over the past year, the Inflation Reduction Act was focused on the the exchanges piece of the law. The tax credits.

Artie Vierkant  00:38:15

Yep. Absolutely. In any case, so, they get their wish, I suppose. The Biden administration gets one less thing to worry about in terms of the potential political fallout from announcing an end the Public Health Emergency in that before the end of the year, as part of the end of year budget bill, states are informed that they can begin disenrolling people from Medicaid—begin what is known as "the unwinding"—on April 1. We all know what's happened as a result, and we're going to be talking about it today also. But just to note that the consequences of this were already very well known. Groups like the Urban Institute and Kaiser Family Foundation—I guess they're now called KFF, but I cannot bring myself to just say KFF—and Kaiser Family Foundation had already published estimates that between 15 and 24 million people would lose their coverage, their Medicaid coverage, because of this, during the unwinding. And as we all know, as we've mentioned already today, 11 million people already have.

Artie Vierkant  00:38:18

So. That's the end of 2022. End of Part One. And I'm gonna roll right into Part Two, if that's cool.

Beatrice Adler-Bolton  00:39:24

Yep. Let's mainline it.

Artie Vierkant  00:39:27

Okay, Part Two. 2023, pre-May 11. 2023, before the end of the Public Health Emergency. So this brings us to January 2023. January of this year. The Biden administration like usual doesn't miss a beat, starting the year off with a lot of activity. In early January as they renew the Public Health Emergency for another 60 days, they start speaking to the press about how this renewal will likely be one of the last. Here is how this is characterized in Politico from January 10. Quote,

Even as Covid hospitalizations and deaths climb once again, Biden officials privately concede the administration sees dwindling benefits in justifying the continuation of the health emergency — especially for a public that’s largely learned to live with the virus. …

Artie Vierkant  00:40:18

Once again, this is what is known as a tautology. It continues, quote,

Biden health officials stressed that the Covid response would remain a top priority for the administration no matter the status of the emergency designation.

—Sure—

The president has continued to urge aides to do whatever is necessary to keep control of the virus, viewing it as integral to the health of both the nation and his own presidency.

[ Laughter ].

Jules Gill-Peterson  00:40:42

[ Skeptically ] Mhmmm.

Artie Vierkant  00:40:45

But, quote,

... aides are weighing whether to begin a wind-down of the White House Covid team in the spring or summer months following the anticipated end of the health emergency, or keep it intact through the end of the year, two people with knowledge of the matter said.

Artie Vierkant  00:41:00

We'll all be familiar, by now, with the Biden administration's stance of pretending it doesn't have much agency over the pandemic, even as it makes decisions [ Abby laughs ] that actively shape its perceived severity and the idea of whether the pandemic is still going on or not. But there's one comment from January to this effect, though, that is particularly rich. On January 12, The Washington Post publishes a piece on how COVID has overburdened the already stripped down capitalist healthcare system. They talk to Ashish Jha about it. Quote,

White House covid-19 response coordinator Ashish Jha said the American health-care system may not be able to withstand the continued viral onslaught, straining the system’s ability to care for other serious illnesses.

“I am worried that we are going to have, for years, our health system being pretty dysfunctional, not being able to take care of heart attack patients, not being able to take care of cancer patients, not being able to take care of the kid who’s got appendicitis because we’re going to be so overwhelmed with respiratory viruses for … three or four months a year,” Jha told The Washington Post."

He described a scenario in which the typical winter logjam of patients begins much earlier than usual — in August or September — because of the coronavirus. It’s a darker scenario than the administration has portrayed in the past, and one Jha said most Americans have yet to realize.

“I just think people have not appreciated the chronic cost, because we have seen this as an acute problem,” Jha said. “We have no idea how hard this is going to make life for everybody, for long periods of time.”

Abby Cartus  00:42:39

Well then why didn't you—

Phil Rocco  00:42:39

Yeah, I can't imagine why we don't know that. [ Jules laughs ].

Abby Cartus  00:42:41

Yeah. Why didn't you do your fucking job, then?

Artie Vierkant  00:42:44

Yeah.

Beatrice Adler-Bolton  00:42:44

Yeah.

Abby Cartus  00:42:44

Like I remember talking about this on an episode. And I think I even said at the time, like, this is the biggest "we're all trying to find the guy who did this" of all time.

Jules Gill-Peterson  00:42:53

Mhm.

Artie Vierkant  00:42:53

Yep.

Beatrice Adler-Bolton  00:42:53

Mhm. Absolutely. And this is why it's so important to not anthropomorphize viruses. Okay, because what we see in that quote, and in Jha's own language that's quoted in that piece, is that COVID is doing the onslaught, right? That respiratory viruses are doing the pressure on the health care system. But viruses, independent of when they enter our bodies and take over our own cells, are not alive. Like this is not some organism that acts with decisive agency, right?

Artie Vierkant  00:43:32

Not intentionally doing—yeah.

Beatrice Adler-Bolton  00:43:33

None of this is anything that the virus is doing, it is all what we are doing, because we as the hosts are the virus's mechanism for doing the only thing that it knows how to do which is to replicate and evolve as it replicates. So the viral evolution, the vaccine escape, you know, the ways that COVID has, you know, persisted, right, despite all of the Biden administration's ignoring it, like the idea that any of this is the result of the virus, right, which is exactly how the language points us to, in so many ways that we discuss it, just completely takes the idea that, like, the way that we interact with each other, the decisions that we make about what COVID protections we're going to use before we interact with each other, when we share space with each other, what our workplaces are like, what the transit is like, what going to the doctor is like, that's all humans doing things and human decisions. Not like a virus that's "targeting" us, because it doesn't like us and it wants to fuck with us. You know, it's just really frustrating to sort of take it out of that idea of an ecosystem and how, you know, things effect each other and point it towards like this actor as if it's like an outside agitator coming in to fuck with capitalism and fuck with your life.

Abby Cartus  00:45:01

There's a parallel here that I think it's important to draw out with some of the discussions about, like, R-naught (R0), like the reproductive number of the virus and "endemicity" and things like that. And I know that we talked in the episode with Ellie kind of recently, like, we were very, very careful to emphasize that the reproductive number, like the R-naught of any virus, not just COVID, is really only partially an innate biological property of the virus, right? Like R-naught is kind of like a hybrid construct that combines some biological properties with a lot of social stuff, right? So like how efficiently a virus spreads has a lot to do with what we do, you know, like what policies and behaviors we enact. But it's been interesting because in some of the like, endemicity discourse which we might get into later. You know what I mean? That social component really, really drops out.

Artie Vierkant  00:46:07

Yeah.

Jules Gill-Peterson  00:46:08

Mhm.

Abby Cartus  00:46:08

And it's just, you know, a discussion of the biological properties of the virus, which is counterproductive.

Artie Vierkant  00:46:14

I have one final thing to add about this Ashish Jha quote, which I think is pretty important context. Which is, I think that these comments are particularly offensive because when we look at the reasoning that the Biden administration itself gave for dropping universal masking, it was all explicitly stated that they thought that we don't need masks anymore because hospitals were not, you know, quote, unquote, "overwhelmed."

Beatrice Adler-Bolton  00:46:42

Yeah.

Artie Vierkant  00:46:42

So. [ Abby sighs ] Whatever.

Beatrice Adler-Bolton  00:46:44

So fucking aggravating.

Artie Vierkant  00:46:46

I digress. A few other important things happened in January, but I'm gonna stay on the Biden administration for the moment. On January 21, Biden once again shows just how much COVID is a priority for him with the following statement at a meeting with Mayors from across the United States, quote,

The need for — I mean, look at what’s happened. And I think we — I sometimes underestimate it because I stopped thinking about it, but I’m sure you don’t: We lost 1 — over 1 million people in several years to COVID.

Artie Vierkant  00:47:16

On January [21], it's reported and then confirmed January 27, that Biden administration Chief of Staff Ron Klain will be stepping down, with Jeff Zients coming in to replace him as the new chief of staff. For our listeners outside of the United States: this is probably the most powerful position in the White House, I would say. Now, probably most people listening to this will be well acquainted with Jeff Zients at this point, but it still bears repeating exactly how consequential this move is. As ever, there's more on Zients in past episodes, including past year-in-reviews, but it bears repeating that Zients needs to be understood as the architect of the Biden administration's COVID response and what is known as the vaccine-only strategy. He came in with the Biden—

Abby Cartus  00:48:01

"Execute, execute, execute!" [ Laughter ].

Artie Vierkant  00:48:03

Oh, I'm getting to that. [ Abby laughs ]. He came in with the Biden administration as its first COVID Response Coordinator, prior to Ashish Jha taking on that job last year. And when he left the job, we here at Death Panel were quick to mention that one of the worst possible things that could happen would be Zients leaving for a short period of time and coming back in a position with greater power, like Chief of Staff. And that's exactly what happened. We weren't the only people to think he might be next in line for Chief of Staff. Here's a Politico newsletter from February 1, 2022, which was titled, um ... "The Zients-geist is coming."

Abby Cartus  00:48:39

Ugh!

Jules Gill-Peterson  00:48:40

No.

Phil Rocco  00:48:40

[ Laughing ].

Artie Vierkant  00:48:40

Quote,

In conversations with over a dozen … officials over the past few months, one name is always at the top of the list [for next chief of staff]: Jeff Zients, the White House Covid-⁠19 response coordinator. The only debate is if he’s the frontrunner to be the next chief of staff or just a frontrunner. …"

As scrutiny has mounted over the Biden administration’s sluggish response to Omicron, several officials — including [Ron] Klain, CDC Director Rochelle Walensky, and Health and Human Services Secretary Xavier Becerra — have taken heat for the missteps.

But Zients, who runs the Covid team and makes nearly every major decision about the direction of the pandemic response, has emerged largely unscathed. He has yet to be called to testify before Congress about the Covid response. And unlike Walensky and Dr. Anthony Fauci, he has made only a handful of television appearances. … The result: he is, effectively, invisible to much of the public even as he wields immense power …

Beatrice Adler-Bolton  00:49:41

He's the Secret President. [ Laughter ].

Artie Vierkant  00:49:43

[ Laughing ] Yeah. Um, the other big thing to know—

Abby Cartus  00:49:46

False Pope. [ Laughter ].

Beatrice Adler-Bolton  00:49:47

[ Laughing ] He's the real Pope and the Secret President.

Artie Vierkant  00:49:51

Jeff Zients in his seat in Avignon. Yeah. [ Laughter ]

Abby Cartus  00:49:54

Exactly.

Artie Vierkant  00:49:56

The other big thing to know about this transition is that Zients picked himself for the job. Which is something that I don't think was mentioned in most of the reporting when the news broke. But I say this because, according to reporting in Axios from September 2022, the Biden administration appointed Zients and the person who had been Zients's deputy, Natalie Quillian, to quote, "oversee a wide talent search effort outside the administration," unquote, for new cabinet picks and other administration roles to come in after the 2022 midterm elections. So in short, Zients ran the search committee that selected ... himself.

Beatrice Adler-Bolton  00:50:33

I mean, the arrogance. It's too funny, though, also.

Artie Vierkant  00:50:37

And Natalie Quillian, once his deputy when he was COVID Response Coordinator, is now deputy White House Chief of Staff. Bea and I spoke to Chris Lehmann from The Nation when Zients was announced as the pick, and I had forgotten exactly what we said. But revisiting it to prepare for this, I think, it's worth repeating ourselves. So this is from January 25 in The Nation, quote,

Within the hothouse political theater of the Beltway, Zients has been widely credited with “turning the pandemic around”—but the real-world import of that transformation courts renewed disaster. “What turning it around seems to mean is a very loud and very performative transition to the private market for the vaccine and therapeutics,” says Beatrice Adler-Bolton, cohost of the podcast Death Panel, which has closely tracked Zients’s tenure as Covid czar. “It’s very clear that Zients is going to have the model of Covid privatization be a priority for him as he moves into this new role.”

Artie Vierkant  00:51:33

"Adler-Bolton’s Death Panel cohost Artie Vierkant is blunter"—I usually am, sorry—

Beatrice Adler-Bolton  00:51:39

Yep.

Artie Vierkant  00:51:40

Quote,

“It’s important to note that this management approach spearheaded the playbook that led to 700,000 Covid deaths on the Biden administration’s watch…. This appointment demonstrates to me that the Biden administration truly does think that the absolute tragedy that Zients oversaw was a major success story. And that should be terrifying.”

Anyway—

Abby Cartus  00:52:00

Well said, Artie.

Beatrice Adler-Bolton  00:52:02

Yeah.

Artie Vierkant  00:52:00

Anyway, just one last piece of reporting I couldn't help but include. The news that Zients will be the next Chief of Staff also leads to this, frankly, incredible small detail Abby mentioned earlier being published in the New York Times. This is the Times on January 22 of this year. Quote,

Inside the West Wing, [Zients] has a reputation for being almost maniacal about developing a plan and sticking to it. He so frequently referred to the National Strategy for the Covid-19 Response and Pandemic Preparedness that aides ordered a blanket with the cover of the thick book embroidered on it.

On the back of the blanket was Mr. Zients’s mantra to his colleagues: “Execute, execute, execute.” His staff had similar T-shirts made up.

Abby Cartus  00:52:47

I feel like this is going to be like—I feel like 20 years from now we're gonna have a viral moment where like, I don't know, someone's gonna sell one of these blankets or something and a whole bunch of kids are gonna be like, oh, this dude's so cool. And then there's gonna be a huge like moment of retrenchment. When it's like, oh, no, he's not cool at all!

Artie Vierkant  00:53:07

I maintain that I really want to see a picture of these things.

Beatrice Adler-Bolton  00:53:12

Yes, absolutely.

Artie Vierkant  00:53:13

The t-shirts. The blanket. Whatever you've got. Please.

Beatrice Adler-Bolton  00:53:16

We still have not—

Abby Cartus  00:53:17

I want a blanket. Like please, mail me one.

Beatrice Adler-Bolton  00:53:20

I just want to know what the font is that "execute" is written in. Like, so bad. And so far, no one that we know that listens to the show and works in the White House and is like very low key about being a Death Panel listener has actually laid eyes on them. So.

Abby Cartus  00:53:21

Jokerman.

Phil Rocco  00:53:25

Papyrus. I was gonna say.

Beatrice Adler-Bolton  00:53:35

Yeah. I wouldn't—I don't blame them for not wearing these out in public proudly, like—

Artie Vierkant  00:53:44

Yeah, they shouldn't.

Artie Vierkant  00:53:47

Not one to let a new cycle linger, especially when it's drawing a bunch of scrutiny, on January 30—just days later—the Biden administration announces that the end of the Public Health Emergency will be May 11. We're going to obviously be speaking more about this later on. But there is an immediate, very interesting and very predictable confusion around this announcement. Recall from just earlier the two potential issues the Biden administration could face if it simply announced an end date of the Public Health Emergency, which were the uncertainty around Medicaid unwinding, which by this point, they've had a full month of news coverage circulating about, so, you know that potential controversy is more or less covered, and people can more easily imagine it as a separate issue. The second issue, though, was the fact that free vaccines and treatments were tied to the public health emergency and the Biden administration had laid precious little groundwork for that change to be announced. If you were on Twitter the day the end of the Public Health Emergency was announced, you may remember that this was immediately a big deal. For those who have been following this closely, you have to remember that this was even before the Biden administration had announced anything concrete about what was planned to do with COVID treatments. You know, we have criticisms of the whole new arrangement and what's now called the "Bridge Access Program" but at this point in late January all that had really been said were just some very vague assurances that the Biden administration would figure something out. Even some of the most normie public health voices at the time point out that this is a problem. Here's a quote from Katelyn Jetelina's newsletter, for instance, from January 2, quote,

... ending … funding for testing and vaccines is a real cause for concern. Once our free supply is out, everything will be privatized. Pfizer announced its vaccine will cost $130 per dose. … This will, no doubt, fuel deep inequities in the U.S. And it is part of a much larger, deeply flawed system of pharmaceutical profiteering that this country hasn’t got the ethical fortitude to address yet.

Artie Vierkant  00:55:44

That last comment is so funny to me. Anyway. The Biden administration appears caught off guard by this being a concern, which in itself should maybe tell you what their priorities are. I'm not going to call anything specific out in this episode, but I said a few more explicit things in some episodes earlier this year, I think in the patron feed. But in the days following the announcement, we do notice some outlets making a few changes to posts of theirs to make implications of the end of the Public Health Emergency a little less concrete. These updates tend to echo the administration's new line, not previously mentioned, but now being adamantly pushed for damage control, that essentially: just because the Public Health Emergency is ending May 11 doesn't mean COVID will be kicked to the private market on that exact date. No, instead, because there is a previously existing stockpile of things the federal government has already bought, vaccines and treatments will remain free until that stock is depleted. In other words, while supplies last. The Biden administration's defense is essentially: look, we don't know when we'll run out of free treatments. You don't know when we'll run out of free treatments. But so help me god, you absolutely cannot say that the end of the Public Health Emergency means they won't be unconditionally free anymore. Even though that's what's happening. [ Laughter ].

Phil Rocco  00:56:57

That makes sense. Makes a great deal of sense.

Artie Vierkant  00:56:59

To get off of the commercialization component for the moment, though, this is a very big deal. We can talk more about the implications as we get to May. But suffice it to say this is the most unambiguous move yet that the Biden administration is declaring "mission accomplished," in the George W. Bush sense, over the pandemic. And that's an appropriate comparison, actually, because as many people point out in the days following the announcement, Biden is ending the COVID public health emergency some three years into COVID, while at the same time, the National Emergency declared by George W. Bush on September 14 2001, the “Declaration of National Emergency by Reason Of Certain Terrorist Attacks,” as it's formally called, is still in effect over 20 years later. Again, priorities.

Artie Vierkant  00:57:45

I do want to address a couple of points that come up in the discourse around this. Some of the pundits who are most critical of COVID advocates use this as an opportunity to say variations of "well, I guess you just want the emergency to last forever." Obviously, I just have to say briefly, no. Obviously everyone wants this to be over. The real thing is that it doesn't matter whether we call it an "emergency" or not. What matters about the end of the Public Health Emergency is two things. One, the explicit material ramifications of it ending, both in the sense of things like commercialization, and in the sense of things like less people masking. And two, second, the same thing I basically just said: the fact that, you know, quote unquote, "Biden ends Public Health Emergency" sends a pretty fucking clear signal to the general public that COVID is over, no matter what nuance you think exists in the technical specifics of the "emergency" part ending.

Phil Rocco  00:58:37

And this is the point, right, that it's—whatever one thinks about, yeah, the designation, the only reason that it matters is that it allows you access certain emergency resources to do things like, centralize and coordinate.

Artie Vierkant  00:58:55

Yeah.

Phil Rocco  00:58:55

Once that's over, and once you make the deliberate decision to move to commercialization, you have the situation that confronts people now, which is that, I called my doctor's office, you know, like last week, and it just—just curiously, you know, like, I ended up getting my—

Artie Vierkant  00:59:13

Wait have you still not gotten the new fucking booster?

Phil Rocco  00:59:15

No no no, I got my booster at Walgreens, because after talking to my PBM, they, you know, "okayed it," [ Beatrice laughs ] but I just was curious, like, you know, if I were to go into the doctor's office, I have an appointment coming up, would they have the vaccine? Their answer to me in, you know, late November of 2023? Is no, they didn't have any. And so the point is, like, you know, there is this really wasted opportunity to take a political position that there are some things that are important enough, and it works much better if their allocation is centrally planned. And that's just like—anybody looking at the way the market for these things works and what has happened in the wake of commercialization would tell you. But that entire, you know, whatever one does with a, you know, "emergency" itself, that whole, like, opportunity for like political leadership is wasted.

Artie Vierkant  01:00:22

Yeah.

Beatrice Adler-Bolton  01:00:23

Well and I think in one way, it's also really important to acknowledge that part of like, the job of the presidential administration is storytelling. Right? You know, it's about communicating accomplishments and you know, how to understand like the passage of time under that leadership for the party. Right. And so, for a while before the official you know, emergency declaration was ended and the Medicaid unwinding started. You know, we saw for over a year, the Biden administration kind of wringing hands preemptively like oh, we don't have enough money. We're not gonna have enough money soon. Oh, Congress won't give us money. Forget the fact we're not trying. But you know, in a very sophisticated, you know, long game public relations strategy, surprise, surprise. They're the ones who ultimately really push the button that turns the lights off on the funding, right? Like they decouple Medicaid, you know, from the end of the pandemic Public Health Emergency declaration, saying, oh, well, we have to do this so that, you know, it's less volatile, so that it's calmer. And we're going to separate these two things. And we're going to make sure that they don't affect each other. And then it's accomplished within such, like, close proximity that it's so obviously clear how part of what we have been up against is not just a "failed public health strategy," but we are up against a narrative that is being built in real time, right, that conflicts our experiences of the pandemic. And that's, I think, important to just say out loud, because I know a lot of times when folks are just like talking about COVID in general, we talk about what's happening in COVID as a "failed public health strategy." But that's us sort of asserting a narrative basically against the narrative that's being built, right, which is: "the pandemic is over, the Biden administration did a great job." Right? Like, the whole sort of framework here is that the Biden administration has been using the pandemic as part of their storytelling, they had a plan and they stuck to it, they executed, executed, executed, right. And they laid this story out for us for months, saying, we're going to turn the lights off, right, like we are going to do—and they sort of prefigure the reality that we all experience, it seems like, right. But part of what's going on is that this is a clear pattern of disengagement, which if you go to, you know, the past coverage that we've done on this, like How Liberals Killed Masking, this is something that begins in the transition to the Presidency, in the beginning of Biden's time in office, right, you have the idea that masking is only going to last 100 days. And we have seen things proceed, regardless of the connection to where the virus is and how it's spreading. So it's always really important to remember that we're not just up against a failed public health strategy, we are up against a narrative that is being built in real time that conflicts with the truth that we all know and have been living through.

Artie Vierkant  01:03:41

Mhm. So, back to the announcement of the end of the Public Health Emergency though, I do want to read three fascinating bits of context that was given for this move, just to make sure we have this on the record. These are three separate justifications for ending the Public Health Emergency that are spoken to completely different audiences at the time. So the first is comments given to CNN by an unnamed aide that put the blame on Republicans who, with fresh control of the House of Representatives, were trying to push forward a floor vote to end the Public Health Emergency. This is from CNN, January 31. Quote,

The White House weighed in because House Democrats were concerned about voting against the Republican legislation to end the public health emergency that is coming to the floor this week without a plan from the Biden administration, a senior Democratic aide told CNN.

Democrats were concerned about the optics of voting against Republicans winding down the public health emergency, absent an understanding of whether and how we intended to do so from the White House,” the aide said.

Artie Vierkant  01:04:49

Optics, we love it.

Beatrice Adler-Bolton  01:04:51

Yeah.

Artie Vierkant  01:04:52

The second piece of context for the Biden administration's decision on the timing to end the Public Health Emergency comes from a letter sent from the White House's Office of Management and Budget, or OMB, January 30. This was a letter sent to the House Rules Committee to ask them to back off from their vote and the Public Health Emergency abruptly. The part I'm most interested in is this, quote,

To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19. They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.

Artie Vierkant  01:05:33

In other words, hey, now let us have our little Public Health Emergency, but just until May 11. We've so thoroughly stripped away any semblance of a COVID response already, any pretense of anything close to a mask mandate, that you might as well just let us have this one. The letter continues, quote,

Artie Vierkant  01:05:49

... an abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans. During the PHE, the Medicaid program has operated under special rules to provide extra funding to states to ensure that tens of millions of vulnerable Americans kept their Medicaid coverage during a global pandemic. In December, Congress enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff. If the PHE were suddenly terminated, it would sow confusion and chaos into this critical wind-down. Due to this uncertainty, tens of millions of Americans could be at risk of abruptly losing their health insurance, and states could be at risk of losing billions of dollars in funding.

Artie Vierkant  01:06:43

I wanted to make sure to highlight that because, to me, this shows that they know the material impacts the end of the Public Health Emergency is about to have, they just want to project the idea that they are going to do it in, to use their terms a more "predictable" fashion. As we said at the time, though, organized abandonment is still abandonment, no matter how neatly it's organized. An eviction notice is still an eviction notice. Obviously, this does not mean that Congress might as well have just ended the Public Health Emergency then and there. Far from it. I'm saying the opposite. I'm saying that I think we can safely say this description of, you know, quote, unquote, "patients losing access to care unpredictably" and the, you know, quote, "sowing of confusion and chaos" is a good way to describe exactly what has happened this year with the termination of the public health emergency.

Abby Cartus  01:07:31

Mhm.

Beatrice Adler-Bolton  01:07:31

[ Laughs ] Yeah. Thank you for bringing that in. I guess I jumped the gun a little bit, there.

Artie Vierkant  01:07:35

That's fine. The third and final piece of context that the Biden administration delivers for why the Public Health Emergency will end on May 11 is the PR spin justification delivered by none other than White House Coronavirus Response Coordinator Ashish Jha in a series of tweets on January 31. They read—I'm just going to read this thread, because it's probably one of the most important Ashish Jha threads from during his tenure. Quote,

The Administration just laid out plans to end the COVID national emergency & public health emergency on May 11

Why now?

Because we're in a better place

We're getting through this winter without a big surge or run on hospitals

Because we have the tools to manage this virus

[Thread emoji] …

So over the next 3 months, we will execute a smooth transition

But lets be clear about something that folks are confusing

The end of the PHE does NOT mean people will suddenly not be able to get the vaccines and treatments they need

This is an important distinction

4/n

We have millions of doses of bivalent vaccines and Paxlovid

They will continue to be available for free to all Americans who need them

Over time, we will transition away from US government buying vaccines and treatments to the regular healthcare market

5/n

And because of the Affordable Care Act (thanks Obama),

Vaccines should remain largely free to most Americans—

Artie Vierkant  01:08:58

—"largely free," it says. [ Beatrice laughs ].

Artie Vierkant  01:09:00

And we are committed to ensuring that uninsured Americans continue to face as few financial barriers as possible to access vaccines, treatments and tests

6/7

So over the upcoming months, you’ll see plans rolled out

Plans where ensuring access is a key priority

Our healthcare system is complicated and leaves too many behind

We are committed to ensuring that—

Beatrice Adler-Bolton  01:09:22

Exactly the way we like it. [ Laughter ]

Artie Vierkant  01:09:24

We are committed to ensuring that when it comes to COVID vaccines and treatments

No one is left behind

End

Artie Vierkant  01:09:31

I said "End" because he wrote "End." He tweets weird. If you've never seen a Ashish Jha tweet, go read them. They're weird.

Beatrice Adler-Bolton  01:09:36

The worst poetry I've ever read.

Artie Vierkant  01:09:38

A lot of paragraph line breaks. Anyway, "no one is left behind" indeed. So. That's mostly what we're going to focus on for January. But now that this is the first month of 2023 proper, I'll say that what I'm going to try and do for the following months is end as many as I can with a sort of "best of this month in the discourse" kind of thing.

Jules Gill-Peterson  01:10:01

Ooh.

Artie Vierkant  01:10:01

For fun. So this is going to highlight one or two things that happened that month that were either the most enervating discourse, in which case I apologize for reminding you of them, or were otherwise something from pundit land that we can all have a laugh at. So, January 2023 in the discourse. Stop me if you've heard this one before. Washington Post January 13 2023. “Opinion: We are overcounting covid deaths and hospitalizations. That’s a problem.” By Leana Wen.

Beatrice Adler-Bolton  01:10:30

[ Laughs ] Aaaah.

Abby Cartus  01:10:30

Yes! [ Laughs ] We need Dancehall siren, like the air horn.

Artie Vierkant  01:10:31

Yes.

Beatrice Adler-Bolton  01:10:31

Ugh. Leana.

Artie Vierkant  01:10:34

So I'll read very little of this, but you get the gist from the headline. Lena Wen saying we are over counting COVID deaths and hospitalizations. She writes, quote,

According to the Centers for Disease Control and Prevention, the United States is experiencing around 400 covid deaths every day.

Artie Vierkant  01:10:53

—"Experiencing." Great. Love to "experience."

At that rate, there would be nearly 150,000 deaths a year.

But are these Americans dying from covid or with covid? …

Two infectious-disease experts I spoke with believe that the number of deaths attributed to covid is far greater than the actual number of people dying from covid.

Artie Vierkant  01:11:18

One of these "two infectious disease experts"—

Abby Cartus  01:11:20

Yeah, two of the biggest cranks you've ever heard of.

Artie Vierkant  01:11:24

—one of these "two infectious disease experts," as she describes them, who so generously give Wen their opinions—remember, she's explicitly said "in the opinion" of these two people. So, one of these two people is, it should be noted, Shira Doron, who did a lot of advocating against mitigations earlier in the pandemic.

Beatrice Adler-Bolton  01:11:46

Ding ding ding.

Artie Vierkant  01:11:46

Wen continues, quote,

Both Dretler and Doron have faced criticism from people who say they are minimizing covid. That is not at all their aim. They have taken care of covid patients throughout the pandemic and have seen the evolution of the disease. Earlier on, covid pneumonia often killed otherwise healthy people. Today, most patients in their hospitals carrying the coronavirus are there for another reason. They want the public to see what they’re seeing.

Artie Vierkant  01:12:13

Skipping ahead, you know, she says a couple of other things. We read this in further detail in an episode way back when, but I want to read the—the big kicker at the end, which is quote,

Most importantly, knowing who exactly is dying from covid can help us identify who is truly vulnerable. These are the patients we need to protect through better vaccines and treatments.

Artie Vierkant  01:12:38

A runner up for this segment, January in the discourse, was this headline—just the headline, because—I'll do this a couple times. You'll see. Time Magazine, January 30. Quote, “The COVID-19 Pandemic Will Be Over When Americans Think It Is.”

Beatrice Adler-Bolton  01:12:53

Oh my god. It's like, truer than I want it to be.

Abby Cartus  01:12:57

"The Secret." [ Laughs ] "Thoughts become things!"

Phil Rocco  01:13:01

You know, it's funny, is it like—some of the stuff I have to wonder like, is it the discourse, or what job was Leana Wen trying to get at this point?

Artie Vierkant  01:13:09

[ Laughs ] Yeah.

Beatrice Adler-Bolton  01:13:11

Yeah.

Artie Vierkant  01:13:12

Just to round out January, rapid fire, a couple quick things. January 27, the FDA formally revokes monoclonal antibody Evusheld's authorization, prompting this incredible headline from CNBC. Quote, “CDC urges people with weak immune systems to take extra precautions after Covid subvariants knock out Evusheld.”

Beatrice Adler-Bolton  01:13:33

Fuck you very much.

Artie Vierkant  01:13:33

Thanks, you're making that super easy. Moderna, also in January, announces it will seek $110 to $130 for its COVID vaccine when it goes to the private market, which I mentioned before. And finally, a study finds 71% of people with long COVID who claimed worker's comp in New York were out of work for at least six months or more.

Artie Vierkant  01:13:55

February 2023 [ Beatrice sighs ] This brings us to February. As usual, we'll start with the Biden administration and federal policy first. Biden delivers his State of the Union speech on February 7, he uses the occasion to take a victory lap on COVID and tout the coming end of the Public Health Emergency. Here are some highlights. Quote,

Two years ago, COVID had shut down our businesses, closed our schools, and robbed us of so much.

Today, COVID no longer controls our lives. … While the virus is not gone, thanks to the resilience of the American people, we have broken COVID’s grip on us.

Abby Cartus  01:14:30

[ Laughing ] "Two years ago we had hope, jobs, cash—" [ Laughter ].

Beatrice Adler-Bolton  01:14:36

But see what I mean about the way that COVID is "doing this to us" right now?

Artie Vierkant  01:14:40

Oh yeah. It's always anthropomorphized.

Beatrice Adler-Bolton  01:14:40

"COVID is doing it," no. We are doing this to us. We are doing this. Like— [ scoffs ] Ugh.

Artie Vierkant  01:14:48

The next day, Zients officially comes in as the new Chief of Staff. His ominous first tweet on February 8 of this year is a picture of him, Jeff Zients, sitting at his desk looking like he's trying really hard to smile, with a caption reading quote, "Day One. Ready to work. Let’s finish the job."

Beatrice Adler-Bolton  01:15:07

Execute, execute execute. [ Laughter ].

Artie Vierkant  01:15:09

He's not wearing a mask in the photo, by the way.

Beatrice Adler-Bolton  01:15:11

[ Laughing ] Of course.

Artie Vierkant  01:15:12

We pass through February with precious few concrete details on how, exactly, the Biden administration plans to navigate the end of the Public Health Emergency, though CMS—Centers for Medicare and Medicaid Services—does release a vague fact sheet by the end of the month. Here's a characterization of what was going on within the White House from Politico from February 16, in an article headlined, quote, “White House mulls post-Covid emergency backstop for uninsured” quote,

The Department of Health and Human Services has pledged to take care of the uninsured, though it’s so far offered few specifics. The department has instead focused first on preparing the health industry and consumer groups for the official end of the health emergency, health officials said, with plans to roll out more details on commercialization as that process is finalized in the coming months.

Artie Vierkant  01:16:01

We also learned in February, through Alexander Tin, a reporter for CBS News, that when the Public Health Emergency ends, so too will the federal requirement that private labs report COVID test positivity data up to the government. As a result, CDC will be—and is now—more in the dark on case counts than it was before, to the point that an HHS official tells Tin that they will no longer be able to calculate Community Transmission Level. I should clarify, because this is a point that, as we have talked about in the past, we think is intentionally confusing. "Community Transmission Level," the thing I was just referring to, is the old system of tracking transmission—COVID transmission—from pre-2022, the one that just looked at pure COVID case count. It's distinct from the similarly named "Community Level" system that focuses more on hospitalizations that the CDC used from Spring 2022 until the end of the Public Health Emergency. So just for only slightly over one year. So the CDC is saying, essentially, it won't be able to even calculate the old system anymore.

Beatrice Adler-Bolton  01:17:04

Which wasn't that—when the switch was made, if I recall correctly, in March [February] of 2021—sorry—in March [February] of 2022—hospitals were supposed to rely on the Transmission Level system?

Phil Rocco  01:17:16

Exactly.

Beatrice Adler-Bolton  01:17:17

Okay.

Artie Vierkant  01:17:18

So at this point in the timeline, in early 2023, the only entities that are using the CDC's old system, based purely on cases and transmission—the system it will no longer be able to calculate as of the end of the Public Health Emergency—are hospitals and other healthcare settings, just like you're saying.

Beatrice Adler-Bolton  01:17:33

"Hospitals are struggling, let's get rid of any visual that might reflect that!"

Artie Vierkant  01:17:37

Well, and the data to suggest that they should in fact, keep their mask mandates in place.

Beatrice Adler-Bolton  01:17:42

Mhm. Mhm.

Artie Vierkant  01:17:42

Oops—Not "oops," you know. Yeah, exactly. These are the same places that the CDC said, yeah, okay, masking optional to, back in September 2022. See, remember, I did promise that all the preamble was going to be worth it.

Beatrice Adler-Bolton  01:17:54

It is, it is. Yeah. Painfully so.

Artie Vierkant  01:17:58

Outside of the Biden administration, there is a very significant development in February, speaking of which. Uh, speaking of masking in hospital settings. The state of New York announces that it will end its masking requirement for hospitals and other healthcare facilities on February 12. This in effect kicks off, or as part of, a wave of states, hospitals and healthcare systems that drop mask mandates across, as we've said many times before, you know, the one setting you might think would be the easiest, at least, to have maintained masking as a standard preventative practice going forward regardless of the state of the pandemic. About a month later, March [3rd], California follows suit, announcing masks will no longer be required in healthcare settings in California as of April. Speaking of masking, let's move to February 2023 in the discourse. And February's discourse is all about the Cochrane Review of masking.

Beatrice Adler-Bolton  01:18:49

Mmmm.

Abby Cartus  01:18:50

Oh, boy.

Artie Vierkant  01:18:52

In brief—

Phil Rocco  01:18:53

I thought I blocked all of this out.

Artie Vierkant  01:18:56

Yeah. I remember getting to this when I was like—

Abby Cartus  01:18:59

I did block this out.

Artie Vierkant  01:19:01

Yeah, when I was doing the research for this, this is one of those things where I was like, oh my god—

Jules Gill-Peterson  01:19:05

Every time Cochrane Review comes up, something bad is about to happen. I just say that. That goes for a lot of things, not even just COVID.

Artie Vierkant  01:19:14

And of course, the Cochrane Review of masking is the thing that, as we,'ll get into in a second, is a meta analysis that went around saying that essentially masks don't do anything, that mask mandates don't work. So in brief, this was a meta analysis of a number of studies on masking, albeit one with so many holes that even Vox did a debunk article on it. Vox, which I think is notoriously willing to repeat things from whitepapers as fact. To make a long story incredibly brief, this purported meta analysis left out quite a few studies, notably ignoring most studies that looked at evidence about COVID itself. It misrepresented the findings of at least one study it included, that did indeed show a positive effect from mask mandates in healthcare settings, and you get the gist. Most importantly, apart from the scientific issues, it was an unabashedly ideological production. Several of the authors had long standing track records of downplaying COVID, and I'll focus here on just one in particular, Tom Jefferson—not Thomas, Tom. Tom Jefferson has a number of articles published by the Brownstone Institute, which is, I guess I would say, more or less a blog—

Abby Cartus  01:20:23

Mamma mia. [ Jules laughs ].

Artie Vierkant  01:20:24

—that has the outward appearance of being a think tank, that is an outcropping or extension, I guess, of the broader Great Barrington Declaration Extended Universe. I'm just gonna read a snippet from an interview that someone conducted around this time with Jefferson for their Substack. This was titled, "EXCLUSIVE: Lead author of new Cochrane review speaks out:  A no-holds-barred interview with Tom Jefferson."

Abby Cartus  01:20:49

Ricky Gervais-ass— [ laughing ].

Artie Vierkant  01:20:52

So we read from this before on the show, but I'm gonna reread a snippet from this just to give you an idea. So the context for this is, there's a bit of back and forth between Jefferson and the interviewer. Then Jefferson says that Cochrane delayed publishing the paper for too long and says that Cochrane did so for ideological reasons, because they were worried about putting out a paper that was critical of masking. So, quote,

[Interviewer]: Do you think Cochrane was playing a political game?

JEFFERSON: That I cannot say, but [the delay] was 7 months that just happened to coincide with the time when all the craziness began, when academics and politicians started jumping up and down about masks. We call them “strident campaigners”.  They are activists, not scientists.

Abby Cartus  01:21:37

[ Mocking ] Oh, my god!

Artie Vierkant  01:21:39

Later, quote,

[Interviewer]: But people say, I’m not wearing a mask for me, I’m wearing it for you.

JEFFERSON: I have never understood that difference. Have you?

[Interviewer]: They say it’s not to protect themselves, but to protect others, an act of altruism.

JEFFERSON: Ah yes. Wonderful. They get the Albert Schweitzer prize for Humanitarianism. Here’s what I think. Your overnight experts know nothing.

Artie Vierkant  01:22:03

—The interviewer laughs—

Artie Vierkant  01:22:05

JEFFERSON: There is just no evidence that they—

Artie Vierkant  01:22:08

—meaning masks—

Artie Vierkant  01:22:09

JEFFERSON: There is just no evidence that they make any difference. Full stop.

Unquote.

Artie Vierkant  01:22:14

So for those who missed this cycle of discourse, I'll just say that lest you think we're just grabbing for a random crank here to punch down on, it's important to note that the Cochrane Review of masking had a very noticeable and dramatic impact. For instance, it was picked up in a very widely shared Brett Stephens op-ed in The New York Times, which was headlined, “The Mask Mandates Did Nothing. Will Any Lessons Be Learned?” And as per usual, when the Times prints something like that, you get a raft of people saying, "see, look, finally, you know, even The New York Times has admitted masks were a mistake," etc. Same as we saw with David Leonhardt the previous year. So here's just a brief bit from that Brett Stephens op-ed, this is from February 21, 2023. Quote,

No study — or study of studies — is ever perfect. Science is never absolutely settled. What’s more, the analysis does not—

Artie Vierkant  01:23:05

—The analysis in the Cochrane review—

Artie Vierkant  01:23:07

—does not prove that proper masks, properly worn, had no benefit at an individual level. People may have good personal reasons to wear masks, and they may have the discipline to wear them consistently. Their choices are their own.  But when it comes to the population-level benefits of masking, the verdict is in: Mask mandates were a bust. Those skeptics who were furiously mocked as cranks and occasionally censored as “misinformers” for opposing mandates were right. The mainstream experts and pundits who supported mandates were wrong. In a better world, it would behoove the latter group to acknowledge their error, along with its considerable physical, psychological, pedagogical and political costs.  …

Abby Cartus  01:23:47

No, how about fuck you instead? [ Artie laughs ] Like, I'm sorry—this just pisses me off so tremendously, because like, [ laughing ] I'm a better scientist than all these people. I'm so—like, I'm sorry. You know what I mean? Especially this Cochrane Review guy. I know this type so well. I don't even know what his credentials are. And it doesn't even matter. The credulity with which people trained in the sciences, accept these like statistical manipulations—like, there's always so much to get into with trying to study something like a mask mandate. But you have to read the evidence in such a rote and mechanical way to arrive at the conclusion, like, "the science shows this"—it absolutely does no such thing. And all of this—I'm sorry, but like, no, I don't accept it. You know what I mean? I don't accept Brett Stephens saying that we all need to, like, humble ourselves and reflect and apologize—we need to do no such thing. And I don't know, I'm sorry, we can cut this out because there's no—this is not propelling the narrative forward at all. But this just pisses me off so fucking much. The weaponization of science, but only in, again, the most rote, mechanical, like the least inquisitive, and I might add, the most ideologically rigid and sclerotic way possible, to try to browbeat people like us! It's unacceptable.

Phil Rocco  01:25:31

But it also, to me, let's think about this as an object lesson. Because, as I think I said on the episode where we talked about this, like the Cochrane Review is one of these sorts of objects that occupies a rarefied position—

Abby Cartus  01:25:51

It's invested with a lot of authority.

Artie Vierkant  01:25:52

Yeah.

Phil Rocco  01:25:52

It's invested with a lot of authority, it's seen as a—whatever—a "gold standard" of systematically, sort of, compiling and interpreting mountains of scientific evidence. And which, actually, I think perversely, that prestige makes it a perfect target for people who want to manipulate information.

Abby Cartus  01:26:20

Oh, absolutely!

Phil Rocco  01:26:20

In fact, it's credibility is one of its greatest vulnerabilities. And I think that we should expect that people will try to use it again this way, but like, people who have done Cochrane Reviews before, you know, in commenting on this, [said] like this never should have gotten through, just because of how many things that combined studies across different settings, that it was really making claims with a really high level of certainty, when that certainty simply did not exist.

Abby Cartus  01:26:50

Yeah, the politics of evidence that have just kind of like recurred throughout the pandemic, I think, are perhaps really on display with this kind of Cochrane Review episode. But, you know, just because the politics of evidence are very interesting to me, and I feel like on this podcast, like we do a pretty good job of parsing them, but yeah. Something like the Cochrane Review is like—

Artie Vierkant  01:27:17

Well, and of course, the most high profile, like—the things that always get the most high profile play are the things that are saying, "oh, well, you know, what if we did less," you know? It's always—

Abby Cartus  01:27:29

"Look at all these longhairs!" [ Laughs ] "Look at all these fuckin' commies!"

Beatrice Adler-Bolton  01:27:32

I mean, it honestly—it reminds me so much of, you know, all these conversations, Jules, that we've had around the WPATH guidelines as gatekeeping, too.

Artie Vierkant  01:27:41

Mhm.

Beatrice Adler-Bolton  01:27:41

You know, I think we look to these ways of sort of systematizing a type of finality on it, right? And seeking this kind of position that can be held up by someone in The New York Times as definitive, right? As a kind of line in the sand, as a horizon to work with. And this is, like, a very powerful gatekeeping mechanism, you know?

Jules Gill-Peterson  01:28:05

And just the death spiral of, you know, of this kind of like liberal, defensive gatekeeping that sort of thrives on a lack of context for: what is Cochrane? What is the standard? What is like, you know, these complicated conversations about evidence—

Abby Cartus  01:28:22

Yeah, "what is evidence?"

Jules Gill-Peterson  01:28:23

Yeah! Which are, like, only partly methodological scientific conversations. They are also political, social conversations. They're also rhetorical conversations and media conversations. And it just—it's like, in the particular political environment we live in, you know, it's a convenient strategy to cover up one's interest—

Beatrice Adler-Bolton  01:28:44

Yes! [ Laughter ].

Jules Gill-Peterson  01:28:45

—in upholding one version of this, right? And it's just like—just perennially, that connection makes sense to me too, Bea, it's just like, it suits people. It suits a certain political liberal strategy to disavow, you know, or make itself "apolitical" in holding up these, you know, these decontextualized evidentiary standards. Precisely because you get to fantasize that only one—only that rabid anti-science side, you know, likes to disavow its politics, and believe whatever it wants to believe about evidence. And it's just like, ugh, this is such a mess.

Artie Vierkant  01:29:25

Yep.

Beatrice Adler-Bolton  01:29:25

Mhm. Mhm.

Artie Vierkant  01:29:26

And, true to form, Brett Stephens concludes quote, "… whatever the reason, mask mandates were a fool’s errand from the start. … The Cochrane report ought to be the final nail in this particular coffin."

Abby Cartus  01:29:39

Yeah, emphasis on "whatever the reason," because I truly feel like any reason would—

Jules Gill-Peterson  01:29:43

Yeah, what an outrageous sentence!

Beatrice Adler-Bolton  01:29:45

The same could be said about your career, Brett. [ All laughing ].

Artie Vierkant  01:29:51

March 2023. This brings us to March. On March 1, a major Public Health Emergency-era improvement to the US social safety net goes away, and one that receives truly precious little coverage. I'm talking of course, about expanded SNAP benefits. The Supplemental Nutrition Assistance Program. SNAP is far from perfect. There are plenty of issues with it. But I'll take a more generous version of an imperfect program over the regular imperfect program any day. Here's one quote from an Urban Institute analysis of the expanded program from August 2022 that says what the expanded benefits did while they were in force, which is, quote, they

... kept 4.2 million people out of poverty in the fourth quarter of 2021, reducing poverty by 9.6 percent in states with emergency allotments. Emergency allotments reduced child poverty by 14.0 percent in states with these benefits.

Beatrice Adler-Bolton  01:30:51

Before we move on, can I just fast forward to a report that came out just a month ago that is the National Hunger Survey Report that showed that quote "the number of Americans without enough food over a seven day period was an average of 40% higher in September and October of 2023 than September and October of 2021."

Artie Vierkant  01:31:11

There you go.

Beatrice Adler-Bolton  01:31:12

Please continue.

Artie Vierkant  01:31:13

The biggest COVID news out of the Biden White House in March is, perhaps for the first time, not about winding down policies or mitigations, but about winding down the entire response team itself. Here is Dan Diamond and Tyler Pager's article from The Washington Post breaking this March 22, and confirming what we knew was an active discussion in the fall of 2022 and early 2023. "White House disbanding its COVID-19 team in May," quote,

A senior administration official said in a statement to The Washington Post that it makes sense now to shift out of emergency status.

Abby Cartus  01:31:49

Poor Ashish. [ Artie laughs ].

Artie Vierkant  01:31:51

As a result of this administration’s historic response to Covid-19, we as a nation are in a safer, better place than we were three years ago,” the official said. “Covid no longer disrupts our lives because of investments and our efforts to mitigate its worst impacts."

Beatrice Adler-Bolton  01:32:06

And because we gave up, so many people are so much hungrier now than two years ago.

Artie Vierkant  01:32:11

Well, also like, because of investments that we're actively undoing. Oops.

Beatrice Adler-Bolton  01:32:16

Yeah. Fucking disingenuous sh—

Artie Vierkant  01:32:18

Quote,

Artie Vierkant  01:32:18

"Covid is not over, fighting it remains an administration priority—"

Artie Vierkant  01:32:22

Sure.

Artie Vierkant  01:32:22

"—and transitioning out of the emergency phase is the natural evolution of the covid response.”

Artie Vierkant  01:32:29

There is also this detail, which I personally love, quote,

The team’s diminished presence has manifested in diminished proximity to the president: [Ashish] Jha’s office was moved out of the West Wing this year to the neighboring Eisenhower Executive Office Building, according to three people familiar with the matter.

Abby Cartus  01:32:47

Womp womp.

Beatrice Adler-Bolton  01:32:47

I mean, it's amazing that "natural evolution" of the COVID response point is almost as close as we've gotten to an official just coming out and saying, yeah, so folks, we've decided to go with social Darwinism, and we're going to turn up the heat a little bit.

Artie Vierkant  01:33:05

I mentioned this Eisenhower Building thing for a couple of reasons. First, because it shows that COVID has already been actively deprioritized. Putting Ashish Jha out to pasture in the Eisenhower Building is a pretty blunt signal. Second, I'm just gonna speculate here, I think, quote "moved to this year" suggests that when Zients came back, there was basically no need for Jha to be around anymore, except as a mouthpiece.

Abby Cartus  01:33:30

Yep.

Artie Vierkant  01:33:31

Elsewhere, in March, on March 6, New York City Mayor Eric Adams says in a radio interview on 1010 WINS quote, "We are putting out a clear call to all of our shops, do not allow people to enter the store without taking off their face mask," adding that quote "some of these characters going into stores that are wearing their masks, they're not doing it because they're afraid of the pandemic. They're doing it because they're afraid of the police." Bea writes in Alice Wong's blog—what's up, Alice, shout out—about such carceral forms of anti-masking, the idea of making masking criminalized behavior, and how it's yet another example of the sociological production of the end of the pandemic as an explicit restriction on disabled and immunocompromised people's access to, or rights to, participate in society. Let's move on quickly, though, because we're getting to another period with a lot of activity.

Artie Vierkant  01:34:24

April 2023. April 1, the Medicaid unwinding begins. States are now allowed to begin executing their plans for how they'll process eligibility redeterminations for the 90-plus million people who are on Medicaid as of April 1. An enormous, record high for the US's social safety net health insurance program of last resort. 90 million people on Medicaid. Which I think is an indictment of the capitalist state in and of itself.

Beatrice Adler-Bolton  01:34:55

Mhm.

Artie Vierkant  01:34:55

So high is this record high, in fact, that even though as of April 1 states begin culling their rolls and reversing those gains, the Biden administration still can't help but gloat about all the coverage that they're about to undo. This gloating happens in August, but it pertains to data through the end of March, so I'm going to highlight it now. On August 3, Health and Human Services Secretary Xavier Becerra tweets, quote,

In Las Vegas ... I visited Cano Health to highlight the successes of @POTUS' Investing in America agenda as it lowers health care costs.

And it's paying off — today we announced that the national uninsured rate reached an all-time low of 7.7% in early 2023.

Artie Vierkant  01:35:39

What Becerra is citing is a report from HHS dated August 3 showing data from the government's annual National Health Interview Survey. If you read the datasheet on this, here is what the very first bullet point says:

The nation’s uninsured rate declined significantly in early 2023, relative to 2020, reaching an alltime low of 7.7 percent for U.S. residents of all ages in the first quarter (January-March) of 2023.

Artie Vierkant  01:36:07

So considering that the unwinding started April 1, immediately after the period that this survey was monitoring, I would call that a pretty crass thing to be gloating about.

Beatrice Adler-Bolton  01:36:16

Yeah.

Artie Vierkant  01:36:16

Particularly in August, because as we'll see, by August, we have some of the first data already on how many millions of people were being kicked off of Medicaid in just the first few months of the unwinding. Another thing just to add for context as we talk about the unwinding going forward, it's important to note that it doesn't happen all at once. Every state, you know—it starts April 1, but every state before that had to submit a plan to HHS for how it was going to process Medicaid denials. And some of the states start sooner than others. Even for those who do start right at the beginning, right on April 1, it will take a lot of time for all that data to come in on what exactly happened with unwinding. And just because a state starts one month doesn't mean they'll finish that month, far from it. The whole process is expected to take roughly a full year. So that means we'll still be hearing about mass Medicaid disenrollments into next year. And we'll be covering that obviously. So the following states start the Medicaid unwinding process right out the gate, April 1. Those are: Arizona, Arkansas, Idaho, New Hampshire and South Dakota. But again, at this point, no data will come out from these yet. From here on out the timeline, I'll be updating us periodically with the best information we had at that given point. As of, you know—as of any given month, on how many millions of people were confirmed at that point to have been kicked off of Medicaid. In other Biden administration related developments, the CDC announces that as of the end of the Public Health Emergency, it will be dropping the Community Level system, the color coded system that we were up in arms about just a year prior, which was itself only introduced on February 25, 2022. Again, it only lasted about a year. This is the other one that I was just talking about, the two kind of confusing—intentionally, confusingly, similarly named—ways of monitoring COVID risk. We also finally, mere days away from the end of the Public Health Emergency, get a glimmer of details from the Biden administration on how they plan to deal with COVID vaccines and treatments for the uninsured after the Public Health Emergency ends. They announced what is known as the quote unquote "Bridge Access Program." How does it work? According to their Fact Sheet released April 18, quote,

This program will ... leverage public commitments by drug manufacturers to provide vaccines and treatments, such as Paxlovid, free-of-charge for the uninsured.

Artie Vierkant  01:38:38

To decode that and say what this program actually does: the government now, instead of paying for the whole thing, will pay pharmacies to administer vaccines, while for the price of the drugs themselves, it's relying on the good faith and good will of Pfizer and Moderna, and the like, to provide the drugs for free via "patient assistance programs." That makes it up to Pfizer and Moderna to decide exactly how generous they're going to be with the free drugs and vaccines and what criteria qualifies someone to actually get them. It's a deferral to just trust these private actors to play nice. We also find out the expected sundown date on this program itself. In other words, how long we should expect vaccines to remain free going forward. They specify that this should be through the end of December 2024. So for anyone listening, who maybe remembers listening to Covid Year Two or Covid Year Three when they were released, I think we can all agree that's pretty soon. It's going to be that time before we know it. And what's more, who knows who will have, you know, won that election next year? So you know, that seems to me like a classic case of kicking the can and hoping no one follows up about where it went.

Artie Vierkant  01:39:45

Other developments? I'm just going to read the title of this Biden administration Facts Sheet because I imagine some of our listeners may take issue with the characterization here. April 5, quote,

"FACT SHEET: Biden-Harris Administration Makes Progress in the Whole-of-Government Response to Long COVID."

Artie Vierkant  01:40:01

Don't recall a lot of advancements there. And I think this is one of those areas where the Biden administration's use of the term "whole of government approach" is more than a little misleading. We're almost to May, which means the end of the Public Health Emergency, but first, of course, our discourse for April. This time, we have a couple of things. The first is a headline: Washington Post, April 16. "Covid is still a leading cause of death as the virus recedes." Words can really mean anything, I guess. Also in April, David Leonhardt puts out a newsletter called "The Long Shadow of Covid School Closures," arguing among other things that, quote, "the closures … caused some Americans to sour on public schools.” Which is just absolutely rich coming from a pro-charter school, school privatization guy.

Jules Gill-Peterson  01:40:50

Never do anything! Always be afraid of souring! No political action is ever possible! Everyone! Do nothing! Every day! [ Laughter ].

Artie Vierkant  01:41:01

That's right.

Jules Gill-Peterson  01:41:02

Managing my blood pressure over here.

Beatrice Adler-Bolton  01:41:04

I was going to say, are you trying out to replace Ashish, when they re-stand up the response?

Jules Gill-Peterson  01:41:10

Right, I have to end every expression like a telegram. Stop! End! [ All laugh ].

Artie Vierkant  01:41:16

We've tried nothing and we're all out of ideas.

Jules Gill-Peterson  01:41:18

Yeah! God.

Artie Vierkant  01:41:19

This brings us to May, and the end of the Public Health Emergency. And by extension, perhaps the Biden administration's last big mission accomplished on COVID. May 2023.

Artie Vierkant  01:41:32

First things first, for May, not COVID related. RIP to Jordan Neely. Killed on May 1. That's also something I was very sad to remember was also this year.

Artie Vierkant  01:41:44

Now for this month, May, as we know, the Public Health Emergency is set to end May 11. So I'm gonna go through the sequence of events leading up to that, maybe we can pause some for some reflection when we get to the 11th. Before we get to that, and the US context, though, let's turn back to May 5, 2023. On that day, the World Health Organization saw fit to declare an end to its own declaration of a COVID global health emergency. The timing of this event, coming just six days before the Public Health Emergency was set to end in the United States, sent a very clear signal, I believe. Repeated endlessly, also, by a whole lot of people that month: that COVID was officially over. Not Joe Biden, whoopsie, was-it-a-gaffe-or-not, Detroit Auto Show 60 minutes "the pandemic is over." But instead, an official, here's the line in the sand, that-was-just-the-end-of-the-pandemic-that-we-passed-by, kind of over. I'm assuming May 2023 is going to become, probably, the historical end date of the global pandemic, even though it's clearly not gone anywhere—as we'll see very, very shortly in the timeline. But Tedros Ghebreyesus gives a speech that day, Friday May 5, 2023, which is also something of a eulogy for an ongoing crisis and includes some of the following statements. Quote:

COVID-19 has been so much more than a health crisis.

It has caused severe—

Artie Vierkant  01:43:09

—this actually dovetails well with what Bea was saying about anthropomorphizing the virus—

It has caused severe economic upheaval, erasing trillions from GDP, disrupting travel and trade, shuttering businesses, and plunging millions into poverty.

It has caused severe social upheaval, with borders closed, movement restricted, schools shut and millions of people experiencing loneliness, isolation, anxiety and depression.

COVID-19 has exposed and exacerbated political fault lines, within and between nations. It has eroded trust between people, governments and institutions, fuelled by a torrent of mis- and disinformation.

And it has laid bare the searing inequalities of our world, with the poorest and most vulnerable communities the hardest hit, and the last to receive access to vaccines and other tools.

This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths.

Artie Vierkant  01:44:11

And then here's the key part, quote,

The worst thing any country could do now is to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that COVID-19 is nothing to worry about. …

COVID has changed our world, and it has changed us. … If we all go back to how things were before COVID-19, we will have failed to learn our lessons, and we will have failed future generations.

Unquote.

Artie Vierkant  01:44:45

The very same day, May 5, the Biden administration announces that CDC director and coiner of such phrases as "the scarlet letter of the pandemic is the mask," Rochelle Walensky, will step down from her role and leave the government on June 30. We'll return to this in a minute but I think it's interesting that she announces her departure before the Public Health Emergency even ends. The Public Health Emergency in the United States, of course, then rather unceremoniously comes to an end on May 11, a closing chapter on a book that continues to be written. On May 11, 2023, when the Public Health Emergency ends, the official designation of COVID as a public health emergency lasted just exactly 1,200 days. Just over three years. 1,131,000 people had died of COVID by that point by the official numbers, which are almost certainly an undercount. More than half, about 700,000 of those, were under Biden, by the way. And by May 11, countless people had been disabled by long COVID, a number that is still growing, and a number that we may truly never know.

Artie Vierkant  01:45:53

But importantly, this is absolutely not where the story ends. That week alone, when the Public Health Emergency ended, almost 1,000 people—about 900—died of COVID, according to CDC counts. The same is true for the week before that. The week ending May 6, 947 people died of COVID in the US. The week before that, 1,024. The week before that, 1,194. These are the official figures and again, likely to be undercounts. In fact, this entire year, according to the CDC's data, the lowest weekly death numbers we have ever experienced this year from COVID came the week ending July 8, when 488 people died that week. Between May 11 and August, somewhere between 500 and 800 people died from COVID every week in the US. And as of the week ending August 26, we have once again seen over 1,000 deaths a week, every week. Which you wouldn't necessarily know, because the CDC now completely abstracts its public facing death reporting into a percentage change week on week and has done so since the end of the Public Health Emergency. So it's harder than ever to even find this out. And death obviously, is again, only one outcome, only one component of this. So obviously, we're not—we're far from done. There's much more, but this is the end of Part [Two]. So I just want to sort of pause here for a second, if anyone wants to kind of reflect on this part of it.

Phil Rocco  01:47:26

I mean, it now becomes really obvious why the Leana Wen column and other things like it is necessary. Not just because she's sort of, you know, not so subtly, angling for a high position in government. But because in order for this, you know, sleight of hand to come off, many other sort of rhetorical, perlocutionary acts have to be taken. So that, you know. You can imagine the Trump administration trying to do something like this, you know, in late 2020. And you can imagine the Biden administration, maybe, trying to do this in early 2021. And getting a little bit more, you know, outrage and blowback and, you know, I think there's some evidence of that. But after the accumulation of all these sorts of perlocutionary acts, you have a population that's receiving this information that's very different than the one that you started with.

Abby Cartus  01:48:43

Yeah.

Artie Vierkant  01:48:44

Yeah.

Beatrice Adler-Bolton  01:48:44

Mhm.

Phil Rocco  01:48:45

There is—a whole cultural, I think, process has taken place that allows you to say this. That allows this shift in kind of the statistical apparatus of the pandemic to change in such a fundamental way, such that we can no longer, you know, talk about those aggregates so effectively. And there's no, you know, real response. It's a whimper. If anything. I mean, it's—it's really. You know, the "opinion leaders" are not going to take a strong sort of objection to this at all.

Abby Cartus  01:49:27

Yeah, Phil, maybe just to kind of, like, rephrase what you said. I was thinking a very similar thing listening to all of this. Which is that—just hearing, you know, the weekly mortality counts around this time, you know, like, in May. It's really clear, like, oh, this is exactly what all of that rhetoric was for. Like, this is what "pandemic of the unvaccinated" was for. This is what like all those David Leonhardt columns were for. I mean, basically, I'm just restating exactly what you said, but it's so.. I don't know, it's just kind of clarifying in a really weird way to see, you know, what I mean? Like the process of conditioning the population to accept this because we've been conditioned to understand that people dying of COVID is their own fault and their own problem. Yeah.

Jules Gill-Peterson  01:50:35

Yeah.

Artie Vierkant  01:50:35

Yeah.

Beatrice Adler-Bolton  01:50:35

Mhm. Well, and—I mean, it's like, we came to describing that feeling as "the sociological production of the end of the pandemic" not because that was like a cute or clever turn of phrase. But like, early on in 2020, we talked about, you know, things like the kind of performativity of some of the discourse for already saying "COVID's gonna last two weeks," you know. And so, as normalization began so quickly, nearly as soon as the quote unquote official pandemic started, you know, it did feel sort of surreal in a way and it—like we settled on that phrase, simply because it was like the best I think that we could articulate and describe what we felt like was maybe unfolding before our, you know, eyes and ears and whatever. It's funny because like [ laughs ] I actually can't stop thinking about my favorite episode of X-Files, around this conversation.

Abby Cartus  01:51:49

Hell yeah, what is it?

Jules Gill-Peterson  01:51:51

Yeah, yeah.

Beatrice Adler-Bolton  01:51:51

It's Jose Chung's From Outer Space. And it's the weirdest, and one of the most fun episodes. It's very meta. But it is about a alien encounter that happens where someone who is a fighter pilot working for the US government, whose job is to fly, you know, US government experimental planes, dressed up as an alien, to do fake alien encounters, is abducted by a real alien. [ Jules laughs ].

Abby Cartus  01:52:24

[ Laughing ] Oh, no!

Beatrice Adler-Bolton  01:52:25

And there is this amazing scene of him as an alien smoking a cigarette, rocking back and forth going, "this is not happening. This is not happening. This is not happening." [ Laughter ]. And like, you know, I feel like I've gone through each stage that that character, Lieutenant Jack Schaeffer goes through in that fucking episode, right? Which is like, you start with being the alien in a cage, you know, and then you have like, later on in the episode, he does, you know, the Close Encounters thing with Mulder in a diner. And he, you know, makes the mountain out of mashed potatoes. And he's like, I'm not sure if any of this really happened. Like, I'm not sure if I'm really here. Or if we're having this conversation right now. Because what we have seen is like, the idea of the pandemic early on, was this incredible threat, right. And we have seen the reality of that threat persist, and yet the comprehension of that threat, be systemically destroyed, such that it has made so many people question, you know, what the point of government and the state are in a way that I think, maybe just had not occurred to some people before? Right. You know, I think there was a lot of, like, expectation that Biden coming in would fix it. Right. And I think we've all just sort of lived through, not just like demonstrating that that notion that I think many people sort of started 2021 with, as false. But as this being way more than simply like, again, like a "failed public health response." This is an indictment of so many dynamics—

Abby Cartus  01:54:06

A whole of government failure.

Beatrice Adler-Bolton  01:54:08

Right, this is a "whole of government approach" that has fucking failed, right? This is a approach of distributing resources and managing resources and society that has failed. If you're counting killing people as failed. And I think it's really become so clear that killing people doesn't count as a failure on that sort of grand ledger, right. And I think for a lot of folks, the facade of the benevolent state has been completely shattered during the ongoing pandemic, but especially during this, you know, the production of its official "end" in the United States, which is particularly this acute period that we have been living through, I'd say like the last 18 months. And I think we're gonna look back at these last 18 months many times throughout our lives and say, what the fuck happened? Because it can feel so bewildering and like it all happened so fast, and it's—what I'm overwhelmed by is just how little time we have gotten through and how much has fucking changed since the beginning of our timeline. Just to where we are right now, and it's just—yeah. I feel like the guy dressed as an alien in a cage, smoking, saying "this is not happening."

Artie Vierkant  01:55:32

This is why I wanted to start in September 2022 with the Detroit Auto Show thing, because it feels like a different universe now.

Jules Gill-Peterson  01:55:41

Yeah.

Abby Cartus  01:55:42

Yeah.

Artie Vierkant  01:55:43

Like, remembering how recent it was that there was an uproar over—obviously, I know some people were clapping for Biden saying quote, unquote, "the pandemic is over," but like, there was an uproar about him just saying it and people were like, "what the f—are you fucking kidding me?" You know, like, "it's not over." And then when you, you know—sitting here now in December 2023 and looking back to that, it really, it feels—yeah. It feels like a different universe or something. But it was so recent. And I feel like that is the power of the sociological production to the end of the pandemic. That's the power of this normalization process that again, is like, principally spearheaded by the Biden administration and the undoing of all of these programs, all of these supports, and particularly all of like—not just policies, but the like changing rhetoric that makes it increasingly the pandemic, the responsibility or the burden of a narrower and narrower, perceived group of people.

Beatrice Adler-Bolton  01:56:47

Right.

Artie Vierkant  01:56:48

Even though it's not.

Beatrice Adler-Bolton  01:56:49

I think it's also important to frame—I'm thinking about this, because of my conversation with Astra Taylor about her book, The Age of Insecurity, which is like, it's these policies that were wound down, yes, absolutely. It's the pandemic that was wound down. Yes, absolutely. But what was also wound down was a temporary shift in the baseline of security for people in the United States that had come with the pandemic response, right? We had a—you know, I think the student loan pause, for example, which, you know, we're living through the turning back on period, and it's been devastating for so many people.

Abby Cartus  01:57:27

Lord, don't I know it.

Beatrice Adler-Bolton  01:57:28

You know. And these tiny things like pausing student loan payments, right? SNAP. The Medicaid disenrollment pause, you know, these were interruptions in the kind of insecurity that drives our economy. That drives so many markets, right. So that also is what was being ended here. Right. It's not just about the pandemic, and this being about them not wanting to recognize disease, it's also about, you know, well, the disease brought proof that our economy doesn't need to be run at the pace of growth and towards the kind of growth that it is run, right? That we don't have to force people into such precarious situations, that we can actually give people, just, Medicaid and not kick them off. Right. So, you know, this is also like, within the workplace, you know, nurses have had this incredibly volatile shake up to the landscape of employment, where you had people basically having nursing shortages in certain areas. And so then they were offering traveling nurses all these bonuses to come travel to the state over to take it over there. So then you had people, you know, being paid a tremendous amount of money to kind of come in for this COVID care on short contracts that has, you know, changed the way that, you know, nurses relate to each other as co-workers, right, as colleagues, because all of a sudden, you have, you know, someone working next to you who's making $3,000 a week, and you're making $600, right, and so you have all of these sorts of things that, you know, whether it's liability also, thinking back to our conversation with Nate Holdren, right, the way that business leaders were really waiting to find out what the liability situation was going to be, whether or not they were going to be responsible for hurting, you know, people—

Jules Gill-Peterson  01:59:14

Mhm.

Artie Vierkant  01:59:14

Yeah, we're getting to that.

Beatrice Adler-Bolton  01:59:15

—or killing people, related to or living with any of their employees, if their employees got COVID at work. So, you know, what was ended was not just the perception that COVID is, you know, something that makes us sick and disables us and kills us and is bad, and that we absolutely, easily, simply, can suppress to a point that makes the world accessible for people like me with fucked up immune systems, on medication, you know, and, you know, to the, like—the shitheads, who want to see everybody smile, right. But it involves effort, and it involves provisioning towards a fucking direct goal that is COVID zero, right, eliminating spread to the point where it's not a problem, right, standing up a real public health response, etc. Right. But that is not just the only idea that was ended. The idea that was also ended was that when there is an emergency, that can incur a temporary pause in the insecurity that defines so many of our lives, right? And that that, above the threat of a deadly, disabling disease, right, like, is really, really important to stop. Even if it means that that makes the disease go on forever. That's the decision that this Democratic administration made. And implemented.

Abby Cartus  02:00:35

Such a great point.

Beatrice Adler-Bolton  02:00:36

And when they had evidence that the plan wasn't going well, they stuck to the plan.

Artie Vierkant  02:00:41

Yep.

Beatrice Adler-Bolton  02:00:41

Execute. Execute. Execute.

Abby Cartus  02:00:45

And that's the metric of success that they judge themselves by.

Beatrice Adler-Bolton  02:00:48

Exactly. Back to our conversation with Adia Benton. You judge yourself by your own rubric? Then baby, you're doing great, right? And we specialize in that.

Jules Gill-Peterson  02:00:58

Yeah. [ Laughs ].

Phil Rocco  02:00:58

But more than anything, don't talk about the rubric.

Beatrice Adler-Bolton  02:01:01

Mhm.

Jules Gill-Peterson  02:01:01

Right.

Artie Vierkant  02:01:02

Yeah.

Phil Rocco  02:01:02

Do not talk about the goal. Once you're talking about criteria, then people start thinking about other criteria. You don't want to talk—you know what I mean? Like, that's, I think that's a very fundamental thing, like, you should not be asking, or you should depress the analytical acuity to ask, "what should we be doing?"

Beatrice Adler-Bolton  02:01:22

Absolutely.

Artie Vierkant  02:01:22

Well which, I mean, to—I just want to bring in, you know, we have to remember, there's also like, stuff that came out in 2022 that we talked about in Covid Year Three that was, you know, to the effect of like, yeah, they had conversations that were: what is an acceptable, quote, unquote, "acceptable" level of daily deaths?

Beatrice Adler-Bolton  02:01:39

Right.

Artie Vierkant  02:01:39

Right? And they decided to not pick one, because as you're saying, Phil, if you have a rubric, if you have a goal—

Abby Cartus  02:01:48

You can fail.

Artie Vierkant  02:01:50

—you can be made accountable for that goal, or you can be pressured over that goal.

Jules Gill-Peterson  02:01:55

Mhm.

Beatrice Adler-Bolton  02:01:55

Mhm. I mean, I have a friend who's a mortician. I hadn't talked to her many years. But we recently reconnected because of COVID. And what she said to me is, you know, I'm, you know, I'm not running a charity, right, and it fucking sucks how much money I've made on COVID deaths. I feel disgusting, like, so I started in mask bloc. Because I don't know what else to fucking do. But it's not like, you know, all of this death is again, necessarily a bad thing from the position of the state, from the position of, you know, this, what is the plan? Is the plan getting back to normal economic production? Then, yeah, if that's your goal, like, and the cost is x many dead, right, it's just a matter of finding the right amount of dead that they've decided they can live with, you know?

Abby Cartus  02:02:43

Right and managing the distribution of where those deaths are going to be concentrated.

Jules Gill-Peterson  02:02:47

Exactly. Regularizing it, making it predictable. Not reducing it to the lowest level possible, or to zero.

Beatrice Adler-Bolton  02:02:55

Exactly. Yeah.

Artie Vierkant  02:02:57

Let's jump back into the timeline. As we mentioned, far from—you know, May 11, far from the end. And we're now arrived at what I'm kind of designating Part Three. 2023, after the end of the Public Health Emergency. May 11, and onwards. So. While we are still here in May, there are a couple of other important things we need to touch on. The first is that the unwinding is kicking into full swing in May, as all of this end of the Public Health Emergency stuff is happening. As I mentioned before, states started their unwinding processes in a staggered fashion, a few clusters at a time. That very small handful of states started in April, a bigger group starts in May. Here are those states. So in May, the following states began their unwinding process: Connecticut, Florida, Indiana, Iowa, Kansas, Nebraska, New Mexico, the Northern Mariana Islands territory, Ohio, Oklahoma, Pennsylvania, Utah, Virginia, West Virginia, and Wyoming. So keep this in mind as we get to the figures of how many people start to get kicked off of their social safety net insurance. The first numbers that come out, which are dramatic, are actually low, because reporting is always delayed. Another important development: on May 9, the California State Supreme Court hears oral arguments in Kuciemba v. Victory Woodworks, a closely watched case concerning so called take home COVID. The case centers on a workers claim that he caught COVID on the job in early 2020, as a result of his employer's negligence and flaunting of local public health regulations, and that he then brought it home to his wife who became seriously ill and was hospitalized for weeks. Kuciemba, the worker, loses in a decision handed down in July. We did a whole episode on this case with Nate Holdren, highly recommend it. It's very fucked up. But the occasion of the year-in-review format allows me to bring in one thing I completely forgot to mention in our episode about it, which is the following quote from the oral arguments in the case, which happened in May. So Robert Dunn, testifying on behalf of Victory Woodworks said:

If you greenlight this duty—

Artie Vierkant  02:05:06

—as in, if you hear in favor of Kuciemba—

If you greenlight this duty it's even hard to see how you would limit it to COVID. I mean, influenza every year kills 20,000 to 80,000 people and we've just never sort of put it on the employers to say, well, you're responsible for anyone at home who gets sick.

Artie Vierkant  02:05:24

To round out May, let's look at the discourse. This one comes not from some pundit crank, but from Supreme Court Justice Neil Gorsuch, so, a crank who happens to be a judge. Quote,

Since March 2020, we have experienced the greatest intrusions on civil liberties in the peacetime history of this country. Executive officials across the country—

Abby Cartus  02:05:46

[ Laughing ] As your phone is collecting every single piece of information [ all laugh ] about every single thing you're doing—like yeah, give me a break.

Artie Vierkant  02:05:53

He's a Supreme Court Justice. He doesn't know anything about technology. [ Laughs ].

Abby Cartus  02:05:57

Yeah, I know.

Artie Vierkant  02:05:57

Executive officials across the country issued emergency decrees on a breathtaking scale. Governors and local leaders imposed lockdown orders forcing people to remain in their homes. They shuttered businesses and schools, public and private. They closed churches even as they allowed casinos and other favored businesses to carry on.

Beatrice Adler-Bolton  02:06:17

Well, no one's saying churches should have stayed open.

Abby Cartus  02:06:20

[ Laughing ] Yeah, I mean, I was in favor of closing casinos—I love the, uh. The old school morality of it, though, like: dens of vice were allowed to remain open!

Beatrice Adler-Bolton  02:06:29

Yes.

Artie Vierkant  02:06:30

I love this because it's just like one of those classic, you know, examples of the imagined giant COVID police state that was, or something. Anyway. This is, I would note, from an official court document in a case on Title 42, which I wish there was more room to put information in, in this timeline, but we did an episode about it [Title 42] with Silky Shah I would recommend. But so, it was a quote from an official court document. Not like, Gorsuch speaking off the cuff on Bill Maher or something. Though you could be fooled.

Artie Vierkant  02:07:02

So this brings us to June 2023. With so much of the COVID response disassembled and the Public Health Emergency now officially a thing of the past, the Biden administration turned inward to disassemble the COVID team itself. CDC director Rochelle Walensky, still at work in June, had already announced that she will be leaving the CDC at the end of the month. We will return to Walensky in a moment. In early June, on the 8th, it's announced that Ashish Jha, too, will step down on June 15. With Anthony Fauci already gone, having left at the end of 2022, this means that by the end of June, practically every high profile face of the COVID response will be officially out of sight and out of mind in time for the next year's election, despite the fact that Jeff Zients, one of the most powerful figures in the COVID response overall, is now in a position of greater power. But of course, as we talked about, he remains still much lower profile than any of the others when it comes to taking public accountability or responsibility for COVID. On June 6, for the first time in a while, a Biden administration official repeats the old—I don't know if at this point it's, you know, this far on, it's better to call it a "pandemic of the unvaccinated" line, or the "winter of severe illness and death" line, which are basically the same line. But speaking at Politico's Healthcare Summit, HHS head Xavier Becerra says the people who are still dying from COVID are quote, "either unvaccinated or undervaccinated." And that quote, "if you're dying of COVID today, you didn't take precautions."

Artie Vierkant  02:08:37

On June 16, Mandy Cohen is announced as Biden's pick to replace Walensky as the new Director of the CDC. We did a whole episode on this called "Who is Mandy Cohen?", but I'll say some highlights of what we knew about her before she came in. We knew she was probably handpicked by Jeff Zients because of their time together in the government during the Obama administration. We know that as Health Secretary of the State of North Carolina, Cohen said multiple times that she was open to adding work requirements to the state's Medicaid program which, as Phil pointed out on that episode, beyond being just an explicitly right wing position for any Democrat to take, is actually illegal. At least for now. We'll have to see what fresh hells are coming. Now I'll also add one thing we know now that we didn't know when we recorded that episode, which is that the moment Cohen would come into the CDC, she immediately started having her social media team post pictures of her running around at the CDC's Atlanta headquarters maskless. This included, famously, in her first week on the job posting a selfie where the one person masking in the photo appears to have been deliberately cropped out. [ All laugh ].

Phil Rocco  02:09:42

Oh, my god. I remember that.

Artie Vierkant  02:09:47

We're gonna do a transcript of this. So I'll make sure that that's a link to the actual post itself, because it's—it's like comically obvi—anyway. Finally, and not to be, you know, referencing a right wing publication here, but I think it's indicative and I think that the characterization is apt. When Cohen's name started circulating as the likely pick, The New York Post ran this headline June 2 quote, "Biden's likely pick for new CDC director loosely followed her own COVID protocols, laughed off lockdowns."

Abby Cartus  02:10:23

L - O - L.  Laughing off lockdowns. [ All laugh ].

Artie Vierkant  02:10:30

Again, more on Cohen in past episodes, but it seems pretty clear that Cohen's job is similar to why Ashish Jha was brought in the previous year, which is to allay fears, change the face of the response and smooth out the transition to a putatively post pandemic environment as quickly as possible. On June 27, a few days before Rochelle Walensky's exit, Walensky publishes an opinion piece in The New York Times. If you go look it up now, the headline currently reads: "What I Need to Tell America Before I Leave the CDC." But I prefer the original title, the one that they silently changed a day or two after it was first published, that original title was, quote, "Our Pandemic Despair is Fading Too Quickly." Here are some highlights, quote,

The job of public health is to strike an appropriate balance between protecting the health of all those who live in the U‌nited States while minimizing the disruption to the normal functioning of society. ‌The goal is to offer science-driven recommendations that balance protection and practicality in the context of one’s individual risk tolerance and value set. For example, the question of how low the rates of infections in schools need to be for them to remain open has much to do with whether you have an immunocompromised family member in the household, or whether you can supplement education with personal tutors or whether you require school lunches for your child’s nutritional needs.

Phil Rocco  02:11:55

So like let—can I?

Artie Vierkant  02:11:57

Yeah, go for it.

Phil Rocco  02:11:58

This is—this is great. It's like, I always think about how, you know, the whole, like structure of any number of algorithms just serves you back the things that you've chosen to see before and just, you know, locks you in a permanent cultural feedback loop. This is great, because it's like, what if public health looked at inequalities in society and said, you know, what, rather than—I don't know, you know—rather than trying to take stock of them and deal with them or confront them, let's actually build them into our strategy. [ Artie laughs ]. Let's assume not only that they exist, but that they are good. And that what we should try to do is make preserving them our criteria for success. That's exactly what that does.

Abby Cartus  02:12:47

Yeah. Well, and it's so interesting, because it's like, the clear—again, maybe I'm just inverting exactly what Phil just said—but it's so strange to blame people, and blame people for having, you know, the—like an "incorrectly calibrated emotional state." And I mean, this is what public health does, as kind of an enterprise, is just rationalizing these things. You know, so much of what is actually social inequality just gets called "bias" in like epi—public health research. And maybe this is a little bit of like a personal note, but it's been hard for me to watch public health be just, you know, this adjunct of this, like, ideological project of the state, you know, rationalizing all of these massive failures as like, mm, I don't know, "issues with our feelings," you know, like, "ooh, we're not feeling the right amount of despair," you know, as if—because I think, you know, what that does is, creates this figment of some sort of connection between, like, what our feelings are, and what happens at a policy level, which, like, we all know, is not real.

Phil Rocco  02:14:03

Yeah. I mean, I think it's also, and we've—I think this has been a consistent theme over the last four years—which is that the structure of the American state, it reproduces a certain kind of top stratum leader, and that person has been selected for the narrow way, typically, that they think about problems sort of individually, not especially synthetically. Because when you look at something like, yeah, the schools situation—and you know, I can recall us sort of talking back, you know, as early as 2020. It's like, you know, there are a lot of reasons why we weren't a "pandemic ready society," so to speak, you know, going in. To actually deal with that you can't sort of look at the individual components kind of one by one and say, what if we tweak this? What if we tweak that? And it's not just like, what they call "a whole of government approach," which is like, we bring in every agency and we ask them, like, what are some things that you could do about this? It's like, a whole of, you know, class society approach where you're like, okay, well, ultimately, we've created a world in which when a crisis happens, the crisis has the potential to absolutely, like, deepen inequalities in profound ways. And the fascinating thing to me, is that by by some—you know, no one would say that the US response to all of this was like, good by any means. But some things happened by who knows what divine intervention. You know, we had programs that did reduce child poverty to a greater extent than had ever been reduced in the last few decades. Temporarily. And then we decided, like. No. That's not a new set point that we want to hit. Right. And I mean, who's to say like, that incident might be politically generative in the future. But it's not being politically generative now, and it wasn't when the, whatever, so-called center left party that you might have thought had been able to capitalize on it could have, right. That's the more kind of fundamental takeaway for me is that by selecting for technocrats over and over again, you've produced a cadre of people who are systematically incapable of seeing the moment kind of for what it is and being able to use the power of government to pivot in a more profound way.

Artie Vierkant  02:16:40

Yeah.

Beatrice Adler-Bolton  02:16:41

I think that's a really great point.

Artie Vierkant  02:16:43

So while we're on the topic of Rochelle Walensky's exit, I'm going to fold something in here that happens slightly later. So in early July, on the 7th, The New York Times publishes an interview with Walensky that is actually a fascinating read. It is conducted by David Wallace-Wells. In the interview, Wallace-Wells attempts to get Walensky to respond to a number of points that actually echo our criticisms of the Biden administration's pandemic response, especially those from Covid Year Three, the episode that we put together last year. I'm going to read only some snippets of this, but I'm gonna link to our episode that we did about it in the description, it's a patron episode called "Walensky Responds," where we go through the whole thing—not the whole thing, but like a lot, quite a bit of it, actually—to see what we learn from it, and what is kind of confirmed by it. And mostly what we learned, I think, was that our assessment of what the Biden administration was thinking, our assessment of their internal strategy, has been pretty spot on. So in this interview, among other things, again, just going to go for some highlights. Walensky says of ongoing COVID deaths that quote, "ultimately, it became that you valued your health only according to how you voted," unquote. Repeating the old, inaccurate, COVID red / COVID blue thing, that COVID is now just a problem for Republican anti-vaxxers or something.

Artie Vierkant  02:18:08

Wallace-Wells asks her also, repeatedly, about breakthrough deaths, which was a major theme of our last year-in-review episode, Covid Year Three. By the way, just a note here, the CDC dataset we used to look at breakthrough deaths hasn't seen any updates with 2023 data, or else I would have been probably reading them out to you this whole time. But you know, we just don't have that right now. So Wallace-Wells brings in that quote, uh, asking Walensky, quote,

In early August of 2021, you told CNN that breakthrough infections caused mild illness: “They are staying out of the hospital. They are not dying, and I think that that’s the most important thing to understand.” At the time, about 5 percent of American deaths were among the vaccinated, [but] the share would quickly grow, to 22 percent by September and 41 percent by January 2022.

Artie Vierkant  02:19:04

Walensky responds, quote,

It’s an interesting question and an interesting conversation that we can have. We did an assessment of who was dying. And we published it in November, I believe, and part of that was showing that those people who are dying from Covid are those who have very high rates of comorbidity. Some of them are dying at home. Some of them are dying in hospice. That is not to dismiss their death. They’re important deaths. But the character of the kind of person who was dying is different.

Artie Vierkant  02:19:36

Yuck. The study she's talking about, by the way, an MMWR—Morbidity and Mortality Weekly Report—we expand on this in that episode, but I will just say the comment she's making is based on data from 36 deaths. So, kind of a paper thin thing to hang your argument on. Anyway, said it before, said it a million times, but, as I think Phil was just alluding to, too, you know, we're interested in Walensky's responses here insofar as she's an avatar of the state, a figure involved in decision making, sure, but ultimately part of a much bigger process within the Biden administration and the federal government. But this does—this whole thing—does tell us a lot about what they were talking about in the earlier years of the Biden administration.

Abby Cartus  02:20:21

She does seem like a nightmare, personally, though. I'm just gonna add that as well. [ Laughter ].

Artie Vierkant  02:20:26

As all of this is happening, of course, the effects of the end of the Public Health Emergency are already being felt. Despite the fact that the Biden administration has sworn up and down that the end of the Public Health Emergency won't mean that vaccines and treatments are no longer free, by June, we've already heard plenty of stories of people getting denied the vaccine or Paxlovid by insurance, or it just being completely unavailable where they are, actually. We, in fact, read a selection of listener's stories about this happening to them on an episode from early June called "Covid in an Abandoned Field."

Artie Vierkant  02:21:00

To turn back to the unwinding for a moment, like I've noted for previous months, Medicaid unwinding is a rolling process will take about a year. So for June, here are the states that begin. This is the—June is the month with the biggest set of states that begin their unwinding—states and territories. They are Alabama, Alaska, Colorado, DC, Georgia, Hawaii, Kentucky, Maine, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Jersey, North Dakota, Puerto Rico, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Washington and Wisconsin. Keep in mind, again, because data on this is lacking, it will still be another two months or so in the timeline before we have data on these states, on how many people they've kicked off. But June is the very first month that we get any insight into how dramatic the unwinding is, and the numbers are not great. According to a Kaiser Health News piece from June 1 called quote "As Medicaid Purge Begins, 'Staggering Numbers' of Americans Lose Coverage": already, from the very first data, with just 12 states reporting—really, again, preliminary data—there are already 600,000 confirmed disenrollments from Medicaid. Those states, those 12 states, don't stop, by the way. Obviously, it's just the early numbers that are reported. Many of these denials, immediately, it becomes clear, are also happening for what are called "procedural reasons." In other words, paperwork errors, or I would say more simply, the high amount of administrative burdens in the regular Medicaid system that essentially is built to constantly be kicking people off for minor technicalities. What is also known as the lovely, grotesque, term "churn." We've talked about that plenty on the show in the last year. Politico also reports on June 14 that some states are kicking people off of the Medicaid rolls simply because of software glitches to read from that report, which concerns Medicaid in Arkansas, quote,

Three Medicaid eligibility workers — who were granted anonymity to speak freely about their work — told POLITICO that they have seen those glitches with the state’s new eligibility system, which was developed by the consulting firm Deloitte as part of a $340 million contract and launched in December 2020. The workers said they call them glitches because they seem to happen right after a system update is performed and because there’s nothing in clients’ files to explain the terminations.

Beatrice Adler-Bolton  02:23:29

God.

Artie Vierkant  02:23:29

In other words we have—in the first month that information is available at all about this impact of the unwinding, not only are the numbers bad, not only is it clear that a lot of people are losing their coverage already because of, you know, quote unquote "procedural reasons." Also, we have reporting that is showing that essentially, like, bad software created by a management consulting firm is automatically disenrolling people, just as a "oopsie." And this again, this is publicly reported, Biden administration does not act on this. One final note on the unwinding, also in June, Kaiser Family Foundation also releases the results of a poll on what the general public thinks is happening with regards to Medicaid. I will read from their written report on the poll, quote,

Most Medicaid enrollees were not aware that states are now permitted to resume disenrolling people from the Medicaid program. Roughly two-thirds (65%) of all Medicaid enrollees say they are “not sure” if states are now allowed to remove people from Medicaid if they no longer meet the eligibility requirements or don’t complete the renewal process, with an additional 7% incorrectly saying states will not be allowed to do this.  Three in four adults 65 and older say they are unsure if states are allowed to remove people from Medicaid, and Black adults are more likely than White adults to incorrectly say that states will not be allowed to do this. Just under three in ten (28%) overall are aware states are now allowed to remove people from Medicaid.

Artie Vierkant  02:25:02

"Nearly half of Medicaid enrollees say they have not previously been through the Medicaid renewal process.“

Artie Vierkant  02:25:11

In other words, a lot of people don't even know that this is happening. And if it's happening to them, don't know what, like—what is happening, or why it's happening. And I'm just gonna say: why should they?

Phil Rocco  02:25:25

Right.

Artie Vierkant  02:25:25

Right? I'm just gonna, you know. They shouldn't have to know. First of all, we should just have a free national health system. But on top of that, I mean, you've paused redeterminations, a key part of Medicaid, for basically three years. Many people on Medicaid—and remember there are some 90 million of them by April 1—many of these people may not have previously experienced the worse version of the system that was set up to kick people off all the time. You basically showed them how much more generous the state could be, and then yanked it away. So. It's also worth noting the Biden administration has the power to stop this. They can intervene. They could have done it then. And they can still do it now. But back then, especially, HHS could have put the brakes on redeterminations, especially after seeing, as we also learned in June, that there are states like Indiana where we already know 89% of their Medicaid denials were those so-called "procedural reasons." So, anyway. They don't stop it, though. Instead, Xavier Becerra sends what I cannot even call, in good conscience, a "strongly worded letter" to states—some states. Here's a bit of that, dated June 12, quote,

Given the high number of people losing coverage due to administrative processes, I urge you to review your state’s currently elected flexibilities and consider going further to take up existing and new policy options that we have offered to protect eligible individuals and families from procedural termination.

Artie Vierkant  02:26:47

He goes on to make a few very, very low impact recommendations such as, hey, you've got a whole year why not space the denials out more, over time? Anyway.

Artie Vierkant  02:26:55

Your "June in the discourse" treat is simply a headline. June 5, LA Times. Opinion: "We've made huge advances against COVID. Why is it still killing so many people?" Why indeed.

Artie Vierkant  02:27:08

July. July 2023. This brings us to July. I'm gonna break with tradition and not start with the Biden administration for July. On July 6, the decision comes down in the previously mentioned Kuciemba v. Victory Woodworks case, the California State Supreme Court case I mentioned earlier. Recall that this case was over a worker's ability to sue under workers comp after a worker brought home COVID to his wife and she became so ill she was hospitalized for weeks. Court says no. Couldn't possibly. Once again, I'll plug the episode we did with Nate Holdren on this which was called "Unlimited Liabilities," if you want more details, but here is some of what the actual language from that court decision in July sounds like, quote,

While employers may already be required to implement health and safety protocols to protect their employees from COVID-19 infections, concluding they owe a duty to the household members of employees has the potential to alter employers’ behavior in ways that are harmful to society.

Because it is impossible to eliminate the risk of infection, even with perfect implementation of best practices, the prospect of liability for infections outside the workplace could encourage employers to adopt precautions that unduly slow the delivery of essential services to the public. …

There is simply no limit to how wide the net will be cast: the wife who claims her husband caught COVID-19 from the supermarket checker, the husband who claims his wife caught it while visiting an elder care home, the member of a sorority who claims a sister while serving on jury duty caught it from the court bailiff, all these people would have potential claims against entities deemed essential to society’s ability to function. The financial burden that duty would impose on employers would be devastating. Even if that duty were limited to the employee’s household, the expansion of liability would be too great in the wake of a replicating virus.

Beatrice Adler-Bolton  02:29:09

Couldn't have that.

Abby Cartus  02:29:10

Our money or your life. [ Laughs ].

Jules Gill-Peterson  02:29:12

Right? What a classic capitalist dilemma. If we were to route this through the normative contractual arrangement of our society, the society would immediately collapse. Therefore, we can't do anything! [ Laughing ] Ever! We have to just ignore this.

Artie Vierkant  02:29:27

You know, in a way, they basically—they wrote Health Communism for us. Sort of. I mean, that's kind of what we were trying to prove.

Jules Gill-Peterson  02:29:35

Yeah, yeah, yeah, yeah. Reverse version.

Artie Vierkant  02:29:37

Yeah, reverse version. Just a last thing to say, I guess. You know, maybe the most important observation I think I have about this. This decision, I think, is very interesting, because it unites two potentially very contradictory positions. On the one hand, they're saying COVID is so pervasive it's just a fact of life now. Not employer liability, and evidence for that—their evidence for that—is essentially that the pandemic is over, by which, you know, basically is meant, like, the Public Health Emergency is over. As they say, quote, "it is impossible to eliminate the risk of infection," unquote, at this point. But then on the other hand, they're saying that if the employer were to be liable, we know that there would be so much harm happening from COVID, that there would be this wave of lawsuits that would bury employers and the court system itself, you know what I mean?

Beatrice Adler-Bolton  02:30:25

Yeah.

Artie Vierkant  02:30:27

You know. I mean, it's somewhat contradictory, which—it is basically like the whole, you know, quote unquote "COVID is over" argument in a nutshell. Ridiculous. Next. The big news in July though, is that even with our warning indicators and data collection systems stripped for parts it's clear to everyone that there is a huge wave happening. This is the month where the headline I read way, way earlier, two hours ago or something, comes from, which is the headline from Forbes [Fortune], quote, "Has COVID-19 become a summer illness? Cases and hospitalizations are on the rise again." Again, you know, I'm endlessly fascinated by the media's willingness to print shock and awe every time there's a wave when it's not the height of flu season or something. Because as we've talked about, you know, we've seen this over and over again, it clearly doesn't go away. It's not really seasonal. This does lead to some jaw dropping, or maybe even, at this point, unintentionally funny other headlines that try to cover the summer wave. I'm going to combine some here, of the pieces that ran in July and August, because that whole span of two months there were a bunch of these articles that did this kind of, like: "wait, there's still COVID?" thing. So stop me if you remember any of these, which we talked about in an episode called "The New (New, New, New) Normal."

(Artie’s note: Some of the following headlines have been changed. These links reflect the headlines as they were originally posted, or in some cases A/B tested versions).

Artie Vierkant  02:31:40

Slate, August 4: “COVID Hospitalizations Are Going Up. Are we … in a surge?”

Beatrice Adler-Bolton  02:31:47

Oh, my god, that one.

Jules Gill-Peterson  02:31:48

Aah!

Artie Vierkant  02:31:48

Politico, July 31st: “Covid-19 Cases Are Climbing But Don’t Be Alarmed”

Artie Vierkant  02:31:54

The Hill, August 1st: “COVID hospital admissions jump in what could be a new norm of summer surges”

Artie Vierkant  02:32:01

New York Times August 2nd: “Amid Signs of a Covid Uptick, Researchers Brace for the ‘New Normal’”

Artie Vierkant  02:32:08

And finally, Washington Post, August 7th: “Covid or a summer cold? Without free tests, many won’t know.” That one's a little sad.

Artie Vierkant  02:32:21

While I could suppose all of this embrace of the new new new new normal could easily pass for July's top discourse, we've got something much better than that. So first, runner up for discourse of the month is July 17, The New York Times's David Leonhardt publishes a piece called "A Positive Covid Milestone." In it, among other things—

Abby Cartus  02:32:40

Oh, god.

Artie Vierkant  02:32:40

—he casts copious doubt on a discussion that is very much on the rise, which is to look to excess mortality data from the CDC, noting that it is much higher than it should be, or, you know, that might be expected to be, or much higher than what the official COVID case count is. And pointing out that that excess death figure, you know, probably gives us a better picture of where COVID deaths are actually at. By July this is basically one of the best ways for people to understand how many COVID deaths are happening, especially since the CDC's public facing tools have, as I mentioned before, changed now to just show a percentage change in COVID deaths week on week. Not to get ahead of myself, but it may not surprise you that the CDC decides to stop doing the excess deaths calculation later in the year, by I think September. Anyway, in this article, Leonhardt is drawing from the same excess deaths data to say that it shows the pandemic is actually over. He also quotes Ashish Jha a few times, because I guess despite the fact that by this point Jha was no longer in the White House, he couldn't help himself.

Phil Rocco  02:33:41

Still good for it. You can always count on him.

Artie Vierkant  02:33:44

Yeah. Leonhardt uses Jha's "expert opinion" to assert that, basically, all the immunocompromised people complaining about COVID aren't as at-risk as they say they are. He then concludes with the following: Leonhardt writes, quote,

Almost a year ago, President Biden angered some public health experts when he declared, “The pandemic is over.” He may have been premature to make that declaration. But the excess-deaths milestone suggests that it’s true now: The pandemic is finally over.

Artie Vierkant  02:34:12

Again, I know this has taken a long time to pay off, but you see why we had to start in September 2022.

Beatrice Adler-Bolton  02:34:17

So aggravating! This is— [ sighs ].

Artie Vierkant  02:34:20

Still though, remember, that was the runner up for discourse of the month.

Beatrice Adler-Bolton  02:34:24

Yeah.

Artie Vierkant  02:34:24

The top pick for July 2023 in the COVID discourse comes from none other than Ashish Jha himself, who rounds out the month with a July 31 op-ed in the Boston Globe called: “With a few basic steps, most of us can finally ignore COVID.”

Beatrice Adler-Bolton  02:34:39

Emphasis  on "most of us."

Artie Vierkant  02:34:43

Just a reminder again, Ashish Jha doesn't work for the Biden administration anymore. He's just doing this for clout. Doesn't seem too self aware, I guess. We also talked about this in that episode I mentioned earlier, "The New (New, New, New) Normal." But basically the whole op-ed is a masterpiece of magical thinking. He repeats his old line from when he was in the administration that "we can now prevent every death," he turns a new phrase to assert that only the quote "profoundly immune compromised" have to worry about the virus, and for good measure, he just straight up pretends that long COVID is more or less done and dusted. I'm not going to read from this piece because we read a lot of it in that episode I mentioned, but what I will do is re-read a rebuttal that the Boston Globe printed some time later, which I also read on that episode. So here is Ezra J. Spier's rebuttal to Ashish Jha's op-ed, also printed in the Boston Globe. Quote,

I would love nothing more than to “finally ignore COVID,” as the headline to Dr. Ashish Jha’s July 31 op-ed reads … As a healthy, vaccinated, and recently boosted 35-year-old, I did what he said: I ignored COVID-19 on a weekend trip with friends in September 2022. But the infection I got as a result has all but destroyed my life.

A week after my infection, I began to experience intense fatigue, overwhelming headaches, and cognitive challenges that continue to this day. These symptoms are debilitating: I can no longer work, socialize, or travel. My finances are dire. And if I am unable to avoid another infection, my condition may deteriorate even further.

Jha wrote of long COVID “treatments” being promising. Perhaps he could clarify what treatments he is referring to, because my doctors say that there are no approved treatments for long COVID.

A recent study funded by the NIH’s RECOVER initiative showed that 10 percent of adults infected with COVID still have symptoms six months later, even with vaccination. By downplaying the prevalence and debilitating outcomes of even moderate long COVID, Jha is signing thousands of people up to the misery and despair with which I live every day.

Unquote.

Artie Vierkant  02:36:46

Before we move on, just a note on the unwinding. By July, we learn that 4 million people have lost Medicaid coverage so far. And a new set of states starts their unwinding process. Those states are California, Delaware, Illinois, Louisiana, Michigan, Minnesota, Missouri, New York and North Carolina. This leaves just one state that have not yet started, Oregon, the lone state to not start their unwinding process until October.

Artie Vierkant  02:37:14

This brings us to August 2023. Now we're getting into very recent history territory. As what is referred to as the summer wave continues, Ashish Jha isn't the only former White House official to crawl out of the woodwork for an ill advised spin in the spotlight. On August 28, Anthony Fauci tells the BBC quote,

I doubt very seriously whether you're going to see the hospital and death surge that we've seen in the past, even if we get a surge of infections, because there's enough fundamental community level protection, that even though you'll find the vulnerable will fall by the wayside, they'll get infected, they'll get hospitalized, and some of them will die, it's not going to be the tsunami of cases that we've seen.

Abby Cartus  02:37:58

[ Exasperated ] Oh, I love—that's very "Hippocratic," I love it.

Artie Vierkant  02:38:02

Love to fall by the wayside. Cool cool cool cool cool.

Beatrice Adler-Bolton  02:38:03

Well, I feel like so much of the conversation last year had been like, okay, you know—we really watched the disposability of certain segments of the population get set up in late 2021. And that was articulated so clearly by a lot of the changes that were done in 2022. Particularly the switch of the map, the going from the red, yellow, and blue and orange map to the little sherbert map overnight, and the calm and—calming pastels, right. And all of a sudden the map's all green, all of these kinds of things that we saw where, you know— [ sighs ] and these are, obviously, this is stuff we've been pushing back on, and we've been talking about over and over. But I just want to show how quickly and completely, actually, "protecting the vulnerable" actually disappears as a goal.

Artie Vierkant  02:38:05

Oh, yeah.

Beatrice Adler-Bolton  02:38:35

Right?

Artie Vierkant  02:38:38

Oh, yeah.

Beatrice Adler-Bolton  02:38:58

In 2020, it was centralized. By 2023, it doesn't even need to be discussed. Because who is dying, and who is "vulnerable," is like de facto common sense already. Right. And yet, further, the focus this year has been undermining the credibility of that group, one. Two, emphasising that that group is actually much smaller than you might think. Three, emphasizing that people in that group are "misinformed" about their risk. And most of them are, you know, "mentally ill." And that's really, "the biggest crisis" here. Is one of lockdowns and, really, "we just need to see each other's smiles again." You know this kind of, like, proof that COVID is somehow just only going for the vulnerable, right, like doesn't even need to be brought up anymore. It is just like considered, just like the baseline, yeah, everybody's in agreement. You know, to the point that Fauci will casually throw off yeah, the vulnerable will fall to the wayside, but, you know—

Abby Cartus  02:40:05

"And die!" That's what he said.

Jules Gill-Peterson  02:40:07

Die!

Beatrice Adler-Bolton  02:40:08

Right! But, you know, the reporter's like, "mhmm." You know?

Jules Gill-Peterson  02:40:12

Right.

Beatrice Adler-Bolton  02:40:13

That's just like—it's not just like, "oh, what do you mean, like vulnerable people are dying?" like, everybody gets that now. Does it change anyone's opinion about how we should respond to the pandemic? No, not really. Right. And I think this is where it's also important to think about, is this direct prejudice? Are we saying society hates sick people? Or can we look at this in the sort of structural sense and say, that is probably because, fundamentally, in our political economy, we put a economic valuation on everyone's life, quite literally. People who are sick, who are disabled, who are chronically ill, we are calculated down and valued at a lesser amount than people that are, quote unquote "healthy." People who are out of the workforce, retired, [in] nursing homes, already sick, the vulnerable who are "falling to the wayside." You know, this is not such a big deal because we understand all of those people who are part of the surplus class as "less valuable." So it's, in the world of cost benefit analysis, "not a huge loss" here. Right. And so the disposability, right, it's not just like, "fuck sick people." It's a much larger kind of economic calculus that says: "society isn't for you, you fucking sick people."

Abby Cartus  02:41:37

Yeah, exactly. The needs of sick people, "vulnerable" people, however, we want to construe that group, are incompatible—like, what was that Deloitte [McKinsey] report, incompatible with the economic functioning of society. And I mean, it's so classic, that instead of thinking like, hmm, "maybe something's fucked up about the economic functioning of society, then," you know, that like the the whole role—I mean, you know, we talk about this a lot with Nate Holdren, and the concept of social murder, generally, like—the whole Biden pandemic response, it's really just an example of how the state responds to social murder by just kind of like reorganizing it and redistributing it to the sectors of society that are—you know what I mean?

Artie Vierkant  02:42:26

Mhm.

Abby Cartus  02:42:26

—that are, like you're saying, Bea, considered "surplus," like, economically valued less. And I mean, that is a real—that is a real structural thing, I think, that like, "the science" is just kind of an inadequate answer to. And I mean, I've struggled with this a lot, because it's like, oh, my god, well, the science is so clear, you know, that we should do all these things, but this is really it, right? Like that what it would take in terms of, you know, getting the virus under control, in terms of non-pharmaceutical interventions, you know, permanent changes to how we conduct public life, like those things are incompatible with the, like, house of cards of profit extraction and accumulation that is the United States. And I feel like that is a really, really big—that's just like a really big thing for, I think, the left to be thinking about. Which, I mean, I don't have high hopes that the left will be thinking about it. But I think that's a very—

Beatrice Adler-Bolton  02:43:31

Well, it's why it's so essentially frustrating for the left to have not risen to this occasion.

Abby Cartus  02:43:35

Yeah. Yeah, yeah.

Beatrice Adler-Bolton  02:43:36

Yeah. To put it that way.

Artie Vierkant  02:43:38

So... so, that Fauci quote is bad. [ Laughter ] But current Biden officials don't do much better. Of course. While much of the administration seems to be conspicuously ignoring the surge, on August 25, [CDC Director] Mandy Cohen posts a video in the format of a sort of faux Q&A. In that video, she says:

Question: I keep hearing on the news that hospitalizations for COVID are going up. Should I be concerned?

Answer: Okay, so we are seeing an increase in hospitalizations for COVID-19. Recently, up to 10,000 people being in the hospital with COVID a week. However, as a reminder, last year we saw up to 40,000 hospitalizations a week at our highest point last August. So we're in a much different and better place in August 2023.

Artie Vierkant  02:44:25

"Different and better place." We'll hear a lot more of that, I'm sure, in the future. But yeah, this is the classic, like, "you may have heard 10,000 people are hospitalized every week from COVID. Don't worry, 10,000 is less than 40,000!"

Beatrice Adler-Bolton  02:44:38

Could y'all Imagine if every time, like, you were all not feeling well, and we recorded the show, and you're like, "oh, I feel really shitty today" [if] I'd be like, "Yeah, but not as shitty as I do! So we're all good." [ Laughter ].

Phil Rocco  02:44:49

Yeah. Or "not as shitty as you did"—

Abby Cartus  02:44:50

—"Not as shitty as you said you felt last week!"

Beatrice Adler-Bolton  02:44:52

Yeah.

Artie Vierkant  02:44:54

As Cohen says this, COVID deaths by the official count tick right back up over to 1,000 a week territory. The week ending August 26, the CDC registers 1,034 COVID deaths. But again, you wouldn't know it from listening to Cohen speak, or from listening to the Biden administration, or even really from a glance at the CDC's website because, again, for the most part, the CDC is reporting deaths, like other metrics, as a percent change now, week on week. As though that means fucking anything. Speaking of the CDC, one thing this timeline doesn't include a lot of detail on is the still ongoing saga of the CDC's revision to its infection control guidelines for healthcare settings. All the episodes that we've done on that are pretty recent, so I'll link to that in the description—link to the episodes that we have done on this with Jane from National Nurses United. In June, the CDC's committee, known as HICPAC, had met to discuss new guideline changes that would drastically reduce infection control standards in healthcare settings, including asserting that surgical masks are as good as N95s for healthcare workers. A vote to finalize the guidance change had been scheduled for August. But when a huge bloc of the public, including a bunch of our listeners, sign up to attend the meeting and protest the changes in public comment, they quietly move the vote to November. And while they did vote to approve those changes at that meeting in November, there is going to be a chance to comment when it hits the Federal Register. And we'll be watching for that to help the campaign against this. So—but I mention that here, at August in the timeline, because the public comment section for that meeting in August was great. People really came prepared and really laid into them.

Artie Vierkant  02:46:38

Elsewhere. Pfizer shares start to slide as it becomes clear that, in an environment where it's been asserted that the pandemic is no longer a big deal, and without a guaranteed windfall of infinite US government purchasing, less people are probably going to get the COVID vaccines and drugs in the future. I bring this up because this shows some of the obvious flaws in allowing private actors with profit motives to play such a huge role in healthcare. Seize pharma, is what I'm saying. The following is a quote from a Wall Street Journal article from August 6 called "Pfizer's Covid Boost Crashes to Earth." Quote,

Should sales fail to materialize, Pfizer is prepared to trim R&D spending for Covid-19 and other disease areas, Chief Executive Albert Bourla said in an interview.

“We are moving post-Covid,” Bourla said.

Artie Vierkant  02:47:27

On the unwinding front, by August, the number of confirmed Medicaid disenrollments climbs to about 5 million. We also find out that, across all states reporting, a full 75% of all disenrollments thus far have been for procedural reasons. Again, in other words, administrative burdens and technical errors. Instead of taking action the Biden administration prioritizes activities that make it look like they're taking Medicaid unwinding seriously. They release a set of previously sent form letters, about 50 of them, that they have sent to states to ask them nicely to slow things down. And Neera Tanden hosts what Politico calls a quote,

... closed door session [with several health advocacy groups] aimed at reassuring advocates that the issue remains a top priority for the White House amid simmering frustration over the administration's reluctance to take stronger action against states that are drastically winnowing their Medicaid populations.

Artie Vierkant  02:48:22

That is a mouthful. September 2023. As with past years, I'm going to put a little less detail in the fall months, as I mentioned, as they're quite recent. But also because this is recent history, I'm also going to start calling out more death figures—more explicitly—because I really don't think that people realize how many people are still dying from COVID. So to start with that, I'm just gonna start September with the death figures from that month. Here's what the CDC reports.

Artie Vierkant  02:48:48

Week ending September 2—which I guess incorporates August part of it.

Week ending September 2, 1,170 deaths.

Week ending September 9, 1,290 deaths.

Ending September 16, 1,378 deaths.

Week ending September 23, 1,385 deaths.

And the week ending September 30 there were 1,409 deaths.

Artie Vierkant  02:49:16

So there is a pattern for you. Speaking of which, I just want to highlight one thing. We've said many times it's basically impossible to know what to make of the data exactly, but one statistic that comes out in September just absolutely blew my mind when I read it. So Pfizer CEO Albert Borla, speaking at the Cantor Fitzgerald Annual Healthcare Conference on September 26, claims that nearly 250,000 courses of Paxlovid were being administered in the US per week.

Artie Vierkant  02:49:49

250,000 per week. The reason I'm mentioning this—I just want to pause on this because I think it's kind of staggering. Just—like, just think about that. I don't know what percentage of people who get seriously ill from COVID end up getting Paxlovid, or like a Paxlovid prescription. But my assumption would be that the conversion rate on that is probably not that high.

Beatrice Adler-Bolton  02:50:10

Yeah.

Phil Rocco  02:50:10

Right. I mean, it's actually I think, with prescribers—I think people are kind of reluctant—

Beatrice Adler-Bolton  02:50:16

Yeah.

Phil Rocco  02:50:16

—often. It—there has to be a good case for prescribing it.

Artie Vierkant  02:50:20

Right. So if this is true, if there are 250,000 courses of, you know—that's not like individual [pills]—like the course of Paxlovid, being prescribed every week. I mean, that's just an incredible amount of COVID cases.

(Artie’s note: One very important thing I neglected to mention is that, thanks to the Biden administration’s push to kick covid vaccines and Paxlovid to the private market, Pfizer now prices courses of Paxlovid at $1,400. So if it is the case that Pfizer’s antiviral has been reducing covid morbidity and mortality (or to whatever extent it has been reducing them), any level of protection from this tool has been pushed further out of reach).

Artie Vierkant  02:50:20

That's a lot of community-level transmission.

Abby Cartus  02:50:25

It's a small percentage of the total transmission, most likely.

Beatrice Adler-Bolton  02:50:44

Yeah.

Artie Vierkant  02:50:45

Yeah. I mean, it's an indirect data point, but it is a fucking mind blowing one.

Beatrice Adler-Bolton  02:50:50

It really is. Yeah.

Artie Vierkant  02:50:51

So. Anyway.

Beatrice Adler-Bolton  02:50:52

I mean, this is what happens if you turn off the spigot, right. Like you can't see the infections, you have to deliberately try and look at it the way that you've just laid it out, right? Like if we look at Paxlovid, and then we think about Paxlovid just being a small percentage of the amount of infections that we're gonna see in an average spread, right? Because not everybody is going to be able to get it. But the thing that's just so difficult, right, is that unless you're willing to do that legwork, like what do you actually have to work with in terms of, let's say, reporting even? And so people who, you know, were doing some coverage on this, I think you're seeing even less, like, semi-good or half-decent coverage of COVID, because there's just not material to work with unless you're willing to, you know, go digging for it.

Artie Vierkant  02:51:40

Mhm. Speaking of which, by the end of September, the CDC also stops reporting its excess deaths estimates, meaning that we lose yet another indicator we could have used to understand what's happening with COVID. That's just two months after that Leonhardt article I mentioned.

Artie Vierkant  02:51:56

On the Biden administration front, in early September Biden's wife, Jill, test positive for COVID. I think a piece from Politico describes what happened next pretty succinctly. This is from September 6, headlined "Biden appears to be over Covid protocols." They write:

For two days straight, the White House told anyone who would listen that President Joe Biden was taking his Covid exposure seriously by following a strict set of public health precautions.

Then Biden strode into a room full of people on Wednesday and reduced those precautions to a punchline.

“I’ve been tested again today, I’m clear across the board,” Biden said, smiling as he held up his face mask. “They keep telling me, because it has to be 10 days or something, I gotta keep wearing it. But don’t tell them I didn’t have it when I walked in.” …

Artie Vierkant  02:52:40

That all happened quite publicly. But the piece also offers this interesting detail, quote,

Inside the administration, some senior officials have argued in favor of minimizing the amount of time the White House itself spends publicly talking about Covid issues, said two Democrats familiar with the dynamics who were granted anonymity to speak freely. …

Artie Vierkant  02:53:00

And this I think, overall, resonates quite specifically with, I think, what one of my big takeaways from this year ultimately is, which is that, you know, we're now in an environment that's pretty different from before. Where once there were certain protections or policies and social safety net programs left to undo. And, you know, Biden administration comments to cry foul over, and a constant stream of normalization work done by a cottage industry of minimizers. But now, at this point, much of what was left to undo has been undone. There's much less of a base or a wall, I guess, to push back against. And so now we're in that circumstance where like, we have to be more creative, in a forward looking vision, I suppose, and with our demands. We can talk about this in a bit. But this is what I think of when I hear, like, the Biden administration intentionally not giving people things to talk about regarding COVID, basically. Anyway.

Artie Vierkant  02:53:53

Also in September, updated vaccine booster doses roll out. We mentioned this a little bit earlier, when we were talking about Phil's vaccine dose, which took for fucking ever for him to get, even. This is the first COVID vaccine update rollout that is attempted under the new regime of vaccines have been kicked to the private market. The press refers to this rollout as a quote unquote, "bumpy start" or "bumpy rollout." But it's a disaster, basically, as we've talked about at length, and it's the inevitable consequence of privatizing the COVID response. Even health policy analysts who have personally tried to assure me that COVID commercialization was going to be no big deal, literally end up tweeting out that they can't get a vaccine without paying over $100 for it. And a reminder, you know, even if you have insurance, it's now a question of whether the place that you're getting it is "in network." So while one person may have a very easy time getting it, you know, for a lot of people the experience can be quite different. And now additionally, now that every individual healthcare setting or pharmacy is on the hook for ordering and paying for the vaccine, you know, stock orders and holding them to be reimbursed only later by insurance, you know, that in itself explains a lot of the issue with distribution. Gotta love health under capitalism.

Artie Vierkant  02:55:12

We have not one but two pieces of top COVID discourse for September. The first is this New York Times headline from September 7: “Covid Continues to Rise, but Experts Remain Optimistic.” I just like this headline. [ Laughter ].

Phil Rocco  02:55:26

Bully for them.

Jules Gill-Peterson  02:55:27

[ Laughs ] Yeah.

Artie Vierkant  02:55:28

I like this headline because I like to think about how that could have been printed really any time in the last three or four years.

Jules Gill-Peterson  02:55:34

Right.

Abby Cartus  02:55:34

[ Laughing ] Yeah, it's indistinguishable from most of the headlines.

Beatrice Adler-Bolton  02:55:37

Mhm.

Jules Gill-Peterson  02:55:37

Mhm.

Artie Vierkant  02:55:37

A masterpiece. Remarkable. The second piece of discourse I have for you all is a more explicitly garish one. September 6 Substack post from Vinay Prasad—remarkably his first time coming up in this timeline. Post is titled: "Do not report COVID cases to schools & do not test yourself if you feel ill."

Beatrice Adler-Bolton  02:55:58

A classic.

Artie Vierkant  02:55:59

Prasad writes:

.. the only option left for remaining sensible people is to not longer comply in the system that yields this outcome. Here are some practical suggestions:

1—If you[r] child is sick—do not test that child for COVID.

2—When they look good enough for school, send them in.—

Phil Rocco  02:56:14

"Look good enough?"

Artie Vierkant  02:56:16

[ Laughs ] Yeah.

Phil Rocco  02:56:16

"Look good enough!" [ Laughing ] Okay.

Artie Vierkant  02:56:17

3—If you are sick— do not test yourself …

4—If anyone is sick, do not tell your employer or school.

Artie Vierkant  02:56:23

—and it goes on like this. "Complain to your employer about any mandates or declination forms." For example. And then ending with quote,

In my estimation— it is the only logical course left. The strategy makes sense. It’s time to go dark with all COVID data. If enough people don’t participate, the irrationality will stop. Eventually.

Artie Vierkant  02:56:44

And with that our enemies have invented, I guess, a kind of bastardized version of collective action. [ Laughter ]. There's one other big Vinay Prasad thing in September, but I'm gonna get back to that in just a second. Before we move on, by the end of September, about 7 million people are confirmed to have lost their Medicaid. As Beatrice tells Truthout, quote, "It's the largest simultaneous disenrollment in American history ... This is going to become the health care legacy of the Biden presidency." Unquote.

Artie Vierkant  02:57:12

This brings us to October 2023. In this month, I'm also gonna start with death numbers and then move directly into the discourse. As usual, these numbers are from the CDC, but buried behind the percentage change figures on the website. So.

Artie Vierkant  02:57:26

Week ending October 7, 1,339 deaths.

Week ending October 14, 1,268 deaths.

Week ending October 21, 1,311 deaths.

And the week ending October 28 1,228 deaths.

Artie Vierkant  02:57:45

In the discourse for October, thanks to a piece that runs in The Lancet, there are a raft of articles that all say just about the same thing, which is: okay, sure, sure. Long COVID. But what about "long colds?" Ever heard of that? Long colds enters the chat. I should note that obviously, a whole vast array of post viral conditions exists. So it's not that this is, you know, referring to a phenomenon that's been spun up out of whole cloth just to minimize long COVID. But that doesn't mean that the way that it's employed doesn't then of course, immediately lead to the minimization of long COVID. For example, this CNN Headline from October 6, which reads quote, "There is more to worry about than long Covid, study shows. You could get a long cold, too." I should add, of course, the original paper in the Lancet I don't think uses the term "long cold." Instead, that's something that gets coined to describe the post viral conditions the paper is talking about. What the concept of long cold is suspiciously similar to, though, is the other Vinay Prasad production I alluded to from September. Posted September 26, but really kicking up in the discourse in early October, this is none other than Vinay Prasad, Tracy Beth Høeg, and Shamez Ladhani's paper, "How methodological pitfalls have created widespread misunderstanding about long COVID." This is another thing we did a whole episode about, it's in the patron feed, "Long Covid and 'Methodological Pitfalls'" is the title. In this paper, they straight up argue that the term long COVID should be abolished and claim that quote,

The existing epidemiological research on long COVID has suffered from overly broad case definitions and a striking absence of control groups, which have led to a distortion of risk. The unintended consequences of this may include, but are not limited to, increased social anxiety and healthcare spending, a failure to diagnose other treatable conditions misdiagnosed as long COVID, and diversion of funds and attention from those who truly suffer.

Beatrice Adler-Bolton  02:59:50

Motherfuckers.

Artie Vierkant  02:59:51

All of this is just on the COVID front though. Whereas of course, obviously, in the month of October, the settler colonial project occupying geographical Palestine launches—or rather, escalates—its brutal genocidal and annihilatory campaign on Palestinian life. Biden's immediate response to this is to say, quote, "Israel has the right to defend itself ... full stop." When a growing movement to demand, at minimum, a ceasefire springs up immediately into view, White House press secretary Karine Jean-Pierre says of this movement, on October 10, quote, "... we’re going to continue to be very clear: We believe they are wrong, we believe they’re repugnant, and we believe they’re disgraceful." Unquote.

Artie Vierkant  03:00:35

And the State Department also quickly puts out a memo directing State Department officials to explicitly not use any of the following terms when speaking publicly on the matter, including: "de-escalation," "ceasefire," "end to violence, "end to bloodshed," and or "restoring calm." We will not be going through more of this step by step on the rest of this timeline. But as of this recording 15,000 Palestinians have been killed. Countless have been wounded and maimed. And large amounts of Gaza had been completely leveled. So it's important to make sure we mention, this is all happening concurrently. And we can't stop showing up for Palestine until Palestine is free. So I don't know what else to say about that. Land back. Free Palestine. Get out to demos if you can, and wear a mask if you do. It has the dual benefit of protecting you from COVID and being good opsec.

(Artie’s note: When I first wrote this part of my notes for this recording, the Palestinian death numbers were around 7,000. By the time we recorded this, the figure was 15,000. As I write this note, it’s nearly 18,000. I have been sitting in silence trying to find a way to finish this transcript-only aside, an aside that most people will never see, as it comes some 33,000 words into the text version of this episode. I can think of nothing but Free Palestine, Free Palestine, Free Palestine).

Artie Vierkant  03:01:26

So. Moving to November now. Almost through with the timeline. And if you're noticing that there's less and less COVID-related Biden administration and policy stuff, that's because there is. They're as silent as possible.

Jules Gill-Peterson  03:01:39

Mhm.

Phil Rocco  03:01:39

They planned it.

Artie Vierkant  03:01:39

Yep. They're a silent as possible. And most of their project of sociologically and politically constructing an end to the pandemic is unfortunately, you know—has been executed at this point. In November, the World Health Organization reports a spike in an unspecified respiratory illness causing pneumonia in children in northern China. As of when we're recording this, I have precious little context for what's happening there on the ground. But what I can say is that it brings one thing roaring back into the discourse in the United States, which is: immunity debt. See, we've gone full circle. I promised the recap was worth it. For an example of this, here's a bit from a piece on it in Nature that ran November 27, which went to, of all people, Francois Balloux, for comment. Quote,

Nationwide lockdowns and other measures implemented to slow the spread of COVID-19 prevented seasonal pathogens from circulating, giving people less opportunity to build up immunity against these microorganisms, a phenomenon known as ‘immunity debt’, said Francois Balloux, a computational biologist at University College London, in a statement to the UK Science Media Centre. “Since China experienced a far longer and harsher lockdown than essentially any other country on Earth, it was anticipated that those ‘lockdown exit’ waves could be substantial in China,” said Balloux.

Artie Vierkant  03:03:00

So yeah, printed as though it was lockdowns all along. It's not just Francois Balloux, though: according to a STAT News piece from November 24, immunity debt is also the WHO's prevailing explanation for what is happening—which is disappointing. November 30, then, also news breaks of an outbreak in Ohio of a mystery white lung pneumonia in over 100 kids, and once again, immunity debt is the go-to explanation. So here is one local news station's take on it, quote,

The ages of the patients range from 8 to 3, and there are several theories as to why children are more susceptible to the illness. Some suggest it is caused by lockdowns that have weakened the immune system or mask-wearing and school closures leaving children vulnerable during seasonal illnesses.

Artie Vierkant  03:03:49

I bring this up in particular because I want to throw back to something I said much earlier, which is that "immunity debt" is an idea that can easily be employed in future pandemics to say, "remember what we did for COVID?"—what little we did for COVID—"Well, we can't possibly do that again!" And sure enough, here is right wing malcontent Charlie Kirk tweeting about this same news, quote,

CDC officials are saying "nothing is out of the ordinary" but according to county health official "Not only is this above the county average, it also meets the Ohio Department of Health definition of an outbreak."

Just in time for election season!

Whatever is going on, never again and do not comply.

Artie Vierkant  03:04:35

On the unwinding front, over 11 million people have lost Medicaid so far. When all is said and done with Medicaid unwinding a total of up to 24 million people could lose their social safety net health insurance, including 7 million kids. We'll be following this process in future coverage on the show as new information comes in. And finally, to wrap out November, we can have one—just one—piece of good news, as a treat. November 29. Henry Kissinger. Dead. [ Laughter ].

Phil Rocco  03:05:07

Yes.

Artie Vierkant  03:05:07

Rest in piss.

Phil Rocco  03:05:09

Just in time for our year-in-review episode.

Artie Vierkant  03:05:14

So this brings us to the end of our timeline. For now.

Beatrice Adler-Bolton  03:05:19

Fuck, Artie.

Jules Gill-Peterson  03:05:20

Hmm. Wow.

Phil Rocco  03:05:23

Jesus, man.

Beatrice Adler-Bolton  03:05:25

It's staggering to see it dry up over the course of the year. Actually.

Artie Vierkant  03:05:30

Mhm.

Jules Gill-Peterson  03:05:30

Yeah, it really is.

Artie Vierkant  03:05:30

It's really.. um. Evident? I don't know, it's—it's very blatant how it just is—everything's turned down.

Beatrice Adler-Bolton  03:05:45

Yeah. Yeah.

Artie Vierkant  03:05:47

That's why I said it's like, the lights go out. And this—I mean, I think, if I can—if you don't mind me saying something first, I guess as we kind of like wrap this out?

Phil Rocco  03:05:55

Yeah.

Beatrice Adler-Bolton  03:05:55

Yeah, I need to process for a sec anyway.

Artie Vierkant  03:05:57

I feel like I didn't know—in a sense I feel like I don't know how to end this one. Or like, I didn't? Because it's so difficult to say what happens from here. I mean, we can make—we can make demands, and we will, obviously, maybe not necessarily on this, like, episode. But I mean, in general, collectively, you know, we're all going to continue to make our demands, we have to also continue to live with, like, our collective responsibility to protect each other, to keep each other safe. And I think so much of the organizing work that's happened even just in the last year is testament to that, like amazing mask bloc work and a bunch of stuff—there could be more, obviously—I hope this spurs some people to join up with some stuff like that. But in terms of looking back at what happened at kind of the level of the federal government, looking at the state and state actions, this last year. I mean, it's like very easy to be devastated. The end of the Public Health Emergency was a huge blow. As were so many of the events that led up to the point where they were able to end the Public Health Emergency with kind of a whimper. And so many of those events happened before 2023 even began. But I think, you know, as a result, I think the thing that I've been thinking about the most is this thing that we've like alluded to a couple of times now, which is—how to put it—like we've had this conversation a little bit amongst ourselves. That it's just, it's difficult, because so many of the policies that were left to undo, they've now just been undone. And so in terms of stuff to.. for so much of the last couple of years of the COVID response there's been like a dialectic, in some sense, between what is happening in kind of one camp, that is the like sociological production of "its over" camp, and then [the other camp is] in like, you know, our world, or the world of people who organize around, you know, COVID advocacy. And there's.. it's much more groundless now.

Abby Cartus  03:08:01

Yeah.

Artie Vierkant  03:08:01

In a sense. The stakes are still there. Everything is all—in a sense, all the arguments, all the things are like, the same. But to an extent—I mean, the Biden administration, not just the Biden administration, but all the adjunct, you know, mouthpieces of the end of the pandemic, whether that's, you know, people like Jha, now outside of the White House, but having been formally been part of it, or whether that's like clowns, like David Leonhardt or Francois Balloux or whoever. Like, they don't have to say anything anymore.

Phil Rocco  03:08:33

Well, right. And that's the point. I mean, I think the thing, my big takeaway from this is, you know. Even when the state is acting against society, when it's acting, and it's acting legibly, it does help to solve a collective action problem. It does help to coordinate things simply by telegraphing what it's doing or not doing. It creates an object, you know, a narrative, a common focal point to organize around. When it ceases to make its activity legible, you go back to a more fundamental collective action problem. Which is, you know, a major vector of disease becomes a disaggregated thing that people experiences as individuals. And so, I mean, actually, this is where, yeah, I think we're beginning to see what it looks like when people have to organize and coordinate that kind of information production, the creation of focal points themselves. But I think the whole phase, here, is defined by that—again, even when the state's not necessarily, you know, acting to protect society, you know, as long as it's sort of being clear about what it's doing, it does help to create some kind of sense of possibility for what people can do. And so now, I think that's where we are, politically. I think people are trying to figure out what you do in the absence of a, you know, a broad, you know, narrative. And I guess, the fortunate thing, one resource is, like, this is not the first time that, you know, a government has decided to ignore something really important that's affecting people's lives, and it's not the first time that people have had to kind of organize and coordinate that kind of thing for themselves. And so there's like, there is, I think, a historical reservoir to draw on here. But it's still, you know—the winding down, not just of all the protections, but all of the, you know, I think, collective action capacity is a dispiriting thing to watch and it does leave me with, you know, no clear sense of what one even takes away. But I do think that sort of—it's important to just take stock of that as a political starting point.

Jules Gill-Peterson  03:11:07

Yeah, and there's something about like, always how helpful it is to sequence out, you know, what otherwise is a series of, you know, media reportages and events and policy decisions to which we're all reacting in real time and part of why it's helpful to sit down, you know, in this kind of recap format, and just ponder it is to see that sequence. And I guess, connected to what you're just saying—I was just thinking about how—what it takes to produce, less so maybe a rhetoric or discourse of inevitability, but the actual feeling of inevitability.

Artie Vierkant  03:11:48

Mm.

Beatrice Adler-Bolton  03:11:48

Mhm.

Jules Gill-Peterson  03:11:48

And so much of what I think "inevitability"—like, often the discourse of inevitability from this kind of political administration is technocratic. "We're doing all the things, don't worry, experts are on it, this is the way it has to play out, we'll"—duh-duh-duh. But the feeling of inevitability is much more like a feeling of exhaustion and despair, this sense of oh, okay, all of these things are now happening. And, you know, I sort of feel powerless, because it's all been downloaded onto me as an individual. And I was just thinking about how that feeling slowly emerges. When you sequence these things out, it's just like stacking little bits here and there. But part of what that—the feeling version of inevitability—is trying to do, exactly, is like demobilize, depoliticize, isolate, and just actually make people exhausted, upset, fed up and unsure what to do. But in some ways, I think the other riddle may be, you know, for all of us in the Death Panel world is, like, we have also been talking about this trajectory for so long. In some ways, I guess I was sort of wrestling with, at the end of listening, like, oh, okay, wait. A really profound shift has happened. And I was like, feeling that kinda like, despair moment. And I was like, okay. But. That doesn't necessarily change the core political demands and critiques that have been guiding, you know, this coverage, and this analysis of the pandemic all along. And in that sense, I think there's something about resisting that feeling of inevitability that is important and political. Which is about saying, like, okay. Yeah. Things are changed materially by a lack of data or a lack of coverage. It's harder to have a kind of sense of what's going on and where we are. But. We've also been talking about and preparing and, you know, thinking and organizing for years, right? And that's another version of year four. And so like, you know, in some ways, I was just kind of thinking like, there are some important evergreens here that bring us back to, you know, the kind of core set of demands, and now it's like challenging to have to make those demands without an obvious—yeah, an obvious sort of singular target, policy target or, you know, media target to hold on to. But that doesn't really change the task in some ways. I don't know if that makes sense or not.

Beatrice Adler-Bolton  03:14:35

Mm. Mhm.

Jules Gill-Peterson  03:14:36

The feeling of it is different. But in some ways, the political task, like, you know—not remains the same, right? But like, we haven't lost that.

Abby Cartus  03:14:46

Yeah. I totally agree with you.

Beatrice Adler-Bolton  03:14:48

Right. Right. Abby, do you want to go next, and I can take the annoying task of going last? [ Laughter ].

Abby Cartus  03:14:52

I mean. I don't really have anything to say that I haven't already said. And I don't know, I'm really resonating with what you said, Jules. And just personally, I've been trying to kind of anchor myself to this understanding of like, yeah, the way that I feel has certainly changed. And a lot of really consequential stuff has changed at the national level. But I don't know, the reasons why I do this are still the same reasons they've always been. And I think I even said—I think I even said, it might have been at the end of Covid Year Three last year that like, where I anticipated things were going to go in the upcoming year was that, you know, COVID was going to become somewhat "less exceptional." I mean, Artie has done a fantastic job of charting, you know, the project of making that the case, and making sure that we all feel that. But what that means to me is like, okay, you know, so COVID is "not exceptional." It's in the private market, it's thrown into this churning maw of like the American healthcare system, just like everything else. And what kind of anchored me at the end of last year, I think is kind of the same thing, which is that like, we are still—you know what I mean? Like we are still fighting capitalist healthcare, we are still fighting for health. And COVID actually remains a huge part of that, right, even as it's being hidden from us. And normalized, and rationalized away. And so I guess, I don't know, if I have any kind of, like, hope it's that this project of like invisiblizing COVID on the national level does not mean that it becomes invisiblized at the level of like, I don't know, organizing work or whatever. But I guess what I'm saying is that I'm hopeful that through the like transformation of how we think about and treat COVID, we are also allowing COVID to transform how we think about the political economy of health and what health justice actually looks like.

Abby Cartus  03:17:14

Mm.

Beatrice Adler-Bolton  03:17:14

Mhm. I think last year my takeaway was like, much more warm and fuzzy, you know? It was like, you know, "ACT UP didn't form until seven years into the HIV/AIDS epidemic being officially recognized." Or, you know, don't despair, it's not too late. And I think I have a less fuzzy but a more concrete takeaway this year. In a strange sense, that's completely different from what I thought I was going to come away from this with, which is always a good sign, to revise your expectations. But what I feel like I've just actually had proven to myself, which is something I think I knew and I thought about and I gestured at but we really just had materially demonstrated is, like, Jules, as you're saying, like: how inevitability is constructed. Right. And just the sheer volume required to do that. And I think that that is a tremendous lesson for those of us fighting for liberation of all kinds to take, you know, I think often we could be searching for, like the right line and the right, written piece or the right citation to try and convince someone to start caring about COVID. You know? And I, I—you know, when you're writing about COVID, you're like, "am I gonna be able to do it?" You know, "am I gonna be convincing?" "Can I get my point across?" Because we're up against so much. And it's like, the point is actually that you can never get to the point to be as fucking belligerent as Vinay Prasad saying something like, "Do not test!" [ Laughter ] "Do not tell the school if your kid is sick! Do not tell your employer! Make complaints!"—you know, like, just replete with typos, you know, just a fucking mess, right? Like, you only get to that point through just massive echo, massive repetition, right? Like, it needs to be something that comes—you know, we have to be like producing, I think, the same type of like "work product" that can be disseminated and reproduced from so many different people, right, like, if we want to actually meet the moment, I think we look at the lesson of how, you know, the end of the pandemic has been sociologically produced over the last couple of years, basically, from, you know, week three forward. And we say, okay, well now we have some sort of sense of what the volume might be required in our current media landscape and our current iteration of the, you know, state that were under, the United States, like, what volume might be required to normalize something, right? What volume might be required to engage consent at that kind of level? Right. And it's actually staggeringly, you know, difficult, I think, to have convinced people to give up, right? We have had to be assaulted with some of the most heinous takes, over and over and over again. "Don't care about people who are vulnerable." "It's not your problem." Over and over and over again. So, you know, this is how—these are the kinds of values that we're being conditioned towards right now. Right. And I think my takeaway, and my lesson that I learned this year is, you know, there's no one—there's no one thing that's gonna work. There's no one point at which people are going to suddenly turn back on COVID, that is going to take just as much work to build back up as it took to build it down. Right? And as we're building that up, how do we build towards not something that just responds only to COVID, but that's forward looking enough to be able to be forward looking in the same way that the deconstruction of COVID's risk was, right? Which was towards not responding to another pandemic. So I think that that, surprisingly, for me, was like the biggest thing that I feel like I was hit with today.

Artie Vierkant  03:21:07

Are y'all okay, if I take the final word here?

Phil Rocco  03:21:09

Yeah, go.

Jules Gill-Peterson  03:21:10

Yeah.

Artie Vierkant  03:21:10

Alright. Just to wrap out, as I was going through this, I thought that maybe the most appropriate place to end, the best thing that I could think of, is actually something that—sometimes, especially with stuff like this, it's like you've already had the idea and you just kind of need to circle back and repeat yourself. Kind of like Bea was saying, actually, in terms of being okay with just like the repetition. But I want to just read a really brief snippet from something that Bea and I wrote in March. Which was an essay called "1200 Days." That came out in In These Times, that was about the end of the Public Health Emergency, which then was, like, you know, a little over a month away. And so we wrote,

As we near the conclusion of the pandemic’s first 1,200 days, organizing toward a more collective pandemic response is set to become even more difficult. With responsibility for public health and the ongoing pandemic increasingly shifted off of the state and onto the private market, the number of actors we will have to target for demands will be increasingly dispersed. Federal, state and local governments will have a renewed list of private actors on whom to deflect blame: health insurance companies, pharmacy chains, hospital groups, pharmaceutical companies and employers. All these entities are powerful — and widely loathed — stakeholders in U.S. political life, but the scope of their power is shaped by the state. The current plans to privatize Covid care amount to an expansion of the power of those groups.

We have been on this trajectory of fragmentation for some time. Many of us have gotten so used to being on the back foot in Covid advocacy that it can become difficult to imagine otherwise. Where once it was common to see demands, even from centrist and moderate public health professionals, that we ​“pay people to stay home,” many have dropped that assertion, wary of its association with an economic ​“shutdown” (itself a demand many of us once embraced). Many in public health have altogether dropped the term ​“mask mandate,” preferring to politely ask that the CDC universally ​“recommend” masking. Soon, when once the federal government was the central target for us to pressure to expand its paltry vaccination efforts, we will instead be caught up demanding Pfizer reduce the price of its vaccine, or of Paxlovid, on the private market. Organizers in individual states will likely have to press their state governments to expand access to Covid testing, vaccines and treatments under Medicaid. And so much activity, both for Covid and its longer-term impacts in long Covid, may slowly mold itself in the image of the abysmal charity-industrial complex model that permeates and compromises so much disease-based advocacy work in the United States.

We share this bleak assessment of a possible future not to demobilize, but to agitate. As we come to the conclusion of these 1,200 days, we will have to make demands that go far beyond many of the platitudes that have become mainstays of pandemic-era discourse. It is not enough to say we must ​“follow the science” in hopes that some putatively unadulterated truth will sway what are nakedly political and economic decisions. It is not enough to wish for soul-searching within the discipline of public health because public health does not, in and of itself, outlay a program for political action; it merely gives us a set of tools and operations with which to understand the world.

To build a better future together, we will have to commit to setting aside the false binary between the ​“healthy” and the medically vulnerable that many of us carry even into spaces of radical and anticapitalist work, and instead acknowledge our collective vulnerability.

Artie Vierkant  03:24:46

So that's it.

Beatrice Adler-Bolton  03:24:48

I think that's a great place to end it. Gang. So glad we could all finally record together.

Phil Rocco  03:24:55

Yeah.

Jules Gill-Peterson  03:24:56

Yeah.

Beatrice Adler-Bolton  03:24:57

Patrons, as always, thank you so much for your support. Literally, none of what you've just listened to today would be possible without it. To support the show, you can become a patron at patreon.com/deathpanelpod, you'll get access to our second weekly bonus episode and entire back catalogue of bonus episodes, and when we do massive shit like this, you'll get it early. And if you'd like to help us out a little bit more, share the show with your friends, post about your favorite episodes. Pick up a copy of Health Communism at your local bookstore. Preorder Jules's new book, coming this January, called A Short History of Trans Misogyny, or request them both at your local library, and follow us @deathpanel_. As always. Medicare for All now. Solidarity forever. Stay alive another week.

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