May 6, 2025

We are all mad now

Five years on, I reflect on the psychological impact of a global pandemic and how we responded, failed to respond, and have since proceeded.

I came to a realisation some time ago, which is that I have failed utterly to convince anyone else to continue to treat COVID-19 and other pathogens as an ongoing threat and change their behaviour in any way. I have failed to convince my family, I have failed to convince friends, I have been unable even to convince partners to do anything as simple as wear a mask, even occasionally. The only people that I know that do mask are people that already got it, that never stopped, that agree with me that potentially becoming disabled or experiencing brain damage is a thing to be avoided.

Faced with this reality, I have a choice to make. I can double down and become a fundamentalist: refuse to have anything to do with those who won't take any precautions. I can become a hermit and refuse to go out forever more, like the many quietly disabled people that our society has abandoned. Or I can accept my destitution, and come to terms with what that means.

What I think it means is that the collective understanding of what is "sane" and "reasonable" has changed and now includes "it is reasonable to accept an ongoing risk of becoming disabled in exchange for pretending that the world is like 2019." Saying things baldly like this always make them sound bad, but let's admit that being reasonable has always included such ideas as "it's okay if people suffer and die if it's outside our borders" and "our society should have homeless and unemployed people to juice the markets" and "disabled people should just quietly be excluded from participating in society" and "we will accept some people getting killed by cars if we can get to places faster". We tend to misrecognise what "reasonable" and "sane" means.

To that end, I must accept that I am no longer sane, if I ever was. If sanity includes "be okay with getting sick, suffering unnecessarily, and dying", then count me out. But I'm not the only one.

Normative sanity

I'm hardly the first to observe that sanity is normative, that is, based on a cluster of what we consider "normal" behaviour and thought. "Anti-psychiatry" critics have long observed that how a person feels is partially dependent on the world around them and that modern society is hostile to wellbeing. The psychiatric fields have been authorised by society to decide what counts as a diagnosable pathology and to subject those in their care to incarceration and medication should it be considered "necessary". Historically, this hasn't worked out great for marginalised people. In other words, in this regard they frequently act as an extension of the carceral police state. Whether this is acceptable or reformable I leave to others to determine.

These days, the increasingly-accepted biopsychosocial model of health at least nominally takes into account this complex mix of factors. However, this has hardly made a dent on policy or health practices, oriented as it still is barely even taught in medical education.

Psychoanalysis has also received its fair share of criticism, but at least from Lacan onward there was the introduction of the idea that the "healthy" response to the crisis of knowledge was still a kind of symptom that could be analysed, that terms like denial and repression can be applied to "normal people" as much as to clinical analysands.

COVID happened to everyone

In many ways, the pandemic of 2020 was the structuring event of our lives. As diverse as our experiences of the pandemic were, we all experienced the pandemic, and we experienced it in a shared way. Our countries responded, or failed to respond. Some of us were deemed "essential workers" while others were consigned to their homes. Our international supply chains hiccupped and stuttered. We all paid close attention to, or pointedly ignored, the international news as bodies piled up and hospitals approached collapse. And then, after vaccines had been developed and widely adopted, the world collectively tried to change back to business as usual.

I can't be the only one who thinks of my life as being divided by COVID into a before and after. The last five years have felt fundamentally different, even as life pretends to return to how things were. I think this is true for many of us, and I think we were confronted collectively with what Alain Badou called the event, a traumatic rupture of being and appearance that allowed us to encounter some (otherwise invisible) truths.

Traumatic knowledge

The world generally operates on misrecognition. To get by without collapse we have collectively developed a swirling miasma of comforting illusions and shared fantasies. This works great right up until we are confronted with the inevitable difference between this symbolic tapestry and how things actually are. This is what the Lacanians call an encounter with the Real, and it is experienced as crisis, if not actual trauma.

With COVID, we simply couldn't look away from the puncturing of our myths, not for months or even years. And it wasn't simply one fantasy that was challenged, but many, and many fundamental fantasies.

When a person is confronted with this knowledge, they find ways to deal with it without having to really deal with it. We can outright deny the reality of the knowledge, or minimise it, or project it onto something else. Or we can intellectually "accept" it but find ways to disavow or negate it ("I know very well but nevertheless") - even, counterintuitively, by fetishistically obsessing about it. Or we can simply choose not to think about it.

Our bodies belong to society and not just ourselves

Many of us maintain the illusion that we personally "own" our bodies and that we have an individual right to bodily integrity. When there started to be consequences for choosing not to vaccinate or abetting others to avoid vaccination, some people took this very poorly. The reality is that one's body has always been subject to social strictures, but that the sharp end of this in the modern world has mostly applied to the mentally ill, children, or immigrants. Or women.

Our circumstances do not depend on our virtue

Diseases challenge the illusion that we have that if we perform the correct actions, we will be safe from misfortune. While there were things that one could do to reduce the risk of catching COVID (and remember that what these might be was not initially clear), the plain reality was that you might still be unlucky enough to catch it. Contrariwise, you could take all sorts of risks and still avoid infection, for a while at least. There were all sorts of people who insisted that their regular whole food diet and exercise regime and vitamin C supplements were more than enough to minimise the harm that C19 might inflict, and many of them ended their lives under intubation.

It's easy to mock the wellness response, but of course, those of us who chose vaccination and took other precautions were just as tempted to believe that our actions might offer more than just a statistical reduction in our risks. To think otherwise would be to accept that we only have some degree of control over our safety, and it is very limited.

The status quo is ephemeral

Here in the wealthy core of the empire, many of us have been able to maintain the Fukuyama illusion of the end of history. With the end of the cold war and the rise of a neoliberal consensus, while things have steadily gotten worse for many citizens we have been able to take for granted a certain socio-political stability that has allowed even such moments as the Global Financial Crisis to continue to operate aboard an essentially functional platform. We are the sweet summer children who have been unable to imagine this long season ending.

The plain reality is that ours was just one island of contingent wealth and privilege, and that we are in no way immune to war, famine, plague, or pestilence. Global warming is a.. uh... global phenomenon, even if it is unevenly distributed. For countries like Haiti, Darfur, Syria, Palestine, Serbia, Ukraine, the illusion of stability was either never present or has vanished into the past, often for our benefit, or as a result of our sins. These periods of relative stability inevitably end and it is very hard to viscerally understand this.

Reason is a mystification

Many of us believed in the primacy of reason, that great enlightenment tool, as a way to analyse and understand the world. While feelings might act as temporary and local distortions, the interlocking machines of the world operate along the lines of reason and rationality.

Both the international pandemic response and the aftermath showed us quite how little in our world is operated by reason. An astonishing mass of science and technology was developed in short order about COVID and what we should do about it, and yet that seemed to only incidentally factor into policy-making process. We knew within the year that N95's masks were significantly more effective than surgical masks to prevent the air-borne disease, but these were never widely distributed or publicly subsidised. At points this may have been due to supply reasons but notably it did not change when supply was restored.

For those of us who have continued to mask after the COVID emergency was declared over, we have also had to witness how little reason is involved in the decisions of the people around us. Reason is not only not rhetorically convincing, it seems to be barely involved in our decision making processes at all. What to do about this remains an active area of research for yours truly.

We may become the Other at any time

Two groups discovered that their position as respected members of society was only ever contingent: the antivaxxers and the CovidIsNotOver types. Regardless of one's privilege, if we fall sufficiently out of line with the social consensus it will leave us behind. Even the implicit threat of social death turns out to be incredibly powerful, and it takes a very firm sense of self and values to hold strong in the face of the collective position. People that I've spoken to that have reduced their masking practices have confided that the social cost was a factor in this decision. Of course it is! We cannot get by without our community and isolation and loneliness will eventually kill us if we don't find a way to mitigate it.

News for some but not others

Many of these realities were already well understood by certain people; people who belong to marginalised groups, people already made subject to the state's whims, or society's callous cruelty. The chronically ill and disabled knew very well that society would both do the bare minimum to prevent sickness and neglects those unlucky enough to fall ill. Indigenous people understand the violence inherent in the state and the fragility of any existing world. Women know how little the world accommodates their safety needs, and how aggressively it responds to demands for change. None of this was new to these groups. However, COVID acted to revictimise those who were already carrying trauma: the disabled watched like Cassandra as everything that they feared about being further excluded from the world came true.

Psychological responses

Nobody was exempt from having a posture about the pandemic. We had all experienced the naked lunch where we saw exactly what was at the end of our fork, and we all had to find a way to make sense of it.

Conspiracists

For some, the threatened rupture of the comforting foreclosure of their ideas about the world exposed a kind of psychotic crisis. They denied the reality of the pandemic, and that the government could tell them what to do, and plunged into narratives where state officials would be put on trial for their "crimes", where the vaccines were not a mere technology but a sinister instrument of control forced upon the citizens to usher in a new age. They were prepared to stretch and distort the net of their symbolic understanding of the world to avoid facing the contradictions in their systems.

For the rest of us, this looked like an explosion in bizarre conspiratorial thinking. But the foreclosure had been gestating a long time, apparently benign, in family and friends, and it was the pandemic that triggered its defensive, psychotic form.

Special Interests

For others, the intolerable uncertainty of the event triggered a kind of obsessive need to know. People scoured international news and scientific and medical journals in a kind of hysterical avoidance by obsession. If they could understand what was happening, they might be able to respond in the "correct" or "smartest" way. They might not be in control of anything else, but they could know what was what.

The sane majority

The vast majority of people simply wanted the world to "go back to normal", to forget what had been exposed by the pandemic. When the governments collectively decided that this could now be the case and dismantled their pandemic response, the temptation to accept the public message was overwhelming, even if it meant a greatly increased risk of getting sick.

This disavowal was of the neurotic type - it didn't psychotically deny the facts, instead it simply ... stopped thinking about it. Yes, COVID was still around. Yes, the impacts of Long COVID were potentially life-altering. Yes, we have no idea what the long-term consequence of experiencing multiple infections of a multi-organ disease are. No, we wouldn't mask. No, we wouldn't change our pre-2020 habits and practices. No, we wouldn't make any accommodations for the disabled or immunocompromised, even if they were loved ones, even if they were us. Why? Shrug.

Our health systems were exemplary demonstrations of this denial. Reports regularly emerged of lower use of masks in hospital wards than pre-2020, and of medical practitioners insisting on patients unmasking before being granted treatment. We got used to a steady stream of news reports from specialists noting that they were seeing all sorts of unusual and previously rare conditions turning up in greater number and in wider spreads of demographics than before, and no mention of the C word. It was simply a mystery.

The perversion of CovidIsNotOver

And those of us who maintain that COVID is still an important and dangerous pathogen that has a 15% chance per person per infection of causing long-term illness. Who believe epidemiologists when they say further pandemics are coming? Are we sane?

When I am out and about, I would estimate that fewer than 1% of the general public around me wear masks... perhaps much fewer. I admit that my behaviours have changed as a result of my COVID caution, that there are events that I refuse to attend due to their risks. That I feel alienated from friends and family when they act with carelessness. That I monitor the wastewater level reporting. That the wider world's indifference upsets me. Could I not be described as having COVID Anxiety Syndrome? Could it be applied to my friends that also continue to mask?¹ Who gets to decide?

Leaving aside this question, I think that the position that #CovidIsNotOver is also at risk of its own unhealthy tendencies. I think there is a risk of a kind of perverse enjoyment of our condition. We are outsiders, fearless truth-tellers! We have the evidence, we have Done Our Own Research. We won't be surprised by the rise of monkey pox, or bird flu.

We are not better than the people around us, we are not more deserving of good health. We may need to dig into a stubborn spite to continue to do what we think of as the right thing, but we must not fetishize our actions or tie the creation of our sense of self to COVID. We must not become the pervert that enjoys their own symptom.

Where to now?

Nowhere, I guess. The majority response of wanting to simply forget the last five years practically makes inevitable greater severity in future pandemics, the rise of eugenics and social darwinist ideas, the active erosion of our health systems, the acceleration of social breakdown. We were called, and we failed. There is no unfucking this pig. Welcome to the Crumbles. Get to know your neighbours, join a union, learn some skills etc

I wish I could end this on a more upbeat note. I suppose, however, that I must be faithful to the event, to describe what I see as honestly as I can. To prepare myself for the age of the cult. Stay safe out there.