Sometime midway through the first year of the COVID-19 pandemic, when it still wasn't clear if vaccines would arrive or even work, I found a page in an old reporting notebook that stopped me cold. It was a scribbled-down idea from 2017, a pitch that never came to fruition, but I hoped to write up for a national outlet. I wanted to ask the question: Why don't Americans wear masks during flu season?
Flu is something I never took seriously growing up, despite some of the worst illnesses I've ever had being flu-related. I'm quite certain that without medical treatment, H1N1 would have killed me in 2013. Every year, thousands of Americans aren't so lucky. An estimated 12,000 to 52,000 people die from flu each year, according to data from the Centers for Disease Control and Prevention (CDC). Those who die tend to be society's most vulnerable: children, the elderly and immunocompromised people.
Many of these deaths could be prevented through vaccinations and masking, but before COVID came along, such an ask from society was simply too much. In a pre-pandemic world, even if flu cases were high, masking in public may have prompted a stranger to treat you like a mentally ill hypochondriac. Because of a lack of paid sick leave in this country, folks are expected to go to work sick, even though this actually puts more drain on the economy by spreading more illness and putting more people out of work, with one recent estimate pegging the cost at more than $273 billion annually in lost productivity.
We were willing to accept a certain level of suffering and death to not impact the comfort of healthy, able-bodied people. Now, we are being asked to do the same with COVID, though it kills and maims far more people than flu. Helen Branswell, a reporter at STAT News whom I deeply respect, recently framed the ongoing surges and mutations of variants as a "new normal." I think she attempted to balance the truth of the matter — COVID is endemic and we have to realize that — with how this disease still regularly disables and kills people.
But I feel like the article pays service to the larger tendency in American culture to simply accept a certain level of death, step over the bodies and keep going to work and the movies. According to the CDC's mortality estimates for 2022, COVID is still the fourth leading cause of death in this country after heart disease and cancer. Just because we've gotten used to it doesn't make it "normal."
We see this attitude deeply echoed in the drug overdose crisis, now apparently in its "fourth wave," which preliminary stats suggest broke another record with more than 110,000 dead in the past year. It's also exemplified in the suicide epidemic, which is only worsening, with nearly 50,000 deaths by suicide in 2022.
How much pointless death this country is willing to tolerate? The answer, it would seem, is a lot. It's led me to believe that America is some sort of a death cult — and I don't just mean the population of people who worship a man raised from the grave. Americans have formed a cult around Mammon, the demon of wealth. Does that mean we invoke his unholy name every time we use an ATM? Not exactly, but when the overall cultural attitude is to put profits above people, it doesn't matter what rituals we perform. The result is the same: a sacrifice in the name of a dollar.
Other countries like Sweden, South Korea, Singapore and Finland demand much more from their governments, resulting in a higher and longer standard of living. The government is supposed to protect your life, according to some very basic understandings of the Constitution. I don't know why this topic is controversial to some — it's really the most basic function of having a democracy. The military protects us from invaders, roads are maintained to prevent accidents, regulatory agencies like the Food and Drug Administration and the Environmental Protection Agency allegedly prevent you from being poisoned. There's no reason why government can't effectively pay for health care.
Over the centuries, the social contract with government has evolved. Kings and lords largely protected plots of land from barbarian raiders. Now, we also expect the government to prevent large factories from poisoning rivers and biotech companies from selling us snake oil. Sure, our institutions could be doing a lot more in those departments, but we can and should be demanding much more. Universal healthcare isn't a nice-to-have, it's literally an investment in our people that multiple peer-reviewed studies indicate would save American taxpayers trillions — not even counting the lives saved. Yes, it's actually cheaper to provide preventive medicine than to pay for the fallout when someone gets much, much more sick and can't work.
But I don't see us getting to a point in the Overton window to make such policies a reality when many of us see our fellow citizens, such as those who are chronically ill or drug users, as disposable. Our reaction after reading of more death shouldn't be one of resignation, but that's the cost of living under capitalism. Until we find it within ourselves to produce a little more empathy and take basic precautions like masking in public, I doubt we will escape the cycle of useless, unnecessary death in America. I think about how my attitude has changed since 2017 and want to believe in a future where even common viruses aren't a death sentence.
An earlier version of this article originally appeared in Salon's Lab Notes, a weekly newsletter from our Science & Health team.
Correction: A previous version of this article stated that COVID was still the third leading cause of death in the U.S. It was the fourth leading cause of death in 2022, according to provisional mortality data released by the Centers for Disease Control and Prevention.
