covid-19 vaccines

How COVID Won the Summer

Giving is getting. Photo: Phill Magakoe/AFP via Getty Images

Long COVID, short human rationality. That would have been dynamite investment advice circa early June (in a parallel universe where viruses and concepts trade like stocks and bonds).

At the summer’s outset, the prospects for public health and economic growth — in the United States and the world writ large — looked bright. Daily COVID infections were plummeting both nationally and globally. Vaccine production was ramping up. With its privileged access to Big Pharma’s wares and stimulative fiscal policies, the U.S. looked poised for an economic boom — one that would lift the fortunes of foreign exporters and tourist destinations. Meanwhile, the world’s wealthy nations were making (belated) gestures toward redressing vaccine inequality: The White House pledged 500 million Pfizer doses to the world’s lowest income nations, and announced its support for waiving international patent protections for COVID vaccines. Drugmakers expected to produce 12 billion vaccine doses by year’s end — enough to contain the pandemic’s spread, if distributed equitably and efficiently.xx

But COVID proved more innovative than expected, and humanity, less capable of acting in our enlightened self-interest. As a result, case counts are rising and projections for economic growth are declining.

There are (at least) two dimensions to our species’ collective failure of solidarity and rationality. One is mass abstention from vaccination in wealthy countries. This phenomenon varies greatly in prevalence across the OECD. Some nations have achieved superlative vaccination rates despite late starts and relatively meager national resources. But anti-vaxx sentiment has proven exceptionally widespread in the United States. America enjoyed early access to top-notch vaccines, and with the world’s largest GDP, and the power to print the global reserve currency, our nation had unparalleled resources for getting shots into arms. Nevertheless, we’ve ended up with a middling vaccination rate throughout the summer.

This fact reflects the American public’s relatively high level of distrust in official expertise, and relatively low level of regard for the common welfare. In some cases, that distrust derives from sympathetic origins: America’s well-credentialed technocrats have a less-than-stellar track record in the 21st century, the U.S. health care system deserves the uninsured’s scorn, and African Americans have no shortage of reasons for skepticism about Uncle Sam’s good intentions. Whatever its roots, however, a dearth of social trust and solidarity has kept vaccination rates in much of our country aberrantly low. And that reality, combined with Delta variant’s emergence, has kept our ICUs aberrantly full. In recent weeks, America has been losing roughly 1,500 people a day to COVID, a higher death toll than we saw during last summer’s surge (when FDA-approved vaccines were still just a twinkle in Anthony Fauci’s eye).

Such grim statistics testify to the irresponsibility of the willfully unvaccinated. That portion of the U.S. population is disproportionately composed of younger adults, who are much more likely to transmit COVID than to suffer severe illness from it. Such Americans are therefore doing less to jeopardize their own health than that of the more vulnerable people around them.

Yet when it comes to COVID, the dictates of social responsibility and narrow self-interest tend to overlap (and not merely because protecting oneself from the tail-risk of catastrophic infection — at the cost of a complementary shot in the arm — is a sound trade). The unvaccinated’s pursuit of normality at others’ expense is, in the aggregate, quixotic. With daily case counts hovering around 160,000, colleges in Virginia and Texas are moving classes online; thousands of students and teachers in Arizona are in quarantine; hospitals in Kansas are running out of ICU beds; Hawaii is turning away tourists; and America’s economic recovery is faltering: In August, job growth in the U.S. hit a seven-month low, while airlines, hotels, and restaurants suffered flagging demand. This week, Goldman Sachs lowered its projected GDP growth for the U.S. in 2021. The ideologically anti-vaccine can ignore the economy’s reliance on public health, or Americans’ collective reliance on each other. But in a pandemic, interdependence is inescapable — and selfishness is self-defeating.

This point is nearly as lost on the governments of the Global North as it is on acolytes of Alex Jones.

In the pandemic’s early days, there was much high-minded talk about vaccine equity. “No one is safe until everyone is safe,” the international bodies and philanthropic organizations correctly observed. Covax, a multibillion-dollar program bankrolled by nonprofits and global health bodies, aimed to leverage massive buying power to ensure poor nations’ timely access to vaccine doses. Rich countries proceeded to slow-walk delivery of their financial pledges to Covax, limiting its ability to ink timely deals. At the same time, wealthy nations engaged in a bidding war for first dibs on doses, pushing up the price pharmaceutical companies felt comfortable charging the philanthropic endeavor.

Covax had its own internal flaws. And any global vaccination campaign was going to run into logistical difficulties. Vaccines require select raw materials, customized manufacturing sites, and demanding storage conditions. Taking production of any good from zero to 12 billion in a year’s time is no easy task; as of September 1, only about five billion doses had been delivered. But the wealthy world’s hoarding of jabs and dollars has exacerbated Covax’s every challenge. In July, the International Monetary Fund estimated vaccinating “at least 40 percent of the population in all countries by the end of 2021 and at least 60 percent by the first half of 2022” would cost roughly $50 billion. That price has proven too steep for the wealthy world. Even the United States — whose humanitarian impulses ostensibly led it to invest $2 trillion into “democracy promotion” in Afghanistan — has declined to cough up a significant fraction of that sum. Today, vaccinating 40 percent of every country by year’s end looks utopian. According to the World Health Organization, only nine African countries have vaccinated 10 percent of their people. And on Wednesday, Covax cut its forecast for the number of vaccines it will distribute in 2021 by a quarter.

The United States has contributed more to the global vaccination drive than any other country, but our contributions have nevertheless been paltry, especially when viewed in light of our resources. America did donate 500 million Pfizer doses to low-income countries. Yet the Biden administration financed that donation by diverting hundreds of millions of dollars that it had previously pledged for vaccination drives in those countries, according to the New York Times. Which is troubling, since shortfalls in funding for transporting, storing, and administering doses have bedeviled public health efforts in low-income countries. Over a five-week period this summer, authorities managed to use only 6,000 of the nation’s 100,000 vaccine doses — even as COVID deaths surged – due to inadequate public health infrastructure.

America’s efforts to expand global vaccine production have also been lackluster. A group of 116 congressional Democrats has called for adding to the party’s $3.5 trillion spending bill a $34 billion investment in global COVID vaccine manufacturing. The White House has yet to approve. Meanwhile, despite America’s official support for waiving patents on COVID vaccines, it has done little to pressure Pfizer and Moderna into transferring their technology to other countries with spare vaccine production capacity, such as South Korea.

As mentioned, other wealthy countries have contributed even less than the U.S. At this week’s meeting of the G20, the world’s rich nations vowed that “no one must be left behind in the vaccination campaign.” But this “political” commitment to aiding the global vaccine drive was not accompanied by any concrete financial pledge. And the Global North’s avowed solidarity is contradicted by its recent movement towards authorizing booster shots, a development that threatens to further deplete the supply of vaccines available to poor countries.

With COVID death rates soaring in parts of Southeast Asia, Latin America, the Caribbean, and Eastern Europe, the G20’s half-hearted humanitarianism is plainly a moral failure. But it is also a betrayal of the rich world’s own enlightened self-interest. The same IMF report that put the price of a comprehensive global vaccination drive at $50 billion also estimated that such a drive would yield $9 trillion worth of benefits by 2025, with “over 40 percent of this gain going to advanced economies as stronger recoveries in the rest of the world raises demand for their goods, and through stronger confidence effects at home as the pandemic ends durably.” The report goes on to note that this gain would translate into an extra $1 trillion in tax revenue for advanced economies, “which means that funding this proposal may possibly be the highest-return public investment ever.”

The G20 didn’t take the IMF up on that offer. Now we’re living in the counterfactual.

COVID’s rampant spread in under-vaccinated, low and middle-income countries is giving the virus ample opportunity to produce more menacing variants (as it did with Delta in India in late 2020). At the same time, dire public health conditions in the developing world are taking a toll on economic conditions in the wealthy one. As Bloomberg reported this week, Delta’s resurgence is depressing global growth, while pandemic-induced factory closures in Southeast Asia are further disrupting global supply chains. Together, these developments could revive “stagflation”: the simultaneous occurrence of weak demand (as public health problems limit hiring and investment) and high prices (as production delays yield a scarcity of critical inputs for popular goods).

If the COVID pandemic is the defining crisis of our moment, climate change is the primary one of our century. And the dynamics that facilitated COVID’s resurgence this summer also threaten to preempt an expeditious green transition. Any program of rapid decarbonization in the U.S. would require increasing the relative cost of carbon-intensive activities and modes of living. Which is to say: It would require some Americans to accept a permanent change in their lifestyles, for the sake of making ecological decline less severe in the future, and thus hypothetically saving the lives of people they care about (assuming that foreign nations emulate our example). Yet a sizable portion of U.S. citizens just proved unwilling to accept a modest and temporary imposition on their personal liberty (wearing a mask, getting a shot), for the sake of immediately enhancing their own personal safety, while accelerating the end of a pandemic that’s already killed hundreds of thousands of their compatriots.

A just transition will also require rich nations to transfer green technology and financing to rising powers like China and India, so as to aid their sustainable development, at some geopolitical risk. Yet the wealthy world is right now proving itself unwilling to transfer mRNA technology or adequate vaccine-drive financing to low-income countries — actions that carry no geopolitical risk, and massive economic and public health benefits for the donor countries themselves.

All of which is to say: Humanity can’t meet the challenges of the Anthropocene without recognizing our collective interdependence. For all that COVID has taken from us, it’s offered a vivid demonstration of the porousness of our borders, and interconnectedness of our fates. We still have a chance to capitalize on that lesson (and render “civilization futures” a sounder investment).

How COVID Won the Summer