Six Weeks of Sheltering in Place

Using the Extra Time

This week I saw two very interesting TV programs. PBS’ American Experience (last night) and CNN’s (last Saturday) that I found instructive and balanced.  I wish we had more programs that increase our knowledge of this deadly epidemic.

Let me start with the CNN program. Don Lemon and Van Jones hosted it. I admit that I am an admirer of Van Jones and that I dislike Don Lemon. Both are African American TV personalities.  The subject was the impact of the virus on communities of color. Findings show that African Americans and Hispanics are being disproportionally impacted. Reasons? Socio-economic by-and-large. Another important factor cited was concentration in major cities such as New York, Chicago, Detroit, Philadelphia, Los Angeles and New Orleans.

African American and Hispanic celebrities such as Magic Johnson and Charles Barkley appeared as guests. It was the general consensus that these communities are more vulnerable because many find themselves at the bottom of the economic ladder, have poor education, are housed in tighter spaces, are reluctant or unable to access healthcare and hold jobs that puts them at a greater risk. African Americans have high rates of diabetes, obesity, sickle cell anemia and coronary problems.

No solutions were offered. Charles Barkley, in his signature candid style, suggested that folks in the communities must take responsibility for their own behavior. He pointed out that many of the underlying conditions are the result of the choices people make e.g., we eat too much, we drink too much, we exercise too little and so on.

The PBS program was different. It chronicled the epidemic from its start in Washington State all the way to the present.  It gave an up-to-date overview of the medical experience, the public health challenge, the politics, the management issues, and the shifting priorities. It points out that initially our leaders failed to take the issue seriously and that the nation was ill prepared for an epidemic of this proportion.

It was interesting to hear that there are seventy projects worldwide working on a vaccine. Five of these projects are on an accelerated testing timeline. Once the vaccine is found the next challenge will shift to how fast and economically to produce the 14 billion doses needed for the treatment of the world population. The logistics and the funding will be huge challenges.

It is a war …

What we have learned to date is that there is an all out war to defeat the virus. Like any war, you do not measure success based on winning one or more battles. You achieve victory when you defeat the enemy. We will not know how good our strategy is until then.

The Fog of War

During a war it is difficult to make decisions in the midst of a conflict.

The lessons learned from the Vietnam War are many:

         Empathize with the enemy.

         Rationality alone will not save you.

         There is something beyond one’s self.

         Maximize efficiency.

         Proportionality should be a guideline.

         Get the data.

         Believing and seeing are both wrong.

         Be prepared to re-examine your reasoning.

         In order to do good, you may have to engage in evil.

         Never say never.

         You cannot change human nature.

It would be wise for our leaders to visit these lessons and avoid repeating the errors. A review of our performance to date shows that we are not fully heeding the lessons. I leave to the reader’s imagination to zero in.

We Are Winning Most of the Battles

Caught up in party politics and blinded by our own paradigm, we often fail to see the progress we are making and as a result we fritter away our accomplishments.

Let’s examine our battles …

We did flatten the curve. While not a strategy to win the war, it did help us prevent the overwhelming of our hospitals. We did such a great job that we did not have to use the field hospitals erected by the US Army of Engineers or the hospital ships provided by the US Navy.

We have won so far the sheltering in place. While not a strategy to win the war, it has helped contain the spread of the virus. By keeping open just essential services we have reduced the human-to-human contact, thus limiting further the spreading of the virus.

We have won the social distancing. While not a strategy to win the war, it has helped us further limit human interaction. Less interaction the more likely that there will be less transmission of the virus.

Congress and the President have acted expeditiously by providing trillions of dollars to help those who have lost their jobs, businesses that have had to close or wind down, and state and local organizations particularly hit by the epidemic. Additional funding is being considered to address disruptions nationwide. Politicians added quite a bit of pork to fund their pet projects by capitalizing on the crisis.

We have won the numbers battle. Initial models and estimates of potential cases and deaths were all over the board. We were told that up to 2.2 million Americans would die. The number of deaths has now been shaved to 60,000. While one death is one too many, each year about the same number of people die from the common flu. As the number of cases continues to grow, we are reminded that 96-98% of the cases do not result in death.

We have not won the battle when it comes to shortages of masks, gowns, ventilators, and other critical medical supplies. We started out with inadequate stocks and have had issues catching up. Much unfinished business remains. The national, state and local strategic resources were woefully inadequate for an epidemic of these proportions.

We have not yet won the testing. The CDC (not Trump) rejected using the German test opting to develop its own. It was a bad decision in the short term. We are now increasing our capacity to test exponentially as the FDA approves new and novel ways to expand the programs. There is room for optimism as these new tools come on line.

The Final Battle

It is shaping up as we speak. There are two approaches in play. It is evolving into partisan choices. Democrats want to go slow on re-opening the economy by insisting on testing, testing, testing. Republicans counter with the argument that one size does not fit all. They prefer a more rapid opening up in places where the risk is less or more manageable.

The nation’s economy has taken a big hit. More than 25 million people have been furloughed. Thousands of businesses have been forced to close. The longer the shutdown, the longer it will take for the economy to bounce back. The longer the shutdown lasts, the more likely that the nation’s treasury is further depleted and beyond repair.

I am a skeptic.

Both approaches are driven by political motivations.  It seems that both parties are jockeying for advantage in the upcoming general election. A rapid economic turnaround would benefit Republicans. A slow recovery would benefit Democrats.

I find this reasoning faulty at best and evil at its worst.

Lessons from Football

American football teaches us an important lesson.

A ball hurled too quickly at a receiver goes over his head. It results in an incomplete pass. The same happens if the ball is hurled too slowly. It lands at the receiver’s feet as an incomplete pass as well.

Are we playing Ping-Pong with a zero sum outcome?  We should leave politics out … there is more at stake here than an election … people’s lives.