Monday, April 20, 2020

OUR PANDEMIC(S)

OUR PANDEMIC(S)

We are in the midst of a pandemic. 

As of today, on a worldwide basis, over 2.4 million people have been diagnosed with coronavirus or Covid-19.  Of those, approximately 636,000 have recovered, leaving about 1.6 million active cases. More than 166,000 people have died.  In the United States, there are approximately 764,000 cases, 652,000 of which remain active.  Over 40,000 people have died here.  The United States leads the world in diagnosed and active cases and in the number of deaths. In the most-infected state -- New York --  242,000 cases have been diagnosed and almost 14,000 have died.

In Europe as a whole, their number of diagnosed cases exceeds ours, as do their number of deaths. But Germany, which did early testing, a form of contact tracing and quarantining, has kept its death total (4,600) low relatively speaking and on average has also had far fewer cases than the worst states in Europe -- Spain and Italy.  For the same reason, South Korea had similar success, as has Singapore. The latter was truly effective, having turned testing and tracing into a  fatality rate of less than 1%.

In New York, the number of new cases appears to have flattened, as is the case in California and Washington state.  This does not mean there are no new infections or that the contagion has been contained.  It does mean that, barring resurgence, there will be enough hospital beds to take care of patients that emerge going forward.  And it also is evidence that social distancing and quarantining works.

There is a growing concern that the economic devastation from the pandemic will exceed the physical devastation.  Over 22 million Americans are now unemployed, the rate having gone from a low of 3.5% to estimates now putting it at levels of the Great Depression in the 1930s (or over 20%). The recently passed stimulus package provides up to $1200 to individuals; the amount declines as your annual income closes in on $100,000 and ends at that level.  The stimulus package also provides $350 billion in loans cum grants to small businesses as so-called paycheck protection; last Thursday, however, that fund was exhausted and no new applications could be accepted.  The package contains $150 billlion for state and local governments, $100 billion for hospitals, $58 billion for commercial airlines, over $400 billion for the Federal Reserve, and $20-30 billion each for farmers, ranchers, schools  and food programs.

Despite the enormity of the package, it is widely considered inadequate to the ultimate need.  Brandeis Prof. Robert Kuttner estimated that we would need a package on the order of 25% of GDP to get throught the crisis, which would require roughly quadrupling the current assistance.  He bases this on what it in fact took to catapault America out of the Great Depression. NY's Gov. Cuomo has already explained that the amount his state is getting under the current package is nowhere near what has been and will have to be spent.  And the jockeying on Capitol Hill has already begun around talk of additional legislation, with Republicans holding back and Democrats demanding more.

Part of the calculation, of course, is that the amount of ultimate government assistance necessary to the task will inevitably depend upon when America can get back to work and what that will look like whenever it happens.  The administration has proposed a set of guidelines that would implement re-opening in three phases, each tied to satisfying so-called "gating criteria" beforehand.

In Phase One, schools, daycare facilities, camps and bars would remain closed, as would visits to hospitals or senior living facilities, but  large venues like restaurants, movie theatres, sport venues and churches could operate with "strict distancing protocols", as could gyms. In Phase Two, the closed facilites (schools, daycare, camps, bars) reopen, the last with "diminished standing room occupancy", and the strict distancing protocols become "moderate" in the large venues.  And finally, in Phase Three, the distancing requirements become "limited" and employers regain full access to their worksites.

The gating criteria require that cases decline for continuous fourteen day periods prior to entering each phase.  Under the plan, states are responsible for testing and contact tracing of their populations,  sufficient equipment (ventilators, PPE, etc.), sufficient hospital capacity (defined as the ability to treat "without crisis care"), the "ability to surge ICU capacity", and "robust" testing for at-risk health care workers.  States must have  plans to protect workers in critical industries, those in high-risk facilities like nursing homes, and employees and users of mass transit.  They must also be able to "monitor conditions and immediately take steps to limit and mitigate any rebounds or outbreaks by restarting a phase or returning to an earlier phase."

None of the states hard hit by the pandemic have anywhere near the ability to do the testing and tracing required to determine on a continuous months long basis that cases have declined, that no new infections have emerged, and that no resurgent outbreak has occurred, the latter of which is almost certain in the event that any "phase" is entered into prematurely or the virus itself is seasonal.  In addition, and as has been demonstrated throughout the pandemic, the states hardest hit have regularly confronted shortages in needed protective equipment.  Though the predicted run on ventilators never materialized, that was only because governors imposed stay-at-home orders and social distancing protocols that flattened the curve of new cases and lessened the run.

The policy is quintessential Trump.  It is high on optics but otherwise shallow and insufficient if the goal is to actually solve the problem and re-open the country without renewing Covid-19's lease on life.  The key to implementing the policy is testing and contact tracing and Trump has decided that this must be the responsibility of the states.  The states, however, have told him they do not have the capacity to do the job. The result, therefore, will be a swiss-cheese approach where states decide to go forward (or not) based on incomplete data in the face of the apocalyptic twins of physical disease and/or economic depression.  To avoid the latter, they will risk the former, or vice versa.

The policy is also quintessential Trump in that it allows him to claim credit and apportion blame without accepting any responsibility.  If a state reopens and avoids a resurgence, he can claim his guidelines were the solution.  If, however, a state reopens and the coronavirus is resurgent, he can claim the state lacked the resources they should have had in place beforehand.  Similarly, if a state does not reopen or others reopen faster, he can claim that the resulting economic hit is also the responsibility of governors who did not adequately prepare.  None of his claims will be true because the lack of preparedness, and in particular the absence of sufficient testing capacity, was itself caused by Trump's early denial that there was any problem.

But truth never matters to him. 

Neither in his personal life.

Nor his professional one.

Meanwhile, his absurd show goes on.

Early last week he announced, czar-like, that he was the public offcial with the ultimate authority to determine if and when any state could relax its emergency protocols and return to work.  This was nonsense, essentially because it is not the law.  On Thursday, however, when he announced the guidelines, he reversed himself, telling the nation's governors that they "would call the shots" on  re-opening.  Unfortunately, he also made it clear that the states themselves would be responsible for insuring that there was adequate testing and then claimed, falsely, that such capacity in fact existed. 

Finally, on Friday, as far-right activists in recent weeks sponsored rallies in a half dozen states demanding an end to stay-at-home orders, Trump launched his all caps "liberate" tweets, seen by the protestors as a Presidential call to arms.  His "LIBERATE  MINNESOTA" tweet that morning was followed in the afternoon by a few hundred pro-Trump protestors packed tightly on the sidewalk outside the governor's residence yelling "USA". Underscoring their demand that the quarantine end, one protestor hoisted a sign that said "If ballots don't free us bullets will."

The call to violence was not unique. 

A QAnon conspiracy theorist with 50,000 twitter followers called for armed insurrection after Trump's liberate tweets, as did a thousand other tweets from a host of on-line extremists. A comment to Trump's "LIBERATE VIRGINIA" tweet said the time was now for insurrection to "earn our freedom . . . like our forefathers did in 1776."  And one of the organizers in Minnesota specifically predicted that "violence . . . will happen. People in our culture are not designed to obey these kind of orders."

It's not entirely clear what specific "orders" annoy them to the point of armed insurrection. The stay at home requirements incident to quarantining obviously qualify, but it is not clear that distancing, masks  and bans on group gatherings of more than ten are not equally offensive.  The Minnesota protestors who crowded onto the sidewalk outside the governor's house were more than happy to shout their epitaphs sardine-like from the street, their mouths unmasked,  and the "culture" whose "design" is  at odds with the orders they loathe includes baseball and football, where packed stadia will become petri dishes of death if opened too soon.

Trump knows he is validating these groups and that they are essentially advocating a return to the status quo ante either immediately or without regard to whatever science may tell them.  But they, like Trump, have no respect for government or science, and he is willing to feed them the red meat they need to remain loyal.  Apart from last week's "guidelines", his signature moves on Covid-19 thusfar have been to blame China (which deserves it), vilify the World Health Organization (WHO) (which doesn't), and attack Democratic governors for the testing and equipment  failures of the government Trump himself is supposed to be running. To that trilogy he has now added inciting/supporting the nut-job and violent far-right.

My college friend and long-time ABC television journalist John Donvan recently noted that, unlike past crises such as 9/11, Covid-19 was not uniting America.  He's right.  There's been no rally round the flag effect.  Trump's guidelines come across as buck passing, fourteen pages of putative instructions to individuals, employers and states that cannot be implemented absent testing capacity the federal government could and already should have put together but hasn't. His daily (and lengthy) press conferences are campaign performances where he routinely attacks journalists, disclaims responsibility, and lies. 

And the citizenry, not surprisingly,  has retreated to its respective red and blue silos.  

America is a nation of myths.

There's the founding myth in which We the People rose up as a whole to throw off the yoke of British colonialism.  There's the governing myth in which the people democratically determine their fate in a land where all are created equal.  There's the economic myth where rugged individuals get ahead in a free market whose only limitation is one's capacity for work. And there's the cultural myth of exceptionalism where we are uniquely moral beacons of progress and virtue.

Each of these myths has within it a kernel of truth. 

But only a kernel.

18th century colonists did declare independence and then wage a war of attrition where British exhaustion and the timely arrival of the French fleet in the Chesapeake Bay turned the world upside down  at Yorktown. But on the way there, and at any one time, somewhere between 40 and 70 per cent of those-to-be-liberated were either rooting for the other side or did not care who won.  Similarly, the famous Declaration did declare as "self-evident" the "truth"  that "all men are created equal". But its authors owned slaves or prospered in economies that relied on slavery at some level, and when it came time in 1787 to create a government, that corruption was more more than respected; it was accepted. 

Going forward, for every rugged individual who spawned the likes of Carnegie and  Rockefeller, Jobs and Gates, there was the pauper, the wage-slave, the unemployed and the uninsured.  And for every moral beacon, every Gettysburg, every moon shot,  there was an abject moral failure, a Cherokee Trail of Tears, a Klan, a coup, a casting couch.

Sometimes our myths are confirmed.

Sometimes they are are refuted.

Which, unfortunately,  is what we are doing now.

Because red and blue, the unbridgeable division in which we now live, the one which our President has decided to actively advance as his only available avenue to reelection,  the one that makes it impossible to act rationally because we are too busy arguing irrationally, is its own pandemic.  

And it's killing the founding myth of unity, the governing myth of equality, the economic myth of prosperity, and the cultural myth of moral exceptionalism.

There truly is no Republican or Democratic approach or solution to this Covid-19 crisis. The notion that we have to be guided by science and data, and that we have to hang together lest in Franklin's prescient warning we wind up doing so separately, is inarguable.  

Dumb and divided has never won a war.

And any effort to play regions or states off against each other, to force them into a price-gouging competition  for scarce resources, to fail to unleash and exploit the power of the federal government to provide the tools neeeded to manage and conquer the crisis, or to set things up so that the finger of blame can be pointed at one or the other party for any death or depression that may ensue . . .

Will not win this one.




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