Yale Sociologist: COVID-19 Will Reshape Humanity

BIANNA GOLODRYGA: Well, so with omicron on the rise, what might next year have in store? Nicholas Christakis is the director of the Human Nature Lab at Yale University and author of “Apollo’s Arrow.” He’s talking to Hari Sreenivasan about what’s to come.

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HARI SREENIVASAN: Bianna, thanks. Nicholas Christakis, thanks so much for joining us. And I got to ask, you have been in conversation with us a couple of times now. Your predictions have been fairly spot-on. And your book, you talk about three different phases of a pandemic. And I want to know, like everyone else, which phase are we in now and when are we going to get to the next one?

NICHOLAS CHRISTAKIS, PROFESSOR OF SOCIAL AND NATURAL SCIENCE, YALE UNIVERSITY STERLING: I think that it’s safe to say while we are not, unfortunately, at the beginning of the end of this respiratory pandemic, we are thankfully approaching the end of the beginning. And respiratory pandemics go through three phases. There’s the immediate phase, which I had thought and it’s proving to be the case, in the case of the coronavirus pandemic, would last into 2022. There’s the intermediate phase, which I think is going to last a couple of years into 2024. And then, there’s the post-pandemic phase. During the immediate phase, we’re feeling the full biological and epidemiological force of the virus. It’s like a wave of the virus that’s sweeping through the human population and the virus will spread and spread and spread among us until it becomes endemic, until we reach actually herd immunity. Basically, unless you’re a hermit in the mountains or you’re incredibly lucky, everyone in the United States, in fact, everyone on the planet is either going to be vaccinated for this condition or infected with the virus. And we’re going to have to wait until that happens. That’s going to happen sometime in 2022 in this country, in the beginning of 2022. And then, we will finally put the biological and epidemiological impact of the virus behind us and enter the intermediate phase. And during the intermediate phase, we’re going to have to cope with the clinical, psychological, social, and economic aftershocks of the virus. It’s like a tsunami has washed ashore and has devastated the countryside. Finally, the waters recede, which is great, but now we have to clean up the mess. And as a nation, we’re going to have to deal with lots of fallout from the virus. And then, finally, in around 2024, and these are approximate dates, we’ll enter the post-pandemic phase, which I think is going to be a little bit of a party. People will be very relieved to the finally have put the pandemic behind us.

SREENIVASAN: So, before we get to that what is life like in phase two and phase three, when you talk about herd immunity, you say it’s either going to happen through vaccinations or by everybody getting infected. And one of the concerns quite a few people who are hesitant to get the vaccine have is, you know what, I’m just going to wait and get infected. I’m going to get COVID the old-fashioned way like I get the flu and then I’m good for it. And part of their almost counterfactual evidence is, look at these people who got vaccinated and they’re still getting the Omicron variant. So, what’s the point? What do you say to those folks?

CHRISTAKIS: Well, I think it’s very important to understand that if you get an infection and survive it, then that’s a crucial point, then you could have natural immunity, which could be quite strong. In fact, we have evidence it is very strong. But first of all, you have to understand that in order to acquire the natural immunity, you have to run a very material risk of death. On average, about half a percent to 1 percent of people who are infected with this virus will die. And that is a nontrivial risk of death. Of course, it varies tremendously by age and that’s just a rough number, and that is a kind of a silly risk to run when we have safe and effective vaccines. IN fact, that’s the whole point of vaccination, that you kind of get the immunity without running the risk of infection. In addition to that consideration is the fact that there is evidence that being vaccinated actually offers superior immunity to acquiring immunity via the natural means. Now, this is a difficult topic. It is usually the case that natural infection, if you survive it, offers superior immunity than vaccination for most pathogens but not always. For some pathogens, vaccination offers better immunity. And there is evidence that in the case of coronavirus, that is also the case. Now, there’s a lot of studies. This opinion could be changed with new evidence coming in. But right now, it’s approximately the case that six months after vaccination with an mRNA vaccine, you have between 84 percent and 96 percent efficacy against serious disease, whereas six months after recovering from a natural infection, you have between 80 percent and 93 percent. So, there’s still a little advantage of vaccination.

SREENIVASAN: So, right now, there is also a focus on the number of people who are dying with this. But I also want to point out the large population that’s living with it and what are the implications for our society if a significant percentage of the population has, say, long COVID?

CHRISTAKIS: I think I’d like to answer that by actually stepping back even more. I think the average American has not yet been able to fully appreciate the gravity of what has happened to us as a people. About 800,000 of our fellow citizens have died. And I think almost for sure, a million of our fellow citizens will have died before the pandemic is over. We have had millions of children miss school. We have had millions of Americans lose their jobs. We have millions of businesses closed. We’re borrowing trillions of dollars against the future. One estimate of the economic consequence of this virus puts it at $16 trillion, which is an economic disaster that surpasses the Great Depression. And in addition, as you mentioned, it’s not just that people who die, the 1 million Americans who may die, we have a lot of evidence that perhaps five times as many people as die will be disabled by this condition. I don’t mean long or short COVID, I mean, you’ve recovered, whether long or short but now your body is scarred. You have pulmonary fibrosis or cardiac problems, a renal insufficiency, pancreatic insufficiency or neurologic or psychiatric problems as a result of the virus. And that means as many as 5 million Americans or our fellow citizens will be disabled to some extent by this virus, and they will also need our care. So, there are so many ways this virus is harming us and I don’t think people fully appreciate yet the magnitude of what is happening.

SREENIVASAN: We have Larry Summers speaking to Walter Isaacson recent and he said that there up to a 40 percent chance of a recession in the next four years. How does that fit with the models that you’ve seen or, I should say, the examples that you’ve seen historically of how pandemics progress?

CHRISTAKIS: You can learn a lot by contrasting what happens to a society when it’s attacked by a plague versus when it’s attacked by an invading army. During a war, a lot of people die. And during the plague, a lot of people die. But during a war, in addition to people dying, you destroy capital. Buildings are bombed and roads are destroyed and farms are destroyed. And actually, there’s no worst waste of money than to build and ammunitions and detonate them, right? Just you want to make all this money to build a bomb and then explode them. So, in warfare, you destroy people and capital. But in plagues, it’s like a neutron bomb. You just kill people and you leave the capital intact, the roads, the farms, the factories, the gold, the knowhow and so on. And if you study across time what this means economically, it has some pretty systemic implications. Because in a plague, people die but capital left intact, afterwards, the labor to capital ratio changes, and you have many more people, about the same amount of capital, so wages tend to rise. For about 20 years after a serious plague, if you look historically, wages rise. And real interest rates overtime tends to decline because there’s so much capital chasing less and less opportunity. So, you can look at the history of plagues and make some informed guesses about what’s also likely to happen today. Coronavirus is a little different because it tends to kill elderly people, not working age people and it’s not as serious as smallpox or bubonic plague or cholera. So, it may not be the same as previous epidemics, but we’re seeing a lot of indications that it might be in terms of what’s happening in our labor markets and in our economy.

SREENIVASAN: You know, it’s interesting that you mentioned labor and capital because it’s not coincidental that there has been a resurgence of strength in labor movements right now. I mean, there are a lot of people who say, you call me an essential worker, but you don’t treat me essential when it comes to how you pay me, how you schedule me or what kind of benefits I get?

CHRISTAKIS: Exactly. And I think we’re seeing a lot of evidence of that. We’ve had what is called the great resignation. A lot of people that were near retirement, for instance, especially if they were not well paid, teachers, nursing’s assistants, low wage workers of various kinds, so- called essential workers in many industries, you know, who are 62 or 63 and they’re saying, gee, it’s unsafe for me to be around. I could get infected and I’m older and I run a bigger risk of death. My job wasn’t that interesting to me. And I’m approaching the end of my career when I could retire anyway, why don’t I retire? It doesn’t take many people to retire to disrupt the labor market. In addition, one of the other fundamental things that plagues do is that plagues often prompt a search for meaning. When — you know, when there’s a deadly germ afoot and people are cooped up at home, they begin to think about what’s important to them in their lives and what kind of lives they want to live and what kind of societies they want to live in. And we’ve seen a lot of indicators of that in this modern plague as well. Yes, religious attendance went down. There’s been a long-term decline in religious attendance in our society and it went further down during the plague when many houses of worship were closed. But prayer, including among the religious and among the previously non-prayerful went up. This is typical in times of plague. In addition, people found other ways to search for meaning. I think the Black Lives Matter protests from a year ago, even the right-wing insurrection at the nation’s capitol, many of this political ferment can be understood through this notion that people searching for meaning, they are questioning what kind of society they want to live in. This rejiggering of the labor market we’re also seeing. For example, there’s been a boom in applications to nursing school and medical school. People see these as meaningful occupations, even though you would think they’d be more dangerous right now.

SREENIVASAN: I also want to ask about this latest variant. I know it’s still early, there’s still a lot of research that is being done. But what do we know about Omicron? Because there are — you know, we kind of see these different reactions. We see people lining up for testing left and right all over the country now. We see numbers of infections that have increased. And then we also hear, well, it may not be leading to hospitalizations at the same rate or, you know, if you’re vaccinated, you have greater protection. I mean, from all the different sources that you’re listening to and paying attention to, what’s your advice to people about this new variant?

CHRISTAKIS: Well, first of all, I have to say, it’s still early days. And, you know, the WHO, I think, declared this a variant of concern on November the 26th approximately, and we’re not even a month after that. And so, scientists have been scrambling to collect data. And so, what happens is when a scientist like me offers an opinion about something, I just have to say, it’s given the current state of knowledge.

SREENIVASAN: yes.

CHRISTAKIS: If knowledge changes, well, then I’ll revise my opinions. Anyway, as of now, if you look at the overall data, it seems very clear that Omicron is much more contagious and it’s more contagious for at least two distinct reasons. One is intrinsically, the virus can spread more easily. For example, if the virus is better able to buying to receptors in your nose than prior variants, if this variant has that capacity, then it can leap from person to person more easily on its own. A distinct reason it’s spreading more easily is another property of the virus, which is its ability to evade, do something called immune escape. It can evade immune defenses of previously immunized people, people who had acquired immunity naturally or through vaccination, the Omicron variant can outsmart that a little bit. Actually, more than a little. So, for those two reasons, the Omicron variant is very — is much more spreadable, and that’s very clear. The second issue is, is this more deadly or not? And this is less clear. If I had guess, I would say on a case-by-case basis, the Omicron variant is less deadly than the Delta variant, but I could change my mind on this depending on additional evidence that comes in. The thing is, even if on a per person basis it is less deadly, at a societal level, it can still wreak havoc. Because it spread so easily, so many people will get sick so fast that our hospitals could once again be overrun. And we’re seeing these very steep rises in Omicron cases in South Africa, in Europe, in American college campuses, which worry me.

SREENIVASAN: You now, I want to ask about the people who are going to hear this and say, you’re right. We could have taken the route of not vaccinating anyone, that our response to this as a planet has been excessive or overblown. I mean, even with 800,000 Americans dead, we still have this mindset in an active debate right now. Explain that.

CHRISTAKIS: I don’t understand that thinking, honestly. If we hadn’t vaccinated anyone, we might have lost two million American lives. I mean, just doing nothing, that was — that’s like a medieval response. You know, our ancestors had to accept that kind of fatality rate. But we’re in the 21st century. We’ve spent 200 years inventing vaccines. Vaccines are a miraculous technology. So, the idea that we would have just done nothing is absurd, in my opinion. And furthermore, whatever your attitude the level of lethality this pathogen, you have to understand that this pathogen is kind of a plague light, like our time in the crucible we this ancient threat, we’re just facing a light version of what our ancestors faced. Our ancestors faced Bubonic plague and smallpox and cholera and the 1918 Spanish influenza, which — all of which were much more deadly. And our pathogen is not as deadly, but there’s no God-given reason it’s not. It could have been. Just imagine if we had been doing — we had been facing the same pandemic but the intrinsic lethality of the pathogen, instead of being 1 percent was 10 percent or 30 percent. There are coronaviruses that are that deadly. MERS, Middle Eastern Respiratory Syndrome, which is coronavirus, kills 30 percent of the people it infects. So, I wonder, what had those people against vaccination be saying if this pathogen was even deadlier? Would they really be saying, oh, never mind, just let 100 million Americans die? So, I don’t — if you’re not going to make that argument with a hundred million Americans, I don’t see why you should make that argument for a million Americans. And million Americans, our fellow citizens, at least, I think, will ultimately have died as a result of this plague. And that is an enormous catastrophe, that, again, I don’t think people fully have grasped.

SREENIVASAN: We’re heading into the holidays right now, and there’s a lot of people who are on the cusp of cancelling their holiday plans, and it is causing not just fatigue but also a deeper frustration that perhaps it was at bay over the last several months. And people wondering, you know, when will this new normal stop or what is 2022 looking like? Paint us a picture if you can.

CHRISTAKIS: Well, first of all, I have a lot of sympathy and empathy for people with those feelings. The fact that we are fed up with this plague, which we all are, has no bearing on the virus. It — the virus is just doing its thing. And we’re — there’s more suffering, more woe ahead of us. Now, for those of us who are fully vaccinated, including a booster, if you want to get together with your family in small groups, I think that’s very safe. If you add to that one other layer of protection, you test people when they come to your home with a rapid home test or you have outdoor gatherings or you increase the ventilation in your home or wear masks. If you add some other layer of protection, I think it’s totally fine. I think the risk is not zero but it’s tolerable. So, for my family, we’re going to gather for the holidays. Everyone has been triply vaccinated. We’re going to test people when they arrive at our house and then, we’re going to spend a week or two together and not worry about the virus.

SREENIVASAN: The book in paperback. “Apollo’s Arrow.” Nicholas Christakis, thanks so much for joining us.

CHRISTAKIS: Thank you for having me, Hari.