COVID-19 Will Fuel Humanity’s Search For Meaning

SARA SIDNER, SENIOR CORRESPONDENT: Our next guest, Nicholas Christakis, is a professor of Social and Natural Science at Yale. He joins Hari Sreenivasan to break down the current phase of COVID-19.

HARI SREENIVASAN, CORRESPONDENT: Thanks, Sara. Nicholas Christakis, thanks so much for joining us yet again. We’re talking about the pandemic. We’ve spoken multiple times about the sort of different phases of the pandemic, both kind of epidemiologically and socially. So, where are we now as we see kind of numbers ticking back up, but not nearly the amount of urgency in the population?

NICHOLAS CHRISTAKIS, STERLING PROFESSOR OF SOCIAL AND NATURAL SCIENCE, VALE UNIVERSITY: Well, I think we’re in the intermediate phase, which is pretty typical of a respiratory pandemic. So, the immediate phase lasted until 2022. We’re sort of ending that now. That’s when we are feeling the full biological and epidemiological force of the epidemic as the virus sweeps through the population. And then, there’s an intermediate phase that will last until 2024, approximately. And that’s when we, ordinarily, are — you know, we’ve sort of put the virus behind us, in a way, and are coping with the mess. It’s like a tsunami, like a wave that is washed ashore and devastated the countryside. Finally, the waters recede, which is fantastic, but you going to clean up afterwards. And then, finally in 2024, we’ll enter the post pandemic phase, approximately, in which we will, you know, be beyond all of this and sort of life will return much more to what we think of as normal. The one thing that, however, is a little wrinkle in this is that we still, unfortunately, are coping with more of the biological and epidemiological impact of the virus than I would have thought. We — the virus has not entered a kind of stable steady state, what epidemiologist call endemic phase. We are still having localized outbreaks. We are still having many people die, as you just mentioned. We have about 400 deaths a day right now in the United States and it is heading north. So, we’re not at a steady state of the virus, yet. And this relates to a couple of factors. One is that we haven’t yet been adequately been boosted. We have not had the uptake of the vaccines that we really would want in the American population. And second, the virus has been sneakier than we would have thought in terms of the Omicron and some of these other variants the way they’ve evolved. So, we’re at the intermediate phase. We’ve got a lot of cleanup to do and we still have the virus around. So, we’re a little bit in trouble, I would say, still.

SREENIVASAN: When you talk about 400 plus people still dying per day, that’s still very real. And have we, kind of, as a society just said, well, I guess that’s the cost-of-living life now?

CHRISTAKIS: A little bit, yes. We have done that, unfortunately, from my point of view. We’re still in the midst of this epidemic. And there’s going to — it’s only going to get worse. We can look at the southern hemisphere, for example, we can look at Australia to get clues about whatever our winter is going to be like and deaths are spiking in Australia right now. So, we’re going to have, as is typical, another winter wave coming in a few months. Kids are going to return to school. There’s going to be a lot more transmission and the deaths are going to rise up from where we are now. So, I remain worried. The reason I follow deaths or hospitalizations, I always did, but I — especially now, is that most people who test at home now, we have such widespread home testing, so, there’s no centralized record of this. So, I really wouldn’t be counting on case counts, I’d be watching death counts and hospitalization counts, and both of those are going up. Just in the last week, we had a 5 percent increase in hospitalizations compared to the prior week. So, those are trending up as well.

SREENIVASAN: When we look at the fall and winter, it’s not just COVID, I mean, there’s also influenza, there’s other respiratory infections that exist that perhaps have been tamped down for a year and a half or two years because of mask wearing.

CHRISTAKIS: And I think we need to be sober minded about what we’re facing. So, as you are suggesting, not only do we have — COVID is still around, the virus is still mutating, there’s going to be another variant that’s named after Omicron is pie. We’re going to have another one, let alone the subvariants we have right now of Omicron that are causing havoc. And the winter is covering. So, we’re going to have to deal with COVID. But also, with all these other respiratory pandemics which have been suppressed, not only because we’ve been avoiding each other and wearing masks the last few years, but because, now, we — because we’ve avoided each other for the last couple of years and worn masks, we’ve reduced our natural immunity to those pathogens. People haven’t been exposed to those pathogens. So, those pathogens are like pent-up. They’re like a dam waiting to burst. And they’re also going to burst on the scene if we just sort of willy-nilly return to normal. So, we’re going to have a bad respiratory — I suspect, strongly suspect, we’re going to have a bad respiratory infection season in the winter of 2022 into 2023, yes.

SREENIVASAN: Do you think that the Biden Administration is going to be able to have kind of operation warp speed 2.0 to try to come up with something, with the big pharma companies, that will, I don’t know, protect us from more than just one variant or two variants? It seems like it’s sort of a game of catch up that were playing and the virus, well, does what it does best, which is mutate and keep outsmarting us.

CHRISTAKIS: I think this is a complicated question. It’s more complicated politically and sociologically, and maybe economically that it is epidemiologically. I think our politicians have sensed that the public is fed up, that the public is eager to declare victory. And I do sense, as you suggesting, a lack of political will, including in the Biden administration and in Congress, more particularly, to deal with some of the ongoing threats we’re facing. However, having said that, the Biden administration, I think it was just leaked earlier this week, is about to announce a kind of operation warp speed analog for a so-called pan coronavirus vaccine. A vaccine that would be effective, it is hoped, against all the coronavirus variants. And it’s unclear whether Congress would fund that. It’s unclear whether there is appetite to spend the money that’s required, which is billions of dollars. That’s not the only thing we should be doing as a nation. We should also, for example, really up our game in terms of boosters. Only 29 percent of Americans older than 50 have had four shots. It is really foolish not to have gotten four shots if you older than 50. The evidence is very strong with that fourth shot stimulates your — it sort of makes your — put your body into fighting shape to cope with the virus. Not just because of the antibodies that you make in the short-term after the — after you’ve been given the shot, but because your body has something called cellular immunity, your body has a long-term ability to fight the virus. We should have more attention to hospitals being full. If you’re a citizen in this country, you should be paying attention to how full are the hospitals are in the city. And when they start getting full, that’s a problem for your city and for you, because if you get sick, there won’t be a bed for you.

SREENIVASAN: Right now, there’s also a bit of swagger from people who have gotten an infection and might not have gotten a booster. And I’m just going to put myself on the spot here. I have had two shots. Had a booster. Had COVID maybe two months ago. And frankly, for those weeks right after, I was very cavalier. I was, like wow, I’m protected.

CHRISTAKIS: I’m Superman. Yes.

SREENIVASAN: I am, right. I’ve got the hybrid immunity.

CHRISTAKIS: Yes.

SREENIVASAN: Now, and then, I thought to myself, well, maybe I should sit there and wait for my second shot until the fall. Again, there’s lots of people making these kinds of calculations.

CHRISTAKIS: Yes.

SREENIVASAN: And I think actually getting COVID changes their perspective on the usefulness or need for vaccines and boosters.

CHRISTAKIS: So, I think, in your particular case, if you’ve had three shots and a natural infection, there was no urgent need for you to get a booster. You’ve had four exposures. And in fact, that is the right order to have them, because where the vaccines first. So, that by the time you got the natural infection your body was able to fight it off effectively, and that fight that your body engaged in really strengthened your body’s ability to fight even future infections that you might get. So, in that particular case, I’m not — I wouldn’t be too worried. If people are on the fence, these are hard decisions. And the other thing that happens with these kinds of things is that things that I would recommend to a particular individual are not necessarily the things that you would recommend is a public policy. It is absolutely case that we want as many people as possible to be boosted. And in fact, on an individual level, if you delay your booster shot during that period of time, you are running some increased risk of death. So, why are you delaying it? Well, you might be delaying it because you think there will be a new booster, which will be better, for example, an Omicron specific booster, or because you think, actually, I’m less likely to get COVID now because it is the summer. But what I really want that extra protection that comes — well, you get two kinds of protection from a shot, long-term production and an extra short-term protection, you might say, I really want that extra short-term production in the winter. From a collective perspective, I’m saying, everybody should get their shots, go out and get them. From an individual perspective, it depends. I think it depends, you know, on your specifics of your lifestyle and your needs.

SREENIVASAN: The part that makes — gives me pause is when I read about the fact that reinfection is not good by any stretch. That it is not automatic that oh, well, since that you’ve had it and since you’ve had the three vaccines, if you get COVID twice, it’s just going to be just like the last time.

CHRISTAKIS: No, that is correct. I do not think one should be cavalier about this disease. Each time you are exposed to a pathogen, it carries a certain amount of risk. Now, if you said to me, does this mean that I’m going to hide in my house for the next few years? The answer is no. I’m living my and I’m out and about. I’ve taken the prudent steps that I can take as an individual. I’ve gotten all four shots. I avoid needless, large gatherings. You know, I’m not going to any rock concerts. Not that I would necessarily, anyway, but — you know, but I wouldn’t. The reason I wouldn’t is for COVID. But — and otherwise, I’m living my life. You know, I will have a dinner party with my friends. I’ll go — I will do what — you know, what’s normal.

SREENIVASAN: How do we deal, as a society, with the aftermath of the different types of social consequences that have happened? We have had all kinds of these ripple effects as a society that we still have to clean up from, really, kind of March of 2020.

CHRISTAKIS: Yes. Let’s talk about some of the ripple effects. And because this is what is typical of the intermediate phase we are in, is the — is these types of, you know, echoes of the pandemic sweeping through our society. One is the impact on young children, and then, specifically, the learning loss that came from the disruptions in schooling. And it wasn’t just the lockdowns and the fact that the school switch to Zoom, for example, it was also that the teachers were wearing masks, so — and the kids are wearing masks, they couldn’t see each other. A lot of teachers got sick and couldn’t come to work even after schools were back. There’s a great resignation. Many teachers have resigned. There are staffing shortages in our schools. There’s multiple, multiple issues happening in the schools that are contributing to this learning loss. So, we — this learning loss has been absolutely documented and it is substantial. And it’s similar, by the way, to what happened a hundred years ago with the 1918 pandemic that people who are young — young people during that pandemic, some of them never recovered in terms of their education, in terms of their ability to read, in terms of their occupational prospects and so on. So, it’s been quite severe. And it has been so economically stratified. So, some kids in some parts of the country are — of certain backgrounds have suffered more than other kids. So, it’s been unequally distributed. But there are other things as well that are echoes. I think suicide and suicide attempts and suicidality and mental health in young people. Now, mental health in our young people was declining over 2010 to 2019 even before the pandemic. We had rising self-harm, rising incidents of depression and anxiety, rising use of psychoactive medications. And among the young people in our society, the pandemic accelerated that. And we had an even further rise. There is some evidence from an adolescent behavior experience survey, which I think is run out by the CDC in 2021, that has a nationally representative sample that reports that in the preceding 12 months, which included the time of the pandemic, 44 percent of American young people in grades nine through 12 experienced persistent feelings of sadness or hopefulness. And 20 percent had seriously considered attempting suicide, and 9 percent had attempted suicide. So, this effect on mental health that we are seeing with COVID is bad, but it is also pretty typical of plagues. I mean, plagues do this. Marcus Aurelius writing about a played in Rome 2,000 years ago, talked about the moles (ph), the kind of depression that is settled on the city because of the plague. There is another thing we need to keep an eye on, which is whether you have had long or short COVID, after you recovered, has your body been affected? Is your body scarred from the infection? Do you have pulmonary fibrosis or renal insufficiency or pancreatic insufficiency or do your problems with your heart or psychiatric or neurologic problems? And it is still unclear, but I think we are going to have maybe 5 million Americans who survive the infection but who are disabled, had some amount of disability afterwards, either mild or severe disability. So, these millions of our fellow several civilians, first of all, will have suffered, will have survived but now, their bodies are harmed, and they’re going to need medical attention and then, going to be make demands on our health care and cost money. So, this is another echo. And what I think is probably one of the most important social and psychological impacts of the pandemic is that pandemic are times when there is a search for meaning. When there is a major disruption in a society and when people are dying or getting sick or worried about dying or getting sick, people rethink the meaning of their lives. And they rethink what is important to them in their own lives, and what is important to them in society. And I am seeing a lot of evidence of this in our society right now. I’m seeing it, for example, in the seas regarding religious participation. I am seeing it in the great resignation and in occupations. People are changing their jobs because they are thinking, I’ve only one life to live. What is the job I really want to do? I’m seeing it, for example, in the large numbers of young people who want to become doctors and nurses and participate in the healing professions, because they’ve seen the importance of that. I am seeing it, for example, in some of the political ferment we are seeing in our society. In — whether it is the Black Lives Matter protests from a couple of years ago or even the January 6th insurrection, I think, partly reflected a kind of search for meaning. People were trying to figure out, what is going on? And I think that is something that is going to very much beyond people’s minds during this intermediate period.

SREENIVASAN: On the one hand, we’ve got the World Health Organization declaring that monkeypox is now a global health emergency. Very different virus, very different transmissibility. I don’t want to confuse it with the coronavirus pandemic. And then, we also have polio showing back up in the United Kingdom and in the United States, and this was a disease that we were so — we were on the cusp of stamping it out around the entire planet. And I wonder whether — kind of our next pandemic, whether it’s monkeypox, whether it’s something else, is coming. I mean, have we not learned anything from this or what should we be taking from the last two years that we should be applying to the next threat?

CHRISTAKIS: Well, I don’t think — no, monkeypox is not coronavirus. It does not have the prospect of being anywhere near as damaging or as deadly as coronavirus. And it is very unlikely to become a pandemic in the same kind of way and kill as many people as coronavirus has. However, it is absolutely the case that we are going to face more pandemics. Respiratory pandemics come every five or 10 years, but serious ones only come every 50 or hundred years or so. But there is some evidence that the inter pandemic interval for respiratory pandemics is narrowing. So, there is a decent chance that those of us listening today, in our lifetimes, will face another pandemic. And I would hope that we would be vastly better prepared, both politically and socially and clinically to cope with this pandemic when it comes.

SREENIVASAN: Nicholas Christakis, thanks so much for joining us.

CHRISTAKIS: Thank you so much for having me, Hari.