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America Is Giving Up on the Pandemic


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April Kincaid
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« on: June 08, 2020, 07:16:30 pm »

America Is Giving Up on the Pandemic

Businesses are reopening. Protests are erupting nationwide. But the virus isn’t done with us.
Alexis C. MadrigalRobinson Meyer
June 7, 2020
Mel D. Cole / Getty / The Atlantic

https://www.theatlantic.com/science/archive/2020/06/america-giving-up-on-pandemic/612796/?utm_source=pocket-newtab

After months of deserted public spaces and empty roads, Americans have returned to the streets. But they have come not for a joyous reopening to celebrate the country’s victory over the coronavirus. Instead, tens of thousands of people have ventured out to protest the killing of George Floyd by police.

Demonstrators have closely gathered all over the country, and in blocks-long crowds in large cities, singing and chanting and demanding justice. Police officers have dealt with them roughly, crowding protesters together, blasting them with lung and eye irritants, and cramming them into paddy wagons and jails.

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There’s no point in denying the obvious: Standing in a crowd for long periods raises the risk of increased transmission of SARS-CoV-2, the virus that causes COVID-19. This particular form of mass, in-person protest—and the corresponding police response—is a “perfect set-up” for transmission of the virus, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in a radio interview on Friday. Some police-brutality activists (such as Black Lives Matter Seattle) have issued statements about the risk involved in the protests. Others have organized less risky forms of protests, such as Oakland’s Anti Police-Terror Project’s massive “caravan for justice.”
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The risk of transmission is complicated by, and intertwined with, the urgent moral stakes: Systemic racism suffuses the United States. The mortality gap between black and white people persists. People born in zip codes mere miles from one another might have life-expectancy gaps of 10 or even 20 years. Two racial inequities meet in this week’s protests: one, a pandemic in which black people are dying at nearly twice their proportion of the population, according to racial data compiled by the COVID Tracking Project at The Atlantic; and two, antiblack police brutality, with its long American history and intensifying militarization. Floyd, 46, survived COVID-19 in April, but was killed under the knee of a police officer in May.

Read: Defund the police

Americans may wish the virus to be gone, but it is not. While the outbreak has eased in the Northeast, driving down the overall national numbers, cases have only plateaued in the rest of the country, and they appear to be on the rise in recent days in COVID Tracking Project data. Twenty-two states reported 400 or more new cases Friday, and 14 other states and Puerto Rico reported cases in the triple digits. Several states—including Arizona, North Carolina, and California—are now seeing their highest numbers of known cases.

These numbers all reflect infections that likely began before this week of protest. An even larger spike now seems likely. Put another way: If the country doesn’t see a substantial increase in new COVID-19 cases after this week, it should prompt a rethinking of what epidemiologists believe about how the virus spreads.

But as the pandemic persists, more and more states are pulling back on the measures they’d instituted to slow the virus. The Trump administration’s Coronavirus Task Force is winding down its activities. Its testing czar is returning to his day job at the Department of Health and Human Services. As the long, hot summer of 2020 begins, the facts suggest that the U.S. is not going to beat the coronavirus. Collectively, we slowly seem to be giving up. It is a bitter and unmistakably American cruelty that the people who might suffer most are also fighting for justice in a way that almost certainly increases their risk of being infected.

The protests have led to unusually agonized public-health communication. They have not been met with the stern admonition to stay home that has greeted earlier mass gatherings. Given the long-standing health inequities that black Americans have experienced, hundreds of public-health professionals signed a letter this week declining to oppose the protests “as risky for COVID-19 transmission”: “We support them as vital to the national public health and to the threatened health specifically of Black people in the United States,” they wrote. Yet the protests are indisputably risky, and officials at the Centers for Disease Control and Prevention have warned the gatherings might “seed” new outbreaks.   

Protesters themselves are not necessarily ignoring the pandemic. In videos of marches taken this week, many if not most, of the demonstrators appeared to be wearing masks. Photos and videos of protests show both large, tightly packed crowds and some demonstrators attempting to adhere to some form of social distancing. Protesters carrying hand sanitizer and water pass through the crowd in many cities.

But the evidence does not reveal universal compliance with public-health guidelines. Protesters lay close together on the ground in many cities for nearly nine-minute-long “die-ins,” evoking the length of time that Derek Chauvin, a Minneapolis police officer, knelt on Floyd’s neck. Many protests have involved some form of shouting, chanting, or singing, which research suggests can be especially effective modes of transmission for the virus. Earlier this week, near the White House, a mostly masked crowd loudly sang “Lean on Me.”

Adam Serwer: Trump gave police permission to be brutal

Protesters and public-health officials alike may be taking into account what The New York Times called “a growing consensus” that being outdoors mitigates some risk of transmission. The virus appears to perish quickly in a sunny, humid environment, even at room temperature, according to research conducted in April by the Department of Homeland Security. (Viral particles may survive for hours longer in drier conditions, and epidemiologists do not believe that these climatic effects alone will dampen the outbreak.) The virus also seems to be more difficult to transmit outside, especially during the day, though scientists still do not know enough about the virus to say confidently that large outdoor gatherings are completely safe. The number of protests over the past week means that researchers will soon have a much better understanding of the risks of outdoor transmission.

Many of the potential drivers of coronavirus transmission this week do not involve protester tactics: Dozens of police forces have used security measures that could allow the virus to spread more easily. In Washington, D.C., for instance, federal officers used tear gas or another chemical irritant on hundreds of peaceful protesters gathered in front of the White House on Monday so that President Donald Trump could pose for a photograph. Tear gas and chemicals like it force people to cough and gag, a fertile mode of transmission for the virus. Later that night, city police crowded protesters together before arresting them one by one, an aggressive crowd-control technique known as “kettling.” Hundreds of protesters who were arrested this week were sent—even if briefly—to the city’s jails, which have so many coronavirus cases that the District government has separated that number out from the citywide total.

In Philadelphia, city police teargassed hundreds of peaceful protesters marching on a freeway, prompting them to cough and gag. (There is no evidence that the demonstrators posed a threat to the safety of officers or bystanders, or were becoming violent, according to the local NPR affiliate.) In New York City, officers crammed hundreds of peaceful demonstrators together, then struck them with batons. From Iowa to Texas, officers used tear gas on large, largely peaceful gatherings; in at least five states, police deployed pepper spray or tear gas on children or teenagers, some of whom just happened to be nearby and were not attending the protests.

Read: I can’t breathe: braving teargas in a pandemic

Journalists from across the country have reported that police officers are wearing masks less often than protesters. “The state is the one with the duty to protect public health,” Alexandra Phelan, a professor of global-health law at Georgetown University, told us earlier this week. Regardless of what the police think of the protests, she said, it is their obligation under international and domestic law to keep the protesters safe, including minimizing the health risk from viral spread.

There are too many variables to know exactly what the summer has in store for the outbreak in America, including what effect the protests will have. There are some signs of hope. Masks are in use around the country. Outdoor transmission seems to be fairly unlikely in most settings. And testing availability has improved. According to data from the COVID Tracking Project, the United States can now conduct 3 million tests a week. The public-health system is discovering and diagnosing a much greater percentage of cases than it did in the early days of the outbreak. Morgan Stanley estimated that the transmission rate in the U.S. was just above 1; this suggests that there has not been explosive growth in the number of active cases in recent weeks.

But that estimated rate also implies that cases are not rapidly declining. And the slow growth reflects the time before the full data from states’ recent moves to reopen their economy became available—before large swaths of the public returned to work, and before the mass protests and jailings began.

Few people believe that the U.S. is doing all it can to contain the virus. A brief glance at Covid Exit Strategy, a site that tracks state-by-state progress, reveals that most states are not actually hitting the reopening marks suggested by public-health experts. Yet state leaders have not stuck with the kinds of lockdowns that suppressed the virus in other countries; nobody has suggested that cases must be brought to negligible levels before normal activity can resume. No federal official has shared a plan for preventing transmission among states that have outbreaks of varying intensity. The Trump administration did not use the eight weeks of intense social distancing to significantly expand our suppression capacity.

What our colleague Ed Yong called “the patchwork pandemic” appears to have confused the American public about what is going on. The virus is not following one single course through the nation, but, like a tornado, is taking a meandering and at times incomprehensible path through cities and counties. Why this workplace but not another? Why this city or state but not others?
Chart tool by Peter Walker; data from the COVID Tracking Project at The Atlantic

The virus has not mapped neatly onto American political narratives, either. While some questions remain about their accounting, Georgia and Florida—where leaders opened up early and residents seemed relatively defiant of public-health advice—have seen relatively flat numbers, while California, which took a more conservative approach, has seen cases grow. The state most poised for major trouble seems to be Arizona, where the outbreak is spreading very quickly. Not only is the state (which lifted its stay-at-home order on May 16) setting new records for positive tests and people in the hospital, but the percentage of tests that are coming back positive is also growing. So much for warm weather and sunshine alone stamping out viral transmission, as some had hoped: Phoenix saw only a single day’s high under 90 degrees during May. The state’s age demographics also haven’t played an obvious role: The state is slightly younger than the U.S. as a whole.
Chart tool by Peter Walker; data from the COVID Tracking Project at The Atlantic

Americans have not fully grasped that we are not doing what countries that have returned to normal have done. Some countries have almost completely suppressed the virus. Others had large outbreaks, took intense measures, and have seen life return to normal. Americans, meanwhile, never stayed at home to the degree that most Europeans have, according to mobility data from Apple and Google. Our version of the spring lockdown looked more like Sweden’s looser approach than like the more substantial measures in Italy, or even the United Kingdom and France. Swedish public-health officials have acknowledged that this approach may not have been the best path forward.

Read: Why America resists learning from other countries

For several weeks at the beginning of the outbreak in the U.S., the need to control the virus took precedence over other concerns. Now, for many people, the pandemic is no longer the most pressing national issue. As protesters and some public-health officials have said they are weighing the harms of police violence against the risk of increased viral spread and choosing to gather in the streets, state governments have made similar risk-reward arguments about balancing public-health and economic concerns. The virus does not care about these trade-offs. Retail reopenings and racial-justice protests may exist on different moral planes, but to the virus they both present new environments for spreading.

Maybe the U.S. will somehow avoid another New York–style outbreak. Maybe the number of new infections will not grow exponentially. Maybe treatments have sufficiently improved that we will see huge outbreaks, but fewer people will die than we’ve come to expect. If so, it won’t be because the United States made concerted, coordinated decisions about how to balance the horrors of the pandemic and the frustration of pausing everyday life. Instead, the United States has moved from attempting to beat the virus to managing the harm of losing.

This is America. The problems with our response to the pandemic reflect the problems of the country itself. Our health-care system is almost uniquely ill-suited to dealing with a national health crisis; preexisting health disparities, entrenched and deepened by decades of racism, cannot be erased overnight; state and local health departments desperately needed federal leadership they did not receive; the Senate has not entertained a longer-lasting economic-rescue package that would allow a more prolonged period of sheltering in place; states are facing a fiscal cliff.

And yet, even though this health crisis reflects our nation’s political, social, and civic infrastructure, this plague has no consideration for morality. People partying in a pool may live while those protesting police brutality may die. People who assiduously followed the rules of social distancing may get sick, while those who flouted them happily toast their friends in a crowded bar. There is no righteous logic here. There is no justice in who can breathe easy and who can’t breathe at all.

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April Kincaid
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« Reply #1 on: June 08, 2020, 07:17:31 pm »

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Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin
April Kincaid
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« Reply #2 on: June 08, 2020, 07:17:54 pm »

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Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin
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