Acceptable casualties

How many deaths is freedom worth? It's a calculation that's rarely discussed but must be made — consciously, as a matter of policy, or tacitly, as a matter of indifference. As the country settles into uneasy coexistence with the coronavirus, will vaccination be required by employers and schools, or left to individual choice? Are mask mandates in public spaces gone forever, or will they return if there's a major surge in fall and winter, or if dangerous new variants emerge? Should we stop fighting this persistent pathogen, and just let it rip? Cost-benefit analyses are tricky, but our choices can be made clearer through comparison: If the flu typically kills from 12,000 to 52,000 Americans a year, would 100,000 annual COVID deaths be an acceptable price for no mask or vaccine mandates? Would 200,000? Since early February, we've had 90,000 deaths, a rate of about 360,000 a year. Too many, or just right?

The BA.2 subvariant of Omicron is now freely spreading, as masks come off and semi-normalcy returns. Thanks to vaccination and prior infections, COVID deaths and hospitalizations remain relatively low. But only 45 percent of the vaccinated have been boosted, and death is not the only bad outcome of infection: More than 20 million Americans already have long COVID, and even mild infections have been shown to sometimes leave lingering organ damage and to trigger chronic fatigue, inflammation, and autoimmune syndromes. Virologists and epidemiologists warn that we are likely in another lull in the pandemic, not at the end. Studies clearly show that immunity from vaccines and prior infection wanes over time, so the shape-shifting virus may return to infect people again and again, unless we keep boosting. We have the weapons to keep this virus under control, but lack the social cohesion to follow a coherent national strategy. Freedom is just another word for "you're on your own."

This is the editor's letter in the current issue of The Week magazine.