Apollo's Arrow Book Cover

Nicholas Christakis on the Cultural, Political, and Health Impacts of COVID-19

The COVID-19 pandemic is arguably the most important and disruptive global event—in terms of impact on health, the political economy, and culture—of the twenty-first century. Understanding the details and full complexity of the pandemic, therefore, is a necessity for understanding the current state of the US and the world. 

Achieving this nuanced perspective is not easy, however, considering the amount of misinformation, disinformation, and superficial black-and-white thinking circulating the web. That’s why it’s beneficial to be able to get the full picture on the pandemic from a source that is actually qualified to discuss it. 

In Apollo’s Arrow, Nicholas Christaskis, a physician and sociologist from Yale University that has been tracking the virus from the beginning, covers the pandemic from all angles, including the epidemiological characteristics of the virus, the history of pandemics, mitigation and treatment options, psychological impact and reactions (both positive and negative), sources of misinformation, political negligence and mishandling, the development of treatments and vaccines, and possible outcomes over the next few years. 

Christakis is uniquely qualified to write this book; as a physician and sociologist, he is able to explain both the epidemiological characteristics of the virus (including containment and treatment protocols) as well as the psychological and social aspects of our various responses to the virus. While the pandemic has undoubtedly deepened political polarization and summoned our inner demons, it has also brought out our better angels as demonstrated through countless acts of altruism and charity. 

The COVID-19 pandemic is therefore complex both biologically and socially; not only are we learning about this new virus on the fly, we are simultaneously dealing with its psychological, social, and economic ramifications, forcing us to confront difficult tradeoffs and ambiguities on a daily basis, which Christakis effectively communicates in a deep yet clearly written way.

You will learn, for example, that while the virus is not as deadly as we first assumed, it is significantly deadlier than the seasonal flu, in terms of its higher rates of mortality and community transmission and its more dangerous physiological effects on the respiratory system, captured in the greater number of deaths, in absolute terms, compared to the flu (30,000–60,000 flu-related deaths per year in the US versus 243,000 COVID-19 deaths as of 11/13/2020). 

COVID-19 has proven difficult to contain because, in addition to its high rate of transmission, infected individuals can transmit COVID-19 asymptomatically (unlike SARS). This makes contact tracing nearly impossible and makes quarantining the infected far less effective (they’ve already spread the disease in an asymptomatic state). This is why non-pharmaceutical interventions (NPIs) such as mask wearing, social distancing, and prohibiting large gatherings are necessary to slow the spread of the virus. (Christakis notes how mask wearing has been politicized, but, epidemiologically speaking, is a very uncontroversial and effective method of reducing community transmission rates.)

The reader may wonder what the point of reducing the transmission rate (“flattening the curve”) is if the virus will not stop spreading until we hit herd immunity, which occurs when a high enough percentage of the community is immune to the virus, making the spread of COVID-19 from person to person unlikely. As Christakis explains, adopting measures to flatten the curve prevents unnecessary or excess deaths by (1) preventing a large number of deaths from occurring over a short period of time and thus avoiding overwhelming our healthcare system, (2) buying time so that vaccines or better treatment options can be developed, and (3) allowing time for the virus to potentially mutate into a less lethal form. All three factors can potentially lower the total number of deaths.

An effective and safe vaccine is our best bet because it allows us to achieve herd immunity without hundreds of thousands of excess deaths, although, as Christakis points out, there is no guarantee that a vaccine will become available anytime soon, as the fastest vaccine to ever be developed was the mumps vaccine—and that took four years (although some promising vaccines are currently in trials). 

There is of course the question of whether or not closing down the economy is worth the lives it will save, but the evidence seems to suggest that even if a country chooses to remain open, as Sweden did, the economy will still suffer as people refuse to go out—leaving you with a depressed economy AND a higher death count. Even Sweden—the only Nordic country not to implement widespread lockdown—has since reversed its course after experiencing higher infection rates and deaths, as Christakis points out. 

The reader of course can decide for themselves how to evaluate the tradeoffs, and must confront difficult questions such as whether or not a mass lockdown is justified, whether a vaccine will actually become available in time, how much personal risk they are willing to bear, and how their own personal and political biases might be affecting their own judgment. But if you take anything away from the book, it should be (1) the pandemic is complex and these are not easy questions, (2) trust the science and credible sources and argue with facts, not conspiracy theories, and (3) our ability to bind together to fight the virus as a common enemy—and stop fighting each other—is the key to keeping the virus in check and preventing excess deaths (by following long established NPIs, not as a political badge of honor, but as scientifically-grounded measures of containment).