“I think people haven’t understood that this isn’t about the next couple of weeks. This is about the next two years.”
~Michael Osterholm, infectious-disease epidemiologist at the University of Minnesota
“Everyone wants to know when this will end. That’s not the right question. The right question is: How do we continue?”
~Devi Sridhar, public-health expert at the University of Edinburgh
A week ago, the highest daily Covid-19 death count for the US was more than 2,000. Now it reached over 4,500 over the past day. That is an expected exponential increase. And that is with strong measures like lockdowns taken place across the country. When doing a recount by adding in all deaths now known, China increased their Wuhan deaths by 50%. That is probably true in many places where hospitals were overwhelmed and many died without medical care.
This isn’t to imply China was necessarily being deceptive in covering up the real numbers. For a while now, medical staff in the US have said the same thing about hospitals here underreporting Covid-19 deaths. Healthcare worker deaths may also be higher. In another article, there was shared the photographs and stories of some of these people who died while helping others. I noticed that all of them looked overweight, indicating metabolic syndrome which is one of the main comorbidities.
By the way, one expert talks about five stages for the pandemic. We are in the second phase which is mitigation following the initial containment. After that will be another period of containment while we wait for a vaccine, other treatments, and improved lab testing. That could take us into next year, but the economy will begin to restart during this time.
As communities begin to open up again, the government will have to become very strict, systematic, and targeted in quarantining the infected. Cleaning and disinfection of public places will become a priority, as will the use of protective gear. The fourth stage comes when we have a vaccine, assuming we get one in the relatively near future. The hope is to be in a more advanced situation of containment before a second wave of infections might hit in the fall.
With everything reasonably under control, we end with the last stage where we assess the situation, determine successes and failures, and then prepare for the next pandemic. That means making pandemic preparation central to national security.
This situation, of course, has long term consequences. Donald Trump being president exacerbates this. Even before the pandemic, his actions as leader were driving a wedge between the US and its allies. Many foreign governments were seeing the US as no longer trustworthy and reliable. Trump’s attacking and defunding the WHO, if somewhat deserved, has further undermined US authority — specifically among the G7. The US might never recover its position in the world. This might be the end of US hegemony.
Now most likely Trump will be re-elected. So four more years of more of the same, precisely at the moment when confidence has been shaken in national leadership and the federal government. The main promise Trump made was that he would make the American economy great again, but now it will be in shambles. All his scapegoating will only go so far. While Americans suffer, people will want actions and reform, not snarky blame games for political gain.
For years and maybe decades to come, we might not only be recovering from the pandemic and all that is related to it but a more general sense of decline and malaise, if not further catastrophes that become existential crises. If we are to enter a re-building phase, it’s going to require entirely new leadership in both of the main parties. We can hope for an era of large-scale reform that will transform our society, but it’s hard to see hope at the moment.
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Some articles of interest:
In case you didn’t notice, the cyber-world (and its 3D counterpart, I assume, but we’re not allowed to venture there anymore) is currently a hot mess of Who and what do we believe? This is zero percent surprising. Official agencies have handled COVID-19 with the all grace of a three-legged elephant—waffling between the virus being under control/not under control/OMG millions dead/wait no 60,000/let’s pack the churches on Easter!/naw, lockdown-til-August/face masks do nothing/face masks do something, but healthcare workers need them more/FACE MASKS FOR EVERY FACE RIGHT NOW PLEASE AND THANK YOU/oh no a tiger got the ‘rona!; on and on. It’s dizzying. Maddening. The opposite of confidence-instilling. And as a very predictable result, guerrilla journalism has grown to fill the void left by those who’ve failed to tell us, with any believability, what’s going on.
Exercising our investigative rights is usually a good thing. You guys know me. I’m all about questioning established narratives and digging into the forces that crafted them. It’s literally my life. Good things happen when we flex our thinking muscle, and nothing we’re told should be immune to scrutiny.
But there’s a shadow side here, too—what I’ll henceforth refer to as “lopsided skepticism.” This is what happens when we question established narratives… but not the non-established ones. More specifically, when we go so hog wild ripping apart The Official Story that we somehow have no skepticism left over for all the new stuff we’re replacing it with.
And that, my friends, is exactly what’s happening right now.
The dangerous conservative campaign against expertise
by Michael Gerson
Motivated reasoning is usually just tiresome. At its worst, it can be dangerous. Sometimes drawing the wrong lesson badly obscures a right and necessary lesson. Sometimes the interpretation of a crisis is so dramatically mistaken, so ludicrous and imprudent, that it can worsen the crisis itself.
Such is the case with conservatives who look at the coronavirus outbreak and see, of all things, the discrediting of experts and expertise. In this view, the failures of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have brought the whole profession into disrepute. The judgments of health professionals have often been no better than the folk wisdom of the Internet. The pandemic is not only further proof of the fallibility of insiders; it has revealed the inherent inaccessibility of medical truth. All of us, scientists and nonscientists, are walking blindly on the same misty moor and may stumble on medical insights.
This argument assumes an intellectual fog that is just lifting. Though we are still relatively early in the pandemic, this much seems clear: The medical experts recommended aggressive social distancing to bend the curve of infections and deaths downward. Americans generally trusted the experts. By all the evidence, aggressive social distancing is bending the curve of infections and deaths downward. And places that were earliest and most aggressive in this approach have seen the best results.
This outcome doesn’t strike me as murky. It is difficult to see how experts whose advice clearly saved tens of thousands of lives can be called discredited. It is easy, however, to see how making this false claim might undermine public adherence to their advice, which still matters greatly in the crisis.
Our Pandemic Summer
by Ed Yong
If it turns out that, say, 20 percent of the U.S. has been infected, that would mean the coronavirus is more transmissible but less deadly than scientists think. It would also mean that a reasonable proportion of the country has some immunity. If that proportion could be slowly and safely raised to the level necessary for herd immunity—60 to 80 percent, depending on the virus’s transmissibility—the U.S. might not need to wait for a vaccine. However, if just 1 to 5 percent of the population has been infected—the range that many researchers think is likelier—that would mean “this is a truly devastating virus, and we have built up no real population immunity,” said Michael Mina, an epidemiologist and immunologist at Harvard. “Then we’re in dire straits in terms of how to move forward.”
Even in the optimistic scenario, a quick and complete return to normalcy would be ill-advised. And even in the pessimistic scenario, controlling future outbreaks should still be possible, but only through an immense public-health effort. Epidemiologists would need to run diagnostic tests on anyone with COVID-19–like symptoms, quarantine infected people, trace everyone those people had contact with in the previous week or so, and either quarantine those contacts or test them too. These are the standard pillars of public health, but they’re complicated by the coronavirus’s ability to spread for days before causing symptoms. Every infected person has a lot of potential contacts, and may have unknowingly infected many of them.
The Pandemic Will Cleave America in Two
by Joe Pinsker
When someone dies, there are three ways to think about what caused it, according to Scott Frank, a professor at Case Western Reserve University’s School of Medicine. The first is the straightforward, “medical” cause of death—diagnosable things like heart disease or cancer. The second is the “actual” cause of death—that is, the habits and behaviors that over time contributed to the medical cause of death, such as smoking cigarettes or being physically inactive. The third is what Frank refers to as the “actual actual” cause of death—the bigger, society-wide forces that shaped those habits and behaviors.
In one analysis of deaths in the U.S. resulting from “social factors” (Frank’s “actual actual” causes), the top culprits were poverty, low levels of education, and racial segregation. “Each of these has been demonstrated to have independent effects on chronic-disease mortality and morbidity,” Frank said. (Morbidity refers to whether someone has a certain disease.) He expects that the same patterns will hold for COVID-19.
To begin with, the physical effects of COVID-19 are far worse for some people than others. There are two traits that seem to matter most. The first is age. Older people are at greater risk of experiencing the more devastating version of the pandemic, in part because the immune system weakens with age. Early data from the Centers for Disease Control and Prevention indicate that, in the U.S., the risk of dying from the disease begins to climb at around age 55, and is especially acute for those 85 and older. “I think the pattern we’re going to see clearly is an age-related pattern” of mortality, Andrew Noymer, a public-health professor at UC Irvine, said. (Younger people aren’t invulnerable to the disease, though; the CDC found in mid-March that 20-to-54-year-olds had accounted for almost 40 percent of hospitalizations known to have been caused by the disease.
The second trait that puts someone at increased risk is having a serious health condition such as diabetes, heart disease, or lung disease. These conditions seem to make cases of COVID-19 more likely to be severe or fatal, and the risks rise considerably for older adults who have any of these conditions, Frank told me.
But while everyone ages, rich and poor alike, these health conditions are not evenly distributed throughout the population. They’re more common among people with less education, less money, and less access to health care. “We know these social and economic conditions have a profound effect on chronic disease,” Frank said, “and then chronic disease has a profound effect on the mortality related to COVID.”