Today is the third anniversary of the first confirmed #Covid-19 case in the US. As good a day as any to write a long and rambly essay about the current state of the nineteenth crow. I'm going to begin and end on a personal note, with some #science in the middle.

Almost my entire adult life has been dedicated to keeping people alive. I became a #medic for a number of reasons, but most directly because a friend was murdered: if there was any way I could keep another close circle of young, healthy people with a reasonable expectation of living for decades more from having to gather to mourn one of their own, I would.

So. First as a medic, then a #biotech #programmer, and now a #bioinformatics #researcher, my goal has been quite consistent. Everyone dies—but if we can claw back just a little more time, a few more years or days or *hours*, that is a victory in the war that never ends. As my fiancee says in another context, a slap in the face of a forgetful future. Only our deeds live after us. There is no greater deed than life itself.

For all that time, I've known there was another #plague coming. It was inevitable. One aspect of the medic's war is the arms race, and pathogens have one hell of an R&D program. We can win skirmishes, and sometimes battles, and occasionally even a campaign. They'll keep coming back, with mindless determination and terrifying numbers.

What I didn't know, couldn't even imagine, was what the primary obstacle to that particular phase of the war would be. I thought the challenges would be technical: spotting the #outbreak, identifying the #pathogen, learning its strengths and weaknesses, developing preventions and treatments, getting #medicine out to where it's needed most. You know, science stuff.

Those are all challenges with covid, to be sure. But it turns the biggest problem is willful, deliberate, self-imposed, homicidal and suicidal stupidity.

I've written at length about my opinions of #antimaskers and #antivaxers, and no doubt I will again. The short version is, they're traitors to humanity. I've given up trying to reason with them. Best to concentrate on what I can control: my own work, the knowledge I gain from others in the field, and the information I provide to people who are willing to listen. Eventually the traitors will benefit too, however little they deserve it.

Okay, on to the facts. The data I'll be discussing are #US-centric. I live here, it's my primary area of concern, and it's what I know the most about. Readers in other countries, please feel free to comment on similarities and differences.

1. There were massive spikes in January 2021 and January 2022: [here is a nice visualization](https://coronavirus.jhu.edu/region/united-states). At the peaks, 2022's spike was more than three times as bad as 2021's. On the other hand, there were only (only!) about three-quarters as many deaths in 2022. I suspect there are a few things going on here:

- New Year's celebrations both years, but especially in 2022, packed a lot of people together in small spaces. This is of course a recipe for mass infection.

- Prevalence of the omicron strain in 2022, which is *generally* more infectious but less lethal than other strains.

- More masks in 2021, preventing infection but doing nothing to reduce severity, compared to *much* more #vaccination but fewer #masks in 2022.

2. [As of September, Republicans were dying of covid almost twice as fast as Democrats, controlling for age](https://www.nber.org/papers/w30512). Of course it's not being a Republican that kills you: it's not being #vaccinated. Antivax has become an ideological purity test for a substantial portion of the Republican Party, and those who try to both-sides this issue have their heads buried so far in the sand they're hitting bedrock.

3. New #variants haven't been much in the news lately. That's not because #SARS-CoV-2 has stopped mutating. It's because what we call #omicron has now mutated so much that it now has more genetic diversity than all the others put together. Tracking variants by letter made sense in the early stages of the pandemic, but now we could go through the entire Greek, Hebrew, Latin, Arabic, and every other alphabet and still run out. As a practical matter, this means we'll need at-least-annual #booster shots forever.

4. In June 2022, we passed a little-remarked milestone: total US covid deaths in people under 30 surpassed total US #military deaths in #Afghanistan and #Iraq, in a similar demographic over a much shorter time. Older people are more likely to die of covid, sure. Older people are more likely to die of *everything*. Youth will not save you.

There is some good news. The January spikes mentioned in item #1 seem so far not to be materializing this year, although we'll have to wait until the data for the entire month have been sifted to be sure. I doubt people are getting any more careful, but 70-80% of the US population is vaccinated, depending on how you count: maybe that's enough for a meaningful degree of herd #immunity.

Older #vaccines aren't as effective against newer strains as newer vaccines tailored to those #strains, but they still help. With *any* vaccination on board, you're less likely to get infected, and less likely to die if you do. Keep getting boosters, and your #immune system will build up a kind of library: "oh, this isn't exactly like anything I've seen before, but it looks kind of like this thing I read about, so ..."

We can't make antivaxers go away. They'll always be there, acting as a reservoir for infection and a breeding ground for new strains. Sure, they'll die at a much higher rate, but more of them will live, largely thanks to the heroic efforts of the science they reject. What we can do, to a degree, is work around them.

Back to the personal.

I've lost a few friends, and I know many people who have lost family, to #antimask / #antivax lunacy. I understand the pain and anger and confusion. Stay strong. Maybe one day before we're all dead, this will be over and reconciliation will be possible, if we choose to extend such grace. Not today, and not for a long time to come.

Any person, any family, any circle of friends, any gathering, any business, any government ... all are *more* than justified in exiling these traitors forever. When they are those we love, grief is inevitable. But the people we loved are already dead. Our job is to avoid joining them.

Let's be careful out there.