Today, a friend suggested that I listen to The Daily podcast from the New York Times. He wanted me to hear an episode featuring science reporter Donald G. McNeil Jr. titled “The Next Year (or Two) of the Pandemic,” which, he told me, was largely about the stark societal divisions that will likely emerge in the United States, as people with COVID-19 antibodies go on to live happy, normal lives, while the rest of us stay locked inside, waiting for a vaccine that may never come. [I’m envisioning the two groups looking like the Morlocks and the Eloi in H.G. Wells’ The Time Machine.]

Well, I found the transcript, and now I’m stuck in a loop, wondering how this might all play out, assuming McNeil is correct when he says that a vaccine may take as many as four years. [That’s apparently the fastest time in which a vaccine has ever been produced.] McNeil talks about the very real possibility that people will eventually just accept the risk, opting to infect themselves, rather than remaining in the purgatory most of us now inhabit. It would be a huge risk, of course, but I can see how, after a year of sheltering-in-place, someone might decide that a 2% death rate is worth the gamble to once again rejoin society — a society where participation is likely to be predicated upon one’s ability to demonstrate that they’ve survived COVID-19, and have the antibodies to prove it.

The thing I’m wondering about is what this begins to look like after a few years, especially if there’s no prospect of a vaccine in sight. At what point, I wonder, do people decide that we no longer want to subsidize the existence of a class of people who are, by that point, unemployable for not having the COVID-19 antibodies? I’m imaging a Gattaca-like dystopian future where huge public health campaigns are aimed at getting the “un-evolved” ready to be infected. Society-wide smoking cessation programs. Mandatory weigh loss clinics. And, eventually, mandated participation in a lottery, where you’re given an assigned date and time to appear at a regional COVID transmission center. I suspect it would just be a quick squirt in the eyes at the desk of a Holiday Inn, before you’re assigned a cot, and introduced to the other members of your cohort, but I’d like to think that we could find a way to add a little spectacle, perhaps making it something like Carousel in Logan’s Run.

One wonders if there will come a time, if there's no vaccine on the horizon, that we'll be asked to come forward in some systematic way to be infected by @COVID19. #HerdImmunity #LogansRun #Carousel pic.twitter.com/MjgkVxm5PV

— Mark Maynard (@MarkAMaynard) April 21, 2020

Here, for those of you who didn’t hear McNeil’s interview, or read his piece in the New York Times that predated the podcast, is a bit of the transcript from The Daily.

…(M)aking a vaccine within 18 months is extremely optimistic. The record we’ve ever had for producing a vaccine is four years. That was a mumps vaccine produced back in the ‘50s. We’ve got new techniques that speed it up, but some things can’t be sped up. And then after we design the vaccine, we have to think about producing the vaccine. If we need 300 million doses of vaccine, or if we need two shots — if we need 600 million doses of vaccine — that’s a gigantic undertaking. I talked to some vaccine production experts, and they said, the average vaccine plant in America makes 5 to 10 million doses. So we’ve got to find some way to make 300 to 600 million doses of vaccine, and we have to start planning now, even before the vaccine exists.

That’s a kind of worst case scenario, as far as timing is concerned. Everything may get lowered in this. We may test vaccines in a way that we would think of as ethically unthinkable in normal times. We may go with somewhat lower safety standards for vaccines, because we’re facing a situation where life is dangerous. But yeah, the fastest human vaccine ever made was mumps. Four years, from start to finish.

…There are a very small number of people now who are immune. And they’re very much in demand. They’re in demand for their blood, because you can harvest antibodies from their blood. They’re in demand for doing medical jobs that are dangerous, like intubating patients, because they can do it without fear of infection. They’ll be in demand for all sorts of other jobs, because they can travel anywhere. They can do face-to-face interactions with customers without any fear. And they’re going to be a special class in society. There’ll be different standards, different ways of living for two different classes in society. So say you’re an immune and I’m not. I basically have to stay inside here in hiding, and I’m depressed as hell about it. I have a granddaughter who’s going to be born in June, and I sit here in my apartment thinking, I may not see her until she’s two years old. And that’s horrible to contemplate, but it may be a fact. Meanwhile, you, as an immune, could go visit my granddaughter, or go out and take my job.

….Germany is talking about issuing certificates, but you don’t want something you can pass from person to person. So China takes people’s cell phones and has a QR code that you read as you come into the subway, you come into a restaurant, you come into any place where somebody can check your phone. And that readout tells the person looking at your phone that you’re immune. So yeah, people are already thinking about this.

…In the years before smallpox vaccine, people used to take pus from the blisters of smallpox victims, or dried up scabs from smallpox victims, and put the pus into — stab a little hole in their child’s arm and put some of the pus in there, or blow the scabs into your nose. And that would give you a usually mild case of smallpox. And I talked to an immunologist who said, look, the child had about a 1 percent chance of dying, and the parents recognized that. And that was better, because if you had a smallpox epidemic come through, usually, about a third of the susceptibles died. So if you had six kids, you might think hard about giving them all a little bit of smallpox in their arm…

There are two big things to consider when talking about the idea of purposefully infecting people. The first is that, even if you live through it, and develop antibodies that give you immunity, we have no idea how long that immunity might last. As McNeil points out, “this disease has only been around since November at the earliest,” and we just don’t know how long you might be immune if you get COVID-19 and survive it. And, second, we can’t accurately predict who will die. “We know that there are people who are more at risk,” McNeil says, “but we also know that it’s unpredictable — that young, athletic, healthy people, totally unpredictably, end up on a ventilator, and a few of them die.” Maybe, over time, we’ll have a better sense of who might likely survive the ordeal, but one would think there would always be a little doubt, especially among older people who might not be in the best possible physical condition.

Regardless of how it plays out, it’s going to be absolutely fascinating. If the government can’t convince people that a vaccine is imminent, we’re going to start hearing more about COVID parties. And, I imagine, we’re going to start hearing more about the possibility of controlled, government sanctioned exposure for those who statistically look like good prospects, and encouraged isolation for those who don’t. [Imagine new, enclosed cities for the elderly who have money.] I doubt that it will look like Carousel, but it’ll be surreal… I’d love to hear what science fiction writers are talking about these days during their Zoom happy hours, and what their imagined scenarios look like. But, absent that, I’d be curious to know what you think. How do you think all of this may play out?