Recently I described how I monitor the disease indicators published by government agencies, and how I’ve set a threshold of 6 people hospitalized per hundred thousand residents for deciding when to relax out of “outbreak mode” and eat and sing indoors. So then, when to go back into outbreak mode and start taking precautions again?
I need to stress again here that I am not a doctor or an epidemiologist. I’m not qualified to make these decisions, and I wish we had guidance from experts. Unfortunately, the experts are assuming that everyone cares only about themselves and provide no guidance for people who care whether they pass these diseases on or develop long term conditions. I do care, so I’m figuring this out as best I can.
Hospitalizations and deaths are trailing indicators: after infection it can take weeks for people to become sick enough to go to the hospital, and longer to die. That means we need to look at leading indicators like case counts and wastewater concentration. I’ll talk about wastewater in a future post.
Case counts are less reliable than hospitalizations and deaths, because they depend on the number of tests administered. As we know, the number of tests dropped precipitously when President Biden declared an end to the State of Emergency and stopped reimbursing for tests. Providers tend to administer tests when they think people might be sick, so if they don’t anticipate infections they may not find them.
Case counts could be inaccurately low, so we should always keep an eye on hospitalizations. There’s a chance that case counts could be inaccurately high, but if that happens, the worst that could result is that we think an outbreak is more severe and take too many precautions. Of course, it’s better to err on the side of caution.
So if we’re looking at case counts, what is a good threshold for going into outbreak mode? This turned out to be a lot more complicated than I thought, but let’s start with the basics and assume that all the data is three weeks old.
I looked at the seven outbreaks we’ve had since the the first wave (when we didn’t have good tests) and found the point when the 7-day average of COVID hospitalizations in New York City went above 6 per lakh per day. Then I looked at the case rates for the day three weeks earlier:
Outbreak
First day with hospitalizations > 6.2
Cases 3 weeks earlier
Fall 2020
2020-11-10
55.4
Fall 2021
2021-08-03
30.8
Winter 2021
2021-12-01
70.8
Spring 2022
2022-05-01
172.8
Fall 2023
2023-09-05
85.5
Winter 2023
2023-12-14
55.4
Summer 2024
2024-07-12
57.5
As you can see, there’s a fair range of variation. But let’s pick a rate that’s in the more common range, say 60 cases per lakh population per day. How much warning would that give us?
Outbreak
First day with hospitalizations > 6.2
First day with cases > 60
Days notice
Fall 2021
2021-08-03
2021-07-18
16
Winter 2021
2021-12-01
2021-11-03
28
Spring 2022
2022-05-01
2022-03-13
49
Fall 2023
2023-09-05
2023-08-02
34
Winter 2023
2023-12-14
2023-11-20
24
Summer 2024
2024-07-12
2024-06-20
22
It looks like anywhere from 2-7 weeks, usually about three weeks, which is basically what we want. If we see a case rate above 60, that means that the hospitalization rate is likely to go above 6, and may already be above 6. That’s a sign that it’s time to go into Outbreak Mode. For me, that means moving karaoke online, avoiding indoor dining and social events, and wearing a mask in all indoor public spaces.
Keep in mind that COVID is only one of many infectious respiratory diseases that can kill or disable. I chose the rate of 6 hospitalizations per lakh per day because that was what we were prepared to tolerate during the 2018-2019 influenza season. The hospitalization and death rates we care about are for all these diseases, but flu and RSV are not as well documented as COVID. Hospitalization rates for flu and RSV are reported nationwide, but the local reports for New York only give absolute numbers for cases and hospitalizations for those diseases.
What I tend do do is to estimate a ratio based on the total case counts for all three diseases, or on the nationwide hospitalization rates. If RESP-NET is reporting that there are as many flu and RSV hospitalizations as COVID hospitalizations nationwide, I’ll assume that that applies to New York. If New York’s flu and RSV report shows that there are half as many positive tests for flu and RSV as for COVID, I’ll go into outbreak mode at 40 COVID cases per lakh instead of 60.
Stay tuned for that post about wastewater concentrations!
I shouldn’t be writing this. I have no training in medicine or epidemiology. I’m just some random person. And if you have something from a better trained source that tells you how to manage your exposure to airborne infectious diseases like COVID, the flu or RSV in order to avoid passing it on to others and perpetuating the pandemic, you should probably go with that.
Unfortunately, our expert doctors and epidemiologists at organizations like the United States Centers for Disease Control and Prevention, and the World Health Organization, haven’t provided any guide for people who want to avoid passing COVID or other airborne diseases on to others. Their guides focus on telling people how to minimize the risks to themselves. They assume that everyone is a selfish asshole.
I’ll talk about what I’ve tried, but again, I’m just one person, with three close people in my family. I have no way of doing an exhaustive study of the transmission of COVID or the flu. My priorities are different from those of many other people. So are the strengths and weaknesses of my body, my family’s bodies, and our risk tolerance. So what works for me – or doesn’t – may well work differently for you.
We’ve also only had four years of COVID. Our understanding of it is constantly evolving, and the disease itself is constantly evolving, so that what works one year may not work in the next.
With that in mind: a year ago I articulated a provisional strategy for balancing my wants and needs, and those of my family, with our desire to avoid catching COVID (and other infectious diseases), spreading it to others, and perpetuating the disease.
I plan on doing the following for the rest of my life:
Wearing an N95-type mask in medical settings, including pharmacies
Monitoring outbreak warnings
Monitoring hospitalization rates for COVID, the flu and RSV
Getting tested regularly during outbreaks
During an outbreak, I plan on:
Wearing an N95-type mask in indoor public spaces
Eating outdoors
Organizing events online/outdoors
Avoiding risky activities like singing
When I’m sick, I plan on:
Staying home as much as possible
Isolating from my family
This much is fairly straightforward, but the key questions are when to switch between regular mode, outbreak mode and sick mode, and back. First of all: which indicators should we watch, and what will tell us that it’s a good time to change our behavior?
Hospitalizations and deaths per population are the indicators that seem to fit most closely with what we care about with COVID. The mild cases I’ve experienced are no fun, but they’re not much worse than what I’ve had for colds, flu, strep or other respiratory infections. Death is the worst outcome, but we want to prevent people from getting infections that are so bad they are admitted to the hospital. We really need a good measure of Long COVID, but as of writing we don’t have one.
Hospitalizations and deaths are trailing indicators – they tell us what happens after infections – so they are good for conservative estimates about when to relax our precautions. They can be compared across time and geographic area by counting the number of deaths or hospitalizations for a fixed number of residents of that geographic area. Dividing by 100,000 gives us nice easy numbers that are usually between 1 and 100. 100,000 is a standard quantity in Indian arithmetic: one lakh.
Last year I found out from the Centers for Disease Control and Prevention that the nationwide peak of hospitalizations during flu seasons before COVID was around 6 per lakh, flu and RSV combined. That means that before COVID we were tolerating six people in the hospital with flu and RSV every day, and not taking extraordinary measures like lockdowns or working from home. I decided that that was a good benchmark: when the combined hospitalizations for flu, RSV and COVID are below 6 per lakh, it’s no worse than what we used to tolerate in 2019.
We can tell when we’re below 6 hospitalizations per lakh nationwide, but how easy is it to check that locally? I’m fortunate that the New York City Department of Health and Mental Hygiene publishes regular reports of citywide COVID cases, hospitalizations and deaths. The data is compiled by day; in 2021 and 2022 these reports were updated daily, but as of writing in May 2024 they are updated weekly.
Data for influenza and respiratory syncytial virus is much less comprehensive. Both the CDC and New York City release weekly reports during the infectious seasons for these diseases, but while the CDC measures hospitalizations, New York City does not. That means there is a nationwide way of measuring the cumulative risk of catching or spreading any of the three diseases, but locally we can only measure COVID and guess at flu and RSV.
Eyeballing the data from the most recent winter wave, it looks like COVID cases constituted roughly half of hospitalizations nationwide. It’s quite possible for flu and RSV hospitalizations to outpace COVID or vice versa, but as a first approximation we can say that if COVID cases drop below three hospitalizations per lakh residents per day, we are no longer in an outbreak and can relax some precautions, like eating and singing indoors.
That is the principle I used to determine when to start organizing in-person meetups for the New York Tech Karaoke Meetup, where I am an organizer, and in general to switch from outbreak mode to normal mode. Switching from normal mode to outbreak mode is a different challenge that deserves a separate blog post. Spoiler alert: I failed to take adequate precautions in December 2023 and was sick with COVID, so I’ll talk about some lessons learned from that experience.
When I first heard that President Biden was going to announce the end of the COVID-19 state of emergency, I was not happy. I was similarly uncomfortable about my employer lifting mask and test mandates. Hospitalization and death rates were still very high, in the United States and worldwide. They could have stayed high, and the end of the state of emergency would have been a disaster. Fortunately, they didn’t, so the emergency does seem to be ending, for now at least, in the United States.
Death rates are now at their lowest since agencies started reporting numbers, in my hometown of New York, across the United States and worldwide. Hospitalization rates are also at their lowest since the hospitals first started filling up.
There’s even more good news: the US Centers for Disease Control and Prevention hosts a web page called RESP-NET that allows you to compare current rates of hospitalization for SARS-COV2, influenza and Respiratory Syncytial Virus (RSV), from the current “season” (October through May) with rates from previous seasons going back to 2018-2019.
In the week of March 11 of this year, RESP-NET shows that the combined hospitalization rate for all three dropped below the peak combined rate for flu and RSV in 2018-2019. Hospitalization rates for all three respiratory diseases have continued to drop since then. If that trend continues, we could wind up the way we ended flu seasons in previous years, with hospitalization rates below 4 people per million per day.
We did get close to those hospitalization rates in June of 2021 and April of 2022, but in each of those cases there was a new wave of COVID right after that. We have to be vigilant, and we have to be prepared to reinstitute emergency procedures if the hospitalization numbers start rising again.
I’m pleased to say that my family and I are starting to wind down some of our own state of emergency, which we’ve maintained since our government started loosening restrictions. Until this week we have tried to wear masks in indoor public spaces whenever possible. With very limited exceptions, we have not eaten in indoor public spaces, and we have avoided vocal and wind instrument performances, and anywhere there are likely to be large numbers of unmasked people.
From now on we will start dropping some of these precautions. We have stopped wearing masks in our building hallways, and yesterday I attended a social event at work where there was food and live music. We plan on attending more events, and traveling more. I plan on organizing in-person karaoke events.
We are in no rush to get back to normalcy. My mother is 84 years old and has multiple risk factors, The rest of us have health issues which make us a bit more vulnerable than the average American. We’ve read that airplanes are particularly high transmission sites, especially when on the ground. And we like eating outdoors!
We also want to minimize our involvement in spreading COVID. There are still billions of unvaccinated and under-vaccinated people. New York is a global port city, and we regularly encounter people from all over the United States and the world. On Monday I had breakfast with cousins from Georgia who were leaving on a transatlantic cruise. My mother has several Medicaid-supplied home health aides, most of whom are from different countries all over the world, and who travel home periodically to visit family.
My family and I live in the epicenter of the first COVID outbreak in Spring 2020, and we saw how it hit our poorer, immigrant, nonwhite neighbors harder than us and our more privileged neighbors. I also have several friends who are immunocompromised in various ways, and who have seen their lives restricted because others refuse to make spaces and events safe for them.
I thought back to times when I had upper respiratory infections before COVID. Nobody ever suggested wearing a mask or eating outdoors when I was sick, and if people talked about staying home, it was usually for my own recuperation. I have memories of sneezing on the subway, coughing in restaurants, and even singing karaoke while battling a sinus infection.
I’ve decided that in the future I want to be more careful about spreading infectious diseases, particularly influenza, colds and of course COVID. I plan on doing the following for the rest of my life:
Wearing an N95-type mask in medical settings, including pharmacies
Monitoring outbreak warnings
Monitoring hospitalization rates for COVID, the flu and RSV
Getting tested regularly during outbreaks
And when I’m sick or during an outbreak,
Staying home as much as possible
Wearing an N95-type mask in indoor public spaces
Eating outdoors
Organizing events online/outdoors
The bottom line is that COVID is not over. We have so far failed to eradicate it. It can come back at any time. And I do not want to be complicit in spreading it to vulnerable people. If it becomes necessary, I plan on reinstating the precautions I’ve been taking for the past few years. It will be inconvenient and annoying, but it’s a small price to pay for saving so many lives.
There are three kinds of attitudes towards the spread of a disease like COVID-19. You can be indifferent to the suffering of others, you can be in favor of eradication, or you can give up. Recently I’ve noticed that more and more of the people I know have given up. At first I was puzzled that so many people refused to talk about our failure to eradicate the disease, but over time I’ve come to understand that this is just what most people do.
First, I want to talk about how we’ve failed on COVID. And when I say “we” I mean all of humanity, but specifically the United States, and more specifically New York State and New York City.
Before I get to our failures, I want to give a nod to our successes. Shutting down non-essential in-person businesses in the spring of 2020 allowed us to “flatten the curve” of hospitalizations. Our hospitals were under severe strain, but we did not get to the point where we needed to use the Javits Center or the Navy hospital ship. After that, the restrictions on indoor dining and avoidance of other indoor in-person activities helped us to keep hospitalizations and even deaths relatively low until the vaccine rollout.
Our record after that has been pretty dismal. Over 800,000 people have died of COVID in the United States since the first vaccine was administered on December 13, 2020, more than twice as many as had died before. Thousands of people have been reinfected with COVID again. Thousands suffer from long COVID. We have failed them.
Our worst failure, of course, is the failure to completely eradicate COVID. We live in an era where humans have eradicated smallpox from the world, eliminated polio and guinea worm from most countries, and are aiming to eliminate malaria and other diseases. We have successfully eliminated the first SARS coronavirus, the cause of the 2002–2004 outbreak, and have made progress against MERS. We had the power to eradicate COVID, and we failed.
I hope that one day we will eradicate COVID, and many of the other diseases that cause misery to humans and other animals on this planet, including diseases that we have not yet encountered. But for COVID, the possibility of eradication gets harder with every new variant.
The result is that many political and institutional leaders have told us we’ll be “living with the virus,” in ways that ensure that thousands will be dying with the virus for many years. The “reopening” of institutions to unmasked indoor activities is a cruel joke to immunocompromised people who are unable to participate. More than a billion people around the world are still unvaccinated or undervaccinated, most through no choice of their own.
What baffled me for months was the inability of almost everyone I know to acknowledge this failure.
Of course, people are plenty willing to acknowledge the failures of others. Here in New York, lots of people are willing to heap well-deserved blame on Donald Trump and his enablers. Some are willing to blame Andrew Cuomo, who deserves at least as much blame, and on other Democrats like Bill de Blasio, Joe Biden, Kathy Hochul and Eric Adams. But I have yet to hear someone acknowledge their own failures.
Remember in 2020 how we were all in this together — wearing masks, socially distancing, getting tested, even washing our hands? Of course, a lot of this was a fiction, but many of us felt like we were contributing to the effort to stop the spread of the disease. I know lots of people who for months, if not years, were diligent about eating outdoors, wearing masks, working from home, avoiding indoor entertainment.
I know some people who have continued to this day with careful measures to avoid spreading COVID. As of this writing, my family and I are still avoiding eating in indoor public spaces, foregoing in-person concerts, and wearing N95-type masks when necessary. But many others just stopped at a certain point. And what struck me was how quietly they all did it.
I’ve seen some people on social media — and on mainstream media, and even in person — announce that they were going to their first party “since COVID,” or maybe attending their first concert or conference, or giving their first interview. Some have even gotten visibly emotional about it, and talked about feeling nervous. But nobody talked about why they decided to start attending parties or conferences, or performing in theaters. Nobody acknowledged that this meant they had stopped taking precautions to avoid spreading COVID.
Some people have parroted the bullshit put out by the Centers for Disease Control and Prevention — that COVID is now “endemic,” and we have to start “living with the disease.” But they pivoted awfully quick from “we have to stop COVID” to “we’ll never stop COVID,” without going through the stage of “we have failed to stop COVID.”
What I eventually figured out — and only recently — is that people just don’t like to admit defeat. Some people are okay with acknowledging setbacks — we’re retreating to the hills, but we will be back! But colossal, catastrophic defeat, the kind that means that a million more people will die, that we may see many thousands die every year for the rest of our lives? That’s something people don’t want to think about.
The key to my understanding this was a Mastodon post I made about the recent fad of Large Language Models. I had noticed a similar pattern: that some people who were typically critical of new technologies had started incorporating LLMs into their work. I posted a critical response to an LLM post from someone I considered a friend, and was shocked that he basically told me to shut up with the criticism.
I recognized this pattern from other trends I’ve studied as well. It reminds me of a scene from Friedrich Dürrenmatt’s play The Visit (Das Besuch der alten Dame), where the character Alfred finds the entire population of his village turning against him. He realizes this when he sees them wearing new shoes, which are yellow, and in most productions of the play they are bright yellow. I’ve never seen the play performed, but my high school English teacher described Alfred seeing first one neighbor wearing yellow shoes, then another, and then looking across the stage and seeing everyone wearing bright yellow shoes. The image has stuck in my mind for decades.
I’ve also been listening to the History of Byzantium podcast, and the recent episodes focus on the capture and sack of Constantinople by the Fourth Crusade. I thought about the people of the city, seeing several emperors killed in quick succession, the harbor filled with Venetian ships, and Frankish knights parading through the streets.
It was too late to flee. What could they do but swear to serve their new lords? And once you decide to serve the new lords, why take the risk of pissing them off by showing insufficient enthusiasm?
In my Mastodon post I compared the new large language model fans to Kent Brockman, the news anchor from the Simpsons who, spooked by a magnified image of an ant crawling across the camera, immediately announces, “I, for one, welcome our new insect overlords.” What I realized recently is that the only thing Brockman does differently from real people is to react a little more quickly.
It’s important for me to acknowledge here that I don’t think that these people gave up fighting the spread of COVID, or the imposition of large language models, because they stopped caring. I think that tomorrow if they thought there was as much chance of eradicating COVID as they thought there was in 2020, they’d mask up again and stop eating in indoor restaurants.
Clearly, they don’t think that wearing a mask again will do much. And they can see that most of our leaders and the institutions they control have come down against eradicating COVID. They’ve gotten their orders from the Centers for Disease Control and Prevention, or from the boss telling them to show up at work in person.
They’ve seen the announcements for in-person conferences and job fairs, with food and drink provided indoors. They don’t want to miss out on those opportunities while less scrupulous competitors take advantage of them.
So why do I care? Why did I expect anything else? Why do I think it’s important to acknowledge failure?
I’ve worked in tech support on and off for most of the past 28 years, either as a direct support technician or as a developer responsible for fixing bugs as they are found. One thing I’ve found to be essential to providing good support is acknowledging and documenting failure. If we don’t understand why we failed, we’re just going to keep making the same mistakes again.
I remember my eighth grade Social Studies teacher telling us how in 1920 the American people were so hungry for “A return to normalcy” that they voted for a cretin like Warren Harding. But he only told us that they craved an end to involvement in World War I; I don’t remember hearing or reading anything about the flu epidemic in that class.
We need to talk about what happened: the people who wanted to sacrifice the vulnerable to preserve their profits organized and won. We need to remember how they did it and figure out how to overcome that. And we need to preserve that knowledge so that the people who are looking out for humanity in the next pandemic can be prepared.
We won’t be able to do that if we continue to live in denial.
Do you remember the first couple of months of COVID pandemic restrictions? Here in New York, all “non-essential businesses” were closed, then some stores and takeout restaurants were allowed to reopen. We washed our hands a lot because we thought it would help. We stood six feet apart. And gradually, those of us who hadn’t learned the value of face masks began to figure it out, or at least to suppose that the majority and the authorities were worth listening to for a while.
Those of us who weren’t “essential workers” worked from home when we could, and every night we cheered and banged on pots for the people who were stocking the grocery shelves, driving the buses, tending to the sick, disposing of the dead. We had support from the government: extended unemployment, eviction moratoria, cash payments, interest-free loans..
We also supported each other. We met up for walks, and later for outdoor dining and to-go cocktails. We organized events on Zoom, Skype, Microsoft Teams and Spatial Chat. We watched each other’s Twitch streams. We maintained Open Streets. We marched in masked, socially distanced Black Lives Matter protests.
When our city government loosened the rules around outdoor dining, restaurateurs and builders got creative, building shelters that protected from rain and wind and provided heat, but still allowed good airflow.
Of course we weren’t all really in it together. From the beginning there have been people willing to minimize the risk of COVID, to spread misinformation about it, and to use its presence as a weapon against people they didn’t like. Restaurants that were secretly open, raids on karaoke clubs, openly defiant bar owners on Staten Island. Servers who wore masks around their chins while taking orders to go. Shacks closed so tight only a meager draft made it inside
Our homicidal president at the time saw that feelings about pandemic responses could be used to divide the country and unite his supporters. Our self-absorbed governor was only interested in saving lives to the extent it supported his political ambitions, and our bumbling mayor was afraid to let saving lives get in the way of any other priorities.
A group of evil people (I can’t think of a better word for them) had the gall to worry that taking care of people might erode the public’s faith in capitalism, so they set out to undermine every protection against COVID, and call, over and over again, for “reopening” and “return to normal,” no matter how little evidence there was that the danger was past. They named their evil plan after a lovely little town in Massachusetts that doesn’t deserve to be attached to it.
COVID has touched all sectors of society, but if you look at the statistics it’s clear that it has had a much greater impact on people who were poor, people who weren’t white, people who couldn’t afford bedrooms of their own to isolate in, people who didn’t have jobs that allowed them to work from home, or savings to keep them going until work picked up.
There was a particular point, I believe some time in April 2020, when the news media in the US reported that the disease was disproportionately affecting poor people, nonwhite people and immigrants. A number of people observed that there was a marked increase in the clamor for “reopening” immediately after these reports. And of course it came from people who were mostly wealthy, white US citizens with large houses and jobs that allowed remote work.
Despite all that, on the streets of New York, and with my friends, I felt a sense of caring. We were all in this together, and we were looking out for each other. Eventually we got a new president who decided to put all his eggs in the vaccination basket, and he and our self-absorbed governor started rolling back the protections that were keeping us safe. The most significant one, I’ve come to realize, was the ban on indoor dining.
Let’s be very clear about this: indoor dining was completely unsafe before vaccines, and is not particularly safe now. It continues to be a vector of COVID transmission among vaccinated people and between them and unvaccinated people. There was no epidemiological justification for lifting the ban on indoor dining. The only possible justification was economic, and that has been undermined by the cost of the subsequent outbreaks that could have been avoided.
What I’ve observed is that here in New York, allowing indoor dining has divided us. Allowing indoor performances, dancing, karaoke and other entertainment has deepened the divide. Even though I knew about the bars and restaurants that defied the indoor dining ban, I was surprised at the number of people who were willing to eat indoors as soon as it was legal.
Shortly after Andrew Cuomo allowed indoor dining in New York, I went to pick up some takeout and saw people eating in the restaurant. All I could think of was the scene in The Matrix where Agent Smith takes Cypher out for a steak dinner.
Agent Smith: Do we have a deal, Mr. Reagan?
Cypher: You know, I know this steak doesn’t exist. I know that when I put it in my mouth, the Matrix is telling my brain that it is juicy and delicious. After nine years, you know what I realize? Ignorance is bliss.
Agent Smith: Then we have a deal?
Cypher: I don’t want to remember nothing. Nothing. You understand? And I want to be rich. You know, someone important, like an actor.
Agent Smith: Whatever you want, Mr. Reagan.
Even more people began eating indoors after vaccines became widely available. Organizations began holding conferences and seminars in person again. Employers began ordering office workers to stop working remotely.
Of course, there are only so many people, and people only have so many active hours available. As people began participating in work and play indoors, there was a noticeable reduction in the amount of restaurants that offered any outdoor options. While many Open Streets and pedestrian plazas have continued to offer outdoor entertainment and activities, and many meetups, conferences and activities have continued online, we don’t see the same energy, creativity and enthusiasm for exploring outdoor and online activities.
For me, this has broken the feeling of unity that I felt in 2020. For me now the world is divided into three groups. The first is the group of people who avoid indoor group activities as much as I do or more. Maybe they share my unwillingness to be a part of the transmission chain or my fear of long COVID, or maybe they just prefer outdoor and online activities.
The second is the people who participate in some indoor group activities but are also interested in outdoor or online activities. They’re available, but not as much as they were before, because sometimes they’re doing stuff indoors. And then there’s a third group who I see on television or social media, who just don’t do much outdoors or on Zoom at all.
So we’re not in this together anymore. There’s a group that’s decided that COVID is over, that anyone who’s not vaccinated deserves what they get, and that anyone who gets seriously ill is just an acceptable sacrifice. And then there’s the rest of us, but we’re getting smaller every day.
Here’s the most ironic thing: the normalcy crowd complains about how difficult it was to take precautions to keep others safe from COVID: wearing masks, eating outdoors, avoiding long-distance travel and indoor meetings, performances and parties. I miss eating indoors in bad weather, long distance travel, and indoor conference, performances, parties, but it never felt horrible or unsustainable.
What feels horrible and unsustainable? Being one of a dwindling handful of people willing to take precautions while I watch my colleagues, friends and relatives flying around the world, singing, dancing and going to shows.
The main reason it’s unsustainable is that these precautions only work if they’re systematic and communal. It doesn’t do vulnerable people that much good if a small percentage of Americans are still wearing masks and avoiding indoor dining while the majority are happy to serve as a conduit for COVID to bounce around the world.
I have a confession to make, and it’s something I feel terrible about. I was prepared to let hundreds of thousands of people die of COVID-19.
In March I was prepared to go right back to work after a mysterious fever that ran through my family for a few days, and keep going in to the office for the rest of the year. I was prepared to continue eating in restaurants, drinking in bars, sleeping in hotels, shaking hands and hugging people right through the pandemic, without masks or social distance, even as people around me were dying.
I was prepared to lose a friend to the disease, since they say the mortality rate is about one percent. I was prepared to lose my mother, my sister, my wife, my child, even to die myself.
I was prepared to carry on through the deaths as though nothing was happening, but then all of a sudden we weren’t carrying on. I got an email that we’d be working from home for a week, and then the rest of the month, then the rest of the semester, and now the rest of the year. I heard the mayor and the governor announce that restaurants, hotels, shops would be closed. I got the orders to wash hands, keep social distance, wear masks. I guess we’re doing this then, I thought.
I was prepared for everyone to march on without caring for the dying because I’ve tried to buck trends before. I’ve been the only boy in the class who cried, the only kid who didn’t say the “under god” part in the Pledge of Allegiance, the only person in my social circle who didn’t own a car.
I knew that these kinds of anti-pandemic measures require widespread participation to be effective, and I knew how hard it is to get that participation. I’ve tried to organize people to make relatively modest changes, and I’ve seen the resistance that people can summon to even the most minor inconvenience. I had little hope that things would change.
But things did change, and I changed to go along with it. I worked from home, organized Zoom get-togethers, did karaoke over Twitch, avoided going shopping, ordered takeout from restaurants and cancelled travel plans. And I started wearing a mask, keeping distance from others and washing my hands more frequently. Since we got past the curve and started “reopening” I’ve gotten together with friends, but stayed outside, kept my mask on and avoided physical contact.
Still, sometimes I think back to things I said back in February and March, and remember how I was prepared to change nothing. I’m not happy about that. I’d like to think that I’m the kind of person who always tries to do the right thing. But what is the right thing for one person to do, when the right thing requires widespread collective action, and that one person doesn’t have the power to compel collective action?
I didn’t have much power, but I discovered that other people did. My department head had the authority to order us to work from home. Our mayor and governor and state legislature had the authority to order offices and restaurants and shops closed, and to impose curfews, and to require mask-wearing. We had the power to resist to some degree, but there has been a lot of compliance. Congress and the President passed appropriations to essentially pay people to stay home.
Over the past several months I’ve learned that we already had traditions of social distance, lockdowns and mask wearing that have been used in past pandemics over the centuries. Why do so many histories focus on innovations in science (germ theory, mosquitoes) and technology (sewers, drainage, vaccines), and on How Stupid People Were Back Then (theories like miasma and night air, and the infamous 1918 Philadelpia victory parade), and not on masks, lockdowns and outdoor dining?
A lot of the shutdown of offices, shops and restaurants was facilitated by the widespread adoption of remote work, online learning and delivery of all kinds of objects, including food and medicine. These practices in turn have been prepared and encouraged by employers, college administrators and the owners of delivery companies, and to some degree by employees, students and shoppers, out of a belief that they are cheaper and more convenient. It’s not obvious to me that that belief is well-founded, but if it weren’t widespread, would there have been as much compliance with the lockdowns?
I was impressed at the amount of influence certain people wielded at particular points. The early injunctions to more frequent and thorough hand-washing, along with catchy two-minute pop-culture songs to hum and mantras to recite (remember “Fear is the mind-killer”?) while washing drew people in and functioned as a kind of structure test. Viral posts about flattening the curve helped to convince people that behavioral changes were urgent but temporary. Influential people who set an example on the street and on social media allowed some of us to feel comfortable adopting practices like face masks that had been seen as foreign.
Of course, people can also withhold their power to compel and encourage collective action. The most tragic example is that of Bill de Blasio and Andrew Cuomo, who could have saved tens of thousands of lives by giving shutdown orders a week earlier, but held back for whatever reasons. Donald Trump and his followers in the Republican Party, including Mitch McConnell and Lachlan Murdoch, have ended the unemployment and stimulus payments, and shockingly turned practices that could save thousands of lives into badges of political allegiance.
Some of these negative practices appear to have been motivated by a thirst for power on the part of people like Cuomo and Trump. Some stem from a fear that generous unemployment and stimulus benefits could lead people to ask why we don’t provide those benefits all the time. Others are driven by the news that those most at risk from the coronavirus are the same people that our society already takes advantage of — Black and Latinx people, American Indians, immigrants and poor people — and a reluctance to do anything that might disproportionally benefit them.
It worries me a lot to realize how much of our ability to act in moral ways is constrained by the power of others. Especially by people who have amassed power for the sake of power, or out of greed, like our current leaders. It saddens me to see how I’ve learned to have such low expectations of our leaders. And how some of them haven’t even risen to those low expectations.
This is the first in a series of posts about COVID-19. Here is the second, and here is the most recent.
I originally published this on Medium. I haven’t been very happy with Medium recently, so I’ve started moving some of my posts from there to this blog.