better
Things are starting to get better. In New York, officials say the case count has begun to plateau. California hasn’t seen the spike it feared was coming. Antibody testing that will help to identify those who are no longer at risk is starting to roll out. Back at home in Toronto, friends tell me health officials are talking about a successful “flattening” of the curve. It feels like we’re slowly starting to bring this ship around.
And I’ve got mixed feelings about that. Don’t get me wrong: this is a tremendous tragedy and it comes with enormous, life altering consequences for all of us. It is disproportionately affecting vulnerable populations and I am acutely aware that I am in a fortunate circumstance. For all of us, I want this to be over. But there is a part of me that has become comfortable with parts of this new normal.
I asked a month ago what the “acceptance” stage of grief might feel like and I think I’m starting to get an idea. I can find gratitude for this experience of a life that is a lot smaller and a little slower, and that I can take an hour for myself in the mornings every day just to go for a walk. I pull a fresh loaf of sourdough out of the oven every Saturday morning that I share with friends or trade for their own home cooking. I’m talking to friends around the world more than ever – about bread making in the UK countryside, about family challenges in Toronto, about creative work in San Francisco, and about social distancing in St. Petersburg. I’ve forged a new relationship with the senior neighbor, who likes to pitch in for meals from her pantry. I have spoken with her more in the past month than in the eight years I’ve known her and I have come to enjoy our daily exchange of texts about what’s for dinner. Tonight, we had burgers she pulled out of her freezer and prepared on her stove, while I gathered up all the vegetables that really needed to be eaten today and mixed them into a quinoa vegetable stir-fry for the side. Before all this, I would have nodded at her in the morning and left it at that. And you know what? It turns out I don’t actually like going shopping; I don’t miss it and this break has been good for my bank account.
At the start of all of this, I kept daily tabs on the case count. It was the only piece of concrete information we really had in all of this and each day I called up the USA versus Canada numbers to evaluate them with an eye to seeing whether I might need to make a sudden move back home.
But the more I have monitored the numbers, the more I realized there is nuance to them: tidy graphs perched on shifting sands.
A month ago, the USA had a total of 19,393 cases with a total of 256 deaths from Coronavirus. What struck me at the time was that the case tally had grown 198% over the previous three days and the global focus of the crisis was shifting to New York. I wrote that day that it felt like we were collectively grieving and that day’s “staggering” number was hard to take. Today, the USA remains a global hotspot for this thing, with more cases than anywhere else in the world. The count is now at 794,330, with the death toll at 42,634.
But really, case-by-case counts don’t tell you very much.
America has a lot of cases because America has a lot of people in it. By area, it’s the fourth-largest nation in the world (behind Russia, Canada, and China) and, with about 330 million people, it’s also the third most populous. (China and India are first and second, with 1.4 and 1.3 billion, respectively).
So, when you standardize those numbers by cases per million of population, topping the list at 14,028 cases per million is the tiny Republic of San Marino. (I didn’t realize it was its own thing until just now when I looked it up. I thought it was part of Northern Italy). Vatican City is next with 11,236 per million, followed by Andorra, with 9,280 positive tests per million population.
The USA is way down the list at 16th, with only 2,400 cases per million people. But China, by comparison, has 57 only cases per million. I had to check that number multiple times. How can that be? Isn’t that where this all started? But, like the USA, China is a big country with a ton of people in it. If you sweep away the sand of their 82,788 total confirmed cases and look at Hubei province, where Wuhan is, you find a different story. The count stands at around 1,150 cases per million of that region’s population (67,803 total). Compare that to New York, where the numbers are finally starting to plateau, and it becomes clear how dire it really got there. New York state’s rate is exponentially worse than that of Hubei, which has recorded around 12,483 infections per million people.
But still these numbers show a fragment of the situation. Patients need to be identified in order to be counted, and that means testing.
Let’s look at a pair of Nordic neighbors. Sweden, which has notoriously relaxed distancing guidelines, has recorded 15,322 confirmed cases -- 1,517 per million. Norway, next door has a similar 1,326 per million case rate, but also fewer people so their total is around half of Sweden’s at 7,191. It looks like Sweden’s loose restrictions and more open economy isn’t causing much hardship for the people until you dig at the numbers a little more. Sweden has only conducted 7,387 tests per million of their population. Norway has done nearly four times that at 26,798 per million of population. So… I don’t think Sweden knows as well as Norway what their infection rate is and they may in fact have many more cases than they have identified.
The USA ranks 42nd in the world for tests issued per million population, currently at 12,277. Russia is 38th with 14,682, and Canada is 37th at 14,995. China doesn’t seem to be releasing that particular number, but Iceland is and they’re doing an amazing 128,445 tests per million of population. In case you’re wondering where my numbers come from, I consult multiple sources — including the economist and the New York Times, as well as the CDC and WHO and even just the front page of Google — but my favorite is this one.
Experts here in the USA are calling for testing to at least double and maybe triple for even a partial reopening of the country’s economy. And there’s a general agreement that contact tracing strategies will be necessary to isolate the potentially sick from the healthy. There’s talk of temperature checks at offices and mask wearing for the foreseeable future. China is slowly starting to get back to business with all kinds of new rules. I saw on the news that people there have a mandatory app on their phones that shows them whether they’re required to be in quarantine or are free to move around. In Russia, a friend tells me, the police are doing spot checks at individual homes to ensure people are respecting the lockdown guidance.
Yet here in America today, facing test and supply shortages and no clear national plan for contact tracing, parts of this country are talking about putting an abrupt end to social distancing.
The president started this conversation a few days ago by asserting he had “total authority” to re-open the nation and asserting that he was preparing to make a decision. This, even though America has been under a patchwork of lockdown statuses imposed by various city and state officials while the federal government has largely refused to act on a national scale. As is now the standard, he reversed his position a couple of days later. And his coronavirus task force downloaded the responsibility for re-opening back to the states as they rolled out vague recommendations for how Americans might get back to business in this country. The guidelines, which appear to be “advice” only, advocate a three-phase approach, with monitoring to ensure there is a 14-day “downward trajectory” of cases in each phase before moving on to the next one.
Officials including the government’s own leading infections disease expert, Dr. Anthony Fauci, have loudly warned that resuming business too soon risks a spike in new infections that will set us back to where we were at the start of this thing. But state officials in some areas are feeling a lot of pressure to get people back to work. This global lockdown has plunged the world into an economic depression and it is manifesting in all kinds of ways — including a crisis of oversupply in the oil industry that actually pushed crude prices into the negative today. On a personal level, the job losses are staggering. There will be astonishing social costs as well. So far I’ve held onto my paycheck, but nobody is safe. The Great Recession of 2008 and 2009 cost an estimated 2.6 million Americans their jobs. The current estimate since this all started is 22 million in the USA alone.
The jobs that are most at risk are the ones that can’t happen remotely. I can do my conference calls and e-mails from home, but employees of an assembly plant or a processing facility need to be where the work is. And a lot of those people have lost paychecks and are wondering how they will keep the lights on this month. And what happens if a member of their family needs to go to the doctor without an employer provided health insurance plan? It’s a sense of desperation that has led people to protest in Michigan, Virginia, Pennsylvania, Indiana, Maryland and more. Many of the demonstrators flouted social distancing guidelines to take to the streets. They are part of a restless group — supported by a furiously Tweeting president — that is beginning to growl that the social distancing cure may be worse than the coronavirus disease. They are in the minority but they are making themselves heard even while officials caution the protests themselves will cause new outbreaks, and the head of the National Association of Manufacturers lobby group, Jay Timmons, was quoted Tuesday in the New York Times calling protesters “idiots.”
It’s an interesting problem we’re unaccustomed to dealing with. We fiercely protect the right to assemble and speak our minds in democracies like America. But what happens when your protest threatens my life and my future? “We don’t want to risk having to shut our economy down again,” Timmons told the New York Times on Tuesday. “We can’t go through this again. And it’s unfortunately likely that that will happen if you have people who are irresponsible beating their chests at a demonstration on the steps of the state capitols surrounded by dozens if not hundreds of other irresponsible people.”
But the nation’s true experiment will be Georgia, which starts to re-open this week over the objections of Atlanta Mayor Keisha Lance Bottoms. Even by the loose federal standards, it’s an aggressive move. The state has not yet seen 14 days of downward movement in the numbers, and nowhere in the country has the medical system been able to double or triple the rate of testing. Even so, state authorities have decreed that gyms, hair salons, bowling alleys and tattoo parlors will be allowed to reopen this Friday. After the weekend, the movie theaters and restaurants will be allowed to re-open. Tennessee and South Carolina plan to follow suit next week. This is a game of follow the leader with the potential for life and death consequences and it will be interesting to see what the individual business owners — and their customers — decide to do.
But with fact and fiction melded together from the presidential podium and pressure to prioritize business and economic needs over public safety, elected officials are doing what they think is right – even if it isn’t. And among a certain segment of this population, a group of people that embodies the fierce American value of individualism, trust in authority is at an all-time low. Expertise is conflated with elitism and facts and science are viewed with suspicion. I disagree but at least in one sense, I can relate because what we all share is a need to know things again. To trust that — most likely — most of the things about tomorrow will be pretty much the same as they were today. And I can’t help but wonder if that ever going to be a thing again. Or is acceptance about becoming comfortable with having uncertain sand underfoot all the time? I’ve never been one for long walks on the beach, but when California finally decides to open them back up, it looks like I’ll be learning to love them.