Plague of willful ignorance worsened by cultural war

In the early 20th century, the American South was ravaged by pellagra, a nasty disease that produced the “four Ds” — dermatitis, diarrhea, dementia and death. At first, pellagra’s nature was uncertain, but by 1915 Dr. Joseph Goldberger, a Hungarian immigrant employed by the federal government, had conclusively shown it was caused by nutritional deficiencies associated with poverty, and especially with a corn-based diet.

However, for decades many Southern citizens and politicians refused to accept this, declaring either that the epidemic was a fiction created by Northerners to insult the South or that the nutritional theory was an attack on Southern culture. And deaths from pellagra continued to climb. Sound familiar?

We’ve known for months what it takes to bring COVID-19 under control. You need a period of severe lockdown to reduce the disease’s prevalence. Only then can you reopen the economy — while maintaining social distancing as needed — and even then you need a regime of widespread testing, tracing and isolation of potentially infected individuals to keep the virus suppressed. A few countries, like New Zealand and South Korea, have largely or completely defeated the coronavirus. The European Union, comparable in population and diversity to the United States, continues to record new cases of COVID-19, but at a far slower rate than at the pandemic’s peak in late March and early April.

But the U.S. is exceptional, in a bad way. Our rate of new cases never declined all that much, because falling infection rates in the New York area were offset by flat or rising infections in the South and the West. Now cases are on the rise nationally and surging in Arizona, Texas and Florida.

It’s true that deaths are still falling for the nation as a whole, although they’re rising in some states. This reflects some combination of the way deaths lag infections, better precautions for the elderly, and better treatment as doctors learn more about the virus.

But we’re still losing around 600 Americans per day — that is, we’re experiencing the equivalent of six 9/11s every month. And many who aren’t killed by COVID19 are nonetheless debilitated by the illness, sometimes permanently.

Why are we doing so badly? A lot of the answer is that many state governments have rushed to return to business as usual even though only a handful of states meet federal criteria for even the initial phase of reopening. Epidemiologists warned that premature reopening would lead to a new wave of infections — and they were right.

Beyond that, in America, and only in America, basic health precautions have been caught up in a culture war. Most obviously, not wearing a face mask, and hence gratuitously endangering other people, has become a political symbol: President Trump has suggested that some people wear masks only to signal disapproval of him, and many Americans have decided that requiring masks in indoor spaces is an assault on their freedom.

The moral of this story is that America’s uniquely poor response isn’t just the result of bad leadership at the top — although tens of thousands would have been saved if we had a president who would deal with problems instead of trying to wish them away.

We’re also doing badly because, as the example of pellagra shows, there’s a long-standing anti-science, anti-expertise streak in American culture.