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The pandemic and the economy seem to be getting better and worse at the same time.

It’s simultaneously true that the omicron wave of COVID-19 seems to have peaked or be peaking—promising some relief—and that good news of this kind is unusually hard to take in during what can only be described as a horribly scrambled time for Americans trying to navigate these choppy waters. The issue isn’t just that messaging about the pandemic has been egregiously mixed; there is a very real sense that different parts of the country—hell, different demographics within it—are occupying entirely different realities. This is clearest in online medical forums, which make for harrowing but instructive reading even at the best of times. But what’s struck me recently, as I’ve lurked these spaces where medical professionals, from doctors to nursing assistants, gather to discuss their jobs, is less the medical insight (or the usual venting about the profession) than the psychological record they jointly create of this particular and peculiar moment when the pandemic is simultaneously resurging and being treated as largely over. Like a canary in the coal mine, the forums are registering the most intense and high-stakes version of a dissonance much of the country is feeling too on some level. People are grappling with a fundamental gap between what should be happening and what it feels like actually is. “Does anyone else feel like they are living in an alternate reality recently?” one Reddit post in /r/medicine from a couple of weeks ago reads.

Professionally, I am seeing cases rise in a way I’ve never seen or could even imagine before. … There are very few, if any, ICU beds open in my city right now. I talk to the CMOs from the hospitals in my jurisdiction. They tell me they are in a dire situation. They’ve never been so overwhelmed. They currently have over 1,000 staff out. They are rescheduling elective procedures and closing their outpatient clinics 1 day a week to pull doctors and nurses.

But none of this matches what I am seeing when I leave the office. I go to the grocery store and maybe half of people are wearing masks. I drive past the bars downtown and it is business as usual. My friends ask me, what am I doing for New Years Eve?

The replies confirm that this feeling isn’t unusual. “Honestly, I felt the same way when I came home from spending a year in Afghanistan looking for road side bombs,” one user replies. “It’s like I’m reliving that same paradox.”

It’s true that medical professionals are experiencing an unprecedented level of alienation from their communities. They’re being called murderers or monsters by sick patients who claim that the nurses and doctors are part of a huge conspiracy to control or misinform or harm the public. Hospitals are badly understaffed and it’s getting worse; people are burning out and leaving. Those who remain are being subjected to conditions that are increasingly untenable.

But what the medical community is experiencing is an extreme version of what might be recognizable to many of us: the sense that competing realities are simultaneously asserting themselves. This makes existing right now an exercise in the uncanny. It is easier to agree that things are bad than it is to acknowledge that matters are in some respects improving. That no one is quite sure how or on what scale those are improvements are taking place has generated a moment of unusual ambiguity in which no account of the present quite adds up or makes sense.

This is particularly true of the pandemic: The omicron variant of the coronavirus was characterized by many experts as “mild” compared with delta even as thousands of flights were canceled across the country during the holiday season due because of how wide and how quickly the variant was spreading. These are not contradictory facts, but they feel like they’re in conflict; the optimism of the experts clashes with startling realities on the ground. Rates of death have not kept pace with record-breaking hospitalizations, which is good news, but try to tell that to overwhelmed staff, or to patients stuck with 36-hour wait times in emergency rooms across the country. And while the president’s comments about the unvaccinated being at higher risk are undoubtedly true, it confused people that vaccination and boosting—while still significantly reducing the risk of severe disease and hospitalization—did not prevent infection or transmission as many hoped it would, and as occurred did with previous variants. These apparent contradictions are destabilizing to conventional wisdom (and what little there is of that does not mutate with the same facility as a virus).

And so, conclusions that seemed obviously correct before—in favor of masking, lockdowns, quarantines, school closures, or keeping workers sick with COVID away from workplaces—are being hotly debated now in ways they weren’t then, because we’re in a moment when things are almost incomprehensibly better and worse. The highest infection rates of all time are coinciding with the greatest availability of medicines to combat COVID, from vaccines to boosters to new treatment pills. That has people arguing that it makes sense to behave as if the pandemic is over, or has at least become endemic, even as overwhelmed hospitals are truly on the brink of collapse. Americans are told that frequent testing is crucial to being able to do normal things, but the administration until recently scoffed at its role in providing them, and their availability didn’t allow places like the U.K. to avoid the omicron surge.

This strain of confusion isn’t confined to public health. The United States’ economic recovery in 2021 was correctly hailed as stronger and faster than almost anywhere in the world, and the stock market rose 27 percent despite the pandemic even as the unemployment rate fell. The historic pandemic stimulus made a big dent in the U.S. poverty level. On paper, these indicators of prosperity have made meaningful differences in people’s lives. But they are also in competition with what Americans see on the ground, including high gas prices and global ramifications of the supply chain crisis, including grocery store shelves starting to go bare once again, a shocking uptick in car prices, and inflation. People have more money but they feel worse off—in an early January CNBC/Change Research poll, 60 percent blamed Biden for his handling of the economy.

Schools are once again in an uncertain place. So are colleges. The holiday supply chain seemed to have mostly held up, and yet grocery stores are now straining again. Returns to the office have been deferred. The aggressive resumption of normalcy has proven to be terrible fragile and the threads that make things feel normal keep snapping. No one’s policies or approaches to the problem match and the results are piecemeal and baffling. No one can chalk up a clear win. Democrats passed infrastructure and have stalled on social and climate investment. Donald Trump made a show of supporting vaccinations and boosters, a move seen by many of his supporters as betrayal.

The inevitable, inescapable question always arises: Who is to blame? Whose fault is it that supply chains are still failing? That inflation is on the rise? That COVID is mutating? That vaccines aren’t responding to this version the way they did to another? When things go haywire in this particular way, explanatory scaffolding collapses, and the complexity multiplies beyond our ability to process. One effect is that any real consensus, even among people who formerly agreed, is failing fast. People in various circumstances, fed up by two years of trying to do the right thing only to have pandemic persist, are turning on each other. Even the bitter comforts of tribalism, which at least offered a sense of unity within a larger fractured culture, are dwindling. Americans of all convictions are so worn down by the murk and the paradoxes and the confusion over what the right thing to do is that it’s no wonder that the country feels—ideologically, philosophically, physically—lonelier than ever.

Read More: The pandemic and the economy seem to be getting better and worse at the same time.

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