With Coronavirus, Overkill is What Works.
As Americans endure the privations necessary to “flatten the curve” of new cases of coronavirus COVID-19, we wish that our leaders could manage even a fraction of the comity and tolerance exhibited every day by ordinary people throughout this country.
Sadly, we see too much of the opposite.
Putting aside the machinations of politicians, there seems to be a widespread need to blame any misstep, or even uncertainty, on somebody or something. The ubiquitousness of social media and the internet drives the conviction that there is a definitive answer for everything, if only you could find the right website or news channel, or follow the right people. And there certainly is no shortage of pundits and pontificators confident about offering predictions based on insufficient or anecdotal data—or, worse yet, making assertions that genuine experts know are false.
America would like to know the exact mechanism by which COVID-19 spreads in order to impose only those measures that are necessary and sufficient.
Unfortunately, although we have many insights, and are gaining more every day, that knowledge is not perfect. We do know that a sledgehammer will drive that nail—in other words, in this situation, overkill is what works, even if it cannot be continued indefinitely.
MONDAY-MORNING QUARTERBACKING IS EASY
Currently, scientists have no way to accurately predict which infected patients will develop an often-fatal condition called “cytokine storm,” a severe immune reaction in which the body releases an excess of chemicals called cytokines into the blood too quickly, which compromises oxygenation of the blood in the lungs and can cause multiple organ failure. Surrogate variables like age and certain pre-existing conditions are helpful, but not definitive, predictors.
Nobody is to blame for our inability to answer such questions. In time, we will have more definitive answers, as well as preventatives (vaccines and/or drugs) and treatments. But some things can’t be done as quickly as we would like. Monday-morning quarterbacking with the benefit of hindsight is easy, but it is a whole lot harder on the field as the game is underway.
Watching any cable news channel, it is evident that we are awash with armchair epidemiologists and infectious disease specialists. But stepping back from the brink of political debate and vituperation, what matters now is the ability of the various leaders—national, state, and local—to adapt to the fog of war on the battlefield of the pandemic, and to seek and heed genuine expertise.
Unsurprisingly, we see a wide range of abilities to accomplish that. At the nadir of this scale must be New York City Health Commissioner, Oxiris Barbot, who, as recently as early February, was encouraging people to essentially ignore the virus, while Mayor Bill De Blasio (D) cheered her on until early March. Other candidates for the pantheon of shame include: Florida Governor Ron DeSantis (R), for failing to minimize the veritable petri dish of Spring Break frolickers on his state’s beaches; the delay in issuing a “stay at home” order in Georgia by Governor Brian Kemp (R); and Texas Governor Greg Abbott (R), for exempting church services from his “stay at home” order.
The ultimate source of the pandemic—which is, of course, China—is largely beyond our influence. Leaving aside their allowing “live markets” that sell exotic animals, which are reservoirs for zoonotic viruses, had China raised a warning about the emergence of the SARS-CoV-2 virus when infections were first discovered, other countries would have had the opportunity to react in a more timely way. When the Chinese government allowed millions of Wuhan residents to move domestically and internationally without disclosing what they knew about their potential to spread COVID-19, it set in motion a series of events that ultimately required our (and other nations’) leaders to react on the basis of limited information.
It is no wonder that our responses, on many levels, have been suboptimal.
But there will be ample time for finger-pointing during the pandemic’s post-mortem (a term we use deliberately). Now, we need to focus on how to mitigate the spread of COVID-19 and to reduce the uncertainty about reviving and restoring the economy.
COVID-19 must be a wake-up call about the need for better surveillance and more research and preparation between pandemics. But just as we accept uncertainty in other realms, such as whether our flu shot will work (depending on the year, they’re only 20-60% effective), understanding the mind-brain interface, and knowing the actual distance to another galaxy, it is time to stop expecting perfect certainty about the progression and best responses to pandemics.
It’s time for politicians to shut up about who’s to blame for what, get expert advice, show leadership, and pitch in to solve the problem.