On COVID, We Fought the Last War. And Lost

When scientists encounter a novel situation, they nearly always shape their thinking by analogy. The analogy that the scientist-bureaucrats who designed the COVID pandemic policy (many of whom came to prominence during the HIV pandemic) immediately latched onto in the early days of COVID was HIV, the virus that causes AIDS. Nearly every element of COVID policy was derived from a misapplication of lessons learned from HIV policy. Among these include a number of false presumptions:

• that recovery after COVID disease would not produce immunity;
• that herd immunity was impossible with COVID;
• that the primary deleterious clinical impacts of COVID disease would occur after recovery from acute infection;
• that everyone is at equal risk of a severe outcome—hospitalization or death—from COVID disease;
• that a physical barrier to a basic human bodily function (breathing) would prevent infected people from spreading COVID disease;
• that tracing the contacts of infected individuals would be an effective means of limiting the spread of COVID disease; and
• that closures of locations like schools where the disease was thought to spread and the limitation of travel would effectively limit COVID disease spread.

The faulty application of lessons from the HIV pandemic explains why many aspects of COVID policy were adopted. And the differences in the biology of HIV and SARS-CoV-2 (the virus that causes COVID) in each case explain the failure of these policies in the latter case. The sole exception—a policy with no direct or obvious analog to a policy adopted during the HIV pandemic—was the society-wide lockdowns implemented in most developed countries worldwide in March 2020. Those were a radical departure from both HIV-era policies and standard pre-existing pandemic plans for managing airborne respiratory virus pandemics.