2024 Election as Political Long COVID

The topic for today’s article comes from reader NP, who suggests that Trump’s ascendancy “is almost entirely attributable to the subjective and objective effects of the COVID years.” These effects, he suggests go beyond economic factors to include

… fearfulness and trauma that Trump tried to deflect to The Other; the hatred of “elites” who were blamed for lockdown, and, of particular import, shutting down schools, which led … to the explosion of “parental control” of schoolboards, curricula, etc., which [in turn] fed anti-trans fever…. [I]t’s no accident … that the online bro-culture, hyper-masculinity, sports and health supplement culture was fertile ground for ivermectin-esque challenges to what “they” were telling you about COVID, including, of course, vaccines (and of which Trump was a prominent part, which explains his current Cabinet appointments, who were people, like him, that the “elites” mocked). There’s also an intersection … with evangelicalism: recall the flurry of cases where public health rules were challenged on religious freedom grounds. And … even though Trump was in power when much of this was going on, he was a conspicuous critic of his own government’s response, thus cementing the paradox of Trump as Outsider while running the government.

So with that framing, let’s begin.

A study published in February 2021 by a commission established by the medical journal The Lancet  found that 40% of US COVID-19 deaths could have been averted. The commission found that Trump “expedited the spread of COVID-19 in the US.” Asserting that “Many of the cases and deaths were avoidable,” the authors wrote. "... [I]nstead of galvanizing the US populace to fight the pandemic, President Trump publicly dismissed its threat (despite privately acknowledging it), discouraged action as infection spread, and eschewed international cooperation."

The Trump administration failures capped “long-standing flaws in US economic, health, and social policy,” going back 40 years, which the Lancet study suggested exacerbated inefficiencies in public-health systems in the lead-up to the pandemic.

The study compared the COVID-19 death rate in the US to that of Canada, France, Germany, Italy, Japan, and the UK, weighted by population. It found that 40% of COVID-19 deaths in the US as of February 4, 2021 – or 180,000 – could have been prevented if the US’s response had more closely paralleled those of other nations in the group. Trump “repudiated science,” the Lancet authors wrote, “leaving the US unprepared and exposed to the COVID-19 pandemic.” For example, even as public health experts warned about the dangers, in June 2020 at an arena in Tulsa, OK, the Trump campaign held the largest indoor gathering seen to that point in the pandemic. Moreover, the Lancet report authors’ wrote,  the Trump administration's refusal to develop and implement a national strategy “worsened shortages of personal protective equipment and diagnostic tests.”

On February 20, 2020 Nancy Messonier, who was then the director of the National Center for Immunization and Respiratory Diseases at the US Center for Disease Control and Prevention, warned that she expected the coronavirus to spread throughout communities in the US, and that the disruptions to daily life could be “severe.” Yet at a briefing on February 26 Trump stated that “within a couple of days” COVID-29 cases would be “close to zero.” A month later Trump told journalist Bob Woodward that he intentionally downplayed the threat because he didn’t “want to create a panic.”

The February 2021 Lancet report echoed and amplified criticisms in earlier analyses. In 2018 a report found that the first Trump administration’s tax cuts for the wealthy, its delaying $20 billion in aid to Puerto Rico following Hurricane Maria in 2017, and its efforts to sabotage the Affordable Care Act “favor[ed] industry and the wealthy, and serve[d] to endanger population and planetary health.” And an October 2020 editorial called the administration’s pandemic response “disastrous,” concluding:

With so much loss and still more at stake, the 2020 presidential election is the opportune moment for the American electorate to embrace change for the better, to reject the stagnancy of complacency, to exchange a view bereft of intention with a vision of progress, and to rejoin the global community in the pursuit of a more equitable and sustainable future.

Dr. Ashsish Jha, dean of Brown University’s School of Public Health, told Business Insider that he found it hard to imagine how the Trump administration’s response to the pandemic “could have been any worse.”

States that had begun lockdowns in March 2020 in an effort to contain COVID-19 tried a “phased reopening” in May, but by June it was clear that the number of cases was continuing to increase. New infections spiked notably in Arizona, California, Texas, and North Carolina – particularly in Hispanic Communities. A CDC task force began looking at whether the increase was related to illegal travel between the US and Mexico, which was experiencing its own pandemic, though marked by many fewer deaths than in the US. Trump’s Health and Human Services Secretary Alex Azar asked the Department of Homeland Security to investigate a connection between the increase in COVID-19 cases and Cinco de Mayo festivities. In Florida after initially failing to make testing and personal protection supplies available to agricultural workers Governor Ron DeSantis declared that “the No. 1 outbreak we’ve seen has been in agricultural communities,” and that the source of new cases was  “overwhelmingly Hispanic” agricultural workers and day laborers.

Notably DeSantis continued his rhetoric blaming the coronavirus on immigrants into 2021. In Texas, Governor Greg Abbott, while lifting statewide coronavirus restrictions In March 2021 also blamed the continuing spread of the virus on undocumented immigrants.

By October 2021 a Kaiser Family Foundation poll found that 55% of Republicans at the time believed that immigrants (and tourists) were responsible for pandemic-related conditions – this despite evidence that higher infection rates were consistently found in areas with low vaccination rates or no mask mandates. On the MSNBC website American University’s Cynthia Miller-Idriss wrote:

Blaming immigrants is a strategic frame that intertwines anti-elite, pro-nationalist and anti-immigrant discourse all at once. Liberal elites and their lenient immigration laws become the real bogeyman, and those laws must be countered with restrictive immigration policies that will protect people here from the dangerous and destructive force of immigration.

Moms for Liberty (MFL), designated a far-right antigovernment organization by the Southern Poverty Law Center was founded in January 2021 after one of the founders lost her seat on the Brevard County, Florida school board when her opponent campaigned against her opposition to mask mandates. The organization’s initial focus included opposition to other coronavirus-related regulations affecting schools, such as remote learning. These were promoted under the banner of “parental rights,” but by October 2021 the group had gained considerable media attention in its efforts to achieve what the Washington Post described as “convert[ing] brawlish pandemic-era cultural divisions into political power.” The initial focus on public health measures expanded to target curricula that broached topics such as “LGBTQ rights, race and discrimination, and even the way schools define a scientific fact.”

Members of a Suffolk County, NY chapter declared mask mandates “segregation,” and urged children to remove their masks in the classroom as a protest. A chapter in Indian County, FL protested teaching the words “isolation” and “quarantine” because they were “too scary of words” [sic] for fourth graders. In Brevard County where the group was formed members picketed the home of Jennifer Jenkins who had defeated MFL founder Tina Descovitch in the school board election. MFL members also reportedly sent threatening letters to her and her family, and filed a bogus report with county Child and Family Services accusing her of child abuse and drug use.

Bridget Ziegler, one of the three original founders, is the wife of Christian Ziegler, then-Florida Republican Party chairman (since ousted because of sexual assault allegations). Christian Ziegler served as a “media surrogate” in Donald Trump’s 2016 presidential campaign, and was at one time a Heritage Foundation congressional fellow. Over time MFL developed its ties with the Republican Party, initially supporting Ron DeSantis’ presidential campaign, and also recruiting voters. Meanwhile, a police report released in May 2024 includes references to three-way sexual encounters among Christian Ziegler, his wife, and the woman who became his accuser.

In April 2021 the New York Times reported Pew Research Center findings that 45% of white evangelical Christians intended to not get vaccinated against COVID-19. With an estimated 41 million Americans in that demographic group, this meant a nontrivial number of Americans might not get vaccinated, thereby threatening their health and that of those around them. While a few evangelical leaders such as Franklin Graham, and Pastor Robert Jeffress of Dallas, TX attempted to assure their followers that vaccines were compatible with their religious beliefs, others – particularly those who in the words of the Times article had “gained their stature through media fame” – stoked their devotees’ fears. Gene Bailey, host of the “Flashpoint” program on the Christian television network Victory Channel, warned that the government and “globalist entities” would use violence to force vaccinations on people. (“Globalist,” is of course an anti-semitic trope intended to convey the message that Jewish people “do not have allegiance to their countries of origin, such as the United States, but to some worldwide order – like a global economy or political system….”) Dr. Simone Gold, founder of America’s Frontline Doctors, and who would later be sentenced to prison for illegally entering the US Capitol Building on January 6, 2021, warned an evangelical congregation in Florida that they were at risk of being “coerced into taking an experimental biological agent.” (NPR found that Gold’s medical license had lapsed in December 2020, and that her professional address was a UPS shipping store in Beverly Hills, CA.)

Texas A&M’s Heidi Campbell suggests that one source of evangelicals’ vaccine hesitancy was a “general kind of theological belief in the sovereignty of God.” “So if you get sick, it’s because you don’t have faith in God and that you’re not living a holy life, so God isn’t able to protect you.”¹ 

The Times noted that one “widespread concern” among evangelicals regarding vaccines has to do with the issue of abortion. It is true that vaccines have been developed using cells originally obtained from fetuses – most from two dating back to the 1960s, and the rest from one from 1985. These cells have continued to grow in laboratories, and as of now no additional cells are needed. These facts have “metastasized online,” as the Times put it, into wild claims about vaccines containing human remains or fetal DNA.

In a peculiar logical maneuver, some evangelicals found a way to blame their neighbors for any health risks from COVID-19. An article in Baptist News from April 29, 2021 includes comments from a reader who wrote:

If the vaccine is really effective, it will protect those who submit to it. Rejecting the vaccine doesn’t endanger the beloved vaccinated neighbor, provided he doesn’t neglect to get the increasing number of boosters required to ensure its efficacy, But that’s on the neighbor, not the one rejecting the vaccine.

An article in The Atlantic from about the same time reported on Kaiser Family Foundation (KFF) polling showing that 29% of Republicans said they would not get a COVID-19 vaccine. But significantly the  KFF survey and another from PRRI showed that “resistance to the coronavirus vaccines looks less like COVID-19 vaccine hesitancy and more like COVID-19 denialism.” Splitting more-or-less along party lines, it seems that a significant fraction of the public believed that “scientific concern [was] being weaponized for partisan ends.” The same divide affected the wearing of masks, practicing social distancing, and following orders to stay at home if experiencing COVID symptoms. And as The Atlantic’s David Graham notes, the split in attitudes more-or-less paralleled the public postures of Joe Biden and Donald Trump toward the pandemic.

An essay on AmericanGreatness.com, which aspires to be “the leading voice of the next generation of American Conservatism,” proudly proclaimed “I Won’t Take the Vaccine Because It Makes Liberals Mad.” In an April 2021 radio interview,  Wisconsin Senator Ron Johnson, who Graham calls “de facto leader of the Senate disinformation caucus,” more-or-less echoed the Baptist News reader’s view

The science tells us the vaccines are 95% effective, so if you have a vaccine quite honestly what do you care if your neighbor has one or not?”  …What is it to you? You’ve got a vaccine and science is telling you it’s very, very effective. So why is this big push to make sure everybody gets a vaccine? And it’s to the point where you’re going to shame people, you’re going to force them to carry a card to prove that they’ve been vaccinated so they can still stay in society. I’m getting highly suspicious of what’s happening here.

Graham notes that Johnson did not elaborate on his nebulous suspicions, observing that that is consistent behavior among COVID denialists. The restrictions are “imputed” to be part of a plot to limit “freedom,” “But who is behind it or to what end they wish to restrict these freedoms is never made entirely plain.”

Disturbingly, several of Trump’s nominees for public-health related positions embody the vague but dangerous skepticism or distrust of government’s ability to serve the public good.

Robert F. Kennedy, Jr., Trump’s nominee to head the Department of Health and Human Services, asserted in 2023 that  the coronavirus had been “targeted to attack Caucasians and Black people,” while Ashkenazi Jews and Chinese people were “most immune.” In a speech from August 2020 recently published by The Bulwark Kennedy went further, saying that “a lot” of the pandemic “feels very planned to me.” He went on to compare public health measures to combat the pandemic to Nazis testing “vaccines on Gypsies and Jews.” “If you create these mechanisms for control, they become weapons of obedience for authoritarian regimes no matter how beneficial or innocent the people who created them,” Kennedy said.

In 2022, Dr. Mehmet Oz, Trump’s nominee to head the Centers for Medicare and Medicaid Services owned shares of Thermo Fisher Scientific, one of the suppliers of hydrocholoroquinine, which Oz promoted as a COVID-19 treatment. (In June 2020 the FDA concluded that hydrochloroquinine was not effective in preventing or treating COVID-19. It is not clear whether Oz, a physician and television personality, owned the stock at the time he was promoting the drug as a coronavirus treatment).

Dr. Marty Makary, Trump’s nominee to lead the Food and Drug Administration, predicted in February 2020 that COVID-19 would be “mostly gone by April,” and that Americans would be able to resume “normal life.” Instead, of course, variants of the virus would go on to kill hundreds of thousands of Americans.

Dr. Jay Bhattacharya, Trump’s designee to lead National Institutes of Health, argued in a March 2020 Wall Street Journal editorial that the coronavirus might have “one tenth of the flu mortality rate of 0.1%,” adding that “Such a low death rate would be cause for optimism.” When Bhattacharya’s optimism proved to have been misplaced, to say the least, he nonetheless went on to co-author the Great Barrington Declaration which argued – in the absence of any scientific evidence – that public health measures should be aimed at protecting only high-risk individuals, while the rest of the populace should quickly return to “normal life,” despite vaccines not being available at the time. As a New York Times report revealed, the document was the product of the American Institute for Economic Research – a self-styled “libertarian” think tank that in practice leans more to the right, and partners with the Charles Koch Institute.

Meanwhile, as Trump’s motley crew of cabinet and agency nominees prepares for whatever version of confirmation hearings emerges from the Republican-dominated 119th congress, the shadow of COVID-19 loomed over the election in ways both obvious and subtle. 1.2 million people died and a significant number of people still have “long COVID,” aka “post-COVID condition” (PCC). Measurements of PCC prevalence have varied, in part because surveys have often used self-reported data, which “may miss a lot of PCC,” according to Ziyad Al-Aly, MD, of the VA St. Louis Healthcare system and long-COVID expert. A study published in December in the Journal of the American Medical Association (JAMA) Network Open found 8.4% of the population had ever experienced PCC symptoms, and 3.6% reported having symptoms currently. While the percentages are low, when applied to the adult population of the US, the numbers are large. The 2024 US Census estimate of total population was 340,110,988, of which 79% were over the age of 18. 3.6% of that number yields more than 9 million people who might still be experiencing “long COVID” symptoms.

Yet, as the Los Angeles Times’ Jeffrey Fleishman observed in May, COVID’s influence on the 2024 presidential campaign was nearly entirely indirect, appearing, as we’ve discussed here,  in issues that presented as “inflation, education, crime, immigration, and unease … about the future.”

The COVID-19 pandemic is seldom mentioned by the campaigns …,  even though its impact on voters and the way we live, work, die and mourn has been profound. It accelerated mistrust in government and institutions, emptied downtowns of workers, sparked fights over masks and science, turned school board meetings into political blood sport, hardened the lines between red and blue states and ignited a mental health crisis.

The Biden administration pushed approximately $5 trillion in pandemic-related economic stimulus in a largely successful effort to prevent economic disaster. When those measures came to an end, as the economy recovered, inflation reached 8% – the highest seen since the 1980s. It has since fallen to an annual rate around 3%, but as of November grocery prices were 25% higher than in 2019. 

In March 2020 the Trump administration invoked part of a 1944 Public Health Services Law that "allows the government to prevent the introduction of individuals during certain public health emergencies." The action came to be referred to as Title 42 which is the section of the law applied in this instance.

The Biden administration took a number of steps to reverse Trump-era restrictions on immigration starting soon after Biden took office, resulting in a record surge of crossings of the Mexican border in 2022. When the Biden administration first tried to end the use of Title 42 policies, Republicans resisted, invoking the spectre of “border security.” As commentator LZ Henderson wrote in 2012, border security is most often a euphemism for “keep the Mexicans out,” since it is rarely applied to the US-Canada border. In January 2023 when the Biden administration ended the national COVID-19 restrictions the Title 42 measures were revoked as well.  

The murder rate in the US rose 30% between 2019 and 2020 – the largest single-year increase since 1905 according to October 2021 data from CDC report and a September FBI report. The increase affected most states, with the largest increases in Montana, South Dakota, Delaware, and Kentucky. Firearms were involved in 77% of the murders for which data was available. The cause(s) of this record increase are not clear. One factor may be that isolation and idleness increased during the pandemic; these are two factors that criminologists have associated with increased levels of crime and violence, particularly among teenage boys and young men. Related: many police, government, and civilian programs that combat violent crime shut down for part of 2020. Another factor may be the breakdown in police-community relations that followed the mass protests of the police killing of George Floyd. There has been speculation that as a response to the Floyd protests police scaled back programs that function to suppress crime. Alternatively the public loss of trust in the police led to less cooperation and in turn both fewer early arrests of individuals who would go on to commit more serious crimes, and also more “street justice” as citizens distrusting police took matters into their own hands. And finally, Americans bought a record number of guns in 2020.

Kristin Urquiza, the founder of Marked by Covid who spoke at the Democratic National Convention, notes that many service industry and low-income workers “felt abandoned during the pandemic.” “I think the rise of workers’ unions is somewhat related to COVID,” she told the Los Angeles Times. “ It called attention to working conditions.” Urquiza has called for a “9/11-like commission” to review and report on the government’s response to the pandemic.

In a February 2024 Pew Research Center survey COVID was not even among the top 20 issues voters listed as concerns for the next president. Some societal effects of the pandemic may not be apparent until time has passed. Natalie Jackson of the polling firm GQR speculated to LA Times’ Fleishman that “Historians in a couple of decades will be able to tell us a lot more about how our behavior changed that we’re not able to understand right now.” She drew a parallel between psychological trauma in an individual, and the effects of the pandemic on the nation. As the US Department of Veterans Affairs National Center for PTSD points out, in the aftermath of trauma:

… [Y]ou may not be aware of how your thoughts and beliefs have been affected by trauma. For instance, since the trauma you may feel a greater need to control your surroundings. This may lead you to act inflexibly toward others. Your actions then provoke others into becoming hostile towards you. Their hostile behavior then feeds into and reinforces your beliefs about others.

1 Note: an alternative to this view is sometimes termed Arminianism, which asserts the existence of individual freedom. This set of doctrines has influenced Baptist, Methodist, Pentecostal, and other Christian denominations. See e.g. https://www.patheos.com/blogs/rogereolson/2013/04/a-non-calivinist-relational-view-of-gods-sovereignty/