Life in the time of COVID

“May you live in interesting times.” Today seems the epitome of this Chinese curse. Ours is the time of the COVID-19 pandemic. The world we live in is partially like the old days and partly an uncertain Brave New World.

There is no uniform experience. Life goes on pretty much as normal for some. For many, a challenging and difficult “new normal” has evolved. And, for a few it comes to a catastrophic end. For the vast majority, the biggest impact has been the government mandated restrictions.

Unfortunately, it is not even clear what the “truth” about the disease really is. Much of the public response is driven by the media and its need to fill the airways 24/7. There is nothing like a crisis to capture our attention (and viewers). Online sources and social media fuel dire (and sometimes crackpot) opinions as well.  Collectively they have turned the pandemic into a panic.

We are told to “follow the science,” but what does that mean? What precisely should we do in response to whatever component of “science” we follow?

For example, we know that Covid-19 is virulent. For at-risk populations, and sadly some healthy people, it is deadly. However, the same can be said about the annual flu outbreak, particularly in years where the vaccine misses the target. Life is always full of risk and we should view this in the same manner we do every choice we make. I could get in a fatal car crash on the way to the grocery store, yet I accept that possible fate every day. This is no different, only the probabilities change. It is question of determining the “acceptable” magnitude of risk, not eliminating it.

We must recognize that much of the science is based on probability and modeling. Early estimates stated that the overall mortality rate was approximately 3.4%; subsequently, that figure has been lowered to below 1% (across all groups). Those figures are misleading. The mortality rate for patients over 80 is more than 13% (that figure is staggering if understandable).  However, it is far lower among healthy younger people, approximately 0.15% for those in their 30s.

These and other factors (impact of side effects, transmission mechanisms, etc) fluctuate almost daily as we learn more about the pathology of the disease. On which statistics are we to base our policy? How do you state emphatically that one particular course of action is valid and efficacious for all groups and across all geography?

The short (and honest) answer is that you can’t. The real question for us today is, “How will we live our lives?”

At one extreme, we can choose to be scared by the “science” (as the media would have us do). We can live in fear. We can shut down business and hope that massive Federal expenditures will solve the problem. We can destroy the well-being of thousands of our citizens, leaving them without meaning in their lives. We can pretend that such actions will not come home to roost in the future. I believe those risks are every bit as relevant and potentially dangerous as denying the nature of the disease and pretending that there is no problem, a path that will inevitably lead to unnecessary death and tragedy.

Furthermore, “following the rules,” creates no guarantee. In today’s world, you can quarantine, mask up, wash your hands frequently and still get infected. Likewise, you can live a healthy lifestyle, have no underlying conditions and still become deathly ill.

But there are clear rational actions. We should continue to pursue vaccines and aggressively disseminate them when they are available (again accepting the risks involved with side effects). We should do a better job of protecting at risk populations (e.g., provide full protective equipment for workers in nursing homes). We can also take prudent precautions (wearing a mask, doing extra cleaning and sterilizing, maintaining separation, etc.). These are not onerous and appear to have a positive impact. Why would we not do this?

However, I have a greater fear for the future if we shutter our society and crash the economy. The risk of massive dependence on government largess is real. We have seen the result of such conditions on the diverse underclass from minority urban neighborhoods to the former coal communities in Appalachia. Do we really want to expand that experience to consume others who were productive members of society, consigning them to the depressive effects of perpetual subservience to a dysfunctional government?

We are better than that. We do not retreat in the face of adversity. We do not lock our doors and whimper in the night as the tide of adversity swallows us up. We have never capitulated because the road ahead was hard, full of risk, or plagued with danger. We are willing to sacrifice for the greater good of our country.

This is what it means to be American…at least that is who we used to be.

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