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Monday, August 3, 2020

The Covid19 pandemic is not getting any better

Impressive, important long-read from The Atlantic.
How did it come to this? A virus a thousand times smaller than a dust mote has humbled and humiliated the planet’s most powerful nation. America has failed to protect its people, leaving them with illness and financial ruin. It has lost its status as a global leader. It has careened between inaction and ineptitude. The breadth and magnitude of its errors are difficult, in the moment, to truly fathom.

In the first half of 2020, SARS‑CoV‑2—the new coronavirus behind the disease COVID‑19—infected 10 million people around the world and killed about half a million. But few countries have been as severely hit as the United States, which has just 4 percent of the world’s population but a quarter of its confirmed COVID‑19 cases and deaths. These numbers are estimates. The actual toll, though undoubtedly higher, is unknown, because the richest country in the world still lacks sufficient testing to accurately count its sick citizens.

Despite ample warning, the U.S. squandered every possible opportunity to control the coronavirus. And despite its considerable advantages—immense resources, biomedical might, scientific expertise—it floundered. While countries as different as South Korea, Thailand, Iceland, Slovakia, and Australia acted decisively to bend the curve of infections downward, the U.S. achieved merely a plateau in the spring, which changed to an appalling upward slope in the summer. “The U.S. fundamentally failed in ways that were worse than I ever could have imagined,” Julia Marcus, an infectious-disease epidemiologist at Harvard Medical School, told me…

Many of the people I interviewed tentatively suggested that the upheaval wrought by COVID‑19 might be so large as to permanently change the nation’s disposition. Experience, after all, sharpens the mind. East Asian states that had lived through the SARS and MERS epidemics reacted quickly when threatened by SARS‑CoV‑2, spurred by a cultural memory of what a fast-moving coronavirus can do. But the U.S. had barely been touched by the major epidemics of past decades (with the exception of the H1N1 flu). In 2019, more Americans were concerned about terrorists and cyberattacks than about outbreaks of exotic diseases. Perhaps they will emerge from this pandemic with immunity both cellular and cultural.

There are also a few signs that Americans are learning important lessons. A June survey showed that 60 to 75 percent of Americans were still practicing social distancing. A partisan gap exists, but it has narrowed. “In public-opinion polling in the U.S., high-60s agreement on anything is an amazing accomplishment,” says Beth Redbird, a sociologist at Northwestern University, who led the survey. Polls in May also showed that most Democrats and Republicans supported mask wearing, and felt it should be mandatory in at least some indoor spaces. It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. But pandemics are rare situations when “people are desperate for guidelines and rules,” says Zoë McLaren, a health-policy professor at the University of Maryland at Baltimore County. The closest analogy is pregnancy, she says, which is “a time when women’s lives are changing, and they can absorb a ton of information. A pandemic is similar: People are actually paying attention, and learning.”

Redbird’s survey suggests that Americans indeed sought out new sources of information—and that consumers of news from conservative outlets, in particular, expanded their media diet. People of all political bents became more dissatisfied with the Trump administration. As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. “Times of big social disruption call into question things we thought were normal and standard,” Redbird told me. “If our institutions fail us here, in what ways are they failing elsewhere?” And whom are they failing the most?

Americans were in the mood for systemic change. Then, on May 25, George Floyd, who had survived COVID‑19’s assault on his airway, asphyxiated under the crushing pressure of a police officer’s knee. The excruciating video of his killing circulated through communities that were still reeling from the deaths of Breonna Taylor and Ahmaud Arbery, and disproportionate casualties from COVID‑19. America’s simmering outrage came to a boil and spilled into its streets.

Defiant and largely cloaked in masks, protesters turned out in more than 2,000 cities and towns. Support for Black Lives Matter soared: For the first time since its founding in 2013, the movement had majority approval across racial groups. These protests were not about the pandemic, but individual protesters had been primed by months of shocking governmental missteps. Even people who might once have ignored evidence of police brutality recognized yet another broken institution. They could no longer look away.

It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

COVID‑19 is an assault on America’s body, and a referendum on the ideas that animate its culture. Recovery is possible, but it demands radical introspection. America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

The pandemic has been both tragedy and teacher. Its very etymology offers a clue about what is at stake in the greatest challenges of the future, and what is needed to address them. Pandemic. Pan and demos. All people.
The article has embedded audio narration. Recommend you activate it and go through the entire 56:33 reading and listening. Well worth your time.

Triangulate with this:

Ch. 4: First Lines of Defence

An epidemic is a sudden disastrous event in the same way as a hurricane, an earthquake, or a flood. Such events reveal many facets of the societies with which they collide. The stress they cause tests social stability and cohesion. Dorothy Porter, Health, Civilization and the State (1999)

What does it mean to possess a health service? At the very least, it represents the commitment of people living in a society (past and present) to the twin ideas of solidarity and collective action. By solidarity I mean the feelings of empathy and responsibility we all feel and owe towards one another. Solidarity stands in opposition to the principles of individualism and competition which so dominate and shape our lives in twenty-first-century capitalist, and even authoritarian, nation-states.

The existence of, public support for, and continuous development of a health system suggests that we are prepared to make personal material contributions (e.g., through taxation) to institutions that protect and strengthen the lives not only of ourselves but also of others in our society. That willingness to act on behalf of others is the second feature of a health system – our commitment to a belief in our interdependence and reciprocal responsibility towards one another and also to the collective action necessary to make those feelings real and tangible.

The whole basis of our society depends upon these two principles. COVID-19 has tested their resilience. So many people have died, so many families are in mourning, so many communities have been left scarred by disease. We have been shocked by the power of a virus to throw our societies into chaos, to deprive us of our lives and liberties, and to destroy economies. COVID-19 invites us, calls on us, requires us to rethink who we are and what we value.

One fundamental shift in our thinking surely has to be around the concept of our security. Ever since the birth of the nationstate, security has been viewed as the protection of national borders and each country’s political sovereignty. An infectious disease such as SARS-CoV-2 transcends states, borders and sovereignty. A virus is not amenable to passport controls or military defeat, despite the frequent invocation of the idea of an ‘invisible enemy’. No person, no country, can survive in splendid isolation.

COVID-19 has taught us to reimagine security as being about people and communities, about our survival, our livelihoods and our dignity. Disease is a threat to our human security, and pandemics are the most dangerous threats of all. Pandemics disrupt every part of our society, leaving us wounded and vulnerable. Protecting our security is not only about having strong military defences. Our security also depends on strong social institutions – and an effective health system is the most important defence we have to protect that security. Think of the security of your own family if you do not believe me…

Horton, Richard. The COVID-19 Catastrophe (pp. 63-65). Wiley. Kindle Edition.
The (Lancet editor) Richard Horton book went to press in May. Ed Yong's piece is even more up to date. Taken together, they provide a comprehensive, clear picture of where we are.

As I go to post, the U.S. Covid19 fatality count at Hopkins is more than 155,000.

I first posted a Hopkins dashboard screenshot on February 11th. Worldwide cases were 20,684, global deaths 427.


“I’ve done my own research.”

“Do your own research.”

How many times have you heard various antivaxxers, cranks, advocates of pseudoscience, and conspiracy theorists repeat these phrases, or variants thereof? In medicine, advocates of what I like to call pseudomedicine—a category that encompasses antivaxxers, COVID-19 denialists and conspiracy theorists, cancer quacks, and all manner of other quacks—are particularly prone to claim that they’ve “done their research” about, for instance, vaccines, and that’s why they think the MMR vaccine causes autism and that vaccines cause sudden infant death syndrome (SIDS), autoimmune diseases, and all manner of other diseases (and, oh, by the way, their “research” has told them that vaccines don’t protect against disease and “natural immunity is better,” too).

Of course, “doing one’s own research” and then “making up one’s own mind” makes perfect sense when it comes to, for example, choosing a place to live, buying a car, pickig a smartphone, and any of a number of decisions we make in our day-to-day lives, although it should be noted that even those decisions are not necessarily so straightforward or easy to research. When it comes to science, the fact is that the vast majority of us are not capable of “doing our own research.”…
Trust science. Or, better yet, become a scientist.




That one is special. I have some looney bin Facebook friends. I may need to up the metaphorical ante to "Occam's Wood Chipper."


More to come...

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