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Writer's pictureGlenn Dobbs

Notes on a Pandemic (Part 8)

Updated: Apr 23, 2020



“For the first time in history there is a fully signed Presidential Disaster Declaration for all Fifty States. We are winning, and will win, the war on the Invisable Enemy!

- Donald Trump on Twitter today


“(It) is not going to be a light switch that we say, 'OK, it is now June, July' ... click -- the light switch goes back on…..it’s going to be depending where you are in the country, the nature of the outbreak that you have already experienced and the threat of an outbreak that you may not have experienced. So it's going to have to look at the situation in different parts of the country.”


“…..Many people who are dying, both here and around the world, were on their last legs anyway, and I don’t want to sound callous about that……a simple man tell’s the truth”

- Former Fox commentator Bill O’Reilly on the Sean Hannity show.


I was in an argument earlier this morning. Well, not really. A friend of mine texted me to enquire how we were doing this holiday weekend. My friend is an ardent conservative so he texted me how frustrated he is that his “Constitutional rights are being violated by the Government”. He was concerned that the Government was overreaching telling people they cannot assemble as they choose.




“When the government decides that my following their guidelines is illegal based on a whim then I have a problem with that, “ he texted vigorously. I assumed it was vigorous, he is a passionate man.

I understand his frustration. This whole pandemic has so disrupted society that it is hard to know what to do anymore. I tried to explain to him the importance of not harming others by transmitting the virus to vulnerable people. My friend understands the concern but remains distrustful of the government experts and feels strongly his personal liberties are being violated.




I remember when we returned from our last trip. Like many, my first reaction was odd curiosity. “This won’t last long," I foolishly thought and busied myself with household chores. But as the days have stretched into weeks it is clear this pandemic is not a passing breeze.




This country has been dealt a devastating blow. Over a half of million people are now infected in the nation and, as of today, 21,489 people are dead. We are in a profound economic recession and poised to tip into an outright depression. Over 16 million Americans are out of work.

Our initial and correct impulse is to save lives regardless of the damage. That is the phase we are in now. How long this phase will last is unknown. There is some data showing less daily deaths, but is sputtering and very location dependent. We are in a very deep hole.




How do we get out? Lord, I do not know. No one does right now. The question is too large. There is no light switch to simply turn on and go back to life as we knew it. Despite our fearless leader’s breathless pronouncements , the world will not come roaring back quickly. He reported from his podium, in between commenting he is #1 on Facebook, that he is developing a Task Force to ‘Restart the Economy’.




When he said that my first thought was, “My God, you don’t already have plans in place?” I threw my sock at the TV, because I don’t wear shoes anymore.


He was asked by a reporter, “What is your metric for feeling it is ok to reopen the economy?”


“I only have one metric,” he said and pointed to his orange head. He went on to say he would reveal his plan next week.




He is right about one thing. (Did I really say that?) The country cannot stay closed for an indefinite period of time. One of the effects of all of this social isolation is to exacerbate poverty in the country. Income inequality and racial disparity have long plagued our nation. The effects of throwing so many middle and low income people out of work for prolonged periods of time will cause significant harm. And remember, we are an affluent nation. In poorer countries around the world who cannot provide even the smallest support for their people, hundreds if not thousands of people will die.




Despite our fearless leader’s confidence there are actually several metrics or things that need to happen in order to restart the economy without killing a lot of people. A review of the literature highlights plans from both right leaning and left leaning proposals. Although some aspects of the plans differ slightly in methodology they all lead to the same place. Here is a map experts are talking about as a way out.

Flatten the Curve

This is where we are now. We all know this term now. The idea is too isolate ourselves so less people get sick and we run out of hospital beds. Despite all of us trying to do this earnestly, over a half a million people are now infected in the last 5 weeks alone. Still we are having a small amount of success in certain areas and that is encouraging.




Raise the Line

Increase our healthcare capacity. We are attempting to do this now with limited success. A recent HHS Inspector General report on hospital experiences with the pandemic showed significant short falls. Our fearless leader, instead of using the important information to improve the response, questioned it’s political motivation and dismissed it as wrong. Governors are working hard to try to accomplish this in their states but since they are competing against each other the results are varied. Until the Federal government provides better leadership, we will continue to hobble towards success in this area.

We need to continue to work aggressively on a vaccine and therapeutic medications.




Establish measurements

In order to reopen the economy you need tools in place to measure and prevent a quick resurgence of the infection rate. The literature is discussing two main tools. Both of them are difficult.

The first is to digitally monitor every American’s movements via a phone app. The government would be able to identify if you come in contact with a Covid patient, test you and potentially isolate you. This tracking would be done with GPS. This technology is currently being used in Taiwan, Singapore, and Korea with success.

Furthermore establishing some kind of paper or digital immunity passport to carry with you would be needed so you can be employed. I imagine my conservative friend would be apoplectic at such an intrusion of civil liberties and many liberals would be opposed as well. The technology hurdles would be massive for a country of this size. Before you feel this is too Orwellian to even consider, know that the apps are currently being developed.




The other measurement is of course virus testing. Yesterday, our fearless leader boasted “We are doing 100,000 tests a day!” The problem is for a country this size it is far too few. Part of this reason is not Trump’s fault. We do not have enough centers in the country right now that are capable of performing the tests. There is a finite number of cotton swabs, reagents and machines that we can use. Although the number is increasing daily, the process is far too slow.

One author writes you need to be doing around 20 million tests a day with quick turn around of the results so you can act on them. Despite our vast wealth, expertise, and willingness to go into debt such an infrastructure currently does not exist in America. We need to pour resources into vastly increasing our testing capacity so we can successfully dig out of the hole. Such a step will take Federal leadership.

At my hospital. We are treating patients as “Presumptive Corona Virus Positive” since we do not have the tests to confirm it. I can bear witness when our fearless leader declares everyone can get a test that wants one is simply not true.

Step Wise Reopening

No one thinks we can simply yell “Olly olly oxen free!” and we will all climb out of our caves and go to work. This is magical thinking. The virus is still there and will cause illness and death.




So experts think likely businesses that allow social distancing with employees, that can be tracked as above, will open first. Think construction sites, infrastructure work, some offices , etc. Careful monitoring will have to take place and shut down will come swift and hard with a rise in infections.


Such a step will require careful coordination with Governors. As of today, eight states still have no shelter in place orders in effect. There is no centralized focus or leadership from the White House. No Federal plan of attack is present. Our fearless leader is comfortable letting each Governor find their own way with the Federal Government to provide support.




Ezra Klein writes, “What’s even scarier to consider is that the debate between these plans is far beyond the political debate we’re actually having. As of now, the White House has neither chosen nor begun executing on a plan of its own. That’s a terrible abdication of leadership, but reading through the various proposals, you can see why it’s happened. Imagine you’re the president of the United States in an election year. Which of these futures, with all its costs and risks and pain, would you want to try and sell to the American people?”

Restaurants and other service industries are more problematic. Some Asian countries have had success with using social distancing at these businesses but it is limited. Without careful monitoring, as above, such openings are risky without guidelines being followed.





Sadly, one plan points out larger gatherings, such as conventions, sporting events, amusement parks, etc are probably not going to be possible anytime soon. When a vaccine is readily available and testing is in place, perhaps by next year some normalcy can return in this area.

Schools

This is the one place where we may see some improvement sooner. Although children can get the infection and in rare cases die from it, the chance of this outcome remains far less than 1%. Many experts believe schools may be able to reopen by the next academic year on a limited basis.




However, schools are not run by children. They require adults who can get the infection to opt into the plan. Parents too will have to agree because the children can be asymptomatic reservoirs for the infection and pass it to others at home. We are likely to see some openings by Fall according to one report.

Surrender


Texas Lt Governor Dan Patrick

There are some on line in the fringe media who have advanced the argument that we should simply surrender to the disease and let it take its course. They advance the notion that while many go about their daily lives, we allow a highly lethal virus kill millions, hospitalize tens of millions more, and crush the health care system The virus will then burn itself out.



We can save lives and slowly rebuild provided we are willing to invest wisely as described above and collectively persevere together. In order to do that we need focused, self sacrificing leadership. This direction must come from the White house. He wants to be a War time president. Here is his chance. Unlike golf there are no mulligans here. He might not want to take responsibility but it is his role nonetheless. History will hold him accountable.


Conclusion

No matter what our fearless leader says about his coming plan for recovery, it will not be quick or easy. As you listen to his proposals see if he incorporates elements of what the experts have said. If he doesn’t, then he will reopen things only to see a surge of infection forcing another abrupt closure. I know Washington is very polarized right now. If our fearless leader somehow is able to look beyond his own narcissism and lead us out of this storm, then I will be the first to offer congratulations.




I don’t know what will happen.


As Easter comes to a close I am reminded at that time the world the world seemed very dark too.


But when Peter raced into the tomb, he found it empty, with the cloth neatly folded at the end.

It filled him with hope.

Today, as I have spent time pondering this deep hole we are in, I will think about that hope.

Dinner is ready.


"The lessons from Passover and Holy Week apply to believers and unbelievers alike, for a tiny virus has humbled us all. As we gather digitally in search of human contact, we do so with a new understanding of how vulnerably connected we are; a novel coronavirus that has spread around the world provides the proof. We will defeat the malady only by putting aside divisions and working together as a global community, united against a common threat. Our real victories are won not with the sword, but through our service and care for each other."

-Phillip Yancy





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