Over the weekend, I read a ton about the virus and found one Atlantic article that covers how we got here and how we can get out of this mess. This post provides numerous excerpts and commentary.
Lack of National Leadership Endangers America
If I have learned one thing in the last month, it is a humbling sense of how little I really understand and how little any of us control our own futures. That is a very troubling combination and one that all of us suffer from right now. It would be so much easier to bear this if our nation were led by Andrew Cuomo or Michelle Lujan Grisham. At least we would understand honestly what they know and what they don’t know. Their sole purpose of communicating with us would not be to look great, spread blame, and self-congratulate themselves.
It is also disheartening to see that at the same time Trump lies, dissembles, and bungles, his favorability ratings soar. Given all he has subjected this nation to, from the Muslim ban in Jan 2017, his racist neglect of Puerto Rico, his caging children at our border, his effort to defund the ACA, to his massive tax bailout for the rich….all of that should be enough, but now he is juggling the lives of literally millions of Americans and his performance is dangerously clownish.
Oh, and he was impeached.
So, given the absence of trust and clarity, today’s post lays out the best understanding I have been able to achieve. Hats off to Ed Yong from the Atlantic as his analysis, excerpted below, has been very useful. Following the analysis, you will find two important videos from Democracy Now! The first is a short piece on how our public health system, starved of funds and resources for decades, has been utterly exposed by the pandemic. The second video lays out what is needed: A Public Health New Deal.
First: Why the US Has Become the New Epicenter
Trump has told us that this pandemic could not have been predicted
A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”The Atlantic: “How Will the Virus End?” by Ed Yong
It Had Been Anticipated & the Reaction Needed Was Clear
To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not. “The Atlantic: “How Will the Virus End?” by Ed Yong
Trump told us, anyone who wants a test, can get a test.
The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases. None of that happened.The Atlantic: “How Will the Virus End?” by Ed Yong
Despite Trump’s claims about his excellent team and their having the virus under control…
Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,” said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”The Atlantic: “How Will the Virus End?” by Ed Yong
London study offers a less optimistic view than what we hear from Trump
A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one. By the end of the summer, the pandemic will have directly killed 2.2 million Americans, notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of heart attacks, strokes, and car accidents. This is the worst-case scenario. To avert it, four things need to happen—and quickly. “The Atlantic: “How Will the Virus End?” by Ed Yong
Four Things We Must Do
Despite our most important priority being an adequate supply of Personal Protective Equipment, Trump continues to tell states they are on their own.
The first and most important is to rapidly produce masks, gloves, and other personal protective equipment. If health-care workers can’t stay healthy, the rest of the response will collapse. “The Atlantic: “How Will the Virus End?” by Ed Yong
This is not a solution, but it will buy us badly needed time, because if our health care workers become infected we will not have the personnel to care for the ill.
Donald Trump could use that time to invoke the Defense Production Act, launching a wartime effort in which American manufacturers switch to making medical equipment. But after invoking the act last Wednesday, Trump has failed to actually use it, reportedly due to lobbying from the U.S. Chamber of Commerce and heads of major corporations.The Atlantic: “How Will the Virus End?” by Ed Yong
Instead, Trump has twiddled his thumb and stated that we are not going to employ socialist strategies when his pals the CEOs can make profits from the pandemic.
What we need most is a nationally coordinated strategy, something Trump refuses to lead
Some manufacturers are already rising to the challenge, but their efforts are piecemeal and unevenly distributed. “One day, we’ll wake up to a story of doctors in City X who are operating with bandanas, and a closet in City Y with masks piled into it,” says Ali Khan, the dean of public health at the University of Nebraska Medical Center. A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.The Atlantic: “How Will the Virus End?” by Ed Yong
The Defense Logistics Agency could also help with a broader testing strategy
This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests. Those tests have been slow to arrive because of five separate shortages: of masks to protect people administering the tests; of nasopharyngeal swabs for collecting viral samples; of extraction kits for pulling the virus’s genetic material out of the samples; of chemical reagents that are part of those kits; and of trained people who can give the tests. Many of these shortages are, again, due to strained supply chains. The U.S. relies on three manufacturers for extraction reagents, providing redundancy in case any of them fails—but all of them failed in the face of unprecedented global demand.The Atlantic: “How Will the Virus End?” by Ed Yong
Unfortunately, according to a different report from the NY Times, the testing strategy is a false choice as the extraordinary international demand for kits and solvents needed to complete a test are likely to run out in two weeks.
The second hard truth is that at this stage, any public health response that counts on widespread testing in the United States is doomed to fail. No one planned on the whole world experiencing a health conflagration of this magnitude at once, with the need to test many millions of people at the same time.
A third hard truth is that shortages of personal protective equipment — particularly N-95 masks — for health care workers will only get worse in the United States as global need continues to rise precipitously. There is no point holding out the false hope that the Defense Production Act will save the residents of the United States. Not enough manufacturing activities can be converted to produce masks in a matter of weeks. You can’t turn engine-making machinery into an N-95 respirator assembly line just because you want to.NY Times: ” It’s Too Late to Avoid Disaster, but There Are Still Things We Can Do”
I think one of the hardest aspects of navigating the coronavirus is the absence of credible information. Trump is the primary promulgator of fake realities, but even when relying on generally credible news sources one report will say that there is no evidence that you can catch the virus from mail packages or from groceries and another articles tells you to let your mail sit for 2 days or wash off your prepared food packaging with an alcohol or bleach-based disinfectant.
In the competing quotes above, two doctors offer differing views on how we can use testing resources. With so much at stake it can be dispiriting in the extreme to essentially hibernate, only venturing out to bring in delivered groceries, and then to wonder if you need to empty and de-virus your fridge because there are a million coronavirus cells on the head of pin and some of them could be on the plastic bag holding your romaine lettuce. In any case, Yong has promised to tell us how this all will end and we aren’t there yet. To continue:
These measures [strategic testing] will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing. Think of it this way: There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission. “The Atlantic: “How Will the Virus End?” by Ed Yong
And here at least, there appears to be complete concurrence among the public health community: Social-Distancing. But for these three strategies to achieve maximum impact, it is essential that whatever is done be coordinated centrally and this is something that Trump has been reluctant to do, leaving it to states to fend for themselves.
In these moments, when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need. The importance of social distancing must be impressed upon a public who must also be reassured and informed. Instead, Trump has repeatedly played down the problem, telling America that “we have it very well under control” when we do not, and that cases were “going to be down to close to zero” when they were rising. In some cases, as with his claims about ubiquitous testing, his misleading gaffes have deepened the crisis. He has even touted unproven medications.The Atlantic: “How Will the Virus End?” by Ed Yong
How Much Is At Stake & How Much Can Social-Distancing Help? Quite a damned lot, actually.
A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care. There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.The Atlantic: “How Will the Virus End?” by Ed Yong
Making Matters Much Worse: America’s Unique Affection for Individualism
Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs. Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells.The Atlantic: “How Will the Virus End?” by Ed Yong
Decades of Neoliberal, Small Government Policies Have Left Us Naked
When an administration prevaricates on climate change, the effects won’t be felt for years, and even then will be hard to parse. It’s different when a president says that everyone can get a test, and one day later, everyone cannot. Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.The Atlantic: “How Will the Virus End?” by Ed Yong
How Does It End & What Could Be Next?
With Our System Exposed, New Models Will Emerge
Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.The Atlantic: “How Will the Virus End?” by Ed Yong
Ron Klain, the Ebola czar offered this view of what could occur in a post coronavirus world.
The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”Ron Klain, the former Ebola czar
As Yong reaches the end of his piece, he lays out one path our nation may take in November — Trump distracts the public from his own mistakes, turns China into the perpetrator of the virus, lauds himself as our savior, enough Fox-informed drones vote for him, Trump gets a second term, and I give up. Literally.
But Yong closes with a far more optimistic outcome, where America penetrates Trump’s lies and recognizes that an entirely new path must be forged.
One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.
In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month. “The Atlantic: “How Will the Virus End?” by Ed Yong
To read the entire Atlantic report, click here. It is extremely thoughtful and well written and I only captured a fraction of what was reported. To review the NY Times’ “It’s Too Late to Avoid Disaster, but There Are Still Things We Can Do” click here
So much at stake, indeed more is at stake than we could have ever imagined. Until now. And so, I leave you with two important videos, both from Democracy Now! The first examines just exactly how our public health system has failed us….and why.
Total System Failure: Democracy Now!
On Monday, Democracy Now! shifted gears and laid out how a Public Health New Deal could help America be far better prepared for the next pandemic, while vastly improving our capacity to effectively address so many chronic conditions that disproportionately impact Americans.
We Need a Public Health New Deal: Democracy Now!
We’ll do our best to help you sort out the news as it unfolds. And we will be using our Facebook page to offer more coverage of coronavirus and other social, political and environmental news. Yesterday, we posted on how the virus is now headed for the farm belt and another piece on how federal officials misled State health leadership causing critical delays in interventions. Click here to get to our Facebook page.
Paul & Roxanne