Covid is finally over. How do I know? I took my mask off. 

Not everywhere, but in more places than I have before – at a hotel, while dining indoors, during a packed lecture, picking up The Jerusalem Post from my local Steimatzky bookstore.

Of course, I know that Covid is not really over. People are still getting sick every day. The U.S. is on track to see 150,000 Covid deaths this year. (If current numbers hold, Israel will have just over 1,000 Covid deaths in the coming 12 months.) 

But at a certain point, despite the documented dangers, we have to make the switch to “live with Covid.” Not just in words but in deeds, too.

For many people, that moment came when indoor mask mandates were relaxed. My wife, Jody, and I held on for longer. Our turning point was the fifth vaccine, the Omicron booster, which we got a few weeks ago.

The feeling on that day was: We’ve done all we can do. This booster probably won’t prevent us from getting Covid again (Covid is likely to continue to infect 50% of us every year, according to Trevor Bedford, a virologist at the Fred Hutchinson Cancer Center), but the cumulative effect is to make the disease less severe. 

Besides which, I had a pretty positive experience when I caught Covid in March and a dose of Paxlovid knocked out my mostly mild symptoms in under a week. So, my thinking went, I may be immunocompromised, but I survived it once, I will survive it again.

We’re still masking up on public transportation, on planes, in crowded locations. Which leads to an awkward place.

“Mask-wearing has been relegated to a sharply shrinking sector of society,” writes Katherine Wu in The Atlantic.“It has become, once again, a peculiar thing to do.”

How could it not when influential figures like U.S. President Joe Biden declare, as he did on TV’s 60 Minutes, that “the pandemic is over…if you notice, no one’s wearing masks.”

But wishful thinking is not epidemiological accuracy. Donald Trump was not some Greek Oracle when he proclaimed in 2020, “One day – it’s like a miracle – it will disappear.” No, you can’t will Covid out of existence; that’s not how viruses work. 

And long Covid remains a huge problem. 

An alarming study from Maccabi Healthcare Services, one of Israel’s largest HMOs, found that 34.6% of participants reported not returning to their baseline health condition some five months since recovery from Covid.

Nevertheless, masking – in America at least – is down to 29% of the population, compared with 50% to 80% in the first two years of the pandemic. 

“It feels like something that now needs an explanation,” a friend told Wu. “It’s like showing up in a weird hat and you have to explain why you’re wearing it.”

“It’s OK, you can take your mask off here,” has become an increasingly common refrain, even when it’s clearly not OK. 

I first encountered it during the height of the pandemic when I flew to Florida for my vitreoloysis treatment, an experimental laser procedure for eye floaters. The doctor, with whom I was in close physical contact, said just that while not wearing a mask himself (this despite the sign at the front door clearly stating masks must be donned). 

I wore my mask during the procedure and didn’t get Covid. Yet I felt a strong urge to conform. He was a doctor, after all. 

“You can feel when you’re the only one doing something,” immunocompromised physician Meghan McCoy told Wu for her Atlantic article. “It’s noticeable.”

McCoy noted that, typically, “there’s no big sign on our foreheads that says, ‘This person doesn’t have a functioning immune system.’” 

Masks now have kind of become exactly that kind of sign.

In our new post-Covid reality, masks draw attention, like a wheelchair, prosthetic device or service dog. They “invite compassion but also skepticism, condescension and invasive questions,” Wu writes. 

To go mask-free, by contrast, is like “reverting to a past that was safer, more peaceful,” Wu notes. “Discarding masks may feel like jettisoning a bad memory, whereas clinging to them reminds people of an experience they desperately want to leave behind.”

Don’t we all want that?

Well, yes…and no. 

I’d be lying if I didn’t admit it was exhilarating to eat in a restaurant again, to walk around a museum unencumbered by a tightly-tied Sonovia cloth. 

And yet, this “new normal” is also an admission that we’ve failed. 

— Failed to stop a virus that will now circulate among human beings forever. There are, after all, still DNA remnants of the 1918 flu pandemic in today’s annual flu outbreaks. 

— Failed to depoliticize science such that mask-wearing, along with vaccines, became not a matter of public safety but one of red vs. blue, right vs. left.

— Failed to embrace good governance over populism, vilification and victimization.

The other night, Jody and I went to the Yes Planet in Jerusalem to see Cinema Sabaya, Israel’s top Ophir award-winning film this year. We didn’t wear our masks – until we heard the man behind us coughing. We donned our cloths in the dark and felt somewhat more secure.

We’ll also wear our masks more consistently prior to a big event or vacation, so that we don’t get sick and miss out.

I wish Covid never came into our lives. Moreover, I wish masking could be a personal choice, free of stigma. 

Wu asked her mother, who lives in Taiwan, “How is masking going in Taipei?” 

It is still quite common in public spaces, even where it wasn’t mandated, her mother explained. 

When Wu asked why, her mother’s response was telling. 

“Why not?”

I first wondered if Covid was over at The Jerusalem Post.

Photo by Isaac Quesada on Unsplash.

Consider the following snapshots from our mid-2022 coronavirus reality show.

Covid is over. So many people have been infected that the end must be near. Or maybe it’s not, since Omicron’s evil stepchildren (the BAs) can reinfect us all – potentially, according to some reports, just a couple of months after a first bout.

A judge in Florida struck down the U.S. government’s mask mandate on public transportation. Flight attendants were shown in videos gleefully collecting masks, chanting, “Wave ‘em in the air like you just don’t care.” Passengers were equally jubilant – except for those who were caught psychologically unprepared for what’s being dubbed the “choose your own adventure” phase of the pandemic. Israel will end its own mask requirement on international flights leaving the country next week.

Masks on or off, Israel halted PCR testing for visitors – Israeli citizens and tourists – at Ben-Gurion Airport as of today, May 20. Yet, by mid-April, nearly 4,000 tourists caught Covid while in Israel. How will we stop future spreads without testing?

It’s enough to give even the most casual observer whiplash. Or in the spirit of the day, “pandemilash.”

I get it, I do. The last two plus years of Covid-19 restrictions have been characterized by rules that zig every time the virus zags. Let’s not forget how Israel dropped its indoor mask mandate in 2021 – for all of two weeks before Delta came raging in and the requirement was quickly reinstated. 

Are we making the same mistake this time? Or has something profoundly changed – vaccines that prevent severe cases and hospitalization; treatments like Paxlovid, Evusheld and monoclonal antibodies, a (currently) less virulent variant – that means we can lighten up and live with the virus?

I’m not immune to the joys of shopping maskless or eating out in restaurants indoors. Once you’ve gotten Covid, as my entire family has now, you tend to feel invincible, like a protein spiky superhero. I had resigned myself to wearing a mask indefinitely, but in the last few weeks, I’ve been to parties, art exhibits, even ridden on public transit – all without my Sonovia. It’s felt fabulous.

After all, “What’s more fun than coming to a holiday celebration, without masks?” asked Prof. Yehuda Adler, an expert in cardiology and internal medicine, before adding the caveat: “I think that [the authorities] acted too soon.

Part of the dilemma is that those of us who’ve had Covid know better what to expect. It’s true that the next time could be very different, but it seems my body can in fact mount a reasonable defense, such that Covid will unlikely be fatal – for me at least. (Long Covid is another worry entirely.)

As a result, the idea of getting reinfected has gone from being an existential terror to a minor, albeit non-trivial, annoyance. 

Let me be clear: I absolutely don’t want to get reinfected. Researchers at Imperial College London and the University of Cambridge have found that serious cases can lead to a decrease in IQ of up to 10 points – equivalent to 20 years of aging!

But I’m feeling pretty confident that if I do get corona again – and unless it’s while traveling in a country where I might not have access to the most potent antivirals – it won’t fell me.

Or as Dr. Anthony Fauci put it, “Things are looking good. We don’t want to get overconfident, but they look like they’re going in the right direction.”

Still, I can’t shake the nagging feeling that I may be putting myself (and others) at unnecessary risk, even as I follow the Ministry of Health’s most recent regulations. 

“Nobody is going to be able to tell us what will happen,” Anne Rimoin, an epidemiologist at UCLA, told The New York Times. “The ending is not written yet.”

“When you’ve got something as transmissible as Omicron, you don’t need it to be incredibly severe to really screw things up,” warned Bill Hanage, a public health researcher at the Harvard T.H. Chan School of Public Health.

Or as Kate Cagney, the director of the Institute for Social Research at the University of Michigan, said in an interview with Vox, “We don’t have a consistent algorithm that we’re all following.”

Perhaps the biggest cause of the “pandemilash” so many of us are experiencing is the sudden shift from concern for the common good to an attitude of “what’s in it for me?” 

That shouldn’t be so surprising 

Anti-maskers have long positioned this as a question of personal liberty. That is, if one is not personally at risk, why wear a face covering at all?

The official attitude has transitioned from an initial approach of “avoid infection at all costs” to “getting infected is a largely acceptable risk of getting life back to normal,” wrote Dylan Scott in Vox.

Even the U.S. Centers for Disease Control website has revised its guidance. “Wear a mask with the best fit, protection and comfort for you” (emphasis mine), the CDC website states.

When Washington Post columnist Kate Cohen was recovering from her own Covid infection, she asked a health department employee when it would be safe for her to be around others. 

“Use your conscience,” the worker said with a shrug. 

“I wish I didn’t have to,” Cohen wrote. “But without a mandate to make us act out of concern for others, conscience is all we’ve got.”

Unfortunately, it’s our sharply divergent consciences that got us into the “pandemilash” we’re in today.

I first coined the term “pandemilash” at The Jerusalem Post.

Photo by Lukas Souza on Unsplash

I had finally resolved to go in for the Evusheld shot I wrote about recently (“How many antibodies are enough?”) – the prophylactic Covid treatment from AstraZeneca that injects antibodies into immunocompromised people like me who don’t create enough (or any) antibodies on their own from the vaccines.

But it was too late. After taking extreme precautions for over two years, I finally caught Covid. 

Not just me but my entire family. 

It’s easy to trace the chain of connection: Our daughter Merav, son-in-law Gabe and four-month-old Ilai got it from someone in Merav’s mothers’ group. (When someone flippantly posted on social media, “Babies never get sick from Covid,” I wrote back in fury, “Tell that to my grandson who spiked a fever of 104 degrees Fahrenheit and had to be rushed to the ER by ambulance!”) Jody and I caught Covid from them. Our youngest son Aviv caught it from us. And Amir, our oldest, presumably picked it up at a Purim party.

Friends who we told of our diagnosis were empathetic. “You were so careful! You got all the vaccines and boosters, you masked up everywhere.”

Everywhere except with our new grandchild. We had heard stories about grandparents who hadn’t seen their generational offspring for two years, to keep from catching Covid. Jody and I decided that was not going to be us. 

We’d be careful: If anyone was feeling under the weather, we’d wear a mask. We ate outside whenever the weather permitted. We sometimes asked everyone to do a home antigen test before unmasking if an indoor Shabbat meal was the only option. Not being able to see our family was where we drew the line.

It worked very well. That is, until it didn’t.

Jody and I have both been very averse to catching Covid. Me, for obvious reasons: My cancer means we don’t know if my immune system will be functioning well enough to keep Covid mild. Jody just didn’t want to risk long Covid, which the latest stats say affects 13% to 30% of Covid patients. 

Our symptoms started off mild a couple of days after our exposure. But the next day, Jody and I both spiked fevers. Twelve hours later, the results of our PCR tests came by SMS.

This time, we were positive.

I immediately went into damage control: If I hadn’t been able to get the Evusheld before catching Covid, the next best thing would be to get a package of Pfizer’s Paxlovid pills that reduces the chance of severe illness in people at risk by up to 89%.

According to a study published in the journal JAMA Network, some 2.7% of Americans are considered immunocompromised – that’s about 7 million people in total. Millions more have diseases, like AIDS and Crohn’s that impact immunity. 

The immunosuppressed have a higher chance of hospitalization and death than healthier individuals, take longer to clear the virus and are increasingly known as being a vulnerable vector for incubating new variants. An Israeli study conducted during the Delta variant surge found that 40% of hospitalized breakthrough cases are in immunocompromised people. 

That’s definitely “a variant of concern.”

It took most of the next day to get the prescription approved by the “Covid committee.” Amir’s girlfriend, Tal, made the pilgrimage to the Maccabi Pharm Agrippas Street to pick up the meds.

“You may have saved my life!” I gushed to Tal. I wanted to impress upon her exactly how grateful I was.

Paxlovid is a big commitment: Three large pills, twice a day for five days. 

I don’t know if it was the Paxlovid or my immune system is working as it’s supposed to, but within five days, my symptoms started to subside. My fever went down, the coughing decreased, and my headache transitioned into more of a dull throb than a piercing knife. 

Jody’s recovery was not as rapid as mine, which got me thinking: Why can’t Paxlovid be given to anyone with Covid, not just those at high risk. I know all the usual reasons: it costs some $500 for a course of treatment and there aren’t enough pills yet in the country.

But maybe this treatment – or something similar in the future – will be what transforms Covid-19 into something more akin to the flu (just as the anti-vaxxers have been clamoring for). If priced right and made ubiquitous like antibiotics or antivirals such as Tamiflu, Paxlovid could become the latest must-have accessory to pack in your luggage. (“Got my eye patches, my hiking boots and my Paxlovid!”) 

That looks more likely after the announcement from Pfizer that 30 companies around the world, including Teva in Israel, will begin producing a generic, low-cost version of Paxlovid. Pfizer says it will not receive royalties from sales of generic Paxlovid.

For two years, I’d been terrified of Covid. In the end, it wasn’t as bad as I’d imagined. I’m well aware that, had I caught the virus before there were vaccines, pills like Paxlovid or prophylactics like Evusheld, my outcome could have been tragically different. For me, Paxlovid has been nothing short of a miracle.

Plus, there’s an ironic silver lining. As it’s unlikely any of us will be reinfected with whatever variant we got just now (was it Delta? Omicron? Deltacron?) in the coming months, maybe we can feel just a tad less anxious about eating indoors or taking our masks off at a rock concert.

At least until the next variant arrives.

I first wrote about Covid and Paxlovid for The Jerusalem Post.

Is my body capable of producing antibodies against Covid-19 following my four Pfizer doses? Or, because I am immunocompromised due to past cancer treatments, does my immune system leave me bereft of antibodies even after multiple jabs? And most important: Would I want to know, or would I prefer to “act as if” and hope for the best?

This question has been reverberating in my brain for as long as Covid vaccines have been available. From 2018 to 2019, I received a bi-monthly injection of Gazyva, an immunotherapy drug, to shrink the tumors of my lymphoma. Gazyva and its close cousin Rituximab are highly effective but, at the same time, are among the most harmful drugs when it comes to depleting the body’s ability to produce antibodies.

Most people with this antibody problem have taken Gazyva or Rituximab more recently than me, but still I was curious – and fearful.

There is a simple blood test to check whether your body can mount an antibody response. But the HMOs in Israel don’t offer it because, as my hematologist told me, “We just don’t know what the numbers mean.”

That is, if your IgG levels for the “Anti-S” Covid test contain more than 50 au/ml of antibodies, you’re considered to have had a response. But does that protect you? What if you have 1,000 au/ml? 10,000 au/ml? No one knows yet what number is going to do the job. So, the HMOs don’t want to pay for it since they don’t know what to do with the answer.

You can, of course, purchase a serological test privately. At NIS 217 ($65), it’s not a huge impediment. 

I had pretty much decided to stay in the dark…that was, until Evusheld became available in Israel in February.

Evusheld is a new medication from AstraZeneca designed specifically for people who are immunocompromised. Unlike Paxlovid or monoclonal antibodies such as Regeneron’s REGN-COV2, which are given after one has contracted Covid, Evusheld is administered before you get Covid and gives you all the antibodies your body didn’t create on its own in response to the vaccines.

According to the U.S. CDC, about 7 million people in the U.S. are considered immunocompromised, whether from cancer, an organ transplant, or an auto-immune disease such as rheumatoid arthritis.

Evusheld is what’s known as “a passive vaccine.” It combines two monoclonal antibodies (tixagevimab and cilgavimab) given in two shots that bind to different sites in the virus, preventing it from entering the cells and reproducing. Evusheld results in an 83% reduction in the rate of symptomatic coronavirus, with protection lasting for six months. The drug is also appropriate for people who had an extreme reaction to one of the main Covid vaccines and, as a result, can’t take more.

My doctor felt I should get Evusheld as I tend to progress from cold or flu to pneumonia more rapidly than people who haven’t had cancer treatments. But if it turns out I do have Covid antibodies, then I wouldn’t need Evusheld, right? 

Had the time finally come to test my levels?

I decided to go for it. 

So, on a recent Tuesday, I visited the “Executive Checkup” center on the first floor near the main entrance of Hadassah Medical Center’s Ein Kerem campus.

Executive Checkup is unlike anything I’ve seen in Israeli medicine. A tastefully decorated space with soft lighting, architectural flourishes, comfy chairs, free WiFi and the kindest, English-speaking front-desk staff, it was worth the price just to enter. The nurse who took my blood was so gentle I didn’t even feel the needle prick.

All that was left to do was wait for the results. They came 24 hours later.

I had 6,684 au/ml of antibodies. Hallelujah! I have protection as a result of the vaccines, I rejoiced. Or perhaps I had an asymptomatic case at some point in the last two years and never knew it.

Not so fast, cautioned my doctor, throwing her usual pragmatic water on the flames of my enthusiasm. “There’s not enough data. You should still get the Evusheld.”

An unauthorized visit to Dr. Google was no more conclusive. No website or journal was willing to state whether my 6,000+ antibodies bodes well. The armchair experts I reached out to on social media were similarly stumped.

I have a prescription for Evusheld now. Will I follow through and get it? The side effects from getting a couple of Evusheld shots are supposedly no more than from the vaccines, and all I experienced from my Pfizer jabs was a sore arm and a bit of nausea in the first couple of days.

If I need any extra inspiration, maybe I should listen to my friend Laurie Kleinman Heller who has been urging me to get the Evusheld shot after she received hers. 

Laurie was interviewed on Ynet about her own terrifying situation (she has an immune deficiency known as CVID as well as lymphoma) where she makes zero antibodies. For the duration of the pandemic, she’s been mostly confined to indoors. “The most remote place I go to is to the park across the road,” she says. 

All that’s changed now.

Raya Cohen, a nurse, was even more emphatic. “There are quite a few people like me who have been imprisoned for almost two years,” she told Ynet. “I need this vaccine like breathable air.”

Evusheld or not, we all could use a little more air to breathe at this point.

I first wrote about my to-Evusheld or not-to-Evusheld dilemma for The Jerusalem Post.

Covid-19 has turned us into reptiles. 

Or to be more accurate, in the face of a once-in-a-lifetime viral threat, the pandemic has switched on our reptilian brains at the expense of our more mammalian, social ones. And the best way to address that switch –through interpersonal engagement with trusted friends and family – has largely been snatched away through two years of social distancing, work-from-home mandates and shuttered entertainment and dining venues. 

The result: Many of us are digging our heels even deeper into our anxieties as we search for partners to help us “co-regulate” but who are now, more often than not, on the other side of a Zoom screen. 

This analysis isn’t mine. It comes from Indiana University Prof. Stephen Porges, who has, for four decades, been psychotherapy’s strongest proponent of the Polyvagal Theory. 

Polyvagal Theory takes its name from the vagus nerve, the longest in the human body, starting in our heads, passing by our faces, zipping through our hearts, and ending up deep in the gut. 

The vagus nerve is responsible for regulating our autonomic nervous system (which controls our heart rate, blood pressure and respiration) when we get stressed. The functioning of the vagus nerve is a big reason why, when we’re agitated, we get a stomachache.

The vagus nerve is also behind what Porges calls “the heart-face connection.” We take many of our social cues from each other’s eye movements, facial expressions, even the sounds of our voices.

But what happens when we can’t connect in person, when we’re unable to see the smiles on our friends’ faces because we’re covered up, whether by a mask or on a poorly lit Zoom call? It pulls the rug out from under our coping skills and allows our reptilian brains to run wild. You go to the supermarket and wonder, “Are you a risk?” about the person in front of you in line.

The reptilian brain is the most ancient part of who we are. It’s where the fight or flight response originates. That’s why, when danger arises, reptiles will often “play dead” or run away.

When our reptilian brains are switched on through some kind of trauma – be that fear, danger, confusion or conflict – we act in antisocial, confrontational ways, displaying anger and belligerence. Logic gets lost as we comprehend the world as black and white, right and wrong, threat vs. security. 

Nuance is not something at which alligators excel.

Understanding how the vagus nerve and trauma interact could go a long way to grokking society’s reaction to Covid-19, the rise of anti-vaxxers, and the hold that conspiracy theories have on otherwise rational individuals.It could even restore some empathy for those with whom we disagree.

After all, “we don’t expect reptiles to be social,” Porges says. “So why do we expect people to trust others” when they’re feeling particularly lizard-like?

Like reptiles, “when people experience trauma, they shut down too,” Porges explains. This may have “an evolutionary adaptive function, even if it’s not the best for our mental health.” 

If Polyvagal Theory sheds insight on how people have been responding during the Covid-19 crisis, can it also help us find a way out of our current culture of distrust? 

“Many anti-vax people may genuinely believe that taking a vaccine places them at risk,” Porges says. “It generates a threat reaction and, when you’re under threat, you’re like a different organism – a reptile. Your ability to trust will be compromised.” 

The Polyvagal solution, Porges exhorts, is other people. We can tolerate a trauma like Covid-19, “if we have an external opportunity to co-regulate with friends, in the workplace, at school. [But] that’s been hard to come by during the last two years of pandemic.” 

Polyvagal Theory helps us understand traumas beyond Covid, too.

“When you support a particular candidate for office, you don’t hear balanced arguments or other points of view,” Porges says. “So, when that person loses, you’re convinced a threat is going on, that there’s fraud. We extrapolate and think everyone shares those views and others are outliers.” 

That said, when you’re in reptile mode, you still crave co-regulation. But where can you find that when your views have been rejected by the mainstream? From conspiracy theory communities which will readily step into that void. And once you feel supported, it’s mightily difficult to break free. 

But there’s good news. Just like there are super spreaders of Covid, there are also “super co-regulators.” 

“These are people who, when they walk into a room, you feel disarmed and comfortable,” Porges says. They make you feel at ease so you can start to distance yourself from any trauma-induced conspiracy-leaning reptilian tendencies.

The world needs more super co-regulators. And we need access to them, ideally in person. 

Does that mean I’m joining the agitators calling for an end to quarantines, isolation and masks? Not yet – the Omicron variant is still too widespread. And it’s certainly possible to signal emotional encouragement by making a conscious effort to look people in the eyes, to raise your eyebrows or tilt your head – even while wearing a mask. 

But once we get past this surge, it would behoove us to reconsider lockdowns and Zoom school and other reactions to the pandemic that have been spinning up our reptile brains. They’ve served us well in terms of minimizing fatalities (yes, 5.5 million people have died, but it could have been so much worse). But as Covid transitions from pandemic to endemic, we’ll need to transition our responses, too.

I’m still scared of catching Covid. But I don’t want to remain an anti-social crocodile forever. If I incorporate Polyvagal Theory into my way of thinking, maybe I could even muster up a bit of mammalian empathy for those who don’t share my opinions.

I first wrote about our reptilian impulses for The Jerusalem Post.

Tim Wise wrote a provocative column for the website Medium earlier this month. Entitled “Covid anti-vaxxers arenâ€t a MAGA death cult – itâ€s worse than that,” the piece argues that followers of Donald Trump with his “Make America Great Again” slogan are not inherently suicidal despite their anti-masking, anti-social distancing, vaccines-are-evil stance. 

“Stories are spilling out every day — outpourings of regret from persons who steadfastly refused to get the vaccine, now awaiting intubation â€“ coming to realize they were wrong,” Wise writes. “That they are bellowing contrition and asking for prayers in the hopes they wonâ€t die proves this is no suicide cult.”

Rather, what weâ€re seeing now amongst outspoken anti-vaxxers is “something more dangerous, sociopathic and sadistic,” he continues. â€œNot suicidal but homicidal… these are people who didnâ€t and donâ€t want to die. They simply thought there was no way they would.”

Covid is “only killing the weak,” Wise explains their thinking: “the less good people, the ones who donâ€t do CrossFit or go to a megachurch or who place their faith in science rather than a Bible study group.” For these types of anti-vaxxers, Wise notes, “those people donâ€t count.”

Wise quotes conservative conspiracy theorist Jack Burkman, who was surreptitiously recorded revealing what he really thinks Covid-19 is all about.

“Mother Nature has to clean the barn every so often,” he was overheard saying. “So what if 1% of the population goes? So what if you lose 400,000 people? Two hundred thousand were elderly; the other 200,000 are the bottom of society. You got to clean out the barn.”

Thatâ€s not just a call for homicide – itâ€s a prelude to eugenics. 

Such people “arenâ€t concerned about getting Covid themselves,” Wise explains. “They [simply] donâ€t care if you do.”

Thatâ€s pretty extreme but how else can we explain the 23 people who were pulled off a New York bound plane at Ben-Gurion Airport after it was discovered they had forged their PCR test results. 

If one of them had been positive for Covid, they could have gotten tens if not hundreds of their fellow passengers sick. 

Australia has been roiled over the past week by an indoor, maskless engagement party held in defiance of the countryâ€s super-strict lockdown regulations. It would have flown under the radar if someone hadnâ€t videotaped the groom joking, “Clearly this is legal because this is a group therapy session.” At least one person in the crowd of 68 attendees turned out to be Covid-positive. The Victoria state government has now tightened lockdown restrictions including a nightly curfew. 

The homicidal moniker is clearly over the top, meant to provoke outrage. Most anti-vaxxers do not have murder on their minds. I would use a different epithet: A strident subset of anti-vaxxers is suffering from a form of extreme narcissism, one that frames everything through the lens of â€œWhatâ€s in it for me?” rather than “How can I help my fellow human being?”

I was privy to some of that sentiment after I questioned in my last column how the vaccinated should relate to anti-vaxxers who catch Covid. Is it acceptable to feel schadenfreude, I wondered?

“â€Anti-vaxxer†is a derogatory name being given to people [who simply want to] exercise their right to free will,” wrote one person in response.

Free will to do what? Kill others? 

“The people who are dying from Covid have had their immune systems damaged or destroyed through medication and adulterated foodstuffs. A properly maintained immune system is a killing machine that can even beat Ebola and rabies.”

Way to go, blame the victim.

“It’s their choice not to be vaccinated. Plain and simple. The problem is that the governments of the world are controlled by global elites and big pharma. The pandemic is a tool for political power gain.”

Hard to argue with paranoia.

Wise calls for treating anti-vaxxers like pariahs, “cutting them out of our lives entirely: non-invitations to the cocktail party or backyard barbecue, no seat for them at the holiday table, no invitation to the grandkidâ€s graduation.”

Israel is doing this to a certain degree on the national level. You want to go to a restaurant, sports or culture event, conference, hotel, gym, pool, event hall, museum or university? Youâ€ll need a “Green Pass” showing youâ€ve been vaccinated, have antibodies indicating youâ€ve recovered from the virus, or received a negative PCR test in the previous 72 hours.

The Canadian government has announced that it will soon require all air travelers and passengers on interprovincial trains to be vaccinated.

These are good initiatives that, hopefully, will serve to incentivize vaccination holdouts to get their jab.

That said, the vaccines arenâ€t perfect, as weâ€re discovering to our chagrin: Immunity wanes over time and boosters will be necessary – sooner than many hoped. 

Then there are the rare side effects, some of which can be quite scary. Israeli researchers have, for example, found a connection between the heart condition myocarditis and the Pfizer mRNA vaccines. Itâ€s not a big number – 148 mostly mild cases reported within 30 days of vaccination out of the over five million people who were inoculated – which gives it a rate of 0.003%. 

Compare that with Covid-19 which has a case fatality rate of close to 1% in Israel. (Itâ€s 1.6% in the U.S. and as high as 9.2% in Peru.)

Whether you call them narcissists or homicidal, this is a cultural and psychological divide that is becoming nearly impossible to bridge. When we canâ€t agree on basic scientific facts – whether thatâ€s about Covid or climate change or, to delve into the truly bizarre, whether the earth is round or in fact flat – I find myself in existential fear for our future. 

Paranoid? I think not.

Narcissism photo from Marija Zaric via Unsplash.

I first wrote that anti-vaxxers are narcissists for The Jerusalem Post.

Is it OK to have schadenfreude (the German expression for “pleasure derived from someone elseâ€s misfortune”) when an anti-vaxxer contracts Covid-19? The Internet seems to think so. 

Every day in my U.S. news feed, Iâ€m sent stories about some vaccine denier who caught the virus, is now fighting for his or her life, and who in many cases has had a very public change of heart, to the point of urging friends and family to get vaccinated ASAP.

One of the most prominent examples in recent weeks was Phil Valentine. 

A conservative talk show radio host from Nashville, Tennessee, Valentine repeatedly spread misinformation about Covid-19 and even mocked vaccines, turning a Beatles hit into an anti-vax ditty he dubbed the “Vaxman.”

“Let me tell you how it will be,” he sang on-air. â€œAnd I donâ€t care if you agree. â€˜Cause Iâ€m the Vaxman, yeah Iâ€m the Vaxman. If you donâ€t like me coming round, be thankful I donâ€t hold you down.”

Even after Valentine was diagnosed in June, he retained the anti-vax mantle. â€œUnfortunately for the haters out there, it looks like Iâ€m going to make it,” he wrote with no small amount of snark.

Two weeks later, he was hospitalized in critical condition.

Valentine hasnâ€t yet come out vocally to promote vaccines (heâ€s hooked up to a ventilator), but in neighboring Alabama, Christy Carpenter told The Washington Post that her anti-vax family was now urging others to get the shot after her unvaccinated son died of Covid-19.

“If Curt were here today, he would make it his mission to encourage everyone to get vaccinated,” Christy said. “If we can help keep people healthier and possibly save lives by encouraging others to take the vaccine, then Curtâ€s death was not in vain. We did not get vaccinated when we had the opportunity and we regret that so much now.”

Danny Reeves is an unvaccinated pastor from Texas who, after contracting Covid, was told he might need a lung transplant. “I didnâ€t mean to be cavalier,” he said, after two touch-and-go days in the ICU. “But thereâ€s a lot of people just like me that havenâ€t gotten the vaccine. Iâ€ve been taught a lesson and Iâ€m big enough and humble enough to say I was wrong.”

Another conservative radio host, Dick Farrel, caught Covid. He texted a friend two words from the hospital regarding the vaccine: “Get it.” He died shortly afterward.

The more I read these stories, the more I am confronted with an ugly feeling inside, one which I try my best to tamp down because it seems so wrong:

These anti-vaxxers should get a taste of the “fake news” theyâ€ve been peddling.

So they know that, no, itâ€s not “just” a flu. 

That no, you donâ€t have an innately strong immune system that can easily fight this off without assistance from a vaccine. 

That no, being young or strong or healthy wonâ€t save you nor will faith in a supernatural deity (unless that deityâ€s last name happens to be Bourla or Bancel, the CEOs of Pfizer and Moderna, respectively).

So, when anti-vaxxers get Covid, my schadenfreude-leaning self wants to say, “Ha, they brought this on themselves. Let them get a tough case. Not one that sends them to the hospital or kills them, but enough that theyâ€ll get scared straight and start talking sense to their unvaccinated followers.”

And then I feel terribly guilty that I ever had such inhumane feelings.

That hasnâ€t stopped other people from expressing similar sentiments – or getting angry like Alabama Governor Kay Ivey who commented that itâ€s “the unvaccinated folks that are letting us down [not to mention] choosing a horrible lifestyle of self-inflicted pain.”

Others are less restrained. “It makes you want to smack people upside the head,” vaccinated 66-year-old Elise Power told NBC News.

But what else can you do? Over the course of the pandemic, itâ€s become clear that trying to change peopleâ€s opinions about getting the vaccine is as futile as convincing Donald Trump heâ€s no longer president. No amount of persuasion gets through. Only action seems to make the difference – and getting Covid is as big an unfortunate action as you can imagine. 

Indeed, vaccine skepticism evaporates once one has experienced time in intensive care. â€œYou can see it dawn on patients that they potentially made the biggest mistake of their lives,” Dr. Samantha Batt-Rawden told the U.K. newspaper The Guardian.

An anti-vax movement certainly exists in Israel but itâ€s less intense than in other parts of the world given that the vast majority of the adult population here (90% of those over 50) – and nearly everyone whoâ€s most at-risk – has gotten their jab. Weâ€re even giving third booster doses now, something I happily went for even before they were offered to the general public. (Blood cancers like mine make it difficult for the body to produce the same level of antibodies as a healthy person.)

Mark Valentine, brother of radio talk show host Phil, was shaken to the core by what he experienced.

“Having seen this up close and personal, I’d encourage ALL of you to put politics and other concerns aside and get it,” he said, referring to the vaccine.

Phil Valentineâ€s diagnosis has already made an impact: Listeners have reported they went ahead and got the vaccine.

“The Lord works in mysterious ways,” added Mark, who got inoculated the same day that his famous brother was admitted to the hospital. “Maybe this happened so Phil could talk to people and make sure that more people donâ€t die.”

Said with entirely no schadenfreude.

I first asked the difficult questions in this article at The Jerusalem Post.

Photo by Trey Musk on Unsplash

I never liked merry-go-rounds. They always seemed like the least worthwhile ride at the amusement park. Maybe thatâ€s why carousels only warranted a lowly “A” ticket in the old Disneyland pricing scheme.

Merry-go-rounds donâ€t go anywhere. You donâ€t make progress like on a roller coaster or a racing ride. Thereâ€s no change of scenery, no thrilling dips. You just spin over and over until you get dizzy and you want to throw up.

Iâ€ve been thinking about a different kind of merry-go-round lately – spinning when it comes to decision-making. 

Spinning sucks away our spirit as we get stuck, regurgitating the same indecisive conclusions over and over, until we are at last forced to move forward, one way or another, but not before weâ€ve inflicted unnecessary anguish on ourselves (and most likely our loving partners, too). 

This was exacerbated during our most recent trip to the U.S. There were so many opportunities for spinning: where to go, what to eat, who to see, the direct flight vs. the cheaper one with more layovers… the list seems endless in hindsight.

If spinning is an issue for you, too, wouldnâ€t it be great if there was a way to shut it down and banish the psychological trauma that comes with it?

Here then are eleven tips to stop spinning in its tracks so you can blast off to Space Mountain instead of getting stuck in an endless loop at the Dumbo ride. 

1. Write it down. Making a pro and con chart can help you visualize – and resolve – whatâ€s causing the spinning. You can also just write down your thoughts, freestyle. But be sure to put your list aside for a day so you can see if you feel the same way tomorrow.

2. Prioritize. Youâ€re not going to get everything you want. Thatâ€s a truism in life as well as for specific decisions. So, decide: Is it more important to buy the fancier dishwasher or to save money? If you canâ€t have both, do you prefer better gas mileage or adaptive cruise control?

3. De-conflate. Have you inadvertently conflated two unconnected issues? If your physician has a sour bedside manner, is he nevertheless good at what he does – an excellent surgeon? Thereâ€s no reason to disqualify a professional based solely on his or her communication abilities. De-conflate skill from style to manage spinning and move forward. (If youâ€re developing a long-term relationship, the calculus may be different, and you may want to place people skills higher on the list.)

4. Is it peripheral? When my wife, Jody, and I were looking to book our Covid-19 tests prior to flying, we had to choose between going to the airport, which was cheaper but would eat up more time, or getting it done in town at a nominally higher price. Was it worth the hassle factor of getting to Ben-Gurion in order to save the equivalent of a couple of falafel sandwiches?

5. Can you confirm it? Do you have a source for the spinning thought youâ€re having? I often worry that, after agonizing over a decision to attend an event or make an appointment, it will be canceled at the last minute. Did I receive a call or message indicating that might be the case? Does the person Iâ€m meeting have a reputation of canceling? No? Then move forward. 

6. Give power to your partner. Sometimes it can be helpful to let your partner make the decision. For control freaks (me included), that takes some serious willpower that youâ€re not going to second guess your spouse after the fact. Removing the burden entirely from your shoulders can minimize spinning.

7. Decide on a cut-off point. Researching options is important – I would not have been comfortable choosing a chemotherapy cocktail when I was treated for cancer without doing extensive due diligence. Itâ€s OK to get a second or even a third opinion, but donâ€t keep running to specialists for a fourth, fifth or sixth one. How many different types of shoes should you consider when searching Zappos? How many USB thumb drives? 

8. Minimize conflict where possible. Conflict is not always avoidable, but you can pick your battles. Get into it with someone with whom youâ€re close. For individuals providing a service, turning the other cheek when confronted by something triggering can lead to less anxiety than if youâ€d engaged.

9. Donâ€t spin about the future. Itâ€s one thing to get in a tizzy about something happening right now. Itâ€s quite another to spin over an eventuality that hasnâ€t and may never occur. 

10. Thoroughness is a spectrum. Being thorough is usually a good thing. But when it goes too far, it can turn into spinning. This is not a “switch” you flip to go from either 100% thoroughness or 100% spinning. Rather, itâ€s a spectrum and itâ€s easy to almost imperceptibly slide to the dark side. Before slipping to anxiety, ask yourself: “Have I gone beyond being thorough?” If so, you still have time to gently course-correct.

11. Accept that spinning is a part of certain types of decision-making. You canâ€t shut down all spinning and, for really critical issues (choosing a college, making aliyah) or ones where you feel particularly helpless (healthcare, taking your car to the mechanic), spinning may simply be part of your decision-making process. Acceptance can reduce some of the frustration when you find yourself stuck. 

If all else fails, try your best to enjoy the ride. After all, even the worst Dumbo ride ends eventually.

I first shared my anti-spinning techniques at The Jerusalem Post.

Picture of merry-go-round in Italy from Ran Berkovich on Unsplash

If you absolutely must travel overseas from Israel these days, beware the PCR testing shuffle. 

In order to keep its citizens safe from Covid-19, Israel has one of the strictest virus testing requirements anywhere. You need to get the nasty nasal swab no more than 72 hours before your flight back to Israel. And thereâ€s another one upon landing at Ben-Gurion Airport. On top of that, the U.S. requires a PCR test of its own before flying out of Israel.

All tests must be paid for by the traveler.

Iâ€m not against testing for Covid. If it can keep us from importing more of the Delta variant, I say bring it on.

But the whole testing system strikes me as a bit of a scam. Less so on the Israeli side, where the instructions are clear, the price is reasonable, and the results come back fast: a 14-hour turnaround costs NIS 45 ($14); NIS 135 ($41) to get results in 4 hours, if youâ€re willing to go to the airport for the test.

In the U.S., itâ€s a whole different kettle of Covid fish.

While there are plenty of testing sites, many of them free, theyâ€re not set up for the kind of 72-hour turnaround Israel needs. (Our experience was in California; other states may differ.)

For example, you can go to most pharmacies to get tested. But they only guarantee results in 3-5 days for Walgreens, 4-6 days for CVS. If you need results in 72 hours, how can you rely on a facility that only promises them in 96 or hours or more? 

This is not just a hypothetical point. We have two friends who were both denied boarding because, in one case, the test results hadnâ€t arrived by departure time (an email came an hour later) and, in the other, our friends†flight was delayed, pushing them out of the 72-hour window.

We regretfully concluded we had no choice but to pay for our test. There was a testing center in Santa Rosa, which is where we were visiting my family, that had a special “travel” package. The cost: $179 per test. 

Ouch.

The “Test Before You Go” booth at the Santa Rosa Plaza shopping mall is a small portable trailer stationed in the parking lot. We arrived at 1 pm but there was no one inside. 

A half dozen people milled around, masked, in the baking hot Northern California sun. The two staff members had, apparently, taken an extended lunch break. I canâ€t begrudge them for eating, but couldnâ€t they at least have posted something online reading, “closed between such and such an hour?” 

The whole process took nearly 90 minutes. I was optimistic that weâ€d get our results in plenty of time before the flight. But 24 hours until boarding, nothing. 18 hours, 14 hours, still nothing.

The results eventually came the night before our flight, but there were complications. Another friend whoâ€d been to the States a few weeks earlier said that it was critical that the form have our passport numbers written on it.

We checked: Ours didnâ€t.

Moreover, the form didnâ€t give any indication of the time the test was taken, only the date. How would the airline know if it had been 72 hours before and not 77 or 80 hours?

I panic posted to Facebook.

“Sometimes the airline staff are sticklers for the right information, sometimes they donâ€t even look,” was the consensus. 

So, would we get an airline representative who was naughty…or nice?

I called Test Before You Go. Could they amend the forms to include our passport numbers and the time? No, there was nothing they could do.  

“But weâ€ve never had a problem,” the customer service representative replied cheerfully. 

Ha, they donâ€t know Israeli bureaucracy, I thought.

My mind began to race. If we got turned away, did we have anywhere else to go for recourse? There was one final alternative: If we got to the San Francisco Airport early enough, we could race over to a separate terminal and do a test with results in 45 minutes. 

The cost: $275. Each.

If we wound up doing that final test, on top of the ones weâ€d already done in Santa Rosa, plus the testing in Israel, we would have spent $1,000 between the two of us – almost as much as our plane ticket!

Wanting to save the money (and not fall into the category of “freier” – Hebrew for sucker – in case the first test forms were deemed sufficient), we opted to hope for the best. 

Still, questions abounded. Why canâ€t all but the priciest of testing facilities guarantee faster turnaround? And why is it so danged expensive? If I didnâ€t know better, Iâ€d think this was some elaborate conspiracy, a cartel dreaming up new ways to milk hapless travelers out of even more of their hard-earned cash. 

The check-in line at SFO was long, giving me even more time to worry. Finally, the Delta representative asked for our negative PCR tests, gave them a quick glance-over, and told us we were good to go. 

That was it. No questions asked. 

I guess we got one of the “nice” ones.

When we were in Santa Rosa, my mother asked me, “Why did you have to travel now, in the midst of a pandemic?” 

“Because I havenâ€t seen you for three and a half years!” I replied.

But unless something unexpected occurs, we will not be traveling again until Covid is truly under control, and we can hopefully avoid the PCR shuffle entirely.

I first shared my thoughts on PCR Covid testing at The Jerusalem Post.

When on the hottest day of last summer our 25-year-old air conditioner finally called it quits, we called Natan, our air conditioner technician. Heâ€d been patient with me as Iâ€d debated over the previous few months the pros and cons of buying Israeli or Japanese: Electra vs. Mitsubishi, Fujitsu compared with Tadiran. 

But with temperatures hitting close to 40, I had no time to procrastinate – we needed a new unit installed without delay.

We opted for the cheaper Electra. Unfortunately, the new machine was fussy from day one.

First, there was an annoying buzz, then a loud rattle, a weird smell and a remote control that periodically switched from cold to hot without warning, then stopped functioning entirely.

I asked Natan to come back to check if there was something wrong with the unit. Maybe it simply needed an adjustment that a smart technician like him would understand immediately. 

Natan was set to come on a Tuesday. That morning, though, he sent me a short but terrifying text message: He was in quarantine after exposure to a Covid-19 carrier. He wouldnâ€t be able to make it.

It was October by this point and the weather was getting cooler. I forgot all about my plan with Natan – that is, until the weather heated up again recently and the familiar old noises were still there.

Natan came last week to pay his long-delayed service call.

“So, did you get corona back then?” I asked. “I assume not.”

“Oh yes, I did!” he replied with a cheer that belied the seriousness of his situation.

As I did my best to empathize with Natan, I simultaneously breathed a sigh of relief. If he had come over that morning as planned and only gone into quarantine afterward, I would have been exposed, too. (This was several months before Israel began its vaccination drive.)

“But you got through it OK?” I continued, doing exactly what I despise when people ask that question rhetorically of me without actually being interested in the answer.

“Well, actually, I was pretty sick,” Natan revealed. “At first I couldnâ€t smell. Then I couldnâ€t breathe. I was on oxygen for a week. I still have symptoms now. If I have to carry heavy stuff up two floors, Iâ€m out of breath.”

Wow, Natan is just 28 years old, a strong guy who had spent a couple of years in the jungles of South America, and he was on oxygen? So much for the mistaken idea that young people donâ€t get severe symptoms from Covid-19.

“My wife also got corona,” Natan added, almost as an afterthought. “I donâ€t know if she caught it from me or I caught it from her.”

“Wait, when did you get married?” I asked. The last time we spoke, Natan was living with his parents in Jerusalem.

“I had just met Noga a few months earlier. When we got corona, it made me question whatâ€s important, what our values are. Weâ€d just survived this awful experience. So, I told her, ‘I had corona. You had corona. Why do we need to wait?†She said, ‘OK, Natan, but letâ€s discuss this again in another half a year.†That same morning, I went out and bought a ring. When I gave it to her, she said, “Hey, I told you to wait!†I said, ‘Take it or leave it.â€â€ 

She took it and Natan and Noga were married just a week and a half later.

Natan showed me some pictures from the wedding on his phone. Bride and groom both looked radiant. (It wasnâ€t from a post-Covid fever, as far as I could tell.)

Covid-19 has upended countless life plans. Some partnered couples have discovered during lockdowns theyâ€re not as compatible as they once thought and have opted to split up. Others, like Natan and Noga, have jumped into relationships for which they might otherwise have taken more time. 

Then thereâ€s the baby boom – or not.

Potential parents “may be foregoing childbearing because the pandemic has forced them to confront their own mortality,” writes Kate Choi on the website The Conversation. After all, how can you bring new life into the world if you “cannot envision a future in which you will be able to provide a loving and secure environment for the child to thrive?” 

Data backs up this trend. Rather than the jokey prediction that bored couples stuck in lockdown with nothing else to do would lead to an increase in pregnancies, the U.S. CDC found nearly 40,000 births “missing” in the final month and a half of 2020, which is also nine months or so from the advent of the pandemic. Demographers predict that the decline in fertility will continue to accelerate, making this the largest fall in births in a century. 

Itâ€s even worse in Europe where 50% of people in Germany and France who had planned to have a child in 2020 said they were going to postpone it. In Italy, 37% said they had abandoned the idea altogether. Spain is reporting its lowest birth rates since records began.

“Having seen how bad the pandemic was, I’m not surprised,” says University of Maryland Prof. Philip Cohen. “But it is still just shocking to see something like this happen in real time.”

Natan and Noga are examples of the opposite trend. When I asked Natan if Covid had affected their own family planning, he responded with a chuckle and a telling twinkle in his eye. 

“Ask me again in a week,” he said.

I first told the story of Natan and Noga for The Jerusalem Post.

Photo by Carlos Lindner on Unsplash.