Sunday is a busy day for me now as we practice social distancing. I attend church online and then watch CBS Sunday Morning followed by the NBC, CBS, and ABC Sunday morning political reviews. I can not force myself to watch Fox News Sunday where Surgeon General Jerome Adams is reported to have said:
“This is going to be our Pearl Harbor moment, our 9/11 moment. Only, it’s not going to be localized, it’s going to be happening all over the country. And I want America to understand that.”
I did see his appearance on NBC’s Meet The Press where I heard him say:
“It’s going to be the hardest moment for many Americans in their entire lives, and we really need to understand that if we want to flatten that curve and get through to the other side, everyone needs to do their part.”
Since the coronavirus emerged, we have been desperate for leaders who give us hope by speaking the truth and demonstrating leadership. In the early days of the Great Depression, Herbert Hoover failed to recognize the need to intervene and use the power of the federal government to address the challenge, and as a result there were bank failures, breadlines, and 25% of Americans were unemployed. Unfortunately, Hoover’s failure occurred early in his term, and the nation languished for over three years until President Roosevelt entered office in March of 1933 and proclaimed in his inaugural address that we had “nothing to fear, but fear itself.” After the damage of Hoover’s neglect, and despite all of the efforts of FDR’s New Deal, the pain and suffering of the nation continued until the horror of World War II brought full employment. As is true in medicine, early and effect attention to potentially large problems is the best approach. Denial is usually the harbinger of disaster.
Our current president has done an even worse job than Hoover did. It is likely that with his lack of insight and empathy he will equal Hoover’s unemployment numbers, and even worse is the fact that tens of thousands here and hundreds of thousands around the world will die. He has failed to lead and protect us at home, and failed to provide the leadership to the world that the world has come to expect from America over the last one hundred years. It is difficult to hear his excuses for his failures, and observe his self serving attempt to shift the blame for the delays in putting together an effective response to those who came before him, and to those around him whom he hired.
Hope needs a plan, and plans usually come from effective leadership. The good news for us now is that we can hire a new leader within the year. These days most of our hope has arisen outside of Washington as several governors like Andrew Cuomo of New York, Charlie Baker of Massachusetts, Larry Hogan of Maryland, Gavin Newsom of California, Gretchen Whitmer of Michigan, and Mike DeWine of Ohio, plus several others from smaller states, like Chris Sununu of New Hampshire, have collectively tried to fill our need for wisdom and for courageous and thoughtful leadership. They have also demonstrated that good sense and empathy are not red or blue characteristics. Their collective good sense, transparency, resourcefulness, and demonstrated courage and ability to put some pressure on Washington to do better job has given many of us the hope that as a nation we still have what it takes as a people to survive with grace under enormous pressure, as our parents and grandparent did during the Great Depression and the Second World War.
Most of our understanding of what will and could happen to us, and much of our effective action to mitigate the extent of the disaster has come from heeding the advice of Dr. Anthony Fauci. If times were not so trying, his quiet persistence in the face of the president’s ignorance and insensitivity would make for good comic theater. As the surgeon general was surprising us with his predictions about the next week, and giving us a great demonstration about how to make a mask out of a bandana and two rubber bands (I tried it, and it works), Dr. Fauci was playing his role as our wise and compassionate source of realistic analysis. On Sunday he was on CBS’s Face The Nation. Vox described the interview:
…Dr. Anthony Fauci, the country’s top infectious diseases expert, told host Margaret Brennan that saying the federal government has Covid-19 under control “would be a false statement.”
“We are struggling to get it under control, and that’s the issue that’s at hand right now,” Fauci said.
Over the past few weeks, since he backed off his insistence that we all go to church on Easter, the president has intermittently echoed the opinions and advice of his medical experts. He refuses to wear a mask, and he continues to hawk the indiscriminate use of hydroxychloroquine, but on Saturday, the day before Adams and Fauci made their distressing predictions on the Sunday morning political commentary shows, the president stunned everyone at his news conference when in somber tones he warned Americans that :
“This will probably be the toughest week. There will be a lot of death…”
President Trump on Saturday urged the American public to brace for a difficult week ahead as the novel coronavirus spreads domestically, saying there would be “a lot of death.”
“This will be probably the toughest week,” Trump told reporters at a White House press briefing on COVID-19 on Saturday afternoon.
“There will be a lot of death, unfortunately, but a lot less death than if this wasn’t done,” Trump continued, referencing the steps the federal government has taken to mitigate the effects of the coronavirus.
It is amazing to contemplate all the reversals of opinion that the president has offered as he vacillates between statements that he hopes will promote his reelection, and statements that he hopes will make him out to be some sort of leader in the war against the virus. Far and away, the most disgusting and self serving piece of misinformation that the president has dispensed was the idea that churches would be full on Easter Sunday. Along with his “Easter proclamation” he espoused what I would suggest might be called “Trump’s Law of the Value of Life.” He reasoned that it was time to get back to business because “the cure should not be worse than the disease.” This self-serving and very subjective statement requires placing some sort of economic price on the value and quality of a life, and making a statement about how much “cost per year of life saved” we could collectively afford to offer. He was offering the fool hardy and supposedly less vulnerable population a deal if they would join him in the decision to put their own economic interests first and compromise the health and wellbeing of their neighbors who were either less vulnerable or less reckless.
It is interesting to review what has happened in the interim since Trump first imagined that we would be in church on Easter. First, his coronavirus team pushed back with staggering estimations suggesting that we were at our best on a track to lose between 100,000 and 240,000 lives. Returning to life as usual, including going to church on Easter, would have substantially increased the loss of life above those remarkable numbers. Secondly, economists and epidemiologists have agreed that a premature attempt to return to business as usual would result in a huge exacerbation of the economic losses and waste much of what had been gained with the sacrifices that had been made in the effort to “flatten the curve.” The president’s knee jerk comments about “the cure being worse than the disease” did stimulate a productive conversation about what circumstances might signal that it was time to ease restrictions and slowly return to non essential business and relax some social distancing requirements. When the time comes, a safe transition will require testing volumes that are not yet possible, patience, and organizational skills that the president is yet to demonstrate.
It’s a ghoulish calculation, but someone needed to show that the cure was well worth the cost. Warren Cornwall writing in Science magazine in an article published on March 31 entitled “Can you put a price on COVID-19 options? Experts weigh lives versus economics,” offers some answers. I hope that you will carefully read this long quote which I have lifted:
The cost of shuttering large parts of the economy is relatively easy for Rebelo and his collaborators, Northwestern University economist Martin Eichenbaum and Mathias Trabandt of the Free University of Berlin, to translate into money, the currency of economics. On the economic side, their model calculates how the disease and government policies would influence how much people work and buy.
But the dollars and cents of a virus are less intuitive. Rebelo uses a modified version of what’s known as an SIR model, an acronym for categories of people: susceptible, infected, and recovered. It simulates how a disease moves through a population based on how infectious and lethal it is, and how much contact people have with each other. To put a price on the results, Rebelo takes the number of predicted deaths and calculates an economic estimate of the value of the lost lives. The approach is similar to the price that the U.S. Environmental Protection Agency used to gauge the costs and benefits of environmental regulations: $9.5 million per life.
His initial modeling efforts showed that even a yearlong lockdown makes economic sense, to allow time for a vaccine to be developed. The pause would shrink the economy by approximately 22%—a cost of $4.2 trillion. By comparison, the model shows that without containment measures, the economy would contract by about 7% over that year—but as many as 500,000 additional lives would be lost, which translates into a loss of roughly $6.1 trillion.
It is difficult to put a monetary value on a life, but it is practically useful to make the effort since by doing it we have a model that argues that persisting with our uncomfortable strategy until we have a vaccine, or at least until we can use testing to tell us who does and who does not have the immunity required to safely return to work, is a much better strategy than denial and giving into the president’s fears that continued economic losses will cost him another term.
I hope that in time somewhat similar modeling will allow us to judge the loss of life and the magnitude of our economic losses that are derivative of the wasted time in February and early March when we were not prepared, and were not preparing, for what we should have known was coming. Considering what has happened and what is continuing to happen, it is mind boggling that 49% of Americans approve of the president’s handling of the crisis. Poles suggest that the president is succeeding with his base, and is also attracting many other Americans with his assertion that he should be credited for keeping the loss of life and the economic losses down. Simultaneously, thoughtful writers like Dr. Elisabeth Rosenthal, editor of the Kaiser News Service, offer us more evidence of his failures, and show us how the lack of effective testing now and in the weeks and months to come will delay the safe return to our new normal. Dr. Rosenthal’s opinion piece in yesterday’s New York Times, entitled “The Real Tragedy of Not Having Enough Covid-19 Tests: How can we know when to reopen society without testing many more people?” is worth your investment of the five minutes it will take for you to read it.
The surgeon general, Dr. Fauci, and the president agree that this week, “Holy Week,” will be a sad week, a trying week, a horrendous week, a week that we will never forget. There were few palms spread on Palm Sunday while the surgeon general was making his predictions. The services usually held to commemorate the high points of the week, Maundy Thursday and Good Friday, will occur on Zoom, if they occur at all. On Easter, it is unlikely that many will be singing about Easter bonnets, and no one will be parading on “the avenue, 5th Avenue.”
In your Easter bonnet, with all the frills upon it,
You’ll be the grandest lady in the Easter parade.
I’ll be all in clover and when they look you over,
I’ll be the proudest fellow in the Easter parade.
On the avenue, fifth avenue, the photographers will snap us,
I have had the somewhat blasphemous thought that the surgeon general is warning us that Holy Week will be a week of loss and sorrow that will not crescendo into a resurrection. I will leave it to the clergy across the land to squeeze some meaning out of this week that begins with the news that Boris Johnson, the British Prime minister, was moved into an ICU as he continues to suffer from his coronavirus infection. I don’t know what the news means that the tiger, Nadia, at the Bronx Zoo, and some of the other animals, have acquired the coronavirus from an attendant. It is probably not true that animals will become a vector that needs to be considered in our plans for containment, but the fact alone underlines the reality that we don’t know enough yet about COVID -19 to be certain about much. We have passed 10,000 deaths as of Monday. Will we see a geometric increase, as predicted, as the week goes forward? Will we get to and surpass 100,000 or 200,000 deaths at some point since in eight states Republican Governors have allowed non essential businesses to remain open, and continue to allow social distancing to be a personal choice, and not a requirement. The fact that smart people like Bill Gates feel that we will not sustain 100,000 deaths is reassuring. The comments yesterday that the curve may be flattening in New York resulted in a huge jump in the stock market. We are desperate for positive news that tells us with certainty that the sacrifices that we are suffering will make a difference.
President Trump, Dr. Fauci, and the surgeon general were not the only notable people to make announcements over the weekend. Queen Elizabeth addressed the “British Nation” on Sunday. It was a remarkable event worth viewing. The fact that a 93 year old woman can deliver a statement in five minutes that provides truth and inspires courage is a dramatic demonstration of what we don’t have in our highest leadership position. She finished her presentation with a reference to the courage of the British in World War II by using the phrase “We’ll meet again.” Many of us know that the phrase comes from the inspirational song, “We’ll Meet Again,” that was sung at the height of Britain’s peril. I promise you that tears will come to your eyes, if you click on the link and listen to the song and watch the pictorial representation of the sacrifices that real people, our parents, grandparents and others of their generation, made at a moment of challenge.
We’ll meet again
Don’t know where
Don’t know when
But I know we’ll meet again some sunny day
Keep smiling through
Just like you always do
‘Till the blue skies drive the dark clouds far away
The responses to last Friday’s post demonstrated that we have our own heroes at this time, and that we share the sentiment of “We’ll Meet Again.” There were comments made to me directly in emails, and others entered into the comments section, that underlined the fact that we understand the importance of our medical professionals and first responders at this time, and appreciate the sacrifices that they are making. The video presented with the Queen’s speech made the same point. The heroes of this conflict are not in foxholes, they are in EWs, hospitals, drive up testing facilities, labs, ICUs, ambulances, and nursing homes. There were even comments on comments, reenforcing the appreciation and esteem we owe to those who go to work everyday knowing that they are putting themselves and their families and friends at some risk as they endeavor to help people who are probably total strangers. Much of the outrage of this moment is justified and driven by the tardiness of the delivery of the protective clothing and masks that should have been available to those in harm’s way. We spend hundreds of billions on military defense, but can’t get it together to fight an enemy that will probably kill more people than have died in our armed services in all of our military actions since World War II.
My friend and faithful reader, Eve Shapiro, summed the feelings of many in her comment:
…. in all the sadness, grief, fear, and anxiety we are feeling at this moment, I hope we will always remember the heroism of the doctors, nurses, and others who risk their own health and lives every day to take care of us, especially in the face of their own exhaustion, anxiety, and fear. This is who they are and what they feel called to do. They are brave. When we think of this pandemic in years to come, may their caring and courage be what we remember most.
It’s hard to improve on those words, but she sent me another note this week that referenced another leader of the WWII era:
Here’s a wonderful quote I read today from a speech Winston Churchill gave in the summer of 1940. It’s about the Royal Air Force bombers during the Battle of Britain but it also applies to our healthcare workers right now: “Never…was so much owed by so many to so few.” Truer words were never spoken.
There has been much written about this moment in time as a threshold to another world. My son the lawyer has sent several quotes to me that are floating around the Internet that you may have already read or heard. The great Will Rogers demonstrated back in the depression that there was sustaining wisdom in humor. Try these on:
World: there’s no way we can shut everything down in order to lower emissions, slow climate change and protect the environment.
Mother Nature: here’s a virus. Practice
Another two I like are:
My 90 day trial of 2020 is up. I’d like to unsubscribe now!
Does anyone know if we can take showers yet, or should we just keep washing our hands??
And finally, in a more serious vein, consider:
In the rush to return to normal, use this time to consider which parts of normal are worth rushing back to.
Dave Hollis
The picture that is seen in today’s header is appropriate to this conversation at several levels. First, it is a screen shot from a Zoom meeting. Could we survive the COVID-19 pandemic and endure the isolation and social distancing required without Zoom? Everything from religion to business and including cocktail parties, birthday parties, and concerts has moved to Zoom. The crowd on this Zoom screenshot are some of my friends and colleagues who were at a meeting to discuss projects and policies as part of the work of Kearsarge Neighborhood Partners. Click the link, and check out our website!
There are now dozens of friends and neighbors in KNP who have been slowly organizing over the last eighteen months to address how we might improve the lives of individuals in our community by addressing the personal issues of poverty and the doing what we can to improve the social determinants of health and wellbeing in our community. We were making progress, but with the events of the last month we have rapidly expanded the services we offer, and greatly enhanced our organization and infrastructure. We are delivering wood, delivering food, running errands for people who can’t get out, reaching out to other organizations like the local food banks, the hospital, the schools, and the Council on Aging to help them as they expand their programs to those who are at greater risk physically and economically. We are focused on food, We are developing concepts of grants and microlending. We have pooled money and human resources to help those people in our community who are the most vulnerable to the inequalities that have been magnified by the recent economic losses associated with the pandemic. Every meeting seems to generate new insights about opportunities that we can take on together.
I think that what KNP (we call it “Kah Nip”) is doing in the Kearsarge region of New Hampshire is being done in many places across the country. I think that the dedication of our healthcare community and the commitment of teachers, police, first responders, and even the military to rise to the challenges of COVID-19 has inspired many neighborhood action groups in cities and in rural communities across the country. There is a new spirit of purpose and involvement promoting a new normal of communitarian action. I am convinced that we are seeing a substantial increase in individual acts of grace across the country, but more importantly we are proving to ourselves that by acting together we can do even more.
If you listened closely to the Queen’s words you may have heard her mention “fellow feeling.” So far, in my community, and I hope in yours, there has been a great increase in “fellow feeling” even if it is a term that we rarely use. It is this love and concern for our neighbors and for the strangers who come our way, that will allow us to rise from the disasters and disappointments that Surgeon General Adams, Dr. Fauci, and for the moment, the president, warn us to expect. They are describing disastrous events. They are not describing how you and I will respond to those events. Unlike the Queen, they did not tell us what we might do to respond to what seems inevitable. Without real leadership we must look to each other for both creative responses and solace. We are not led by an FDR or a Churchill, but we can adopt the attitudes and the resolve that carried them through their challenges. The people in the picture are not smiling at the prospect of how bad it might become, they are energized by the thought of how much better they might make things if they work together with the vision of a better, safer, healthier world for everyone as their collective objective.
