You’ve seen that graph from which the term “flattening the curve” derives 100 times already this week. But this series of visual simulations at WaPo explains the virtues of social distancing amid an epidemic even more effectively. The point to bear in mind when watching each simulation is that we have a finite capacity in our ICUs, of course. Speed kills with this disease because it’ll overwhelm that capacity. Slowing the spread thus matters momentously to the quality of care gravely ill people will receive, and not just people gravely ill with coronavirus. If the ICUs are full, by definition no one’s getting in. Not cardiac patients. Not diabetes patients. Full means full.
So if you want to do a small public service today, read that WaPo piece and then forward it to your friends. Especially the friends whom you think are most likely to blow this off and keep socializing in crowds.
Because, let me tell you, there are a lot of idiots in the United States who are blowing this off.
Downtown Nashville is undefeated. pic.twitter.com/BFIOzukFct
— Janna Abraham (@SportsPundette) March 15, 2020
France has ordered all restaurants closed. Spain has told everyone to stay home.
This was the scene in Brooklyn on Saturday afternoon.
(Photos by my always awesome niece.) pic.twitter.com/XyDYoopH2T
— Eric Umansky (@ericuman) March 15, 2020
Text from a friend:
"I’m running through Rockridge (Oakland) and the popular restaurants are PACKED. I feel like I'm taking crazy pills. People jammed in like sardines in a FAMILY STYLE eating place that is actually perfectly set up to do robust delivery."
— Yashar Ali 🐘 (@yashar) March 15, 2020
Honestly blown away by the number of people I follow posting Instagram stories of themselves out at crowded bars and restaurants with ironic tags about social distancing or quarantines.
— Guy Benson (@guypbenson) March 15, 2020
A physician friend driving home tonight from a long, grueling day at nearly-overwhelmed hospital treating COVID19 patients, knowing it's going to get much worse for us all, saw lines of young people waiting to get in the bars in his city, writes, "I cannot believe the stupidity."
— Rod Dreher (@roddreher) March 15, 2020
Speaking to friends/family in Spain, they are upset the gov didn’t shut things down earlier. No one headed the warnings coming from Italy n stopped. 2nite it’s business as usual in the East Village. People partying like crazy. It’s not a badge of honor. Its a colossal mistake
— Kirsten Fleming (@KirFlem) March 15, 2020
Every person who was out last night in a crowded place was a willing vector for this disease. The young are less likely to become gravely ill than the old but there’s no evidence that they’re less likely to pass the virus along, which means every additional potential carrier who’s out mingling in crowds is raising the threat to older people exponentially. Nor is it the case that asymptomatic people are less of a risk to others; to the contrary, there’s evidence that those without symptoms are playing a bigger role than thought in passing this around. A German study suggests the infected are actually more contagious in the earliest stages of the illness than they are after it’s hit them hard, adding to the fiendish difficulty of trying to control the spread. The only effective strategy is avoiding crowds even if you feel fine and are low-risk.
And as much as I’d like to tell you that it’s only random morons who are continuing with business as usual (which would be bad enough), it is not. Meet the governor of Oklahoma:
I mean this without exaggeration: If, God forbid, Stitt comes down with a case of this illness that requires hospitalization, he should go to the back of the line. I don’t care who he is. Unlike the average American dipsh*t, he had every reason to know from his health advisors how insanely reckless it is to promote going out at a moment when the country is scrambling to slow this thing down. If there’s one ventilator left and it’s down to him and some grandma who stayed home but then got infected at her doctor’s office because of an appointment she couldn’t miss, let grandma have it. Stitt can take his chances with Tylenol and well wishes. It’s only fair.
He isn’t the only idiot among the leadership class who’s encouraging the spread of the disease. Bill de Blasio is still telling New Yorkers, even at this late hour, that it’s okay to keep schools open because kids are largely immune from the disease. Which is true, they are more or less immune, but the parents and grandparents to whom they’re going to spread the disease after contracting it on the playground are not. Devin Nunes was on Fox Business this morning advising “healthy” people that “it’s a great time to go out and go to a local restaurant, likely you can get in easily.” Again, the entire problem with this disease is that people who already have it are perfectly capable of infecting others even when they haven’t had symptoms yet and think they’re healthy.
Is there any other country in the world where public officials can’t or won’t follow the most basic health advice offered by medical experts in the teeth of a catastrophe? Said one Twitter pal, “Imagine being in a global war where all we need to do to win is stay at home, eat a pack of noodles and binge watch Netflix and we’re still somehow losing it.”
But it’s worse than that. The nightmare scenario that’s momentarily still hypothetical here is actually playing out in western Europe, in a first-world country with a perfectly fine medical system, where the spread of the disease 10 days ago looked exactly how it looks in the U.S.. It would be tragic but understandable if Americans ignored speculation about a public health disaster which they were told was days away; human beings often have to learn the hard way. But Italy has already learned the hard way for us. American newspapers are full of dispatches from that country about the health-care meltdown they’re experiencing because doctors and nurses can’t cope with the patient load.
Italy has reported its biggest day-to-day jump in cases of COVID-19. National health authorities told reporters on Saturday that health officials recorded 3,497 new cases in 24 hours. That’s roughly a 20% increase in cases from the day before. A little more than half of those new cases occurred in Lombardy, the populous northern region which has been hardest hit in Europe’s worst outbreak. Italy’s total cases now tally 21,157.
The death toll rose by 175. A day earlier, the same authorities had predicted glumly that Italy would still see a jump in cases despite a national lockdown that began on March 9, barely two days after severe restrictions on personal movement in the north. They cited irresponsible behavior by many citizens, who despite the earlier warnings not to gather in large numbers, headed to beaches or ski resorts, and hung out together in town squares, especially after the closure of schools.
Six days ago BuzzFeed published a piece about the lockdown in Italy quoting one Italian as saying, “Probably for true Milanese, it’s quite difficult not to go for an aperitivo, and that’s why you can still see people pouring into restaurants and bars, completely ignoring safety advice.” Now they’re dealing with 3,500 new cases per day. Italian journalist Mattia Ferraresi has a piece in the Boston Globe today titled “A coronavirus cautionary tale from Italy: Don’t do what we did.”
We of course couldn’t stop the emergence of a previously unknown and deadly virus. But we could have mitigated the situation we are now in, in which people who could have been saved are dying. I, and too many others, could have taken a simple yet morally loaded action: We could have stayed home.
What has happened in Italy shows that less-than-urgent appeals to the public by the government to slightly change habits regarding social interactions aren’t enough when the terrible outcomes they are designed to prevent are not yet apparent; when they become evident, it’s generally too late to act. I and many other Italians just didn’t see the need to change our routines for a threat we could not see.
Go look again at the WaPo simulations to see what he means about not being able to see the threat until it’s too late. In the first few seconds of the “free-for-all” simulation, only a few dots are infected. A few seconds later, dozens are. If people are distancing themselves early in the outbreak, it takes awhile for carriers to reach all of the uninfected. If people don’t start distancing themselves until, say, 20 percent are infected, there are a lot more infected dots bouncing around to spread the contagion to all but the most thoroughly isolated.
Italy has been brought to its knees. Americans who are there right now, like Newt Gingrich, are pleading with those of us back home that there’s no time to waste in distancing themselves. Newspapers are publishing stories with headlines like “Please, don’t go out to brunch today.” Trump himself has very belatedly taken to encouraging social distancing as a way to slow the virus down. Humanity has never been able to spread information as quickly as it does now. So why can’t we listen, pause a moment to absorb what Italy’s enduring, and change our behavior?
Has the sense that we’re too rich and too “advanced” to have major calamities befall us paralyzed us, even when evidence of our vulnerability is right in front of us? Even when all we’re being asked to do to manage this is … to stay home for awhile?
The sense of uncertainty and of the fragility of human life that I saw in Asia over the past two months is easy to explain if poverty and disease are still an everyday occurrence or at most two or three generations in the past. Often, that historical experience is reflected in public institutions: The lack of advanced social security and public healthcare systems forces Asians to contemplate in their daily lives the possibility that their world might suddenly collapse. In Europe the general psychology too often reflects the ideology of development, the idea that the most serious threats to individual happiness have been definitively conquered. Why worry about an epidemic if you have excellent public hospitals available more or less for free? What no one considered was that a virus could bring this perfect system to the point of breakdown.
Of course Europeans have their own nightmares and demons. But remember that the tragedy of the World Wars has been interpreted in political terms. They are a reminder of the dangers of nationalism and imperialism. The practical import of our recent history is to confirm our conviction in the rightness of our values, not to force us to doubt ourselves. And even the bloody history of the 20th century in Europe has not changed the fact that we look at the world from what we think is a central position to which others can only aspire. Europeans have been taught by the whole course of modern history to think that they can guide or at least influence the rest of the world while being protected from events originating elsewhere.
Is our sclerotic bureaucracy, especially as mismanaged by the current administration (e.g., American airports being turned into petri dishes last night as people returned en masse from Europe), just not nimble enough to deal with major threats anymore?
Without the threats and violence of the Chinese system, in other words, we have the same results: scientists not allowed to do their job; public-health officials not pushing for aggressive testing; preparedness delayed, all because too many people feared that it might damage the political prospects of the leader. I am not writing this in order to praise Chinese communism—far from it. I am writing this so that Americans understand that our government is producing some of the same outcomes as Chinese communism. This means that our political system is in far, far worse shape than we have hitherto understood…
The United States, long accustomed to thinking of itself as the best, most efficient, and most technologically advanced society in the world, is about to be proved an unclothed emperor. When human life is in peril, we are not as good as Singapore, as South Korea, as Germany. And the problem is not that we are behind technologically, as the Japanese were in 1853. The problem is that American bureaucracies, and the antiquated, hidebound, unloved federal government of which they are part, are no longer up to the job of coping with the kinds of challenges that face us in the 21st century. Global pandemics, cyberwarfare, information warfare—these are threats that require highly motivated, highly educated bureaucrats; a national health-care system that covers the entire population; public schools that train students to think both deeply and flexibly; and much more.
Has too much of the general public become slovenly in its ignorance and perceptions of basic civic responsibilities?
We are doomed pic.twitter.com/EpIXKo84IH
— Barstool Sports (@barstoolsports) March 15, 2020
I feel like it’s not a great sign that people are pleading with LeBron James and Taylor Swift to get involved in the push for social distancing because it’s somehow not enough to have the president’s top infectious disease expert warning them hourly that our hospitals are two weeks away from catastrophe. Now that Lady Gaga’s gotten on board, perhaps our very serious country will begin to turn the corner.
Or is this all mostly a function of selfishness? Maybe there’s a certain cohort of people in the low-risk category that understands the epidemiology here and decided they’re going to enjoy their Saturday night out anyway, even if doing so meaningfully raises the risk of a health-care fiasco and a wave of deaths among local older people. As social solidarity atrophies, so does civic responsibility.
It’s worth your time to read this short piece crunching the numbers and urging NYC to fully shut down — bars, restaurants, everything except the supermarkets, banks, and pharmacies — within the next week or else the metropolitan area will be facing somewhere between 65,000 and 115,000 infections … 13 days from now. That means social distancing not just on a macro scale, like shutting down sporting events, but on the kind of micro scale that Americans all over the country openly flouted last night. My guess is that we’re collectively just too slovenly to voluntarily stay away from things like bars if they’re open — this is not a snow day — which is why de Blasio and Andrew Cuomo will have to make a hard decision to declare a public health emergency to try to force them closed. Better do it soon, though. St. Patrick’s Day is 48 hours away.
Here’s Anthony Fauci ineffectually pleading with people to be just slightly less stupid than usual and selfish because their lives, and the lives of everyone around them, literally do depend on it.
"I would like to see a dramatic diminution of the personal interaction we see in restaurants and in bars," Dr. Fauci says about the coronavirus. Young people are not immune: "There are going to be people who are young who are going to wind up getting seriously ill" #CNNSOTU pic.twitter.com/iF5J2gccta
— CNN Politics (@CNNPolitics) March 15, 2020
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