In covid-19′s dismal fourth wave, some things haven’t changed. Vaccination still dramatically reduces the chance of serious disease. Mask-wearing and distancing are still effective tools in fighting an easily aerosolized pathogen.

But some of the pandemic’s moral mathematics have become harder to figure. Because of the delta variant, more people who did the right thing and took the vaccines are testing positive for covid (though they are far less likely to become dangerously ill). Whole nations that did the right thing — such as Israel, which has vaccinated as much as 78 percent of its population age 12 and older — are seeing new cases rise. The delta virus falls on the just and the unjust.

The gradual fading of vaccine protectiveness highlights and accentuates global inequities. Who in wealthy countries should get a third dose before health professionals and the vulnerable elderly in poor countries get their first? Are we left with a brutal vaccine nationalism as far as the eye can see? Will such nationalism be punished by new monsters that emerge from the global genetic churn?

In a few areas, however, the fourth wave has brought greater clarity. As covid’s third wave seemed to be fading in the spring, and the promise of normality was in the air, Republican governors Ron DeSantis of Florida and Greg Abbott of Texas came out strong — through legislative measures and executive orders — against masks and vaccine mandates. The issue had a growing symbolic power among right-wing populists, who are always searching for ways to operationalize their contempt for government. Accusations of covid-related coercion now constitute another front in the culture war. DeSantis and Abbott took full political advantage.

But then Florida and Texas led the resurgence of covid-19 in the United States, filling hospital beds and intensive care units across those states. Cities, school districts, hospitals and businesses naturally want to take measures such as mask and vaccine mandates that are equal to the severity of the outbreak.

What was supposed to be a costless, largely symbolic political commitment has led DeSantis and Abbott to a particularly vivid moral choice. Should they allow local government and community institutions to save people from harm? Or should they actively prevent those measures to appease a radical faction of their party?

The decision, it seems, wasn’t close for them. There is no public evidence of inner turmoil. If they had defied the populist base of the Republican Party, their careers (and presidential prospects) would have been as good as over.

Now these governors have a problem, as does their party.

The challenge for the governors is that public health is not the same as other issues. Their actions will lead, directly and predictably, to deaths in their states. This constitutes a betrayal of public trust so grave — a violation of moral responsibilities so depraved — that I am not sure there is a word for it. Selling the lives of your fellow citizens to a foreign power is treason. What is the proper description of selling the lives of your fellow citizens to a crazed political interest group?

These governors are attempting, of course, to take refuge in principle — the traditional right not to have cloth next to your face, or the sacred right to spread nasty infections to your neighbors. But such “rights” talk is misapplied in this context. The duty to protect public health during a pandemic is, by nature, an aggregate commitment. Success or failure is measured only in a total sum. Incompetence in this area is a fundamental miscarriage of governing. Knowingly taking actions that undermine public health is properly called sabotage, as surely as putting anthrax in the water supply.

So maybe that’s the right word: saboteurs.

The problem for the Republican Party is that one of the central demands of a key interest group is now an act of sociopathic insanity. Some of the most basic measures of public health have suddenly become the political equivalent of gun confiscation. It’s as if the activist wing of the GOP decided that municipal trash pickup is a dangerous socialist experiment. Or chlorine in public pools is an antifa plot. There can be no absolute political right to undermine the health and safety of your community. Or else community has no meaning.

Public health can’t be reasonably understood in culture war terms. There are no winners and losers here — because all of us, together, either win or lose. This is one area — perhaps the primary area — where we are one people. But it also shows how sick souls can result in sick and dead bodies.