"Our understanding of COVID often suffers from a linguistic determinism. The words we use encourage a binary conception of viral threat: we are in an acute state of emergency—a pandemic—or we have entered a long-awaited, tractable endemic phase. But, of course, an endemic pathogen can be all kinds of bad. Tuberculosis has infected humans since at least the Stone Age and is the thirteenth leading cause of death in the world, killing a million and a half people a year. COVID seems to have settled into its own punishing form of endemicity. Even without a major surge this past winter, it has killed some forty thousand people in this country so far in 2023 and is on track to have taken tens of thousands more lives by the end of it. Last week, the Centers for Disease Control and Prevention announced that COVID was the fourth leading cause of death in the U.S. in 2022. This year, it will likely remain a top-ten killer. But, because the toll is concentrated among older and medically vulnerable people, it quickly recedes from the public consciousness."