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Crematorium supervisor Ginger Rowley checks the names on cardboard caskets containing bodies to be cremated at the Maryland Cremation services in Millersville, Maryland, on April 17, 2020.ANDREW CABALLERO-REYNOLDS/AFP/Getty Images

This week the United States surpassed a million deaths from the plague that has swept the world since 2020. We live in a relentlessly forward culture, and resistance in Ukraine occupies the space in our psyches once taken up by COVID. Nonetheless, the once-unimaginable number is a reminder of several things worth remembering.

First, that the disaster of the pandemic was not an invention nor an illusion. The coronavirus was not the flu, nor a fantasy or a fiction invented for the ends of state control. It was a plague that acted as plagues do – ruthlessly and relentlessly taking the vulnerable and then reaping significant numbers of those who thought they weren’t. It creates a continuing occasion for reflection, not all of it self-soothing or likely to reaffirm truths that we believed before it happened. And that, as plagues will, it unleashed an extraordinary range of irrational behaviour, even warping the idea of liberty into something close to its opposite.

The logic behind vaccine mandates for travellers no longer holds

Early on in the pandemic, for instance, some of us tried to insist, because we wanted it to be true, that countries such as Canada with high levels of social trust and civic capital would do dramatically better – indeed, were doing dramatically better – in the face of the virus than countries such as the United States, which has so much lower levels of civic capital. This turned out to be, sadly, though not false, less dramatic than one had hoped; the continuing attempts to arraign the American medical system as inequitable and unjust – which it doubtless is – fall down on the obvious point that countries such as Canada and France and Germany, with radically different and more benevolently “socialized” medicine, struggled, too – shut their cities down and saw them remain closed, with similar internal uncertainty and the same frustrating pattern of cessation and renewal that America knew.


No country escaped unharmed or unpanicked – but the level of harm and panic in the United States is so much higher than it is in Canada, with almost three times as many deaths per hundred thousand people, that it demands a special explanation. One thing has emerged, unsurprisingly, as a constant truth, one that does correlate absolutely with success and failure in the pandemic: Inducing immunity by introducing the immune system to the bad agent before the agent gets to go wild protects people from lethal infection. In plain English, vaccines work. They always have. And yet by now it is the anti-vaccination movement‚ almost alone, that is responsible for the long tail of the pandemic in America. The best estimate is that something close to 200,000 needless deaths have occurred as a result of what is politely called “vaccine hesitancy,” while, as one study shows, an unvaccinated adult is an astonishing 53 times more likely to die from COVID than a boosted one. And yet this movement was, for the most part, unforeseeable in its ferocity and tenacity. Though it overlaps with Trumpism, it isn’t just Trumpism: Donald Trump had the carnival barker’s confidence in magic formulae that he could sell – with Trump Vaccines meant to be an addition to the Trump Steaks and Trump Vodka.

Vaccine refusal? Blockades? Bitcoin? What does any of this have to do with conservatism?

Con man though he was, he misread his marks. A much darker and more violently irrational appeal to a morbid idea of liberty, set free even from obvious self-interest, underlies the ideology.

Anti-vaccination ideology is, after all, not only indefensible by any rational argument, but by any appeal to one’s own welfare, let alone the common good. It is, essentially, a form of anti-social capital, a way of draining civic trust for no discernible purpose.

It is, not to put a fine point on it, pure selfishness, dressed up with a special sociopathic twist. Vaccines are not a difficult private choice; they are an obvious public-health obligation, and as such have never before been significantly or widely controversial in America any more than in Canada. General George Washington had a smallpox vaccination mandate for his soldiers at Valley Forge. It’s the American way. And, of course, insisting that you are somehow not opposed to vaccines but only to vaccine mandates is exactly like insisting that you are not opposed to speed limits but only to cops arresting people for speeding, or pretending to be opposed to fires while arguing against fire departments. Saving lives with a vaccine without a vaccine mandate – i.e., a limit on activities the unvaccinated can engage in for fear of infecting others – is an impossibility, and vaccination meaningless without one. Invariably, those who start out pretending to be merely anti-mandate are soon openly anti-vax.

You could not, indeed, have found, prepandemic, a more obvious and uncontroversial instance of the limits of liberty than this one. In a classroom discussion in 2018, searching for an instance of how even those who cherish individual liberty must accept some boundaries upon it, a professor might have argued that personal liberty could be limited, in a remote instance, by the necessity of universal vaccination during a deadly plague, with your right to refuse the vaccine limited by the fact that it endangers the health of everyone else. Even the most classic Millian libertarian would have conceded this point: Your freedom ends only when it directly endangers the lives of others. (And it is their lives, not their morals or beliefs, that have to be endangered.) Heads would have been nodding at the obviousness of the notion, even as eyes squinted at the improbability of so universal and deadly a pandemic in modern times and in modern countries.

So, what can explain the prevalence of this irrationality? In a significant way, the anti-vaccination movement, which is what keeps the deaths going, and the score running now to a million, is actually readily, if obscurely, derived from other irrationalisms of the American authoritarian right. The argument against gun control depends not on ignoring all of the needless deaths inflicted at Sandy Hook or in Las Vegas, but on stoically accepting them as necessary sacrifice to the god of autonomy – to “liberty.” How could you, we once asked, in the face of so many children dying, continue to resist obvious gun sanity? The answer, somewhat obscure before, was that the children and the concertgoers were the necessary sacrifice made to the Moloch of autonomy, to this vision of freedom. The continuing dying of the unvaccinated – and with it the complete truth that the causation, no matter how powerfully proven, never significantly affects faith in anti-vaccination ideology – is proof that the conviction is only reinforced by the suffering it engenders. Like a crazed national cult in wartime, the more destruction there is, the more precious becomes the credo.

And so, searching for the sources of anti-vaccine sentiment, one realizes that here, too, the search for a rational argument is in vain, because having a rational argument would undermine the force of anti-vax belief rather than assist it. The belief is an irrational affirmation of a mystical idea of autonomy; the deaths the anti-vaccination ideology creates are the point, not the problem.

As the American novelist Kurt Andersen has written, a cult of human sacrifice, in every culture where it arises, makes the fact of mass dying a positive good to be celebrated – proof of the seriousness of the values and of the cult itself. Rational arguments depend on lives lived; religious faiths depend on martyrdoms acquired. So many, it seems, have been deliberately martyred to a not-quite-sane idea about personal liberty and government control that has nothing to do with either.

Two truths resonate in the face of this dark fact: first, that self-interest is a much less reliable guide to human behaviour than identity and religious conviction. And then that the anti-vaccination movement is further proof of the larger metaphoric point that Albert Camus was making in his much-read but much-misunderstood classic, The Plague – which is not that plagues teach us morals, but that at any moment, madness still can sweep through seemingly secure modern societies. The struggle to accommodate or explain the madness is in some ways futile. All we have to do – all we can do – is recognize it, and resist.

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