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I experienced a certain amount of reluctance when I decided to do another post on COVID-19. For starters not only is everyone kind of sick of hearing about it, but there is also a credible argument to be made that the biggest problem right now is just how many different opinions there are when it comes to the crisis. That what we might need are fewer opinions, not more. If this is the case then adding my opinion to the hundreds that are already out there just makes the problem worse, not better. Of course, as you can see I overcame that reluctance, and decided to go ahead with it. I hope that doesn’t end up being a mistake.I suppose you’ll have to read it and decide for yourself.
Part of the impetus for this post came from reading Ross Douthat’s latest, and an excerpt from that article might help set the stage.
“Americans play to win all the time,” George Patton told the Third Army in the spring of 1944. “That’s why Americans have never lost and will never lose a war. The very thought of losing is hateful to Americans.”
That was in another time, another country. When Patton spoke the United States was still ascending, a superpower in the making. But once our ascent was complete, our war making became managerial, lumbering, oriented toward stalemate. From Vietnam to Iraq to Afghanistan to all our lesser conflicts, the current American way of warfare rarely has a plan to win.
Maybe the America of mass mobilization belongs as much to the past as Patton, MacArthur, Ike. But nothing that’s happened so far in this crisis proves, definitively, that we the people lack the will to win — especially when the alternative is just enduring, and dying, for months and months to come.
So as we look for a post-lockdown strategy, maybe what we’re actually looking for are leaders — be they governors or legislators, Trump and his appointees or the Democratic nominee for president — willing to embrace the old-fashioned idea that in this struggle, as in the wars our country used to wage, there is no substitute for victory.
That was the first two and last two paragraphs from his article, and I hope you (and he) will forgive the length of the excerpt, but his point was an important one. There is no substitute for victory and we should be doing whatever it takes to get there. The problem, at least for me, and I assume a lot of people, is that it’s not clear how to get there with the America we have, and it’s even a little unclear how to get there period.
In answer to this last statement a lot of people will retort, “Well what about South Korea, Taiwan and China?” Haven’t they been victorious? So let’s start there. First, we need to be clear that we can’t trust all of the information coming out of China, which I’ve mentioned in previous posts. But that issue aside, these countries are fantastic examples of what to do and I think the US should be emulating their example as much as possible. And that when Douthat talks about a lack of leadership it’s the failure of our leaders to aggressively follow these countries’ examples, particularly in the case of masks which I blogged about previously. But also in areas like testing and tracing. So the solution is just “copy Taiwan”? End of story? Unfortunately there are two reasons why it’s not that simple. First, there’s the idea I already alluded to, America is a very different place than Taiwan or South Korea. But beyond that, and important to mention, the final tally of deaths is not in yet, and until it is, the possibility remains that we should be emulating Sweden not South Korea.
Before people start accusing me of wanting old people to die, let me offer some clarifications. First, if I was given absolute control over the US pandemic response I would definitely be trying to emulate Taiwan (for those who didn’t follow the link, they’ve had 440 cases with 7 fatalities so 1/10,000th as many deaths with 1/15th the population of the US). Second, it’s important to remember that it’s not today’s death toll that matters, it’s the final death toll. And it’s not even the final death toll from COVID-19, it’s the final death toll from all the things we do. If suicides go up, our numbers should do their best to reflect that, and ditto if traffic fatalities go down. And it’s not even the final death toll from all causes, what really matters is the final toll period, what did that path cost us when all is said and done. This is the hardest thing of all to quantify, particularly since as much as people hate to put a dollar value on human life, in some fashion, at least, economics has to be part of that calculation.
For the moment imagine that the window for containing the virus is past, that it’s too widespread and too deeply entrenched and there are too many asymptomatic carriers. That a vaccine ends up taking years or being outright impossible. That despite our best efforts (and recall we’re a long way even from that) the virus can only eventually be stopped through worldwide “herd immunity”. That as great as Taiwan’s measures are, they eventually fail and when the final tally is made, their death rate ends up being essentially the same as Sweden’s. If that’s how it plays out, one would expect Sweden to reach this immunity much sooner than Taiwan. What will that mean for them? If the death rate ends up being essentially the same for both countries won’t people end up envying Sweden rather than Taiwan? Because they didn’t have to deal with years of heightened precautions which ended up being pointless?
I suspect that this last point is not one people think about a lot. When you consider what it takes to maintain a system like the ones these countries have in place, it’s neither cheap nor unobtrusive. There’s definitely got to be some downside, some drag, consequences to the perpetual uncertainty, where years go by with lockdowns imposed and then lifted, continual monitoring and screening, closed borders, no really large gatherings, etc. And to reiterate if these methods work, then that’s great, and that’s the path I would prefer to take, but what if ultimately they don’t? What if Taiwan and South Korea end up with the same basic death rate as Sweden, but had to suffer through years of ultimately futile precautions as well?
The point being that, while I would definitely prefer to implement the South Korean or Taiwan approach, there is still an enormous amount of uncertainty, and a lot we don’t know. Consequently I’m grateful that both Taiwan and Sweden are out there and that they’re trying different approaches, because ideally we’d learn from both in constructing our own response. Which takes us from the “how do we get to victory” problem (answer: it’s complicated, and a lot of questions remain) to the question of how do we get there with the America we have? How do we turn the current quagmire into victory?
One of the things that characterized all of our past victories, to one degree or another, is sacrifice. But what does sacrifice look like in the current crisis? Are the Swedes sacrificing? Are the Koreans? I’m not sure. What about the US? I can certainly think of one example of sacrifice, which got a lot of press, both because people love stories of sacrifice, and also because so far I don’t think there’s been a lot of them. (i.e. demand far outstrips supply) It’s the story of the workers who lived in the factory for 28 days making polypropylene to get turned into PPE.
I will admit to personally loving that story, and I’d love to expand the example into some broad lesson, but I’m not sure if it scales up. Are there other critical factories that could do the same thing or something similar? Perhaps, and I’ll get to that later, but I think this issue of sacrifice is at the root of the leadership problem Douthat mentioned in the article I quoted from originally. That good leaders inspire sacrifice, and sacrifice is how you win.
This is certainly not all a leader does, but in a crisis like this I’d be willing to bet that it’s a big part of it, and to the extent that it is we’re still left with two problems. Finding a leader who can inspire the entire nation to sacrifice and figuring out what sort of sacrifice this leader should be advocating.
As to the first, Trump is clearly not that leader. I will admit, in the past, to being something of a Trump apologist, which is to say, I think he’s an awful person, and an awful president, but I didn’t think he was Satan incarnate, and, also, like many people, I thought labeling him as such made it more difficult to call out actual Satans. I still basically feel that way, but it’s apparent that his failings, which are many, have been magnified by this crisis and that if, as Douthat claims, victory requires some amount of leadership, say a Patton or a MacAuther, a Roosevelt or a Kennedy (which is not to say that those people didn’t have their own failings) that we have been saddled with basically the opposite. Unfortunately, it doesn’t appear that Biden is such a leader either. But as I said it’s still not clear what the ideal leader should be doing. Even if we assume that we had the required leadership, what sacrifices would this leader ask of us?
The largest crises of the past were all wars and the sacrifice people were asked to make was death, or at least the risk of death. And people volunteered in their thousands and tens of thousands, to personally risk death. Today no one is being asked to do that (there are some proposals asking for healthy people to volunteer to be infected, but they’ve gone nowhere) and it’s impossible to imagine any leader suggesting it even obliquely. And to be clear I’m not arguing that they should, I’m just pointing out how off limits it is. Is it so off limits because when it comes down to it there’s really not that much similarity between a war and a pandemic? Or is it off limits because this is 2020, not 1918?
Those are interesting questions, in particular what did happen in 1918? Was leadership an important part of things? Was there a Churchill equivalent who rallied an entire nation? As far as I can tell the answer no. And what’s even more interesting is that despite all of the current sturm and drang, the 1918 pandemic, which was vastly worse on every measure, ended up mostly being forgotten. Up until possibly the last few months, if you had asked people to name the greatest disaster of the 20th century almost no one would have said the Spanish Flu, and most wouldn’t have said it even if you’d asked them to list the top ten disasters.
(If you want hard numbers as of 2017 there were 80,000 books on World War I, and 400 on the Spanish flu, and most of those had been written since 2000. Alternatively just do a Google search for: spanish flu forgotten.)
What are we to make of that fact? Why didn’t the Spanish Flu loom larger in the collective imagination? Is it because it came and went so fast? (The majority of deaths took place in a 13 week period at the end of 1918.) Is it because it was largely a solitary crisis? Should the level at which something is remembered be used as a proxy for how bad it was? Apparently not, because the Spanish Flu was really bad. Should it be used as a proxy for how impactful it was? One would think that this is almost the definition of memory. Does that mean the Spanish Flu didn’t have that much of an impact? Maybe?
Frankly I’m not sure what to make of this, nor do I intend to use it in service of some sweeping recommendation or conclusion. But it’s something I haven’t seen mentioned elsewhere, and it feels important.
In the course of writing this post I was more thinking through things than holding forth on some pre-formed opinion. And in the course of that, I think what I’m inclined to do is offer a caveat to Douthat’s call for leadership. I don’t think we need leadership in the traditional, “rally the country”, “call for sacrifice” sense. What I think we need is smart and effective leadership (man did we end up with the wrong president in this crisis). Which is easy to say and hard to do, so allow me to explain.
Vox.com recently published a list of recommendations on how to beat COVID. It included the things you might expect, universal mask wearing, more testing, contact tracing, etc. But it also included things like removing restrictions on outdoor spaces and spending a lot of money. And these latter two in particular begin to touch on what I mean by being smart. But before we fully switch to that topic, it also illustrates one last thing about sacrifice.
You can imagine that it’s a sacrifice to wear masks, or to stay at home. We might also have to make sacrifices to ramp up testing and tracing. But none of these things really fit in with how sacrifice has worked historically. For one thing they’re not particularly demanding, nor are they particularly… flashy. But more than that, most of the time when we imagine sacrifice we imagine shared sacrifice. A band of brothers, or living in the factory for 28 days to produce material, or even a group of founders working crazy hours on their startup. All of the things we’re being asked to do, in addition to being fairly low effort, are also pretty solitary as well. You would think that if the measures being recommended required less effort that this would be a good thing, but I get the feeling that it’s not. That we’re actually having a harder time unifying because less is being asked of us and what’s being asked of us doesn’t require us to come together.
So if having a charismatic leader inspiring us all towards victory through the medium of shared sacrifice is out, then we have to be smart. We can imagine achieving victory through enormous effort, lockdowns that lasted months, 99% mask and handwashing compliance, quarantining people centrally, and everything else we could think of. In other words a plan where we’re not sure which measures are the most effective, but we do them all just to be sure. The problem is that this has a high social and emotional cost. A charismatic leader, and a lot of unity might allow us to pull it off anyway, but we don’t have those. This being the case it suddenly becomes a lot more important to pick our battles, figure out what really works and emphasize those things. It becomes far more important to be smart.
Above I mentioned Vox’s recommendation that we allow people outside, and this is exactly the kind of thing I’m talking about. Despite very little evidence of transmission out of doors (a study of over a 1000 transmissions in China found only one case where it happened outside) numerous jurisdictions have closed outdoor spaces, and we’ve probably all seen alarmed stories about packed beaches, which to begin with, aren’t that dangerous, and also aren’t that packed, they just look that way because of what amounts to photographic trickery (i.e. a telephoto lens).
If we had unlimited reserves of patience, then it might not matter if we did some things that are dumb, but we don’t. Accordingly we should be picking our battles, and from what I can tell the battle over outdoor spaces is not one I would pick. It’s not smart, and unfortunately since the beginning of the crisis it would seem that most of what the government has been doing is not particularly smart.
I’m not going to spend any time revisiting the testing failures, or the ridiculous regulatory hoops people have to jump through, or really the massive failure at all levels. But the story of the only domestic mask manufacturer is interesting. Because it combines a little bit of everything. This is a company who ramped up production and staff and made huge sacrifices in 2009 during the swine flu pandemic. But the minute it was over the company just about went out of business because all the people that had previously been desperate for masks at any price, all dropped the company in an instant once it was over. This meant the company had machines they still owed money on, and way more staff than was needed. After massive layoffs and other restructuring the company survived, but only just barely.
Thus, it shouldn’t be surprising that this time around the company is not willing to do that. They want long term contracts. As an example of how this has played out. When the pandemic was first ramping up the company approached the government with an offer to use their mothballed machines (evidently left over from 2009) to make seven million N95 masks a month. And the government basically blew them off. And in fact as near as I can tell those machines are still sitting idle.
If this was an isolated story, or if there were lots of problems at the beginning, but eventually we got our act together, it would be one thing, but each day brings a new story of how we’re not being smart. Like the story on Friday about the FDA shutting down a well-regarded COVID testing project in the Seattle area. This seems beyond merely not being smart and well into the territory of actively being stupid.
If this isn’t the kind of crisis we can get through with shared sacrifice; and if we don’t have the leadership to pull it off even if it was; and if we don’t have much in the way of leadership period; and if we’re not being smart, where does that leave us? For myself it leaves me reluctantly considering the Swedish approach. If nothing else at least it’s straight forward. And remember, no one is forced to do anything, people are free to take as many precautions as they want. And yes, I understand this does not entirely protect people from the actions of others, but recall that it’s not as if Sweden has zero restrictions, in fact I would hazard to say that if you compared what Sweden is doing now with what municipalities did in 1918 that they would look very similar. Recall that when people talk about the cities who had it the worst in 1918, they’re talking about cities which had parades in the middle of the pandemic, which I’m pretty sure even Sweden is avoiding.
Combine this with the point I made earlier about how little impact the Spanish Flu had on people’s memory of the 20th century, and I’m inclined to be cautiously optimistic. What do I mean by that? Am I suddenly advocating for the Swedish approach? No, but I fear that after a lot of groping around doing stupid and counter productive things that we’ll end up there eventually anyway. It may never be the de jure policy, but I think it will increasingly become the de facto policy. (Also, people do what they want more than governments are willing to admit. People start taking precautions before lockdowns begin and stop taking them before the lockdowns end.) In other words, in contrast to my normal position, I’m offering up reasons to be cautiously optimistic. Of course I have to be alarmed about something, so if I’m not alarmed by how poorly we’re handling things, even now, what am I alarmed about?
Well, I’m out of space, so I’ll have to write more on this topic later (and it won’t be my next post, that’s already spoken for) but I’m becoming increasingly alarmed that in the process of fighting the pandemic we’re going to make an even bigger mistake. What might that mistake be? Well keep your eye on this space, but I’ll give you a hint: As you might imagine I’m not a fan of the colossal amounts of spending we’ve engaged in to fight the pandemic. A world with pandemics is well covered territory, a world where money has ceased to have any meaning. less so.
As sick as you probably are of hearing about COVID-19, you’re probably even more sick of hearing me try to come up with a clever request for donations. Too bad, just like the pandemic, it’s still a long way from running it’s course, lots of stupid choices are being made, and at some point I’m imagining you’ll just want to get it over with.