Ed Yong, ein Wissenschaftsjournalist von The Atlantic, hat den diesjährigen Pulitzer-Preis für Hintergrundberichterstattung ("explanatory reporting") bekommen. Im Lauf des letzten Jahres habe ich öfter Artikel von ihm geteilt. Auch diese Woche fand ich einen Artikel von ihm interessant, bei dem es zwar um amerikanischen Individualismus geht, der aber aus meiner Sicht zumindest teilweise auch auf europäische Länder passt:
The Fundamental Question of the Pandemic Is Shifting
We understand how this will end. But who bears the risk that remains?
During a pandemic, no one’s health is fully in their own hands. No field should understand that more deeply than public health, a discipline distinct from medicine. Whereas doctors and nurses treat sick individuals in front of them, public-health practitioners work to prevent sickness in entire populations. They are expected to think big. They know that infectious diseases are always collective problems because they are infectious. An individual’s choices can ripple outward to affect cities, countries, and continents; one sick person can seed a hemisphere’s worth of cases. In turn, each person’s odds of falling ill depend on the choices of everyone around them—and on societal factors, such as poverty and discrimination, that lie beyond their control.
Across 15 agonizing months, the COVID-19 pandemic repeatedly confirmed these central concepts. Many essential workers, who held hourly-wage jobs with no paid sick leave, were unable to isolate themselves for fear of losing their livelihood. Prisons and nursing homes, whose residents have little autonomy, became hot spots for the worst outbreaks. People in Black and Latino communities that were underserved by the existing health system were disproportionately infected and killed by the new coronavirus, and now have among the lowest vaccination rates in the country.
Perhaps that’s why so many public-health experts were disquieted when, on May 13, the CDC announced that fully vaccinated Americans no longer needed to wear masks in most indoor places. [...]
Framing one’s health as a matter of personal choice “is fundamentally against the very notion of public health,” Aparna Nair, a historian and an anthropologist of public health at the University of Oklahoma, told me. “For that to come from one of the most powerful voices in public health today … I was taken aback.”
From its founding, the United States has cultivated a national mythos around the capacity of individuals to pull themselves up by their bootstraps, ostensibly by their own merits. This particular strain of individualism, which valorizes independence and prizes personal freedom, transcends administrations. It has also repeatedly hamstrung America’s pandemic response. It explains why the U.S. focused so intensely on preserving its hospital capacity instead of on measures that would have saved people from even needing a hospital. It explains why so many Americans refused to act for the collective good, whether by masking up or isolating themselves. And it explains why the CDC, despite being the nation’s top public-health agency, issued guidelines that focused on the freedoms that vaccinated people might enjoy. The move signaled to people with the newfound privilege of immunity that they were liberated from the pandemic’s collective problem. It also hinted to those who were still vulnerable that their challenges are now theirs alone and, worse still, that their lingering risk was somehow their fault. [...]
Neither is true. About half of Americans have yet to receive a single vaccine dose; for many of them, lack of access, not hesitancy, is the problem. The pandemic, meanwhile, is still just that—a pandemic, which is raging furiously around much of the world, and which still threatens large swaths of highly vaccinated countries, including some of their most vulnerable citizens. It is still a collective problem, whether or not Americans are willing to treat it as such.
The U.S. also largely ignored other measures that could have protected entire communities, such as better ventilation, high-filtration masks for essential workers, free accommodation for people who needed to isolate themselves, and sick-pay policies. As the country focused single-mindedly on a vaccine endgame, and Operation Warp Speed sped ahead, collective protections were left in the dust. And as vaccines were developed, the primary measure of their success was whether they prevented symptomatic disease in individuals.
Vaccines, of course, can be a collective solution to infectious disease, especially if enough people are immune that outbreaks end on their own. And even if the U.S. does not achieve herd immunity, vaccines will offer a measure of collective protection.
There’s a catch, though. Unvaccinated people are not randomly distributed. They tend to cluster together, socially and geographically, enabling the emergence of localized COVID-19 outbreaks. [...]
According to a Kaiser Family Foundation survey, a third of unvaccinated Hispanic adults want a vaccine as soon as possible—twice the proportion of unvaccinated whites. But 52 percent of this eager group were worried that they might need to miss work because of the reputed side effects, and 43 percent feared that getting vaccinated could jeopardize their immigration status or their families’. Unsurprisingly then, among the states that track racial data for vaccinations, just 32 percent of Hispanic Americans had received at least one dose by May 24, compared with 43 percent of white people. The proportion of at least partly vaccinated Black people was lower still, at 29 percent.
When leaders signal to vaccinated people that they can tap out of the collective problem, that problem is shunted onto a smaller and already overlooked swath of society. And they do so myopically. The longer rich societies ignore the vulnerable among them, and the longer rich nations neglect countries that have barely begun to vaccinate their citizens, the more chances SARS-CoV-2 has to evolve into variants that spread even faster than Delta, or—the worst-case scenario—that finally smash through the vaccines’ protection. The virus thrives on time. “The longer we allow the pandemic to rage, the less protected we’ll be,” Morehouse’s Camara Jones says. “I think we’re being a bit smug about how well protected we are.”
Ian Mackay, a virologist at the University of Queensland, famously imagined pandemic defenses as layers of Swiss cheese. Each layer has holes, but when combined, they can block a virus. In Mackay’s model, vaccines were the last layer of many. But the U.S. has prematurely stripped the others away, including many of the most effective ones. A virus can evolve around a vaccine, but it cannot evolve to teleport across open spaces or punch its way through a mask. And yet, the country is going all in on vaccines, even though 48 percent of Americans still haven’t had their first dose, and despite the possibility that it might fall short of herd immunity. Instead of asking, “How do we end the pandemic?” it seems to be asking, “What level of risk can we tolerate?” Or perhaps, “Who gets to tolerate that risk?”