Dawn beckons as COVID vaccines roll out, but the next few months promise to be the darkest yet, and echoes of the AIDS era

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Credit: Richard Borge
Credit: Richard Borge
One strange aspect of plagues is that they often finish strong. I learned this the hard way last time around. Many people have a general sense of AIDS being terrible in the 1980s and then slowly petering out in the 1990s, as treatments improved. It’s intuitive to think this way, and even to remember things this way. But, in reality, the worst ever year for deaths from AIDS in the US was 1995 — over a decade after the first deaths in America — and just before the arrival of the cocktail therapy that turned everything around. The virus killed more people in America in the year right before the medical breakthrough than in any other previous year.

AZT, known as Zidovudine or Azidothymidine, the first approved treatment for HIV. Credit: Will McIntyre/Deni McIntyre/Getty Images

I remember this vividly because a very close friend of mine died that September. Like me, he had been diagnosed two years earlier, but his infection was much more advanced than mine. He’d soldiered through humiliating opportunistic infections, his body contorted into agony as it turned into a living skeleton, covered in lesions, struggling to breathe, slowly starving, as microbes ate his food before his body could.

Two years was an almighty, courageous slog through this indignity, and so it was agonizing to watch him finally surrender to the virus just as the breakthrough treatments emerged on the horizon. He was 31. It was like watching a fellow soldier killed on the last day of the war. There was something poignantly devastating about the timing.

It comes back to me now because we seem to be in the same, awful moment with Covid19. The medical puzzle has largely been solved — the vaccines clearly work, and more are arriving. And yet the deaths mount — in some places, exponentially. And they are mounting in many parts of the world because of new, mutating variants, from 30 to 70 percent more transmissible and perhaps deadlier than those we have become used to. I don’t think we’ve quite absorbed that reality. This virus was very easily spread in the first place. Now it’s far easier. In other words, we are much more likely to get infected now than at any previous time in the pandemic.

In Britain, the death rate has tripled since December, as the B.1.1.7 strain takes hold. As Ezra Klein notes, in Portugal, “daily confirmed deaths have shot from about seven deaths per million in early December, to more than 24 per million now. Denmark is doing genomic sequencing of every positive coronavirus case, and it says cases involving the new variant are growing by 70 percent each week.” In Spain, the number of new cases is double what it was in the second wave and four times as bad as the first wave — as Madrid suspends all new vaccinations because the EU has run out of the supply. The strain that is becoming dominant in South Africa is measurably more resistant to some existing vaccines. In Brazil, the city of Manaus was hit hard by the virus last May, killing 348, the highest monthly toll in 2020. But in the first three weeks of January this year, with the new viral strain P.1. gaining momentum, 1,333 have died. It’s as if a Category 3 storm has been updated to a Category 5.

A memorial in New York City in May, when the U.S. coronavirus death toll passed 100,000. Credit: Angela Weiss/AFP/Getty Images

In the US we’re now accustomed to a daily death toll of 4,000. It’s amazing how easy it has become to live with mass death. Yes, we just saw the sharpest decline in new cases since the pandemic began — but that’s off a record high, remains far higher than last spring, and if new strains emerge, as they will, infections will surely rise again. A virus is a dynamic target; and time matters. Covid19 can elude us; and adapt to us. It can kill millions even in retreat. If we do not keep on top of it, and act quickly, and restrict its spread now, we could go backward.

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All of which, it seems to me, makes the case that this plague, like many others, could become worse yet before it suddenly turns the corner. The next couple of months may be the most fatal of the entire pandemic — even as freedom from this virus is within sight. There’s a special agony to those deaths, as there will be for all those human beings who will die of a virus for which a vaccine already exists.

This makes fast, effective vaccination essential. Nothing matters more in government right now. Apart from that, we have our own work to do. So I’ve made a special effort to batten down the hatches. I see almost no one any more; I wear three masks everywhere. I binge on streaming services (currently “The Bureau,” perhaps the best miniseries I’ve ever watched). I get groceries delivered. However isolated I was before, I am more isolated now. I’m lucky — yes, privileged to be able to do this. But if you can, you should. In epidemics, a large number of small decisions can make a massive difference.

And yes, I have some PTSD about this — and not just about losing my friend right at the finishing line of AIDS. I got infected myself years before. The patterns of safety I had relied on failed me. I can’t recall any moment where I fucked up, but obviously I did. I wasn’t vigilant enough, even though I thought I was. And I’m determined not to make that mistake again.

In this plague, among others in history, the exhausted cliché is actually true. It is getting much darker just before the dawn. From a survivor of one plague, I just want to say: don’t let your guard down now. Don’t be the last one to die.

Andrew Sullivan is a British author resident in the United States, editor, political commentator and blogger. Find Andrew on Twitter @sullydish

A version of this article was originally posted at the Weekly Dish and has been reposted here with permission. 

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