A crisis tends to focus the mind. It tends to point to weaknesses in value systems, as-well-as societies. In the United States, we are witnessing this at a frightening speed. This is now happening among neighbors and family. For example, how many of you are calling relatives more often? How about checking on neighbors? (Watch for those six feet in between.) have you called a friend you have not in decades? Maybe, donate or volunteer to keep others fed.
Even at a policy level what was unacceptable even forty days ago, is now the norm. We are talking of essentially universal basic income. This is something that conservatives were against, until these extraordinary circumstances. Still, excuses are rife, the reason why the administration did not take the World Health Organization test kits is that they produced high positives, I kid you not, that is the excuse. We’d rather have false positives, more quarantines and data, instead of flying blind. We are essentially flying blind, even as we climb the exponential curve.
But at the most basic, we are going to emerge as a far different society. This is global incidentally, but let’s concentrate on the US. People in the States have ignored other aspects of life for far too long. These include things like nature and family. Why? Low wages, no sick leaves, and a weak safety net mean people work two and three jobs just to barely survive.
This is not just the service workers preparing your burgers and fries. It is also a middle class that feels it still has to work seventy to eighty-hour weeks. Why? That same rat race where people have no time for anything else. This leads to people who are always connected and always working.
Sure, some of those jobs mean benefits such as decent medical, but many of them are still one bad diagnosis away from slipping down the economic ladder. But there are other things that disappear from life.
When was the last time you sat at home for a meal with your family? Well, now this is your chance. Going out for walks, unless you are in a high-risk group, can still be done. Just stay away from others, six feet at least. Enjoy the sun, the emerging spring plants, and the chirping of birds. I am sure many have not done this in a long time.
When was the last time you sat down with your children and had a long conversation with them? Perhaps it is time to teach them how to cook, fold clothes, clean and other things they will need if they are old enough. Have you played a family game recently?
All of this will show something important. A society that runs on consumption, and in getting the latest toys is one whose values are not healthy. A society that does not pay the lowest rung enough to live, is not healthy. A society that does not have medical emergency leave, is not healthy.
Most of this started in the roaring 80s when our values went into greed is good. They spread like poison under the guise of the prosperity gospel, which also changed the nature of Christianity for many. Be kind to the poor, and feed the hungry was replaced by wealth signals your salvation.
Resilient societies are also one that understands math. Yes, one problem we have is that the exponential curve for many is just two words. It has little meaning. Resilient societies rely on expertise, and our age of anti-intellectualism will come to an end with the deaths of over a million Americans in the worst-case scenario.
Here, from the Centers for Disease Control via the New York Times:
Between 160 million and 214 million people in the United States could be infected over the course of the epidemic, according to one projection. That could last months or even over a year, with infections concentrated in shorter periods, staggered across time in different communities, experts said. As many as 200,000 to 1.7 million people could die.
And, the calculations based on the C.D.C.’s scenarios suggested, 2.4 million to 21 million people in the United States could require hospitalization, potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds. Fewer than a tenth of those are for people who are critically ill.
Of course those numbers should be lower, given how social distancing works. At least that is the expectation from the experts. Why we are doing this, and staying home.
The lesson here is that we need to respect people who have the knowledge and know what they are talking about. Everybody having an opinion is just that, until they can back it with facts.
Another thing that needs to disappear as we emerge on the other side is our penchant for conspiracy theories, as well as an end to ideas such as the pro-plague people who refuse vaccines. For starters, once a vaccine for COVID-19 is developed, this must be mandatory. The only exceptions, the usual medical reasons that prevent you from getting a vaccine. This is not a free speech issue or religious freedom. You can take a vaccine, you will get it, and you will complete your schedule. Does this seem authoritarian? In a society that believes in facts, we would not have that issue. States like California and Maine were already moving in the right direction. The rest of the country needs to follow.
Our values need to change, and we need to come up with a society that works. This emergency has also made the case for a national health service. Before you say Italy, they actually have more capacity than we do. And they also have an older population. Here, since if you do not believe me:
A crucial thing to understand about the coronavirus threat — and it’s playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time. Our country has only 2.8 hospital beds per 1,000 people. That’s fewer than in Italy (3.2), China (4.3) and South Korea (12.3), all of which have had struggles. More important, there are only so many intensive care beds and ventilators.
Europe is also facing a shortage of critical medication, which is leading to the kind of Triage you usually see in developing economies. It is not because they are socialized, It is simply they are getting far more patients at the same time than they can handle. As I pointed above, Italy has more intensive care beds and the staff to run them, than we do.
Why is this happening? This is a matter of resources. I will use my own experience as a medic during a train wreck, where we had over 100 patients, and two crews to handle that early in the incident, meaning six people.
One of the things medics do in these situations is what we call play god and decide who lives and who dies. The obviously dead are immediately tagged black. Meaning, incoming crews know they are done. The critical are tagged red and transported first as soon as capacity is there. People who are wounded, but can wait, get a yellow tag. Those who are the walking wounded are tagged green. Then there is the people who are still breathing, but will be dead soon. I had that situation with a three-year-old. She was breathing, barely, her pupils were fixed and dilated, and brain mass was coming out of her ears, while blood came from her nose. In any normal circumstance, she would have been treated by the field crew, likely to die later at the hospital, assuming she would not code in the ambulance. I was the triage officer who placed the black tag on her. Why? She would have taken at least four medics, and medical gear we could use on red tags that had a chance.
So that is what is happening in Italy, and what we will face here. The decisions are never easy, and as you probably suspect, I still see her face.
Ethically it is a hell of a call. Especially when you are talking of a young person with a life ahead of them. It is never easy, but it easier to rationalize that with a person in the twilight of their lives. This is also why Italy may stop treating people who are in their eighties, it is again a question of resources. And I know people who do not want to believe this, and think this is fake news. It’s not, it is a triage reality. And this is why all of us staying home, on the advice of experts, may prevent this in the United States.
However, we have no public health to speak of in this country. That needs to change. Doctors need to be trained for free. While at it, public education has to go to graduate school. Why? An educated society is investing in Human Resources, and right now we do not have enough respirators. And even if we produce them. We do not have the people to man them.
This is also another reason why we need to move away from fake news, and misinformation. It clouds the mind. And as a society, we will have to decide what to do with “news outlets” that lied to the general public during this crisis, and continue to lie to the general public (yes Fox I am talking to you.) We will also need to hold serious hearings on this, and some of our politicians will have to face the music. This includes the president of the United States who tried to weaponize this, was never honest and is still lying. No, you were not the first to call this a Pandemic, before The WHO did.
We do not have the greatest medical system in the world. We will not come out of this strong, and yes, we can start using the word depression as far as the economy goes. And not accepting The WHO kits was a serious error which means we have been flying blind all this time. Which leads me to the other matter. International organizations and treaties work, and they work best when we all work together.
The conservative trickle-down economics will also need to die. All measures in planning to help the economy are all Keynesian. Meaning, they are the kinds of things that Franklin Delano Roosevelt would have enacted, or Bernie Sanders proposed. It is time to adapt and change our society towards a more humane model. Regardless of who is nominated by the Democrats, circumstances demand this path.
And one casualty of this should be American Exceptionalism. We are just another nation with people who are not qualified running it at the moment. And I do not mean the experts in the government. We have many lawmakers that need voting out, and the president has proven his incompetence time and time again. What we have is a kakistocracy, and it is time to go back to a normal government.