Category Archives: Later, on health

Coronapresident

I don’t know what makes me feel worse: the rampant coronavirus that could kill me if somebody sneezes or the fact that Donald Trump is still the president of the United States. I can protect myself from the virus by staying at home a lot, wearing a mask, and keeping away from other people, but there is no social distancing from this president and from our national nightmare.

Both things—the virus and the president—make me feel a sickness in the pit of my stomach. It is not a stretch to conflate the two. They are both nightmares.

Most of the time, I keep my mind busy with an assortment of activities and distractions because I try not to dwell on things that make me feel bad, and I suppose that’s good for my mental health. But my mind likes to wander, and my thoughts seem often to gravitate toward what’s wrong in my world.

I am getting used to a vaguely queasy sensation that something is not right, that my life is somehow out of balance. It is not just a fear of becoming infected. The coronavirus and the coronapresident are parts of the same pattern. The virus and what the president is doing about it, or failing to do, are not two different things but they are one unresolved story that has been playing over and over in my mind since early March.

The coronavirus does its deadly work by spreading from person to person and by replicating, a process that chokes off our oxygen supply and attacks our vital organs in ways that are not yet well-understood by science. Some of the damage may be permanent. It is both microscopic and bigger than any one of us. Stopping its global trail of death—over 283,000 deaths worldwide as of this writing—demands a national and global response.

An effective national response calls for a kind of leadership that that the coronapresident does not have. Instead, he denies the risk, complains about a hoax, ignores the science, blames the Chinese and Obama, hides or distorts the facts and now has begun to doubt the death toll.

Yet, as John Adams is credited with saying: “facts are stubborn things, and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” As of this writing, the death toll in the United States is approaching 80,000 people.

The medical experts who advise the president speak to the public through a White House filter, careful not to contradict him. He can barely hide his boredom with them but they are useful props, standing by him on the same platform as if he were their equal.  

While there seems to be universal agreement in the medical community that a greatly accelerated testing and contact tracing effort is the only way to begin to stop the coronavirus, the coronapresident is not enthusiastic about testing because he believes that more testing will reveal more cases of COVID-19 and more cases will make him look bad and undermine his reelection campaign. The idea that more testing could prevent infections, reduce suffering and save lives is of little importance to him.

All he wants to talk about now is “reopening” the country because “we can’t let the cure be worse than the problem itself.” Let me fill in the blanks.

The “problem itself” is a deadly and uncontrolled virus that is super-contagious and for which the world has no treatment or vaccine.

The “cure” is the whole range of measures to reduce the spread of the virus: social distancing, wearing masks, and finding out, by a lot of testing, how widespread the virus has become. The cure, at present, means that some types of social and commercial interaction must be curtailed because those interactions enable the virus to spread and make the problem worse. Such interactions will be unsafe until human ingenuity finds new ways to block viral spread from person to person in workplaces, shops, restaurants, theaters, public transportation, and other places where people come in close contact.

The coronapresident rejects the cure and by implication prefers to do nothing about the problem, even if doing nothing about the problem means more disease and more death. The problem, he says, will go away on its own, without a vaccine and without all that much testing, like a miracle, it will disappear.

The coronapresident is not a real president. He is an accomplice. He is the virus made visible.

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No Time To Relax

There was a lot of discussion about when to “open the country” again. The president was hoping to do it “very, very, very, very soon.” He would decide when that should be, he said, based on some miraculous metrics in his head. It had to happen soon because “the cure could not be worse than the problem.”

I didn’t know what any of this meant. I suspected he mainly wanted to preen. He wanted the credit for “opening the country” but none of the blame if anything went wrong. Blame was for governors (losers) who had issued stay-at-home orders in their states.

He had boldly announced on April 13: “The president of the United States calls the shots.” In what surely would have been news to Thomas Jefferson, he said that the president had “total authority” to tell state governors when to “reopen.”

The next day, he said that he would soon be “authorizing each individual governor of each individual state to implement a reopening and a very powerful reopening plan of their state.” But, he said, “We will hold the governors accountable.” The federal government, he said, would be “watching them very closely.”

I supposed that any day now he would declare the nation open for business, and if the economy did not “roar back” as he had predicted, then it would be because the governors failed to fall in line. Behind the scenes, I presumed, he would try to make governors cooperate with his “open the country” edict by withholding vital medical equipment or other assistance that the federal government could provide but only if governors were sufficiently appreciative of his efforts.

Most governors who had weighed in on the subject did not seem to be falling for this foolishness. The governors of Washington, Oregon and California announced a coordinated “West Coast framework” for cautiously easing up on the mitigation measures that had been put in place to slow the spread of the coronavirus—measures that so far appeared to be working.  

The president’s fantastical I-will-open-the-country notion was illusory. The coronavirus would continue to spread, and for now, our only defense was to slow it down. It was not a question of whether or not to “open the country.” Ninety-five percent of the people were still susceptible and vulnerable to the coronavirus. The real public health challenge was how to maintain our only defense against the virus—blocking its transmission—while creating safer environments where more people could get back to work, more businesses could operate, and more friends and families could be together—in actual, not virtual space—and feel less isolated.

Modification of stay-at-home orders would come when the rates of new infections declined and stabilized at a level that medical facilities could handle. It would come when widespread testing for coronavirus infection had at last become possible. It would come when each state had adequate stocks of necessary medical equipment and supplies of all sorts. It would come when it became possible to test, quarantine and contact-trace.

We already had the template for economic life in the shadow of the virus because, in fact, much of the economy had never closed (grocery stores, mail and package delivery, construction, public safety, and medical facilities to name a few areas of economic activity considered “essential” and therefore exempted from stay-at-home orders). Many of these activities had adapted to the risk by adopting mitigation measures that effectively interrupted the transmission of the virus.

I had no doubt that, in time, other types of economic activity would adapt. “Opening the country” would not happen by presidential decree on a date selected by the commander-in-chief. We, the People would decide. The economy would not begin to approach normal until we felt safer—safer to work, safer to shop, safer in numbers. It would be gradual, and there would be setbacks. A second COVID-19 wave seemed likely in the fall.

Would people feel safe going to restaurants any time soon? Would theaters re-open if audiences continued to fear potentially fatal infections? Would fans feel safe enough to fill arenas and stadiums to watch sporting events without wondering whether they would be risking their lives? When would parents have confidence that their children would be shielded from the virus at school? How could we be protected from the virus while receiving various kinds of personal services that by their nature involved close person-to-person contact?

No one had all the answers, least of all the fat guy in the White House with the Super-Bowl ratings. The economy had already been severely damaged and damaged beyond repair for some businesses. Things would not get “back to normal” until people could safely mingle more, and normalcy ultimately implied having an effective vaccine. The timeline for vaccine development was uncertain. The most optimistic estimate was a year, but it could take much longer, perhaps three to five years.

What we did know was that this particular coronavirus, left to its own devices, could spread at an astonishing rate. We had watched it happen.

By March 13 (the day the president declared a national emergency) there had been 1,629 reported COVID-19 cases in the United States, and 41 people had died from the disease.

One week later, the cumulative number of COVID-10 cases had grown to 15,219, and the number of deaths had grown to 201.

One week later, there had been 85,356 cases and 1,246 people had died. Meanwhile, in my state, 414 cases had been reported and 12 people had died.

One week later, the cumulative number of cases in the US had grown to 277,205 and 6,593 people had died from COVID-19, and in my state, there had been 899 cases and 22 deaths.

One week later, by April 10, the number of cases had grown to 492,416 nationwide and there had been 18,599 deaths; in my state, there had been 1,371 cases and 48 deaths.

It appeared from the data that a peak fatality rate of 2,150 deaths per day had been reached on April 13.

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