Title text: When you get to hell, tell smallpox we say hello.
Megan and Cueball are discussing the possibility of SARS-CoV-2 eventually becoming "another circulating common cold virus". This is considered to be a serious possibility, as a combination and vaccines and acquired immunity cause most people to have some degree of immunity as they age. This is particularly likely because SARS-CoV-2 poses little risk to small children, and if most people are infected with it in childhood, they'll likely be immune as adults. Multiple other coronaviruses are common in the human population, and fall under the category of "the common cold", causing only minor and temporary symptoms, with little serious risk for most people.
If SARS-CoV-2 does transition to being a minor disease, there will be little reason to continue focused eradication efforts, because the ongoing harm will be too little to justify such efforts. It's extremely difficult to wipe out a virus all together, as it requires every human population to be either isolated from the disease, or vaccinated until herd immunity is achieved. There are only two viruses which have been totally eliminated in the wild: Smallpox and rinderpest, and rinderpest infects only cattle and other ruminants, not humans. The elimination of smallpox was one of the greatest public health accomplishments of the 20th century, and resulted from an aggressive and ambitious global vaccination effort. Smallpox is now considered to be extinct in the wild, with only a small number of samples still preserved in government labs.
Where diseases continue to be dangerous, ongoing global efforts are made to eliminate them entirely (polio, measles and rubella are currently targets of such programs). If a disease ultimately becomes more or less harmless, its elimination is less of a priority.
The joke of this strip is that, in the aftermath of the COVID-19 pandemic, Megan feels so much rage and ill-will toward the disease that vaccination efforts are no longer only a matter of protecting health, but an expression of hostility toward the virus. Her argument is that, even if global elimination efforts are no longer justified by the danger of the virus, they should be pursued "out of spite". Like many other strips in this series, the characters tend to anthropomorphize the virus, treating it as an intelligent and sentient enemy, rather than mere force of nature. Given that mindset, the idea that the virus could cause so many deaths and so much disruption, and then continue to live ('live') without consequence, would upset many people. Cueball agrees with her perspective, approvingly referring to it as "revenge". Cueball has also previously shown a merciless attitude towards endemic infections, even those that aren't particularly deadly, and so the idea of eliminating one entirely would probably appeal to him on its own merits.
The title text refers to the aforementioned extinction (in the wild) of smallpox. This is the type of line one might see in fiction, delivered to someone who is about to be killed, taunting them about the death of one of their friends or associates. The line treats the virus like a villain in an action movie, and revelling in the fact that we're finally going to kill it.
- [Megan holding a hand up, palm held out, is walking with Cueball.]
- Megan: Even if the threat eventually fades, thanks to vaccines and stuff,
- [They walk on, both with their arms down.]
- Megan: And it becomes just another circulating common cold virus,
- [Megan holds her hand up in a fist, while Cueball hold his hand to his chin as they walk on.]
- Megan: I think we should pursue global eradication of SARS-CoV-2 out of spite.
- Cueball: Revenge-based public health policy. I like it.
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