“Covid-19 need no longer control our lives,” President Biden announced in the State of the Union address, speaking to a room of unmasked though back-room-tested members of Congress. He then offered, magnanimously: “If you’re immunocompromised or have some other vulnerability, we have treatments and free high-quality masks. We’re leaving no one behind or ignoring anyone’s needs as we move forward.”
But that’s not exactly true. Throughout the pandemic, immunocompromised Americans at higher risk for serious illness from Covid, or those who, like me, live with vulnerable family members we are desperate to protect, have often found ourselves feeling like an unfortunate parenthetical. We are acknowledged, but easily forgotten.
The pandemic isn’t over and yet, as another subvariant spreads, there is little real regard for those whose ability to participate in society hinges on the behavior of everyone else. We have all suffered from isolation, indisputably. But the rush to roll back precautions appears to abandon some to remain isolated forever.
It seems no one knows what it would look like to do otherwise. That’s in no small part because society has rarely taken the most vulnerable into account when it comes to how daily life is navigated. Not during this pandemic, and certainly not before it. The greatest good for the greatest number invariably implies the existence of an expendable few.
Ever since I moved to the precarious side of society (my 13-year-old daughter received a liver transplant as part of her cancer treatment in March 2020), I have been thinking about what we owe the vulnerable. I constantly wonder: Was I truly aware of such precarity before I found myself here? Who would I have been had I continued a life lived only among the well?
“There is always a sense that this is a very tiny minority of the population and that you are asking an unreasonable number of people to make a sacrifice for a very small group,” said Dr. Boghuma Kabisen Titanji, an infectious disease specialist at Emory University. “When you look at the definitions of what makes someone more vulnerable to Covid,” she explained, it is a significant proportion of the population “that we essentially are failing to offer protections to.”
Estimates suggest about 3 percent to 4 percent of Americans are immunosuppressed. Some fall into the same category as my daughter, who takes daily drugs to tamp down her immune system. Cancer patients often have their immune systems temporarily wiped out during chemotherapy. Others have conditions or diseases, autoimmune and otherwise, that alter their ability to fight infection. In all, somewhere north of seven million people, not counting their loved ones, fall into this woolly space. And that number doesn’t include children younger than 5 who are not yet vaccine eligible, though they fare better than adults on average. (During the Omicron surge, the United States reported the highest numbers of hospitalizations for children under 5 since the pandemic began.) To be sure, there have been a few hopeful studies showing our loved ones would survive Covid, but none of us want to be part of the experiment to see if that bears out.
I understand that in the big picture, we are not so many; accommodating us can feel onerous. But this is only one way to see the problem. What if we also calculated the benefits of teaching empathy and inclusion?
In other words: What if we could see this time as an opportunity for a correction? Covid broadened the scope and definition of vulnerability, allowing everyone, however briefly, to viscerally understand the need to protect one another. We worried over our aging parents, our asthmatic selves. We were “all in it together,” clapping each night for the brave frontline workers. What if we applied that understanding going forward? What if we no longer thought of the world as so blithely divisible? Instead of a return to how life was, unconscious of those who are unable to accompany us, why not situation-specific considerations for different populations?
In practical terms that could mean, say, that the family of a child undergoing chemotherapy might ask her classmates and teachers to don masks to protect her against Covid (and other diseases like flu), without having to sue the school to comply. Offices might create masked spaces or offer on-site testing and flexible work arrangements. Restaurants would continue to protect the staffs by asking patrons to present vaccine cards and not show up ill.
Returning to what once was is not possible for all; we need, instead, a new normal, one that recognizes that everyone deserves the chance to participate in daily life. As the philosopher Martha Nussbaum suggested to me, we might start by simply asking the vulnerable what they need.
Thirteen orchestras nationally, including the Chicago Symphony and the Boston Symphony, have done just that. Led by WolfBrown, a research and consulting firm, the Audience Outlook Monitor Covid-19 Study is a continuing effort to gauge what allows audiences to feel comfortable enough to return. (Orchestras often have older audiences, who can be at higher risk.) So far, most patrons say they still want masks in place, though the numbers are trending downward. A survey conducted by Theatre Washington, an umbrella organization working with Washington, D.C., theater organizations, also found a preference for keeping masks on.
“Arts groups are really good about accessibility,” WolfBrown’s managing principal, Alan Brown, told me. “They have been doing that for a long time for people with various disabilities and abilities.” Still, right now, he said, the focus is more on filling seats than long-term changes. “The notion of accessibility has changed and our sector has yet to really figure a response,” he added.
Couldn’t some performances simply remain protected, even if mask requirements fall? I don’t mean special, one-off performances. I mean that we might require masks for some performances for the foreseeable future or designate specific areas of the theater for compromised individuals, offering inclusivity in perpetuity.
After all, it is not as though Covid has disappeared. The BA.2 variant is on the rise. Just as mask mandates fell, the White House announced that money has dried up for free testing and vaccination for the uninsured and for the purchase and distribution of monoclonal antibodies, a treatment for Covid-19 that is still not readily available.
Thus we are dismantling the safety nets, even as the United States sees around 600 deaths a day from Covid. While those at highest risk are the unvaccinated, “when you look at the metrics of what determines when we should be scaling back these protections,” said Dr. Titanji, the infectious disease expert, “are we focusing on the right groups in determining what is acceptable in terms of how much excess death we are willing to tolerate? Because essentially these excess deaths are happening disproportionately among the groups of people who are the most vulnerable in society.”
COVID and CLL -- A little good news
How do I safely live my life with CLL if my antibody test results are one of three scenarios?
Go to the wedding, or not?
Grand Kids and viruses/bugs
