Tomorrow
Tomorrow: David Wallace-Wells
Pandemics and protests
almost as soon as the first marches to protest the killing of George Floyd began, in Minneapolis on May 26, conservatives and covid contrarians seized on the rallies as a case study of liberal coronavirus hypocrisy. If the disease spread rapidly through the assembled protesters, they felt, it would show that those who’d spent the spring scolding Americans for resisting lockdowns didn’t care as much about public health as they did about advancing their own set of political values. (Liberals, of course, would put it differently: that the cause was worth the risk.) If there were relatively few new cases, the thinking went, it would demonstrate that the lockdowns themselves were unnecessary.
Three weeks later, we have the first results from the natural experiment: Across the country, from Minneapolis to California and New York City to Albany, the protests produced, at most, very few additional cases of covid-19. The same was observed in the aftermath of the much-derided Lake of the Ozarks Memorial Day
party (where one sick partygoer may have infected as many as … one other). Does this mean we’re out of the covid-19 woods, and that the intrusive and intensely burdensome lockdowns of the spring were excessive? Well, no. The same week, a major study led by Berkeley’s Solomon Hsiang exploring the effect of lockdowns across the world found that, in the U.S., social-distancing and shelter-in-place guidelines prevented as many as 60 million additional cases. At least tens of thousands of lives were saved by social distancing and pandemic vigilance— and possibly many, many more.
These findings would seem to contradict each other, but only if you are proceeding from the reductive assumption that either lockdowns were absolutely necessary or that no precautions at all were. But whatever your impression as a lay consumer of publichealth guidance, scientists have known for months that “all or nothing” was a misleading way to combat the spread of the disease—which could be substantially mitigated by warm weather, mask-wearing, and better hygienic practices. Indeed, one recent analysis of more than 1,000 “superspreader” events around the world, for instance, found that more than 97 percent of them took place indoors.
All the way up through the beginning of the protests, and even after, America’s juryrigged, Rube Goldberg health-messaging apparatus failed to communicate most of these nuances—suggesting, for instance, that Georgia’s reopening was a “death sentence,” and that its governor had “blood on his hands,” rather than emphasizing relative risks and the precautions that might be taken to avoid them. Groups of scientists who would weeks later defend the marches on public-health grounds attacked Wisconsin’s in-person election. Even the same scientist who called reopening the economy “extraordinarily dangerous” in late May “wholeheartedly” defended and embraced the protests in early June.
And while there has been plenty of crowing about what these reversals say about liberals’ true concerns, the failure on the right has been considerably larger—because while it is indeed the case that reopenings can be relatively safe if the right precautions are taken, conservative leaders in the states reopening first have done basically nothing to ensure that they are. In Arizona, where the pandemic is growing rapidly, the governor has even tried to prohibit local officials from offering mask-wearing advisories. It was recently announced that, inside the White House, officials will no longer be required to wear masks.
This erratic pattern of advisories wasn’t just about mass gatherings, in other words.
And it wasn’t a sign that the underlying science had changed; it hadn’t. Instead, it reflects an unfortunate pattern from the first months of the pandemic, in which publichealth messaging has had a considerably less stellar record than you might hope for.
In January, as the earliest scary research into the outbreak began arriving from China, public-health officials downplayed the threat and advised that panic be channeled into vigilance about the flu, which they considered a bigger problem. In February, as initial data arrived from China showing a dramatic age skew in mortality, with the older at far greater risk than the young, political leaders and public-health officials did practically nothing to protect the most vulnerable. In New York, where roughly 6 percent of the nursing-home population has died, Governor Cuomo granted immunity to the executives who run those facilities; in California, where no such immunity was given, the toll was only 2,000, meaning less than one percent of its assisted-living population (though, to be fair, the total death toll outside nursing homes was much lower as well). In March, as evidence about the imperfect-but-still-significant efficacy of masks began rolling in, the who continued to advise against it. As recently as March 8, Anthony Fauci was advising the same thing on 60 Minutes, presumably to try and head off a possible mask run that would leave health workers undersupplied. Even Obama health-care adviser Ezekiel Emanuel, who recently touted a study showing several hundred thousand American cases were averted by mask-wearing, spent the winter insisting categorically that masks could not help. In April, as it became clearer that outdoor transmission was significantly harder than indoor transmission, officials across the country nevertheless continued closing parks and beaches.
Throughout these months, public-health messaging was hobbled by two complementary and distorting convictions. The first was a strong preference for universal messaging
The cost of this muddled messaging is becoming terrifyingly clear.
rather than more targeted guidance, which brought us to effectively national shelter-inplace orders before most of the country had even tried social-distancing, mask-wearing, and a focus on the most vulnerable. This meant that rather than a slow ratcheting up of concern, beginning in January, the public was treated instead to a whiplash from “Just the flu” to “Stay home, perhaps for months.”
The second was a lack of confidence in the public’s ability to process nuances and act responsibly, so that rather than be transparent about the limited protection offered by masks and the risks of supply problems, officials and journalists instead told the public they were useless. Similarly, rather than emphasizing that outdoor activity was basically safe, so long as you kept your distance from one another, we were told that for all but the most essential activities we should stay indoors—where we then entertained ourselves in part by shaming those selfish enough to walk through the local park or go to the beach. The most potent weapons in the public arsenal against the pandemic all require buy-in from the public, and this muddled and erratic messaging has undermined the public’s trust.
The cost of all this is becoming terrifyingly clear, even as the country has begun a rapid and humiliating project of normalization. Over the past few weeks, as the deaths of almost a thousand Americans a day have retreated into a sort of cultural background noise, with the protests taking their place on the country’s front pages, the total death toll has passed a series of grim milestones. Perhaps the most illuminating comparison is this one: The U.S. has about 4 percent of the world’s population and about 26 percent of its covid cases—more than twice as many as the next country, Brazil, and more than 20 times the official number reported by China, the world’s most populous country (and the one where the coronavirus first appeared).
In other words, the world’s richest country, as recently as the Ebola crisis of 2014 the planet’s leading disease-response force, has become the single most significant global incubator of the pandemic, perhaps even more central to the worldwide distribution of covid-19 than its country of origin. We should not be surprised if, over the next few weeks, the explosion of cases in Latin America, where the pandemic is growing fastest, is traced back to the U.S. And if, as a result, the U.S. response comes to be seen globally as not just a domestic catastrophe or a sign of the total failure of American leadership on global health but the central worldwide driver of this, the worst pandemic since 1918. That intervening century was once called the American one. ■