I love a good chart. This one is devastating. I really hoped to confine the Covid Pandemic to history but the Republicans in Washington DC have unleashed all of the horrible memories in service of political theatre.
At its peak in January 2022, unvaccinated Americans were dying from COVID-19 at 33 per 100,000 per week. Among those vaccinated without a booster, the rate was around 3 per 100,000. Among those with a bivalent booster, it barely registered. These are not marginal differences. This is the arithmetic of a preventable catastrophe.
Last week, Dr Anthony Fauci invoked the Fifth Amendment 111 times before a “show trial” in the US Senate , refusing to answer questions that Republicans are using to try to build a contempt case against him. In anticipation of a ‘witch hunt’, Biden pardoned Fauci before leaving office, covering virtually everything related to his government service - a fact that complicates the legal path considerably. None of that stops the spectacle. The man who helped lead the US response to the worst pandemic in a century is being treated as a criminal suspect for doing so. The bona fide idiot who suggested injecting bleach as a cure remains a Republican hero.
What the data actually says
The CDC data, age-standardised and peer-reviewed, tells the story plainly. In January 2022, unvaccinated Americans were dying at roughly eleven times the rate of those with a bivalent booster. By mid-2022, all three lines had converged toward zero - but for the unvaccinated, that convergence came at a cost measured in bodies.
Fauci and colleagues worked against a novel virus with no established playbook, at a pace medical science had never attempted. Their public communication was imperfect at times - how could it not have been, when infection pathways were still being mapped in real time? But the core advice was right. Wear a mask. Social distance. Get vaccinated. The data confirms it. The deaths of those who refused confirm it too.
A study published in JAMA Internal Medicine in 2023 puts a political dimension on that cost that is hard to look away from. Researchers at Yale linked voter registration records in Florida and Ohio to individual mortality data, covering 538,159 deaths between March 2020 and December 2021. Before vaccines were available to all adults, excess death rates for Republican and Democratic voters were statistically identical - the lines tracked almost perfectly. After May 2021, when eligibility opened to everyone, the gap split open. By the end of 2021, the excess death rate among Republican voters was 43% higher than among Democratic voters - a 7.7 percentage point difference in the adjusted analysis. The gap was concentrated in counties with the lowest vaccination rates and was near zero in counties with the highest.
The authors are careful about causation - they did not have individual vaccination status, and political affiliation correlates with other factors. But the timing is not ambiguous. There was no partisan mortality gap before vaccines existed. The gap opened precisely when vaccines became available and one political tribe, at far higher rates than the other, declined to take them.
What AI can and can’t fix
One of the great hopes for artificial intelligence in medicine is real and justified. Drug discovery compressed from years into months. Rare disease diagnosis at scale. Pandemic modelling that outpaces the virus. AI is accelerating all of it in ways that would have seemed like science fiction a decade ago.
None of that helps if people refuse to take the medicine.
COVID demonstrated, with brutal and measurable clarity, that the limiting factor in public health is not scientific knowledge. It is human behaviour. Millions of people were persuaded - by politicians, by social media algorithms, by anti-science voices with enormous platforms - to reject vaccines the data shows would have kept them alive. They died preventable deaths. Many of them on respirators. Many of them in pain.
AI can decode a genome in hours. It has no known cure for the person who has decided that scientists are lying to them.
The only long-term answer
I do not have a quick fix for this. Nobody does.
Investment in media literacy and science education from school age is the long-term solution. If people graduate with the instinct to ask where a claim comes from, who is funding the research and what the data actually shows, the problem becomes more manageable over time. Not solved - human nature does not solve cleanly - but more manageable.
For the rest of us, the response is to actively support fact-based journalism and to back leaders who make decisions on evidence. Not leaders who perform conviction while ignoring science. Not leaders who reach for contempt charges when the scientists turn out to have been right.
The artificial intelligence that will reshape medicine in the next decade will be extraordinary. It deserves to work in a world where the humans on the receiving end are equipped to use it. That is a cultural project, not a technical one. And it is nowhere near finished.
Sources:
- United States: COVID-19 weekly death rate by vaccination status - Our World in Data / CDC (2023)
- Why Anthony Fauci might not be safe after pleading the Fifth - CNN Politics
- Could Fauci face criminal charges for refusing Senate COVID questions? - US News -Disinformation Is the Real Threat to Democracy and Public Health ! Scientific American
- Excess death rates for Republican and Democratic registered voters in Florida and Ohio during the COVID-19 pandemic - Wallace, Goldsmith-Pinkham & Schwartz, JAMA Internal Medicine (2023)