Good morning,
As we continue to live through this crisis, I have been reflecting on what can be done, both collectively and individually. Two weeks ago I wrote an essay entitled “Fear Is the Greatest Danger,” which can be found on my web site:
https://ameaningfullife.org/uncategorized/fear-is-the-greatest-danger/
The following is a continuation of those thoughts. It is quite long, so dive in if you want to be stimulated to think through this historic time in our history for yourself, or read sections as you can to add another perspective to your own emerging thoughts. There is no one right perspective or one right set of answers – we are all called upon to try to understand and solve this world crisis together.
The Large Picture
As we enter the fourth month of this worldwide crisis, we must come to terms with the fact that it is not only a medical crisis, but a societal, cultural, economic, and moral crisis as well. The effects of what is going on, and the decisions we are making, will have profound consequences on our lives for many years to come. Although it is hard, we must attempt to shift our gaze to the large picture as we make our decisions and live through, as best we can, this dramatic time.
One thing we must accept is that, given where we are now, the illness and resulting deaths from this pandemic will be spread out over at least 18 months. All our planning has to be in relation to that kind of a time frame. We must think about how to function as a country for many months as we deal with this disease.
One misleading issue that has been widely discussed is the seeming tradeoff between lives and money. This is a false choice. This crisis is not a matter of lives versus money. Many lives will be lost to this disease no matter what we do. There is no good outcome any more – it is a matter of trying to come up with the best overall response that takes all factors into consideration. All our actions must take into account the longer-term effects of this crisis – including all the lives that will be harmed through the destruction of jobs, businesses, communities – and perhaps even our whole way of living – if we react in the wrong ways. These dangers must be major factors in all our considerations.
For this and many other reasons, a measured response taking all factors into account is critical, not only for saving the economy and jobs, but for saving lives in the long run. A measured response will reduce the number of lives that will be disrupted and destroyed as more and more people lose their income, can’t buy food, abuse the people around them out of frustration, commit suicide because their lives are devastated (the suicide hotlines have seen a flood of new calls), start stealing to pay for food (or drug habits), give up on life and just die out of loneliness and despair, and on and on. A 2015 report by Julianne Holt-Lunstad, a neuroscientist and psychologist at Brigham Young University, concluded that “loneliness increased the rate of early death by 26 percent; social isolation led to an increased rate of mortality of 29 percent, and living alone by 32 percent – no matter the subject’s age, gender, location, or culture.” Tyler Norris of the Well Being Trust suggests that every one-percentage-point increase in unemployment leads eventually to a 3.5 percent increase in opioid addiction. And the secretary general of the United Nations has expressed alarm at a “horrifying global surge in domestic violence.”
We must also come to terms with the fact that feelings of fear intensify, and sometimes cause illness. A measured approach will allow us to build up our medical system as quickly as possible to deal with the pandemic over the months and years it will be with us, while at the same time allowing us to get beyond the fear. It will allow us to begin to live our lives again and rebuild our economy before it is beyond repair. No one has a whistle to blow to signal when we have reached a safe place from this enemy. Rather, it will be attacking us for at least 18 months, and our response has to be strategic, based on longer-term thinking. It is a medical issue, but it is much more; it is a societal issue as well. There will not come a time for many months, perhaps years, when the medical community can say we are “all safe.” In this situation, we must realize that many decisions are not medical decisions alone.
If immediate risk to life were the only issue to be considered in making our decisions, no one would ever ride in a car or an airplane again. They are dangerous. People die. Certainly no one would ever visit a foreign country with malaria or other infectious diseases like yellow fever or dengue fever (in 2019 there were an estimated 228 million cases of malaria in the world, and it killed close to half a million that year, as it does every year). In fighting the SARS-CoV-2 virus, and the disease it causes, COVID-19, there are many different factors that must be considered and balanced against each other, and we will inevitably take risks over the next few years in order to restore our lives. Let us be wise in how we balance the risks. If the only issue were limiting the risk of disease, each of us would “shelter in place” forever. We would all grow our own food, forbid strangers from entering our personal space, and never travel.
This is, of course, an extreme image, but hopefully it can help us focus on the importance of balancing many factors in making crucial decisions in this perilous time. We must try to “flatten the curve” of how fast the contagion spreads, but if this leads to all-or-nothing thinking, this itself will create many serious problems. Unfortunately, most of the charts I am seeing focus on such all-or-nothing thinking. In many charts, there are frequently two options: a dramatic spike in the short term compared to a very gradual spread over a longer term. The first use of such a chart for this pandemic was drawn on the spur of the moment by a person who had no numbers to go on. It was imaginary, dealing with imaginary possibilities. And the numbers that have been put to it so far are all imaginary as well – we just do not know such numbers, so these charts are not based upon facts.
The “bad” outcome charts are often based on numbers that no one has any idea about. And the “good” outcome charts are based on our ability to do a number of things quickly that we are not in a position to do quickly. If we could do them all in an instant, that would be wonderful. But there are many parts of the “good” outcome scenarios that we are not in a position to implement in the time frame necessary for those charts to be meaningful. They do not deal with the situation we actually have. I desperately wish we could do a lot of those things right now. But we can’t. And the crucial thing is, starting down that path, believing we can solve this crisis going down the road of a complete shutdown of our country, could paralyze us for months, or even years. If a hurricane approaches, you batten down the hatches and wait a few hours for it to pass. But you can’t do that with an 18-month-long hurricane.
The world does not work in an all-or-nothing manner. We must begin to focus on many, many gradations of flattening the curve, and develop charts that show how each action we take will help. Each of us can reduce our own risk by taking many small actions – perhaps reducing our personal risk by 95%. And if a lot of us take these small steps, we will reduce the societal risk by an equal amount. We cannot create a risk-free world. What we can do now is to start putting in place these different steps with a realistic, long-term time frame in mind. One aspect of this approach is to realize that it is necessary to vary the number and degree of actions to be taken in different places depending on the population density, the numbers of those infected, and the resources available. This will maximize the chance for the best overall outcome, including the effect of this crisis on our lives and our economy in the long term. We desperately need a measured plan of action that can be implemented through various steps and with different levels of intensity, a plan that will help us live together and carry on with our lives for months; for years.
Over time, the only healthy path is to find a response to this crisis that can be sustained for the long-term. This is a vast country, and one size does not fit all. Closing down the whole country, even those places that have few cases, doesn’t seem wise. There has to be a measured response that fits each location, while we focus efforts on helping those people who are in the greatest danger, getting them the medical supplies they need, and finding ways to serve them and sacrifice for them – even at risk to ourselves.
A Plan of Graduated Actions
Here are several steps that will help flatten the curve while allowing us to adapt to the needs of each locale. I have put number estimates with them, not because it is possible to know such numbers, but to provide a sense that we need to think about the steps we can realistically take in a nuanced way, realizing that each step will add to the positive overall benefit. Rather than thinking in all-or-nothing terms, or thinking we must choose between the two extremes of shutting everything down or doing nothing, as many of the charts are showing, we need to focus on the fact that some steps are crucial, some worthwhile if we can do them without too great a cost, and some are simply speculative ideas about what might help.
Crucially, we must try to get beyond dividing our responses based on political position. This is not a red state versus blue state crisis, and the best response is not being given by either political party. Can’t we find a way to develop a measured response that takes into account the arguments on both “sides” of the political spectrum, a response that unites us in solving this existential crisis our country is facing?
The Most Important Steps
1. Test as broadly as possible as quickly as possible and follow up with quarantines for those who test positive, and with the people with whom they have been in contact. (Those who are quarantined must be taken care of, such as with a stipend, for they are making a sacrifice for the good of all.) Effective testing and quarantine could save 30% of the lives at risk. This should be a national priority and the federal government should take the lead in prioritizing and funding – working through the states to create and organize the administration of as many tests as possible as quickly as possible. This seems to be the most important step that curbed the outbreak in South Korea, Singapore, and Germany. Iceland has used this approach very effectively, without the need to massively curtail actively in their culture.
2. Create a crash program to get the medical equipment and supplies we need. Again, only the federal government is in a position to do this. The federal government must use all its powers to make sure the equipment we need is produced and paid for – and distributed quickly and fairly to those who need it most. This is a war, and only the federal government is in a position to wage this part of the war successfully. This will save many lives over the next several months – perhaps as many as 20% of those that would otherwise be lost.
3. Support our medical personnel fully. The importance of letting our medical community know they are appreciated and supported is incalculable, along with providing them with all the materials they need as soon as humanly possible.
4. Make a major effort to get anyone who has cold, flu, or similar symptoms to self-quarantine, along with those in their families with whom they have had contact. This will have a dramatic impact. If most everyone did this, it could cut the possible deaths by 15%.
5. Restrict dramatically big social events, large gatherings, and all events that bring people from various regions together. This could save 10% of the lives that would otherwise be lost.
6. Encourage people to thoroughly wash or otherwise sanitize their hands often. If 80% of us do this frequently, it could save 10% of the possible lost lives.
7. Persuade people to stop shaking hands and coming close to those met casually – keeping a reasonable distance as much as possible when interacting. If 95% of us do this faithfully, it could save 10% of the lives at risk.
8. Clean all businesses and public spaces frequently with disinfectants, like most grocery stores are doing now. This could save 10%, as we begin to open our businesses and restaurants and start to resume normal life.
9. Separate every other table in restaurants and other places that are being reoccupied. Have an intense training program in each restaurant about safe practices. This could save 5% of the potential deaths.
10. Make a special effort to protect and take care of those most vulnerable.
11. Make a major effort to support payrolls. This should be a governmental priority at all levels. A lost job is so much more catastrophic to a life than just being temporarily delayed in reporting for work. Much of the immediate aid the government is providing should be directed toward keeping people on payrolls through their current employers. Doing this, rather than the government handing out money directly – especially to those who don’t need it right now – is a crucial step that will have a great impact on how our economy recovers from this crisis.
12. Provide financial assistance to the individuals and businesses that are suffering right now. This is crucial and will save many lives from many causes in the long term. In Berlin today, around $5,400 (in U.S terms), is being given three or four days after an application for immediate assistance has been submitted by self-employed people and small-business owners who are unable to cover their basic expenses. Small employers and freelancers like computer programmers, hair stylists, web designers, coffee shop owners, and other small businesses and independent entrepreneurs account for a quarter of all business in Berlin, and helping them make it through this crisis has been made a priority. We must do this too.
There are other steps to be taken, especially an all-out, wartime effort to develop vaccines and treatment therapies for this and other potential new viruses. But the above 12-steps are the most important to be done right now. Of course, the percentages I have used are just wild guesses. But no more so than a lot of the numbers that are tossed around in the discussion of this crisis. My wild numbers are a way to focus our thinking on prioritizing the effective steps that, one by one, can make a big difference in the eventual outcome. We cannot put this virus back in a bottle; it will be with us a long time, perhaps forever. But we can learn to live with it much more wisely and safely – it is not an all-or-nothing affair. The fewer times you encounter it, the less likely you are to get sick. The smaller the number of viruses you encounter, the less likely they are to set up a colony in your system. The more often you wash them off your hands, the less likely they will make it inside to create illness. There are many, many small steps we can take now to reduce the long-term danger from this crisis. The most effective approach we can take is to begin to build a pattern of many small steps, some of which should be nationally implemented, some on a more local basis.
At the same time, let us begin to find ways to restart our economy and our lives in the places that are not the raging centers of this crisis. Our factories and businesses must start to reopen, and we cannot wait until this pandemic is over, because it will not be over for a long time. Let’s get busy taking the above steps in as many places as we can, depending on the situation in each area, rather than operating from all-or-nothing thinking, or believing that shutting everything down will solve the problem. If we shut the country down, the disease will still be with us, and whenever we begin to function again, it will flare up again. We must begin now to find the middle path that allows us to begin functioning as a society without waiting for a “safe” signal that will not come for a long time.
In some situations, a further, more dramatic step would be to prescribe a stay-at-home policy for a specific, interconnected region – for two weeks. This might be valuable for small rural areas that are experiencing an outbreak, as well as for large metropolitan areas. Doing so would allow anyone who has contracted the virus to manifest symptoms and be tested, or, if without symptoms, to have passed through the highly contagious stage and, hopefully, into the stage of developing immunity. This action will not end the pandemic. Nothing will, at least anytime soon. But it would give a geographic region the chance to break a vicious cycle, while simultaneously giving people a sense of a time-frame around which to organize. To tell people they must stay at home for two weeks is a manageable request – people could then know when they were returning to their jobs, jobs that had not been lost but put on hold for two weeks.
Crucially, everyone would know when they would be able to begin their lives again. The return would, of course, need to be within the umbrella of the 12 steps listed above, but it would allow a major step toward a return to normal functioning. To repeat, this two-week pause would not end our crisis. But it would be infinitely better for the long-run health of our people and our country than this endless nightmare we are now in – of deadlines being set and extended, set and extended, with no end in sight, with no one having any idea when the extreme measures will end, of if they will have a job or business when it is over.
Different Models
Looking around the world at different responses to this crisis, Germany seems to be having a much lower death rate than other countries, probably because they are testing widely and following up quickly with those who test positive. Sweden has taken steps to limit the spread of this virus but is following a path much less restrictive than the 12 steps I have proposed above. They are not even close to the shutdown that has happened in many parts of the U.S. – and they have not had the severe spike in cases we have seen in some areas of our country. So far, their curve has been flattened by less restrictive measures, and they have a cold climate without the hoped-for benefit of a warmer climate to limit this disease. And crucially, their economy has not been devastated. Few jobs have been lost, and those who are temporarily unemployed are being compensated by the government.
An even more moderate approach has taken place in Iceland, where life is much more normal today than in the U.S. What seems to have worked there is that they began preparation as soon as the disease was discovered in China, prepared to test extensively, and then followed up immediately with those who tested positive and with people with whom they had come in contact. They have now tested a much higher percentage of their population than any other country, and those statistics are beginning to provide valuable information to the rest of the world. One piece of that information suggests that as many as half of the people who have COVID-19 have few or no symptoms, which is good in one sense, but which makes this disease especially hard to control, because symptomless people spread the disease without knowing they have it. Again, this is why widespread testing is crucial if we are going to contain the SARS-CoV-2 virus.
If Iceland continues on its current path, even if the disease does spread a bit more, that country will be in a far better place than many other countries. Importantly, the 12 steps offered above are more restrictive than Iceland has implemented thus far, so a measured response of the kind they are modeling is one we could undertake with much hope that we would be dealing with the long-term issues as well as the short-term ones.
Another example from which we can learn comes from the Wuhan province of China. Their approach was close to a total lockdown of several hundred million people, and it seems to have been effective (although the numbers we have been given are clearly suspect). But there are many problems with implementing that model in the United States. For one, China has, for many years, been developing a vast network of surveillance that can keep track of almost every citizen through their electronic devices. Coupled with the deployment of hundreds of thousands of people to monitor the movements of everyone, check temperatures at residential and essential service entrances, track down and monitor all the contacts of those who tested positive, check the authorization papers of anyone who was moving around, and the almost total use of quality face masks by everyone encountering other people for any reason, the virus transmission was brought under control. Additionally, they are in a good position economically to weather this storm, because most households have had a very high savings rate for several years, and because they have a top-down command economy to mitigate the damages of a lockdown on both companies and workers.
But the ways of China are not how our system works. And it is too late to move in that direction now to deal with this crisis, even if we wanted to. And to do so in the future would profoundly alter our way of life. For me, therefore, the solution imposed in China is not our solution to this crisis. We are not in a position to do many of the things they did, even if we wanted to. In dealing with this pandemic, we must find our own creative methods. Hopefully they will be better, while at the same time allowing for more personal and political freedom. Furthermore, China’s lockdown approach is now leading to another serious problem: as they try to open up again and relax control, the disease seems to be spreading again. It is much too early to know how much of a problem this will be.
There Is No Risk-Free Path
In fighting a war, you must think both tactically and strategically, and the tactics for one battle might have to be modified to fit the larger picture of the strategy of the overall war. General Eisenhower knew lives would be lost when he authorized the invasion of Normandy. He did it anyway, knowing there would be inevitable losses, because there was a strategic, longer-range vision that grew from important moral and civilizational issues. Today, we are in a very different war, but it is a war, and much is at stake. It could even be a matter of our whole way of life. This might not be the case, but the probability is as great as some of the extreme numbers of projected deaths from COVID-19 I have seen, such as one widely quoted number of 2.2 million deaths in the U.S.
We must not take any death lightly. No one wanted to be in this war. No humans sought it. But now that we are in it, we must look at the overall war, and not just one battle. One credible estimate I have seen is that there could be 500,000 deaths in the U.S. over 18 months, if our response is too limited. But we have mounted a serious attempt to limit deaths, so let’s speculate that it is possible that as many as 200,000 lives could be lost in the next few months if our actions are at the low end of the range of containment. However, taking the 12 incremental steps listed above would reduce that 200,000 considerably. Trying to face the hard truth honestly, it is possible a greater number of people would die in the short term if we used only the 12 steps listed above, rather than a complete shutdown of the country. Again, all projections at this point are speculative, but accepting for a moment that it is possible that failure to shut down everything in the country immediately would cost more lives in the short term, that number is almost certainly not 2.2 million or 500,000, or even close to those speculations. The number of losses between taking the 12 steps suggested above and shutting everything down is much, much smaller.
But, assuming for a moment there might be more losses if we don’t shut everything down completely, why would we not do it right now? Because the long-term cost in destroyed lives, and the number of long-term deaths following a total shutdown, might be much, much higher. A wiser approach would be to take as many measured steps as possible now, while simultaneously experimenting with the safest ways to begin opening businesses and allowing people to return to their lives. We must do both things at the same time at some point – there is no other option. And to begin now might will minimize the cumulative losses.
Right now, all around the world, the countries that are beginning to relax their tight controls are seeing an increase in infections. Unfortunately, this will go on for many months, all over the world. This disease does not respect country boundaries. We are all in this together. There are only two ways this pandemic will end:
1. When we develop a vaccine that can be made widely available. The hope is this will only take something like 18 months, and that mass production and distribution can be in place in time to head off a wave of new infections in the winter of 2021. Until then, there will be recurring waves all over the world.
2. When someone has been infected with COVAD-19 and recovered, the hope is that that person will have full or partial immunity. (We don’t know this yet, but this outcome is common – but not certain – from studies of similar viruses.) And, once a large portion of the population has immunity, this disease will still be present, but will operate more like a cold or the flu, infecting some people each year, killing some, but nothing like what we are facing now. One decent guess is that when 60% of a population has immunity, the average transmission from each infected person is less than one additional person, so the spread is contained. Until that time – which could take several years without a vaccine – we will be dealing with this disease.
So, let’s assume that by June of 2020, 20 million people in the U.S. have been infected with the SARS-CoV-2 virus. (One recent credible study estimated that for every reported case to date, there are probably 5 to 10 times that number out there in the population.) So, hopefully, by June no more than 100,000 will have died from COVID-19. But that means that 94% of our population will still not have been infected, thus will not be immune. By that time, the number of cases being reported each day might be falling, but the virus will still be out there, and will spread anew each time restrictions are relaxed. Given this likely possibility, will our whole country try to close down and stay closed down through July, through August? If so, our economy will be beyond recovery in any way that is related to the world we have known. Millions upon millions of lives will be in shambles, and many of those 45 million jobs projected to be at risk in the next few weeks will have been destroyed – for many years to come.
That is why another approach besides closing the country down is needed. We must begin now to open up activity in the places that are not the primary hot spots, begin to find the best ways to function as a society while simultaneously dealing with this terrible disease. To reiterate, the steps that so far seem to be proving effective, in various parts of the world, are: 1) wide-spread testing and the quarantine of those testing positive, and attempting to find those with whom they have been in contact and isolating them as appropriate, 2) providing all the medical supplies and support needed to those who fall ill and those caring for them, 3) refraining from shaking hands and coming too close to those we meet casually, and keeping a reasonable distance as much as possible when interacting, 4) washing our hands frequently and trying not to touch our faces, 5) canceling large gatherings and events, and groups of people that congregate in close quarters, 6) frequent and systematic cleaning of all shared spaces, and 7) anyone with cold or flu symptoms staying away from other people until they can be tested for COVID-19.
Crucially, none of these measures requires the complete shutdown of our country. We can begin to operate again while emphasizing these things. Of special importance is recognizing that there is no good evidence that other measures beyond these seven, and the governmental actions in the 12-step plan above, are necessary to win this war. The need for a shutdown everywhere is pure conjecture. Certainly there are special circumstances, such as the danger that subways pose, and to some degree, all mass transit. We need to work on those issues in creative ways. And certainly the hot spots of this disease require stricter measures than other locations. But surely the same policies that are appropriate for New York City in the midst of its outbreak do not apply to a small farm town in Kansas. And what we do in each factory that reopens will be very different from the practices put in place in hair styling salons, dentist offices, barber shops, therapists’ offices, churches, and all the other places that need to start functioning again. Let us find creative ways to defeat this enemy, while beginning to live our lives again. This will protect our society from very great long-term dangers.
Thinking About Projections
One of the problems today is that much of the coverage of what we are going through is confused, with some bordering on the hysterical. The broader context within which we must think about this challenging time is that all projections of the number of deaths that will occur in the U.S. are completely unknown and unknowable right now. China has more than three times as many people as the US, and they have only reported 3,182 deaths as of March 29. (There is no question, however, that the actual number of infections as well as deaths in China is much higher than has been reported.) This disease is a great danger, but to use figures like 2.2 million deaths in the U.S. if we do not shut everything down – as if anyone has any idea what is going to happen – is wrong. The number might be 50,000, or 500,000 deaths, or more, or less. No one knows or can know the number. This is true whether we shut down or do not shut down. There are many graduated levels between the extreme projections. We have to accept that we just do not know.
What percentage dies among those who contract this disease? No one knows. We have no idea how many people have had this disease worldwide, or in the U.S. China seems to be NOT reporting people who TEST POSITIVE, unless they also have significant symptoms of the disease. In the U.S., until recently, it has been primarily the people with significant symptoms who have been tested, so we have no idea about the percentage who die from contracting this infection – for including the people who have been infected but not reported would significantly reduce the percentage of those dying from it. The result is simply that we do not know any percentages yet, and it would be valuable if we stopped acting like we did and making decisions as if we did.
Fortunately, there are reasons to hope that the percentage will not turn out to be too high, such as the numbers from South Korea, which has done one of the most thorough jobs of testing. Their death rate was given a couple of weeks ago as 0.7% (although it does seem to have gone up recently), but even there we do not know how many people have been infected but showed no symptoms. A study in Iceland, which has probably tested a higher percentage of its citizens than any nation, concludes that half the people infected show few symptoms. If this figure holds up, it means that for a lot of people, this disease is not very dangerous. It also means that, since most of the world has been testing primarily those who are pretty sick, when we are able calculate the final toll, the percentage of those who die from COVID-19 could go down significantly. Focusing again on to the Australian study that suggested there are 5 to 10 infections in the world for every one that has been diagnosed to date, and using the Johns Hopkins official tally of total confirmed cases in the world on April 8, 2020, of about 1.5 million, that would mean that in the world today there are between 7.5 and 15 million cases. Again, taking the Johns Hopkins figure for deaths so far of almost 83,000, and doubling it (there have also clearly been more deaths from this disease than reported), that would mean a death rate of no more than 0.2%.
Perhaps this is wishful thinking on my part. I do very much hope the number turns out to be low. But the only thing we know for sure at this point is that we do not know what the death percentage will be. If the number turns out to be low, that will be our great good fortune. Three months ago we did not know it wouldn’t be 2%, or 5% – which is one reason it was a terrible decision in the U.S. not to prepare much more fully, not to create large numbers of test kits, not to set up systems to test and follow-up, not to put in motion a crash program to produce the medical supplies and hospital capacity that might be needed. Germany did a very good job of doing these things, and although they have had a lot of infections, the disease there seems to be coming under control, and their medical system has not been overwhelmed.
One of the implications from the numbers out of many countries so far is that a countrywide shutdown is not the only approach, or the one that works best, and to suggest that we must shut everything down all over the country or it will cost millions of lives is scaremongering. Thinking this way could itself end up destroying many lives. Neither South Korea, Iceland, Sweden, or Singapore, some good models for this fight, did anything like that. South Korea did not close their restaurants or most businesses. Singapore did not close most schools. “Shut down everything” is a fear reaction to a crisis, mostly by sincere people who have not thought through the longer-term issues of such actions. In the worst hot spots, extreme measures must be taken for a time, but that does not apply everywhere. We must quickly develop a measured response that limits the spread of this disease, but one that can be used for many months, which a countrywide shutdown cannot. And at the same time, we must begin now with a measured program of starting to function as a country again.
Close to Home
My concerns have been brought vividly home to me by several events in the last few days. I live close to the Great Smoky Mountains National Park, and it is now closed. I drove to a remote entrance, parked outside, and started walking down the middle of a two-lane paved road. There was no one else in sight, until a park ranger drove up, rolled down his window, and told me that what I was doing was illegal. How can this make any sense? There was not another person in sight? The whole park closed? 800 square miles of mountains and trees and streams. Over 800 miles of trails. Could there be a safer place in the whole of America for me to avoid the virus? How long will the whole park be closed – for how many months? The virus will still be with us 3 months from now. And 6 months from now. I can understand why it would be a good idea to close the places where people congregate, like the visitor’s center and restrooms, but the whole park? How could walking down a deserted road increase the risk for myself or anyone else? I also understand why the ranger did it – those were his orders, and he should follow them. But the decision to close the whole park grew out of all-or-nothing thinking, rather than leaders realizing this is a long-term crisis toward which we must find measured responses rather than absolutist ones. Absolutist thinking can lead to bad decisions, and even to tyranny.
Another example comes from going to buy groceries a couple of days ago. Almost everyone – even in a small city that has not had a major problem so far – is now looking at everyone they meet with fear. Many people have become afraid of each other. I read that people in small towns are beginning to look at those from outside as dangerous. As I watched people in the store, I saw many who seemed to be afraid of their world – afraid to touch anything, afraid touching anything was a grave risk. Some people are afraid of their mail and of delivered packages. Yet for context, we must remember that each year approximately 50,000 die from the flu in the U.S., which is spread among us in the same way as the SARS-CoV-2 virus. The flu does not create fear and panic in most people; why should this disease? Tens of thousands of people die and are maimed each year from automobile accidents, yet most of us do not live in constant fear of getting in a car. (For a positive note, it is very likely that the dramatic focus so many people are placing on washing their hands, not touching their faces, staying home when sick, not shaking hands or being close to each other in public will save a good number of lives that would otherwise have been lost to the flu and other infectious diseases. And there will be fewer auto accidents because people are driving less.)
Still another example of the effects of this crisis came up when I felt a sneeze coming on yesterday. My first reaction was – Oh No, what does this mean? Do I have it? Quickly I realized that this is the beginning of the allergy season. Then, my second reaction was, if anyone sees me sneeze, they will think I am spreading the virus! Then I wondered how many people will call their doctors when they have the first sign of an allergic reaction to pollen this spring. How do we get beyond letting a virus dominate our lives and color every thought? (If I had any other symptoms, however, I would get tested if I could.)
Another danger is the way people are starting to blame each other. I have read reports that some people are pointing their fingers at New York and saying it is somehow their fault, or that we must treat New Yorkers differently. Or sometimes it is the Chinese, or simply those from another state. This is scapegoat thinking, trying to find someone or some group to blame, rather than seeing that this is a shared problem that we will either solve together or it will overwhelm us all. Viruses do not recognize or stop at our artificially created governmental boundaries. This virus is a world problem, and we will solve it together, or not at all.
Still another issue: I read an otherwise thoughtful commentator on this crisis offering a plan that involved government-enforced isolation of people over 70 after others begin to return to normal life. From my point of view, if someone over 70 has the virus, they should be quarantined, just like everyone else. If they have been exposed, they should be quarantined, just like anyone else. These steps are ways a society protects itself, which societies have every right to do. But to quarantine people over 70 who have no greater danger than anyone else of infecting others, just because being over 70 means they are at greater personal danger, is a society beginning to think it should decide what risks each person should take in their own lives.
Such thinking is exactly the same as if the government said that no one can climb mountains, or skateboard, or play most sports because such things are dangerous. Or if the government decreed that no one under 30 could drive a car because those under 30 are at greater risk of an accident than those who are over 30. Society has a right to manage my behavior if I am posing a risk to other people, but do we want to create a society in which the government decides what each person can do that might pose a risk to themselves? It is dangerous for anyone to work on roofs, to be a pilot, or in the police force. Should the government prevent them from doing these jobs? It was dangerous for Mother Teresa to work with the sick in the slums of Calcutta (which she continued to do when she was over 70). Winston Churchill traveled extensively during WWII – after he turned 70 – including to the U.S. to meet with Roosevelt. Some of his travels posed a great risk, especially traveling to the U.S., for the Germans had submarines prowling the Atlantic. Nelson Mandela took many risks with his life for the cause of freedom in South Africa – after he was 70. To suggest that the government should start deciding how much risk each person can take is dangerous in a free society. There is no light at the end of that tunnel. In a free society, each person gets to decide how much risk they will take in their own lives, as long as they are not endangering others.
The Long Term
The crucial thing we must face is that this pandemic will not end in a few weeks, or even a few months. Yet the fear so many are living in right now is creating its own crisis. How do we end this crisis of fear? Mass fear is not easy to overcome. How do we do it? How long will it take? Until we get beyond the fear and panic, we will suffer an increasingly great toll in our country and in the lives of many, many individuals. That is why some of the fear stories about this disease are a part of the problem. It is a crisis, but we must see it in perspective. Almost 3 million deaths would have occurred in the U.S. in 2020, without any from COVID-19. In the world, there would have been about 56 million deaths if there were no pandemic. Death is a part of life. We must not let this disease overwhelm us with fear and panic. We must deal with it. We must take wise steps, but we must do this in ways that do not use fear as the primary motivator. And we must deal with this crisis as the long-term issue it is. We must learn to live with and manage it for many months, perhaps years, while we rebuild our lives and our country.
Primarily out of good intentions and short-term thinking, too many people have been teaching fear as the way we should respond to this disease – fear of each other, fear of touching the world around us. But once you teach fear, it is hard to unteach. No one has a switch with which to turn off the fear that is now being unleashed in this country and around the world. We must begin that long process now. We must teach courage and compassion, care and concern for each other – along with wise actions in relation to this real but manageable danger. Helping, serving, and yes, taking risks, are the ways a war is won. Today, millions of health care workers are risking their health and their lives to save others. All of the people who are reporting to work in essential services to serve the public in grocery stores, drugstores, package delivery, post offices, repair services, and more are risking their health and their lives for the larger good. More of us must do this to get our country moving again, for there are many, many more functions that are essential in the near future if we are going to save our country from collapse.
The longer we live in fear, and the more we talk about shutting everything down as the fix, the more we will suffer in the long term. Many of the businesses being closed now will not be back. Beauticians, barbers, therapists, farmers, dentists, small restaurant owners, servers, dishwashers, those millions upon millions who started a small shop or small business – and so many more – are losing their way of life right now. Countless millions of livelihoods are being lost – such as all those who work for airlines, hotels, travel agencies and on and on. One recent estimate is that 45 million people in the U.S. who were working 2 months ago will not be reporting for those jobs within a couple of weeks. What happens if this pandemic is still going on in 2 months, or in 3 months? Will all those people have to continue to stay away from work? If so, to restart the economic engine will take many, many months, probably a couple of years. We must act now to save as many of those jobs as we can. From where we are now, it will take a long time for our economy to recover, and the longer everything is at a standstill, the greater the devastation will be. From the first, we should have been telling people to take this very seriously, but not let fear overwhelm us. There are many things we should have done to prepare the medical system and perform wide-scale testing, but we should have also developed a plan to keep our country running. These are glaring mistakes that have already been made. Let us not compound these mistakes by living from fear now.
The Spanish flu killed perhaps 1 percent of the U.S. population in a period of about 18 months, and it seems to have been a much more deadly virus than this one. If we lose as many as 500,000 to this coronavirus, that would be about 0.15 percent of the US population today. This is terrible. Unacceptable. But there is no path to a safe outcome from where we are now. The Black Plague ravaged many countries for years and years, with estimates of between 30% to 60% of the people in Europe dying. Yet people then had to find a way for life to go on, and they did.
During the many decades of the that plague, many people acted horribly. Some treated “strangers” with fear and violence, refusing travelers food and shelter. Some even treated their neighbors horribly – whole families were shunned and sometimes killed if others imagined they might be infected. Often it was those who were considered “other” who were treated this way. Yet these actions had no positive benefit; they were just barbarous cruelty motivated by fear, for the plague was not passed from one person to another, but spread by fleas living on rats. Let us not fall into that trap of fear. (Let me rush to say that during the plague there were also many people who acted with courage and compassion. A significant number went around ministering to the sick and dying, even though they thought they were putting their own lives at risk.)
Very fortunately, the SARS-CoV-2 virus does not seem nearly as deadly to those infected as was the bubonic plague. Still, whatever we do now, this virus will take a heavy toll. Our challenge is to cut down the number of deaths without destroying the economy, turning on each other, destroying millions of lives, and perhaps even our very way of life.
For instance, there is now a danger that the fall election will be disrupted or perhaps compromised, which has never happened during the worst crises our country has faced – civil war, world wars, the Great Depression, mass riots, and more. We must step up to this challenge with courage and make sure our democracy is not compromised.
We must also be mindful of the economic risks. We have just passed a 2 trillion-dollar package of relief, and much more will be needed. But how can a wise use of such a large sum have been thought through in a few days. Inevitably, some of it will be wasted from being rushed through so quickly. Yet because of the panic in our country, leaders felt they had to do something. Perhaps they did. But it could have been done in steps that dealt with the medical issues first, then taking care of those without basic food and care, then with people who were losing jobs, and then with small businesses being forced to go bankrupt. Other things could have been dealt with over the next few weeks. But we rushed in, giving direct cash payments to everyone, including those who still having well-paying jobs, and tax cuts that have little to do with meeting this crisis. This was not a thought-through strategy. Or perhaps it was, with an underlying motive that was more political than strategic.
This pandemic is a unique kind of economic crisis. It is not a normal recession that requires stimulus, at least at this point. To expand on the economic points in the 12-step plan above, the urgent financial steps are those of disaster relief: A) immediate aid to people who have lost their source of income, including independent workers and small-business owners; B) businesses of every size that are feeling significant impact should be provided an immediate backstop of funds and incentives to keep their employees on payrolls; C) an all-out effort to pay for the health care needs of our people during this crisis, and to support the medical community and provide it with all the resources required to provide the best medical care; D) and accelerated research to overcome this peril. Right now, tax cuts and stimulus spending are not the issue. Perhaps they will be needed in the future, but right now we must recognize this as a one-of-a-kind financial crisis.
There is little reason to dwell on the old relief package, however, except to try to ensure that the money is used as intended. And to learn from its mistakes. That money is gone, and the national debt will increase dramatically. Further, vast sums will now have to be spent on unemployment benefits and the many increased demands that will be made for social services and medical care. Then there are the billions upon billions that will be lost in tax revenue by states, counties, cities, and the federal government as the economy shuts down. All these things will add enormously to the eventual economic burden of this crisis, and much more spending will be needed. Added together, the costs of this crisis will have far-ranging negative financial consequences – which makes it even more crucial that future steps be done wisely. The federal government must act; it must commit our resources, but the results will be much more effective if we can act out of a calm resolve rather than panic and fear.
For instance, there is now a real danger down the road of hyperinflation, and the tremendous negative consequences that would bring. And there is a danger that a collapse in the economy, which a prolonged shutdown could bring, might lead to an authoritarian government. If we don’t get beyond fear and panic soon, there is grave danger that the U.S. and the principles we have stood for will lose much of their influence in the world. China is already saying that they overcame this disease more effectively than did we, so they are asserting their authoritarian system is better than our system of government. They will carry this message to countries all over the world. We must find a creative response from within our way of life and our values that demonstrates to ourselves and the world that our culture and society is strong and worthy.
In their finest hour, the British people faced the Nazi menace with courage and determination, setting a positive example that inspired the rest of the world for generations. We must do the same now. We as a country must act boldly, but wisely, and not give in to fear.
And we must not forget that we are all in this together. We must find a way to inspire the people of America to face this crisis with courage, and we must help and support each other rather than acting out of fear or blaming others. Can we use this crisis to become better as individuals, and a better people? Let us learn to respond with care and concern for each other, helping each other through this difficult time.
A great danger arises if too many of us start thinking this crisis can be dealt with by cutting ourselves off from others, cutting our communities off from other communities, our states from other states, our country from other countries. For both good and ill, this is an intertwined world. Any attempt to deal with this crisis in one country alone will fail. Border guards cannot arrest and imprison a virus. The American economy could be reconstructed within a decade to be more independent, but during that decade there would be massive loss and disruption, at least on the scale of the Great Depression. There are many things we cannot make in this country now, and many raw materials we do not have. It would take many years to change the systems that are currently in place, and many businesses, large and small, would be destroyed. If this enemy is to be defeated without devastation to the world economy, as well as that of the U.S., it must be dealt with on a global basis. And if this country pulls back from the world, the freedom and democracy we have stood for and advanced (however imperfectly) will be in great peril. The fight is underway, and we will either find a way to lead, or our values and beliefs will fall by the wayside in the theater of world opinion and action.
The most encouraging thing I have seen in trying to follow this traumatic emergency is how many people, especially health care workers – doctors, nurses, technicians, the service personnel who keep the medical establishment running – have stepped into the breech and done their jobs, have gone far beyond the normal requirements to help and to serve. They might be afraid, but they have not let fear keep them from doing all they can. And I cannot emphasize enough that the same is true for all those working in grocery stores, delivery services, and the other essential services, those who are risking their own heath to keep our country operating. All of us must learn from them, be inspired by them, and find ways to do what we can to help others, even though we might be afraid. I have seen numerous reports of people helping those in need. They are meeting this challenge wisely. But it is only if many more of us begin to act from courage and concern for others that we will get through this crisis with the best possible outcome, and perhaps even a better country than we had before.
As Thomas Friedman of the NYT wrote, “Considering all the people who have come together in this crisis … would it be asking too much for our political system to mirror the best in us rather than to continue to exacerbate the worst?” This can be our hope. In the meantime, if our leaders cannot bring us together and lead us toward this kind of solution, we must find a way to do it ourselves, as we have at other key moments in our history. By so doing, we might just call forth the leaders we need to embody our deepest ideas and values.
The challenge of this crisis is to somehow find a creative response that is not based on fear but grounded in courage and determination. We must take wise actions but not overreact. We must help each other, and at the same time protect each other from this disease.
In the broad picture, there are several things only the government can do, which I suggested above. But if the government tries to manage all the details of individuals’ lives in a nationwide fixed response, this nation will be forever changed. That response does not fit our underlying values and way of life. Rather, the government must find a balanced path to do the things only it can do, provide guidelines for how we can best respond as individuals in our own lives, and then trust the American people to gradually work out a wise set of responses to this great crisis. Will we make mistakes? Of course. But the government has made and is making many serious mistakes at this moment. And the more it tries to manage everything, the more mistakes it will make – just as authoritarian governments have always made and are making today in other countries. Let us, here in America, come together to find a balanced way through this once in a lifetime crisis, one that provides a model for the world. Let us find a healthy balance between individual freedom and governmental control. If we fail in this challenge, as Thomas Friedman suggests, we will wake up one morning and find ourselves living in what history will come to see as the Chinese century.
At the personal level, it is so hard to know what each of us can do to solve this great crisis and the great unfolding disaster brought about by many mistakes in response to it. But each of us can help the people around us. If we do this, it will help us as individuals. And if enough of us do this, it will change for the better who we are as a country and as a people.
And each of us can make a monumental effort, deep within ourselves, to find inner peace and calm, and then share those qualities with everyone we meet. Some of the greatest figures in human history found inner peace in the worst of times. If you can do that, it will make a tremendous difference in your life and the life of everyone you touch (in whatever way you do that now). And who knows – perhaps the spreading ripples of your inner peace will affect many more people than you could ever dream.
May you be well,
and may you find as great a measure of peace as possible
in these very difficult times,
David
P.S. Here are some thoughtful articles I have read lately:
https://www.nytimes.com/2020/03/27/opinion/coronavirus-trump-testing-shortages.html
https://www.nytimes.com/2020/04/06/opinion/coronavirus-end-social-distancing.html
https://www.nytimes.com/2020/04/03/opinion/coronavirus-pandemic.html
https://www.nytimes.com/2020/04/07/opinion/coronavirus-science-experts.html
https://www.nytimes.com/2020/04/04/opinion/sunday/coronavirus-covid-19.html
Here is an article about what is going on in Sweden:
https://www.nytimes.com/2020/03/28/world/europe/sweden-coronavirus.html
And in Iceland:
https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html
