The pandemic’s panic-neglect cycle isn’t over

Make Me Smart May 23, 2023 Transcript

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Kimberly Adams 

Hello, I’m Kimberly Adams. Welcome to make me smart, where none of us is as smart as all of us.

Kai Ryssdal 

I’m Kai Ryssdal. It’s Tuesday, the 23rd of May. It’s a Tuesday, single show single topic. We’re talking about COVID, the public health emergency, but more importantly, what it still means for us because you know, the pandemic is not really over even though everybody says it’s over.

Kimberly Adams 

And today we want to take a look at the overall legacy, how the US handled it and what that might mean for future public health crises. And so here to make a smart about this is Ed Yong. He’s a science journalist at The Atlantic. Welcome to the show.

Ed Yong 

Hi, thanks for having me.

Kimberly Adams 

Thank you so much for joining us. Obviously, at this point, the public health emergency is over but goes without saying that COVID is still here. What does the pandemic look like today?

Ed Yong 

You know, I think unquestionably we’re in a better position than we were several years ago when the pandemic first started. The there are vaccines that blunted the risk of death and severe illness, there are better treatments. But I think COVID is still an emergency, it is still something that is with us and will continue to exact a high toll for a long time. It was in September of last year that Biden said the pandemic is over. And since then 75,000 Americans have died of COVID, you know, around 100,000 are predicted die every year making this a significant cause of death. And then there are people who are having to have not died but who have been profoundly affected. Around 15 million people in the US have long COVID, persistent symptoms that last for months, possibly years after the first infections. So is the pandemic over? I assure you that it is not. We’re still going to be having to deal with this for a long time to come.

Kai Ryssdal 

Do you think we’re… so so let’s stipulate we were not ready for the pandemic when it came? Do you think we’re ready for the long haul on this one?

Ed Yong 

I’m sorry to say that we’re not. I think that people in public health often talk about this thing called the panic neglect cycle, where a crisis hits, people freak out, attention and investment flow into dealing with the problem. And then the minute stuff gets calmer, all of that resource start going away, and we end up back to square one, no better prepared for the next threat than we were for the previous one. We’ve seen that cycle play out multiple times over the course of the pandemic. It happened with the rise of new variants with Delta with Omicron. And we’re very much in the neglect stage now. The end of the emergency also means the end of a lot of funding for measures that would help to control future pandemics, and future ones are on the horizon. You know, I think that we constantly let ourselves slide back into this state of amnesia. That means that we get perpetually battered by whatever new infectious disease is on the horizon. COVID should have taught us that lesson, but it it seems to not have done so.

Kimberly Adams 

Was there anything though, from the worst of the pandemic or even from where we are now that’s been sticky, that is really sort of changed in society and a staying with us?

Ed Yong 

I think it’s a bit of a hard question to answer right? I do actually think that there is more of a social awareness of the cost of threats like epidemics. You know, I think that the next time we have a new respiratory virus circulate, a lot of people are just going to immediately put masks on. I think there is more talk about the consequences of the long term consequences of viral infections. Long COVID is just the latest in a long line of chronic illnesses like MECFS, dysautonomia, that often have viral infections as a trigger. A lot of these illnesses were long neglected by the medical community and by society at large. I think that long COVID has really shone a light on the true cost of these conditions. I don’t think that is going away anytime soon. But, you know, I think that a lot of the measures that could have been put in place, better ventilation in our indoor spaces, for example, simply never manifested to the right degree. And I think that the real lesson we should have learned was that pandemics are not just science and health problems. They’re not things that you tackle solely through creating vaccines and drugs, or those those things are important. They are social problems. To deal with them, you also need to tackle really hard things like racial inequity, like poverty, like crowded housing conditions, or hazardous working conditions. You frankly, need measures like paid sick leave as much as you need new vaccines. And there was a period of time when I think the country started to learn that lesson. But a lot of those measures have gone away. And without that kind of social revolution, we’re still going to be stuck in the same place where the same groups of marginalized people, poor people, people in rural communities, black and brown, indigenous people, disabled and immunocompromised, people will continue will continue bearing the brunt of new diseases, just as they bore the brunt of COVID.

Kai Ryssdal 

With the understanding of that, literally, the definition of pandemic involves, you know, a global spread of a disease, we obviously in this country concentrate most on this country because that’s what we do historically. Is it your sense, though, that this amnesia, which you spoke a minute ago, is a global thing as well?

Ed Yong 

I think it does. It is a global phenomenon. You know, I reported on pandemic risks in 2018. And I saw surprisingly similar problems and rhetoric in the Democratic Republic of Congo and in the United States, two countries with very different resources at play. But with similar, you know, bent to words, this amnesia towards the panic neglect cycle. I think that it’s, it’s sort of almost in our nature to fail to grasp the magnitude of the problem. Pandemics, as you say, affects all people “pan” and “deimos.” And they move quickly, and yet they last a long time. They are, you know, they are, the virus behind the viruses behind them are invisible, the ruin they cost us all is often out of sight. You know, if you weren’t working in a hospital, if you don’t have long COVID, or have someone in your family, your hands, it might be easy for you to walk around your neighborhood now and think that it’s all done. But it’s not, you know, the long term costs of this pandemic, not just in terms of long symptoms, but in terms of traumatized healthcare workers, burnt out educators, that’s going to be with us for a long time. And I think unless we actually really grapple with that, we’re going to lose a lot of people who are in caretaking professions that we’re going to need just in normal times, but also whenever the next pathogen decides to rear its head.

Kimberly Adams 

It’s a little difficult to understand how despite what we’ve been through, and all the evidence to the contrary, we still aren’t as a society taking long COVID more seriously. Why do you think that is?

Ed Yong 

I think there are lots of different reasons. I think that almost every aspect of this disease serves to hide its full reality from public view. The symptoms of long COVID, things like fatigue, and brain fog are invisible. You can’t see them in someone else. They are very subjective. There’s the fact that long COVID and its related illnesses disproportionately affect women who are much more likely to be dismissed by the paternalistic medical establishment, whose symptoms are much more likely to be psychologize. They’re often told that they just have anxiety or depression or they’re making things up. Then there’s the fact that our society handles disability really, really poorly. It stigmatizes it, it denies it, you know, it denies the full reality of it. it. And so people with long COVID are massively incentivized to hide their symptoms, to pretend that they everything is normal, to try and push through, get on with work, with their lives. And sometimes they can. It’s in the nature of long COVID symptoms, that they’re fluctuating their tidal. That some people might have good days, and crushingly bad days. On the good days, that they, their colleagues, or their doctors might see them and think, “Oh, you’re fine.” And they don’t see what happens the next day, when they can barely get off the sofa, or, you know, can’t shower without severe pain. There’s so much about long COVID that makes people want to pretend to be as well as possible. And that makes people who are healthy just ignore their plight. I’ve heard from so many people, “I don’t know anyone with long COVID. It can’t possibly be that huge problem.” Think of how many steps it requires for someone with this condition to not only understand what they have, but then to trust other people enough to want to share the details of that illness. Time and again, that trust has been, has been betrayed. Because people with long COVID, one of the most common things they experience is the dismissal and disbelief of the people who should help them, medical professionals, friends, family colleagues. We can do better than that. And we need to

Kai Ryssdal 

this is going to sound like a like a flip or a simple question. But but I assure you it’s not. On a superficial level, as President Biden said a number of months ago that pandemic is over people have moved on. But I guess my question to you, as a guy who studies this and writes about it and thinks about it is, on a much deeper level, things are never going to be the same again are they?

Ed Yong 

Yeah, I don’t think they are. You know, I think we have now lived through a really bad example of this problem. You know, people, folks in public health emergency preparedness, journalists like myself warned that a pandemic like this was possible for years before it actually happened. And then it happened. One thing that I see often is people saying that this was a sort of generational event, you know, it’s not going to happen for a long, long time. I’m afraid it is. We live in an era now where infectious diseases, new ones are more likely to jump into humans. And we can expect more of this in the future. So we better start getting better at it. Because this isn’t the last time it’s going to happen. We’ve already, as you say, we we are permanently changed now. You know, I think that one of the big mistakes has always been trying to return to normal. But as far as I’m concerned the world as we knew it stopped in March 2020. And we then have a choice to either build a better world, or to revert to something that was actually hugely costly: a world in which our healthcare workers were already burned out, a world in which people with long term chronic illnesses were already being marginalized. Here’s a really interesting study, that if you compare America to the average wealthy nation, not that not the best, just the like the mediocre, wealthy nation. In 2021, if America was as good as the average wealthy nation, 1.1 million Americans who died of COVID and other causes would still be alive today. But if you look at 2019, that number is still 626,000. We were doing so poorly even before COVID hit, and COVID exploited all of the weaknesses that were already present in American society: the lack of universal health care, the carceral state, the overstretched healthcare system, these systemic problems meant that despite having the best biomedical infrastructure in the world, and you know, and so much wealth, this country that was ranked most prepared for a pandemic, was just obliterated. And you know, that is what normal is. Normal lead to this. So do we want to go back to that normal as we seem to do? Or do we want to actually create a society where we don’t have to go through this again? That is still on the table. Like we can still choose to be very good at this problem at any given time. We just choose the opposite.

Kimberly Adams 

What are some of the better choices that are still available to us with the knowledge that our funding models are a mess, that Congress is doing what Congress does, and that we are a very polarized country? What can we still do to be better? To not just pretend like we didn’t just lose more than a million people in a very preventable way in many cases, and to not be like this, for the inevitable next pandemic?

Ed Yong 

So, we’ve talked about… I’ve talked about the difference between biomedical and social measures, right? So a lot of the biomedical stuff is very much like on the cards, people are working on ways to develop vaccines more quickly, etc, etc. But we’ve clearly seen that even after you get a vaccine, you don’t fix the problem. So a lot of the things we need are social measures. We actually do really need paid sick leave, we need better social supports of the kinds that have been eroded since the 80s. Ideally, we would have universal health care. Now I say these things, and it’s very easy to think that it is just a pipe dream, that is never going to happen. Like, you know, we are baked into this extremely polarized society, there’s absolutely no traction there. And to which I would say, like, all of the social revolutions of the past, you know, however many decades, like none of them seemed very likely until they actually happened. And, and I think that we need to remember that it doesn’t have to be like this, that we don’t have to live in a world where social safety nets have been shredded. Like, actually, quite recently, as recently as several decades ago, we did not live in that world. And we can choose something better. I think what we need to realize is that these are not just like, you know, airy fairy, lefty, you know, goals that have nothing to do with what we just went through. They’re actually critical. Like, if you don’t allow people the privilege and ease to take care of their own health, and their family’s health without sacrificing their livelihood, things are going to break in spectacular ways. That should have been the lesson from the last three years. Like pandemics are about more than just vaccines more than drugs. They’re about whether the poorest, most vulnerable people in your society have the means to look after themselves. And we can still create a world in which that is possible.

Kimberly Adams 

All right, Ed Yong is a science journalist at the Atlantic. Thank you very much for all of that. And hopefully, we will do better next time.

Kai Ryssdal 

Yeah thanks a lot.

Ed Yong 

Thank you.

Kai Ryssdal 

So that was depressing as hell, but it is exactly what I thought it was gonna say. It is exactly what I thought he was gonna say. Right? I mean, you know,

Kimberly Adams 

I just want us to be better, you know?

Kai Ryssdal 

Of course. Sure.

Kimberly Adams 

And, you know, I just… so when I was a kid, I was I was raised very religious, as you know, and every Sunday after church, my dad or my mom, because they were deacons and deaconesses, there would be a list in the church program of what we call the “sick and shut in,” which were people in our church, who were either sick, or for some reasons, couldn’t come to church. And we would go and visit them, right? And either give them communion or just sit and chat, right. And I was thinking, you know, at the beginning of the pandemic, about these systems, and how they’ve dissolved over time, because fewer people are involved in religious communities, and people were staying away. And so not only were folks going through these things alone and without their communities, but now coming out of it so many of these communities don’t exist anymore. And layering that on top of just the sort of lack of care, and yeah, there’s the medical establishment, and the funding problems, but what has just stuck with me through the whole pandemic is the lack of empathy and a lack of care. And I wonder how, as a society, we’re ever going to come back from that.

Kai Ryssdal 

Totally agree. Totally agree. Well, yes. Okay. So that was kind of depressing. But we do have the rest of the show to get through. Here’s what we’re going to do for the next 20 seconds and then we’re going to hit a break. I’m going to point out that our May fundraiser wraps up the end of the week, things are getting serious. We’re about halfway to the goal. We’ve got let’s see Tuesday, Wednesday, Thursday, Friday, we’ve got not as much time as we want left. If you’ve been procrastinating that’s okay, we get it, but if you can, we would we would dearly love your support. marketplace.org/givesmart if you can help us out.

Kimberly Adams 

Yeah, it only takes a couple minutes. You can use PayPal, you can use Apple Pay, if that’s more convenient. And again, it’s marketplace.org/givesmart. We’ll also have a link in the show notes and thank you for any support you can give.

Kimberly Adams 

Okay, time for the news fix. It feels like we’re very retail today.

Kimberly Adams 

You’re not though

Kai Ryssdal 

Yeah, we are. It’s really funny. And this is not at all coordinated. But but we did pick sort of complementary items. I just, I it’s, you know, spending on… spending by or on behalf of consumers in this economy 70% of what drives this whole economy. So that’s why we concentrate so much on retail and consumer spending and all that good stuff. Amanda Amanda Mull at The Atlantic, a colleague of Ed Young’s has reported on this a lot, returns and the amount of money that it costs retailers. Piece in The Wall Street Journal today, I’ll just read you the headline and the deck, “retailers clamped down on returns merchant short and return Windows increase male fees and discounts to discourage returns.” Returns are really, really expensive for retailers. And as retailers try to look now at the bottom line as they think about the economic uncertainty that may be coming second half of the year, they do not want you to return things. And it’s really challenging now, because consumers have gotten used to for the past 10,12,15 years. You buy like three of something, I’m exaggerating, you buy three of something…

Kai Ryssdal 

I’m not actually. That’s true. You buy three is something, two of them don’t fit, you mail them back no cost to you, and you keep the one that works. And retailers are like “we’re not doing that anymore.” And it’s just sort of a sign of a tightening environment. Yeah, I guess I’m the atypical shopper here. I don’t I don’t do that. But, but a lot of people do. Yeah.

Kimberly Adams 

Yeah. And I mean, because when you lose that in person shopping experience, you want to cover your bases, it’s easy to cover your bases if there’s a free return policy. But what that created was all of these increased shipping costs for retailers and also created all of these returned items that retailers then had to offload which is somewhat related to one of the links that I wanted to share, which is the “climate coach newsletter” from the Washington Post. And Michael Coren has a piece in this today called “why you should buy everything used” where he didn’t experiment for a month, just trying to buy everything he needed, obviously not food stuff, used and had a lot of success partially because so many returns are sitting in warehouses after people try them on and send them back or use them once and then they got refurbished or whatever, that there are a lot of really high quality used items available. And thanks to better technology and AI, it’s a lot easier to connect used goods with the people who want them now in a way that didn’t exist before. It’s a more streamlined process. It doesn’t help with the fact that, you know, sometimes it’s cheaper to buy something new than it is to pay the shipping and whatever for it to, you know, be used. But it’s a thing that can be done. It’s better for the planet. And it you know, often gets you things cheaper. That was one thing, but you were talking about sort of the tightening in retail and, and retailers sort of trying to trim expenses. Well, part of that is because we are finally starting to see consumer spending slow down in a way that everybody’s been waiting for with all this inflation that we’ve been having, because that’s usually what happens: prices go up, consumers spend less. And we hadn’t been seeing it to the same extent that we expected to or that economists expected to up until relatively recently. And so now, according to CNN, business and others, the home improvement boom seems to be over. So you’re seeing Lowe’s and Home Depot, lowering their profit and sales estimates saying that they’re not really sure that things are going to be as active as they have been. You know, everybody was doing all these projects at home during the pandemic. And that’s starting to taper off because people don’t want to spend on these big ticket, you know, do a new bathroom or do your kitchen over again, or even some of the small DIY projects. People are just like, “Nah, I think I’m gonna save that money for the now much more expensive night out to dinner.” Also, on the other end of the scale, luxury goods. In Bloomberg, there’s a piece about luxury stocks, losing $30 billion in one day because like LVMH, and Hermes and all these other fancy brands are predicting a slowdown in the luxury markets. And you know, so if you’re seeing people at the lower end start to tighten up, and people are at the higher end of the income scale starting to tighten up. You know, that’s a very important signal of where the economy is going. Because as you said, consumer spending is most of our economy.

Kai Ryssdal 

Totally. Yeah, I don’t understand still how we get to a recession with unemployment at 3.4% and the economy still technically growing. But I guess we shall see. We shall see.

Kimberly Adams 

I really… you know, we have to do a deep dive on this at some point, because I really do think a lot of these economic models, we just gotta throw them out the window

Kai Ryssdal 

Right? Yeah. Just to pick up on just to pick up on on our talk with Ed Young. Right? This is one of the things that has changed. The economy has changed probably permanently, but certainly in the medium term. It ain’t going to be the way it was and we need to readjust our models. I think that’s a really good point.

Kimberly Adams 

Because it was happening even before the pandemic because remember how long they tried to push inflation up by lowering interest rates and nothing happened. And so yeah, I think we have to just wholesale revisit, I mean, says the non economists, revisit some of these economic models and see what actually works in the economy we really live in.

Kai Ryssdal 

Alright, that’s the news. Let’s do some mail.

Mailbag 

Hi Kai and Kimberly. This is Godfrey from San Francisco. Jessie from Charleston, South Carolina. And I have a follow up question. It has me thinking and feeling a lot of things.

Kimberly Adams 

Okay, recently, I was talking about my favorite sort of catch all emoji to us on Slack, which is the dancing penguin and we got this.

Rachel 

Hello, this is Rachel from Tempe Arizona. I just wanted to make a comment about the dancing penguin. And I I love it.But I also wanted to suggest there’s a dancing Corgi and a break dancing hamster that I really enjoy It’s like sending a smiley face or you know i guess it’s a Rorschach test. or just like hey, here’s a penguin. Okay, well thank you for making me smart all these years and I hope everyone has a great day bye!

Kai Ryssdal 

Okay, wait. So as long as we’re on the topic, there is some sort of like rotating or dancing like, like, parakeet. Yeah. What is that about? What do you do with that? What does that mean?

Kimberly Adams 

So the parrot I think, was one of the very early like, Slack emojis for excitement and fun. And it just got more and more elaborate as different people started gif-ing it in different ways. And so the… and to me, like the, the dancing parrot was just overdone. To be honest, like, it’s fun, but everybody does the dancing parrot. And the dancing penguin just felt, just different enough. And also the reason I prefer the dancing penguin to the dancing corgi and the breakdancing hamster, is I just feel like the lines are a little bit cleaner on the dancing penguin. And I’ve given thought to this, believe it or not.

Kai Ryssdal 

Clearly you have

Kimberly Adams 

I see them pop up whenever I’m you know, making the micro decisions that take up probably far too much time of my day. And I’m just like, “No, no, not that dancing animal. This dancing animal.”

Kai Ryssdal 

I’m just gonna stick with a thumbs up. But anyway.

Kimberly Adams 

Okay, before we go, we’re gonna leave you with this week’s answer to the make me smart question, which is: what is something you thought you knew but later found out you were wrong about?” And in honor of the release of The Little Mermaid live action remake this week’s answer comes from my personal mermaid instructor because believe it or not, I am a certified mermaid. And her name is Jen Downey.

Jen Downey 

I thought I knew what mermaids look like. I’ve seen the King’s daughter, Pirates of the Caribbean and the Little Mermaid.I took a trip to the Bahamas in 2014 and a mermaid had left her tail behind for the liveaboard crew. Some of the guests tried it on and went for a swim. I knew my body shape was not that of a mermaid so I didn’t participate. I swam as a human with a mermaid with the heaviest heart and I regret the stigma I put on myself. I’m now a PADI mermaid instructor trainer, I teach humans to be mermaids and I am so excited for the live action Disney remake showing that representation in our media is especially important. Go find a pod near you and make the image of a mermaid look like you!

Kimberly Adams 

And yes, there will be more mermaids coming on Marketplace. Just you wait. But in the meantime, what is something that you’ve been wrong about? We want to know you can leave us a voice message with your answer to the make me smart question. Our number is 508-827-6278, also known as 508-UB-SMART.

Kai Ryssdal 

Make Me Smart is produced by Courtney Bergsieker. Ellen Rolfes writes our newsletter. Our intern is Antonio Barreras. Today’s program was engineered by Juan Carlos Torrado with mixing by Gary O’Keefe.

Kimberly Adams 

Ben Tolliday and Daniel Ramirez composed our theme music. Our senior producer is Marissa Cabrera. Bridget Bodnar is the director of podcasts. Francesca Levy is the executive director of Digital. And Marketplace’s Vice President and General Manager is Neal Scarbrough.