Many toys for babies are designed to be loud. A baby moves, and suddenly there’s sound! Bells or jangling rings or stuffed animals that drink batteries to sing!
These toys delight! (Well, they delight the baby. Parents often find them aggravating.) These toys make a baby feel powerful.
With these small hands, I can change the world!
And, crayons! And paint! Oh, the apparent joys of non-toxic fingerpaint! As the baby moves, the world retains a visible memory of that movement!
The world remembers me! My presence here: it matters!
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My eldest is now in second grade. Like most second graders, she has recently discovered that she is hilarious! She can read a joke in a book and then tell it to people. She can tell those jokes again and again and again and they are funny every time!
My younger child is now in kindergarten. Because her older sibling is telling jokes, she wants to tell jokes also. And her jokes are hilarious, too! She knows that they’re hilarious because she tells the same jokes as her sibling. One after the other, they tell me the same jokes.
Each time I say, “Hmmm, I don’t know, _______, what do you get when you cross a sheep dog with a rose?”
And each child in turn is hilarious when they tell me that it makes a collie-flower. Or that the cheese that isn’t yours is nacho cheese. Or that …
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All the jokes that my children tell are funny (to them), but a certain genre is particularly loved. Yes, the knock-knock jokes! Because a knock-knock joke isn’t only a chance to feel hilarious – knock-knock jokes are power.
You can see the realization dawning: if I say “Knock knock,” people have to say “Who’s there?”
Knock-knock jokes are like sorcery. Like a form of puppeteering. Knock-knock jokes allow a child to control everyone around them!
But, oh! The moment when people decide that a particular child is too old for knock-knock jokes – when friends and family fail to respond with “Who’s there?” – must feel so disillusioning! Suddenly, a font of power has been wrested away! The child will have lost a way to control the people around them!
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Eventually, this sense of power fades. Or rather, we grow older and become jaded. Inured to the sense of empowerment that children’s toys and knock-knock jokes once gave us. Being able to alter the world with a crayon no longer feels enough; we want to do more than make red marks on stray sheets of paper.
Many people age into these evolving expectations gracefully. Recognizing the increasing amounts of work and effort needed to change the world in meaningful ways. When an adult makes art, we expect rather more from their creations – the blobby monsters drawn by a child might seem less impressive if they’d been made by someone in their thirties. Children reap praise by building a fort from cardboard boxes; a grown-up might be expected to build a house.
Sometimes, though – and this is especially common among men – the world doesn’t make people feel as powerful as they think it ought to.
I was supposed to be master of my domain, and instead you’re talking back to me??
And so they attempt to wrest a sense of power from the world around them with violence. They find ways to circumvent their gnawing fear of being ignored.
When I say “Knock knock,” people have to say “Who’s there?” When I whistle and shout a lewd comment at a woman, she has to cringe!
Ah, right – aggrieved men don’t just wrest a sense of power “from the world.” Unfortunately, men are often given the false impression that power is synonymous with power over. And so their sense of power needs to come at the expense of someone else: someone perceived as weaker, lesser, lower in their imagined hierarchy.
By harassing a woman, a man might feel momentarily powerful again.
The aim of harassment … is not only to control women’s bodies but also to invade their minds. … Harassment is always a sexual demand, but it also carries a more sinister and pathetic injunction: ‘You will think about me.’ Like sexual abuse, to which it is affiliated, harassment brings mental life to a standstill, destroying the mind’s capacity for reverie.
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Power: the sense that our actions will be noticed. For our 45th president, leading a nation was not enough: he wanted for people to pay attention to him. He kept shouting into the insatiable maw of social media; he needed to watch television news to see evidence that people had noticed his latest shout.
But not every aggrieved man has a bevy of journalists to amplify his inane blather. “My I.Q. is one of the highest,” “Windmills are the greatest threat to eagles,” “The concept of global warming was created by the Chinese” – lots of men say this sort of thing, yet still they go unnoticed! Which makes them feel powerless! It’s very unfair!
But there’s a solution: interject oneself into the world in a sufficiently awful way, and then it’ll be impossible to be ignored!
In Culture Warlords, Talia Lavin describes how it felt to immerse herself in the internet worlds of white supremacy and hate. In some ways, this might feel like a silly project: isn’t the goal of internet trolls to feel powerful by being noticed? By intentionally studying them, isn’t Lavin giving them what they want?
In a passage describing her observation of a flame war between pagan white supremacist trolls and Christian white supremacist trolls, Lavin writes:
While researching that religious expression, it was easy for me to get bogged down in who’s drinking goat blood for Satan and who thinks a cone-shaped Crusader helmet is an extremely cool fashion accessory and who’s climbing mountains to sacrifice to Odin in hopes of awakening the white race.
Sifting through the details, and observing the nonstop, puerile nature of their speech, it can be easy to wonder precisely what the point of decoding all this hate is. Isn’t it just hate? Aren’t these just losers pontificating and arguing on the internet?
The thing about hate, though, is it metastasizes. The thing about channels that are filled, twenty-four hours a day, with stochastic violence – testosterone-filled megaphones shouting for blood – is that, sooner or later, someone is going to take them up on it.
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In many ways, a person who has studied martial arts for decades is just as dangerous as a person with a gun. Either person, if they felt sufficiently threatened, could cause someone to die.
But there’s a difference: the power from martial arts is earned. During long years of training, a person learns not to feel threatened. Having put in the work, they’ll feel powerful and so learn to control that power.
Whereas it’s trivially easy to buy a gun. There’s no impetus for psychological growth. You’ll be left with the same weak, scared, angry person – now suddenly more dangerous.
Boorish men. Internet trolls. Self-appointed militia men asserting their Second Amendment right to feel powerful without effort. They’re like aggrieved children, furious if you’re not responding to their knock-knock jokes.
You have to notice me!
Harasser, internet troll, attention-starved man with a gun: in the modern world, this might well be a single individual. Which is why Lavin’s journalism matters: these men’s hate speech can lead so easily to physical violence.
The hateful internet troll who murdered 49 people in an Orlando nightclub (while wounding & traumatizing many others) was checking Facebook during the act. As though the only way to be noticed – to feel any sense of power – was to be awful.
How is white paint like the defeat of our nation’s (former!) white-supremacist in chief?
They’re pulling us back from the brink. Both ample cause for dancing in the street.
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When I woke on Wednesday, November 4th, the news looked grim.
Before the 2016 election, I felt pretty sure that Donald Trump would win. I felt horrible about the prospect, but based on conversations I’d been having with people – and because the man embodies so much of our crass, self-serving, money-hungry national id – it seemed very likely that Trump would be elected.
But I had no prediction this time. I haven’t been talking to people. My family has returned to something vaguely like our regular life – my spouse is teaching, my kids are in school – but the local jail won’t let me inside, and I have far fewer conversations with folks around town. Our voices are muffled, and I can’t see their lips for extra help in parsing words.
I had hoped, obviously, that watching what the man has done to our country would induce people to vote for anyone else.
Nevertheless, almost half the people who voted wanted that man to stay in office.
Sure, Joe Biden clearly won the popular vote – but it wasn’t a landslide. It was something like 51% to 48%. Even ignoring, for a moment, the awfulness of the electoral college – a system that was designed so that some people could enjoy the FREEDOM to abduct, torture, and murder other people – 51% to 48% is quite close.
Almost half our nation’s voters think the president has been doing a dang fine job and should carry on with it.
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On Wednesday morning, it looked like the electoral college might proffer another victory to our current president.
I didn’t take to the streets. Nor did I descend into my secret bunker.
Backyardigans secret lair / Nickelodeon
I don’t even have a secret bunker. Although I did notice, when I went grocery shopping on Monday before the election, that the shelves were stripped bare of most types of canned beans. I imagine other people were stocking their secret bunkers.
And it’s not clear to me whether I’d be more in need of a secret bunker if Trump had won – four more years of ravage – or if Biden had won decisively, which might induce violence from the most prominent terrorist organizations in our country, the well-armed white supremacists.
I bought some dried beans. Which is silly, I know. With young children in the house, I almost never plan our meals well enough ahead of time to use dried beans instead of canned. And, in the event of TOTAL CHAOS, there’s no guarantee that we’d have running water to cook dried beans with. And also, maybe it’s excessively paranoid to be at the grocery store a day before a U.S. presidential election and feel an overwhelming dread of impending violence.
But maybe it’s not. That’s the thing. Maybe it’s not.
Any Rip Van Winkles who lay down for a nap in 2015 would have thought I was being absurd. But in 2020, other people had gotten to the canned beans before I did.
So, waking up, feeling nauseous at the gaping blood-red wound / chasm confronting me from the New York Times website’s map of the United States on Wednesday, I sat down to send sad emails to a few people I care about. Given that depression is normally a very private affair – too private, most people suffering in silence, alone – it felt almost cathartic to have the opportunity for such shared despair. Perhaps 52% of our nation felt the same hopeless nausea that I did.
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During one of these sad emails, I wrote about stocks. I’d hedged my bets – stock in construction equipment like CAT in case Joe Biden wins and actually embarks on our sorely-needed infrastructure project; stock in HVAC (air conditioning) and Canadian agriculture in case Trump won.
And, sure, maybe I shouldn’t unload my Canadian ag stocks yet. If the obstructionists hold the Senate, maybe Biden will be stymied in his efforts to address climate change. But, you know what? At least he’s gonna try.
The other guy was going to keep tweeting that sacred-water-poisoning pipelines and mountain-wrecking coal mining would Make America Uninhabitable Later, and, after an erudite Black man had successfully governed our nation for eight years, lots of folks really wanted to maul something.
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But, the dire need for air conditioning?
Well, let’s preface this by saying that air conditioning is going to be a really problematic feedback loop in our efforts to address climate change. The world gets hotter, people feel miserable, people use more air conditioning, air conditioning is a huge energy suck, which makes the world get even hotter. That’s bad. If a chemical company develops a more efficient coolant, it’ll be a huge boon.
Kinda strange for a hippie environmentalist like me to extol the efforts of companies like Dow chemical, but also, I’m a scientist, and, also, this is where we are in the world. Things would be different if we’d made better choices years ago.
No matter. This essay is a happy one, chock full of good news.
The first good news is that, pending a few lawsuits that will (eventually) fizzle in a tangled mess of illogic, Biden has won the U.S. presidency. Of our nation’s approximately 140 million eligible candidates for president, Joe Biden isn’t my number one pick. But, still. I voted for him. He’s good enough.
I’m quite happy he won.
(Given the stakes this year – buying dried beans on Monday, honestly! – that’s an understatement.)
Charles McQuillan / Getty Images
Here’s some more good news: new paint!
Seriously. If you can spare a minute to read Science magazine’s layperson-friendly press release, please, click here!
There’s a charming new research article – published three weeks ago, but unnoticed by me until this morning – that describes how much cooling we could achieve by painting buildings with a fresh coat of this special formulation of white paint.
Sunlight shines down, ready to heat any buildings covered in black shingles or whatever, but sunlight will bounce off this white paint, and be reflected in a lovely spread of wavelengths to fly back harmlessly into outer space.
This is, after all, the usual problem with greenhouse gases. Carbon dioxide lets inbound sunlight pass through, but all our stuff down here on Earth absorbs the photons of sunlight and in return ships off a larger number (more entropy, more chaos) of lower energy (so that no energy is created or destroyed) infrared photons, and the greenhouse gases won’t let those new photons fly off into outer space, so our planet heats up.
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Joe Biden. And white paint.
Our species is a bit less likely to face extinction in the coming centuries. And that sounds great to me!
I was walking my eldest child toward our local elementary school when my phone rang.
We reached the door, shared a hug, and said goodbye. After I left, I called back – it was a friend of mine from college who now runs a cancer research laboratory and is an assistant professor at a medical school.
“Hey,” I said, “I was just dropping my kid off at school.”
“Whoa,” he said, “that’s brave.”
I was shocked by his remark. For most people under retirement age, a case of Covid-19 is less dangerous than a case of seasonal influenza.
“I’ve never heard of anybody needing a double lung transplant after a case of the flu,” my friend said.
But our ignorance doesn’t constitute safety. During this past flu season, several young, healthy people contracted such severe cases of influenza that they required double lung transplants. Here’s an article about a healthy 30-year-old Wyoming man nearly killed by influenza from December 2019, and another about a healthy 20-year-old Ohio woman from January 2020. And this was a rather mild flu season!
“One of the doctors told me that she’s the poster child for why you get the flu shot because she didn’t get her flu shot,” said [the 20-year-old’s mother].
These stories were reported in local newspapers. Stories like this don’t make national news because we, as a people, think that it’s normal for 40,000 to 80,000 people to die of influenza every year. Every three to five years, we lose as many people as have died from Covid-19. And that’s with vaccination, with pre-existing immunity, with antivirals like Tamiflu.
Again, when I compare Covid-19 to influenza, I’m not trying to minimize the danger of Covid-19. It is dangerous. For elderly people, and for people with underlying health issues, Covid-19 is very dangerous. And, sure, all our available data suggest that Covid-19 is less dangerous than seasonal influenza for people under retirement age, but, guess what? That’s still pretty awful!
You should get a yearly flu shot!
A flu shot might save your life. And your flu shot will help save the lives of your at-risk friends and neighbors.
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For a while, I was worried because some of my remarks about Covid-19 sounded superficially similar to things said by the U.S. Republican party. Fox News – a virulent propaganda outlet – was publicizing the work of David Katz – a liberal medical doctor who volunteered in a Brooklyn E.R. during the Covid-19 epidemic and teaches at Yale’s school of public health.
The “problem” is that Katz disagrees with the narrative generally forwarded by the popular press. His reasoning, like mine, is based the relevant research data – he concludes that low-risk people should return to their regular lives.
You can see a nifty chart with his recommendations here. This is the sort of thing we’d be doing if we, as a people, wanted to “follow the science.”
And also, I’m no longer worried that people might mistake me for a right-wing ideologue. Because our president has once again staked claim to a ludicrous set of beliefs.
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Here’s a reasonable set of beliefs: we are weeks away from a safe, effective Covid-19 vaccine, so we should do everything we can to slow transmission and get the number of cases as low as possible!
Here’s another reasonable set of beliefs: Covid-19 is highly infectious, and we won’t have a vaccine for a long time. Most people will already be infected at least once before there’s a vaccine, so we should focuson protecting high-risk people while low-risk people return to their regular lives.
If you believe either of those sets of things, then you’re being totally reasonable! If you feel confident that we’ll have a vaccine soon, then, yes, delaying infections is the best strategy! I agree! And if you think that a vaccine will take a while, then, yes, we should end the shutdown! I agree!
There’s no right answer here – it comes down to our predictions about the future.
But there are definitely wrong answers. For instance, our current president claims that a vaccine is weeks away, and that we should return to our regular lives right now.
That’s nonsense. If we could get vaccinated before the election, then it’d make sense to close schools. To wait this out.
If a year or more will pass before people are vaccinated, then our efforts to delay the spread of infection will cause more harm than good. Not only will we be causing harm with the shutdown itself, but we’ll be increasing the death toll from Covid-19.
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On October 14th, the New York Times again ran a headline saying “Yes, you can be reinfected with the coronavirus. But it’s extremely unlikely.”
This is incorrect.
When I’ve discussed Covid-19 with my father – a medical doctor specializing in infectious diseases, virology professor, vaccine developer with a background in epidemiology from his masters in public health – he also has often said to me that reinfection is unlikely. I kept explaining that he was wrong until I realized that we were talking about different things.
When my father uses the word “reinfection,” he means clearing the virus, catching it again, and becoming sicker than you were the first time. That’s unlikely (although obviously possible). This sort of reinfection happens often with influenza, but that’s because influenza mutates so rapidly. Covid-19 has a much more stable genome.
When I use the word “reinfection” – and I believe that this is also true when most laypeople use the word – I mean clearing the virus, catching it again, and becoming sick enough to shed the viral particles that will make other people sick.
This sense of the word “reinfection” describes something that happens all the time with other coronaviruses, and has been documented to occur with Covid-19 as well.
The more we slow the spread of Covid-19, the more total cases there will be. In and of itself, more cases aren’t a bad thing – most people’s reinfection will be milder than their first exposure. The dangerous aspect is that a person who is reinfected will have another period of viral shedding during which they might expose a high-risk friend or neighbor.
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If our goal is to reduce the strain on hospitals and reduce total mortality, we need to avoid exposing high-risk people. Obviously, we should be very careful around nursing home patients. We should provide nursing homes with the resources they need to deal with this, like extra testing, and preferably increased wages for nursing home workers to compensate them for all that extra testing.
It’s also a good idea to wear masks wherever low-risk and high-risk people mingle. The best system for grocery stores would be to hire low-risk shoppers to help deliver food to high-risk people, but, absent that system, the second-best option would be for everyone to wear masks in the grocery store.
Schools are another environment where a small number of high-risk teachers and a small number of students living with high-risk family members intermingle with a large number of low-risk classmates and colleagues.
Schools should be open – regions where schools closed have had the same rates of infection as regions where schools stayed open, and here in the U.S., teachers in districts with remote learning have had the same rates of infection as districts with in-person learning.
Education is essential, and most people in the building have very low risk.
A preponderance of data indicate that schools are safe. These data are readily accessible even for lay audiences – instead of reading research articles, you could read this lovely article in The Atlantic.
Well, I should rephrase.
We should’ve been quarantining international travelers back in December or January. At that time, a shutdown could have helped. By February, we were too late. This virus will become endemic to the human species. We screwed up.
But, given where we are now, students and teachers won’t experience much increased risk from Covid-19 if they attend in person, and schools aren’t likely to make the Covid-19 pandemic worse for the surrounding communities.
That doesn’t mean that schools are safe.
Schools aren’t safe: gun violence is a horrible problem. My spouse is a teacher – during her first year, a student brought weapons including a chainsaw and some pipe bombs to attack the school; during her fourth year, a student had amassed guns in his locker and was planning to attack the school.
Schools aren’t safe: we let kids play football, which is known to cause traumatic brain injury.
Schools aren’t safe: the high stress of grades, college admissions, and even socializing puts some kids at a devastatingly high risk for suicide. We as a nation haven’t always done a great job of prioritizing kids’ mental health.
And the world isn’t safe – as David Katz has written,
“If inclined to panic over anything, let it be climate change … Not the most wildly pessimistic assessment of the COVID pandemic places it even remotely in the same apocalyptic ballpark.”
In April, I wrote several essays and articles about our collective response to Covid-19.
I was worried – and am still worried, honestly – that we weren’t making the best choices.
It’s hard not to feel cynical about the reasons why we’ve failed. For instance, our president seems more concerned about minimizing the visibility of disaster than addressing the disaster itself. We didn’t respond until this virus had spread for months, and even now our response has become politicized.
Also, the best plans now would include a stratified response based on risk factor. Much more than seasonal influenza, the risk of serious complications from Covid-19 increases with age. Because we didn’t act until the virus was widespread, eighty-year-olds should be receiving very different recommendations from forty- and fifty-year-olds.
Our national response is being led by an eighty-year-old physician, though, and he might be biased against imposing exceptional burdens on members of his own generation (even when their lives are at stake) and may be less sensitive to the harms that his recommendations have caused younger people.
I’m aware that this sounds prejudiced against older folks. That’s not my intent.
I care about saving lives.
Indeed, throughout April, I was arguing that our limited Covid-19 PCR testing capacity shouldn’t be used at hospitals. These tests were providing useful epidemiological data, but in most cases the results weren’t relevant for treatment. The best therapies for Covid-19 are supportive care – anti-inflammatories, inhalers, rest – delivered as early as possible, before a patient has begun to struggle for breath and further damage their lungs. Medical doctors provided this same care whether a Covid-19 test came back positive or negative.
(Or, they should have. Many patients were simply sent home and told to come back if they felt short of breath. Because they didn’t receive treatment early enough, some of these patients then died.)
Instead, our limited testing capacity should have been used at nursing homes. We should have been testing everyone before they went through the doors of a nursing home, because people in nursing homes are the most vulnerable to this virus.
I realize that it’s an imposition to make people get tested before going in, either for care or to work – even with real-time reverse-transcription PCR, you have to wait about two hours to see the results. But the inconvenience seems worthwhile, because it would save lives.
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From March 25 until May 10 – at the same time that I was arguing that our limited Covid-19 tests be used at nursing homes instead of hospitals – the state of New York had a policy stating that nursing homes were prohibited from testing people for Covid-19.
I really dislike the phrase “asymptomatic transmission” – it’s both confusing and inaccurate, because viral shedding is itself a symptom – but we knew early on that Covid-19 could be spread by people who felt fine. That’s why we should have been using PCR tests before letting people into nursing homes.
But in New York, nursing homes were “prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”
Not only do nursing homes have the highest concentration of vulnerable people, they also have far fewer resources than hospitals with which to keep people safe. Nursing home budgets are smaller. Hallways are narrower. Air circulation is worse. The workers lack protective gear and training in sterile procedure. Nursing home workers are horrendously underpaid.
The low wages of nursing home workers aren’t just unethical, they’re dangerous. A recent study found that higher pay for nursing home workers led to significantly better health outcomes for residents.
This study’s result as described in the New York Times – “if every county increased its minimum wage by 10 percent, there could be 15,000 fewer deaths in nursing homes each year” – is obviously false. But even though the math doesn’t work out, raising the minimum wage is the right thing to do.
If we raised the minimum wage, we probably would have a few years in which fewer people died in nursing homes. But then we’d see just as many deaths.
Humans can’t live forever. With our current quality of care, maybe nursing home residents die at an average age of 85. If we raise the minimum wage, we’ll get better care, and then nursing home residents might die at an average age of 87. After two years, we’d reach a new equilibrium and the death rate would be unchanged from before.
But the raw number here – how many people die each year – isn’t our biggest concern. We want people to be happy, and an increase in the minimum wage would improve lives: both nursing home residents and workers. Which I’m sure that study’s lead author, economist Kristina Ruffini, also believes. The only problem is that things like “happiness” or “quality of life” are hard to quantify.
Especially when you’re dealing with an opposition party that argues that collective action can never improve the world, you have to focus on quantifiable data. Happiness is squishy. A death is unassailable.
Indeed, that’s partly why we’ve gotten our response to Covid-19 wrong. Some things are harder to measure than others. It’s easy to track the number of deaths caused by Covid-19. (Or at least, it should be – our president is still understating the numbers.)
It’s much harder to track the lives lost to fear, to domestic violence, and to despair (no link for this one – suddenly Fox News cares about “deaths of despair,” only because they dislike the shutdown even more than they dislike poor people). It’s hard to put a number on the value of 60 million young people’s education.
But we can’t discount the parts of our lives that are hard to measure – often, they’re the most important.
My spouse posted my previous essay on social media, and I’d like to address some of people’s comments. There were some excellent points!
My apologies if I failed to address everything that people said, but I tried my best.
Scroll to find my responses to:
A shutdown could have prevented the Covid-19 epidemic.
We know that the current shutdown is either delaying or preventing deaths due to Covid-19.
Ending this epidemic with a vaccine would be ideal.
Ending the shutdown while requesting that at-risk people continue to self-isolate would save lives.
Why is it urgent to end the shutdown soon?
Why might more people die of Covid-19 just because we are slowing the spread of the virus?
How is the shutdown causing harm?
What about the rate at which people get sick? Isn’t the shutdown worthwhile, despite the risks described above, if it keeps our hospitals from being overwhelmed?
Don’t the antibody tests have a lot of false positives?
What about the political ramifications of ending the shutdown?
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1: “A shutdown could have prevented the Covid-19 epidemic.”
If we’d acted early enough, we could have isolated all cases of Covid-19 and prevented this whole debacle.
2: “We know that the current shutdown is either delaying or preventing deaths due to Covid-19.”
To date, the data suggests that the virus has only reached saturation inside a few closed environments, such as prisons. In Italy, both the timecourse of mortality and the results of antibody studies suggest that infections were still rising at the time of their lockdown.
Among the passengers of the Diamond Princess cruise ship, deaths peaked 21 days after infections peaked – if the virus had already reached saturation in Italy, we’d expect to see deaths peak sooner than 21 days after the lockdown began. They did not.
So, again, this much is clear: worldwide, there was a significant new cause of death. When we look at mortality data, we see the curves suddenly rise in many locations. Some researchers, such as John Ioannidis, have speculated that Covid-19 causes death primarily in people with low life expectancy, in which case we would expect to see these mortality curves drop to lower-than-average levels after the epidemic ends. But even then, it’s unprecedented to see a number of deaths that would usually occur over the course of a year all within a matter of weeks.
Covid-19 is killing people, and the shutdown is either delaying or preventing people’s death from Covid-19.
For the shutdown to actually prevent death, one of the following needs to happen:
1.) We create a vaccine, allowing our population to reach 70% immunity without as many people contracting the illness.
2.) We take action to change which segment of the population is exposed to the virus, allowing us to reach 70% immunity without as many at-risk people being exposed.
See #3 and #4, below.
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3: “Ending this epidemic with a vaccine would be ideal.”
Vaccination is great science. Both my spouse and I love teaching about vaccines, in part because teaching the history of vaccine use is a good component of anti-racist science class.
Developing vaccines often takes a long time. I’ve read predictions of a year or two; my father, an infectious disease doctor, epidemiologist, research physician who runs vaccine trials, and co-developer of Merck’s HPV vaccine, guesses that it will take about five years.
And then, for the vaccine to end this epidemic, enough people will need to choose to be vaccinated that we reach approximately 70% immunity.
The reason it’s worthwhile to compare Covid-19 to seasonal influenza is that a vaccine will only end the epidemic if enough people choose to get it. Many people’s personal risk from Covid-19 is lower than their risk from seasonal influenza. Will those people choose to be vaccinated?
Obviously, I would be thrilled if the answer were “yes.” I’d love to live in a nation where people’s sense of altruism and civic duty compelled them to get vaccinated. My family is up-to-date on all of ours.
But many privileged families in the United States have elected to be freeloaders, declining the (well tested, quite safe) measles vaccine with the expectation that other people’s immunity will keep them safe. And, despite the well-documented dangers of influenza, only 40% of our population gets each year’s influenza vaccine.
A vaccine with low efficacy will still offer better protection when more people get it. If a higher percentage of our population were vaccinated against influenza, then influenza transmission would drop, and so each person’s immunity, whether high or low, would be less likely to be challenged.
The influenza vaccine saves lives. In Italy, where fewer people choose to get vaccinated against influenza (about 15% compared to our 40% of the population), the death rate from influenza is higher. Although it’s worth noting that this comparison is complicated by the fact that our health care system is so bad, with poor people especially having limited access to health care. In the United States, people between the ages of 18 and 49 comprise a higher proportion of influenza deaths than anywhere in Europe. Either our obesity epidemic or limited access to health care is probably to blame; possibly a combination of both.
In summary, for this plan to help us save lives, we will need to develop an effective vaccine, and then people will have to get it.
I am quite confident that we can eventually develop a vaccine against Covid-19. The virus includes a proofreading enzyme, so it should mutate more slowly than most RNA viruses. We don’t know how long it will take, but we can do it.
I am unfortunately pessimistic that people will choose to get the vaccine. And, unfortunately, when a low-risk person chooses to forgo vaccination, they’re not just putting themselves in harm’s way, they are endangering others. Most vaccines elicit a weaker immune response in elderly or immunocompromised recipients – exactly the group most at risk from Covid-19 – which is why we spend so much time harping about herd immunity.
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4: “Ending the shutdown while requesting that at-risk people continue to self-isolate would save lives.“
This plan has major downsides, too. Because we didn’t take action soon enough, every plan we have now is bad.
Low-risk people can still die of Covid-19. Even if they don’t die, Covid-19 can cause permanent health effects. Covid-19 reduces your ability to get oxygen to your body and brain. Even a “mild” case can leave your breathing labored for weeks – you’re not getting enough oxygen. Your muscles will ache. Your thoughts will be sluggish.
With a more severe case, people can be looking at heart damage. Renal failure. It would be cruel to look at all these long-term consequences and blithely call them “recovery.”
If our health care system were better, we’d treat people sooner. The earlier you intervene, helping to boost people’s oxygen levels, the better outcome you’ll have. There’s a great editorial from medical doctor Richard Levitan recommending that people monitor their health with a pulse oximeter during this epidemic.
If you notice your oxygen levels declining, get help right away. Early intervention can prevent organ damage. And you’ll be helping everyone else, too – the sooner you intervene, the less medical care you will need.
Because medical debt can derail lives, many people in this country delay treatment as long as possible, hoping that their problems will go away naturally. That’s why people are often so sick when they show up at the ER. I imagine that this is yet another reason – alongside air pollution, food deserts, sleep loss, and persistent stress exacerbated by racism – that poor communities have had such a high proportion of people with severe cases of Covid-19.
And I imagine – although we don’t yet have enough data to know – that financial insecurity caused by the shutdown is making this worse. It’s a rotten situation: you have a segment of population that has to continue working during the shutdown, which means they now have the highest likelihood to be exposed to the virus, and they’re now under more financial strain, which might increase the chance that they’ll delay treatment.
We know that early treatment saves lives, and not everyone is sufficiently privileged to access that.
All this sounds awful. And it is. But, if we took action to shift exposure away from high risk groups, the likelihood that any individual suffers severe consequences is lower.
And there is another caveat with this plan – some people may be at high risk of complications for Covid-19 and not even realize it. In the United States, a lot of people either have type 2 diabetes or are pre-diabetic and don’t yet realize. These people have elevated risk. Both smoking and airpollution elevate risk, but people don’t always know which airborn pollutants they’ve been exposed to. (Which, again, is why it’s particularly awful that our administration is weakening air quality standards during this epidemic.)
Even if we recommended continued self-isolation for only those people who know themselves to have high risk from Covid-19, though, we would be saving lives. The more we can protect people in this group from being exposed to the virus – not just now, but ever – the more lives we will save.
We won’t be able to do this perfectly. It’ll be a logistical nightmare trying to do it at all. People at high risk from Covid-19 needs goods and services just like everybody else. We might have to give daily Covid-19 PCR tests to anyone visiting their homes, like doctors, dentists, and even delivery workers.
At that point, the false negative rate from Covid-19 PCR tests becomes a much bigger problem – currently, these false negatives reduce the quality of our data (but who cares?) and delay treatment (which can be deadly). A false negative that causes inadvertent exposure could cost lives.
Some people will be unable to work, either because they or a close relative has high risk of Covid-19. Some children will be unable to go to school. We will need a plan to help these people.
We will have to work very hard to keep people safe even after the shutdown ends for some.
But, again, if everyone does the same thing, then the demographics of people infected with Covid-19 will reflect our population demographics. We can save lives by skewing the demographics of the subset of our population that is exposed to Covid-19 to include more low-risk individuals, which will require that we stratify our recommendations by risk (at least as well as we can assess it).
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5: “Why is it urgent to end the shutdown soon?“
1.) By delaying Covid-19 deaths, we run to risk of causing more total people to die of Covid-19.
2.) The shutdown itself is causing harm.
See #6 and #7, below.
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6: “Why might more people die of Covid-19 just because we are slowing the spread of the virus?“
[EDIT: I wrote a more careful explanation of the takeaways of the Harvard study. That’s here if you would like to take a look!]
This is due to the interplay between duration of immunity and duration of the epidemic. At one point in time, seasonal influenza was a novel zoogenic disease. Human behavior allowed the influenza virus to become a perpetual burden on our species. No one wants for humans to still be dying of Covid-19 in ten or twenty years. (Luckily, because the virus that causes Covid-19 seems to mutate more slowly than influenza, it should be easier to design a single vaccine that protects people.)
In the Harvard model, we can see that there are many scenarios in which a single, finite shutdown leads to more deaths from Covid-19 than if we’d done nothing. Note the scenarios for which the colored cumulative incidence curves (shown on the right) exceed the black line representing how many critical cases we’d have if we had done nothing.
Furthermore, their model does not account for people’s immunity potentially waning over time. Currently, we do not know how long people’s immunity to Covid-19 will last. We won’t know whether people’s immunity will last at least a year until a year from now. There’s no way to test this preemptively.
If we could all go into stasis and simply not move for about a month, there’d be no new cases of Covid-19, and this virus would be gone forever. But people still need to eat during the shutdown. Many people are still working. So the virus is still spreading, and we have simply slowed the rate of transmission.
This seems good, because we’re slowing the rate at which people enter the hospital, but it’s actually bad if we’re increasing the number of people who will eventually enter the hospital.
Based on our research with other coronaviruses, we expect that re-infection will cause a person to experience symptoms less severe than their first case of Covid-19. But a re-infected person can still spread the disease to others. And we don’t know what will happen if a person’s risk factors – such as age, smoking status, diabetes status, etc. – have increased in the time since their last infection.
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7: “How is the shutdown causing harm?“
If you turn on Fox News, I imagine you’d hear people talking about the damage we’re doing to our economy. They might discuss stock market numbers.
Who gives a shit? In my opinion, you’d have to be pretty callous to think that maintaining the Nasdaq bubble is more important than saving lives.
At the same time, I think you’d have to be pretty callous to not feel extremely concerned by the United Nations’ policy brief, “The impact of Covid-19 on children.”
In this report, they estimate that the shutdown we’ve had so far will cause hundreds of thousands of children to die, many from malnutrition and the other health impacts of poverty. The longer the shutdown continues, the more children will die.
That’s a worldwide number, and most of those children live outside the United States. But I’d like to think that their lives matter, too.
The report also discusses the lifelong harm that will be inflicted on children from five months (or more!) of school closure. Drop-outs, teen pregnancy, drug abuse, recruitment of child soldiers, and the myriad health consequences of low educational attainment.
I live in a wealthy college town, but even here there is a significant population of students who don’t have internet access. Students with special needs aren’t getting the services they deserve. Food insecurity is worse.
You’re lucky that privacy protections prevent me from sharing a story about what can happen to poor kids when all the dentists’ offices are closed. I felt ashamed that this was the best my country had to offer.
As the shutdown continues, domestic violence is rising. We can assume that child abuse is rising, also, but we won’t know until later, when we finally have a chance to save children from it. In the past, levels of child abuse have been correlated with the amount of time that children spend in the presence of their abusers (usually close family), and reporting tends to happen during tense in-person conversations at school.
The shutdown has probably made our drug epidemic worse (and this was already killing about 70,000 people per year in the U.S.). When people are in recovery, one of the best strategies to stay sober is to spend a lot of time working, out of the house, and meeting with a supportive group in communal space. Luckily, many of the people I know who are in recovery have been categorized as essential workers.
A neighbor recently sent me a cartoon suggesting that the biggest harm caused by the shutdown is boredom. (I’m going to include it, below, but don’t worry: I won’t spend too much time rattling sabers with a straw man.) And, for privileged families like mine, it is. We’re safe, we’re healthy, we get to eat. My kids are still learning – we live in a house full of computers and books.
But many of the 75 million children in the United States don’t live in homes like mine, with the privilege we have. Many of our 50 million primary and secondary school students are not still learning academically during the shutdown.
Whether the shutdown is preventing or merely delaying the deaths of people at risk of serious complications from Covid-19, we have to remember that the benefit comes at a cost. What we’ve done already will negatively impact children for the rest of their lives. And the longer this goes on, the more we’re hurting them.
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8: “What about the rate at which people get sick? Isn’t the shutdown worthwhile, despite the risks described above, if it keeps our hospitals from being overwhelmed?“
In writing this, I struggled with how best to organize the various responses. I hope it doesn’t seem too ingenuous to address this near the end, because slowing the rate of infection so that our hospitals don’t get overwhelmed is the BEST motivation for the shutdown. More than the hope that a delay will yield a new vaccine, or new therapies to treat severe cases, or even new diagnostics to catch people before they develop severe symptoms, we don’t want to overwhelm our hospitals.
If our physicians have to triage care, more people will die.
And I care a lot about what this epidemic will be like for our physicians. My father is a 67-year-old infectious disease doctor who just finished another week of clinical service treating Covid-19 patients at the low-income hospital in Indianapolis. My brother-in-law is an ER surgeon in Minneapolis. These cities have not yet had anything like the influx of severe cases in New York City – for demographic and environmental reasons, it’s possible they never will. But they might.
Based on the case fatality rate measured elsewhere, I’d estimate that only 10% of the population in Minneapolis has already been infected with Covid-19, so the epidemic may have a long way yet to go.
If we ended the shutdown today for everyone, with no recommendation that at-risk groups continue to isolate and no new measures to protect them, we would see a spike in severe cases.
If we ended the shutdown for low-risk groups, and did a better job of monitoring people’s health to catch Covid-19 at early, more-easily-treatable stages (through either PCR testing or oxygen levels), we can avoid overwhelming hospitals.
And the shutdown itself is contributing toward chaos at hospitals. Despite being on the front lines of this epidemic, ER doctors in Minneapolis have received a 30% pay cut. I imagine my brother-in-law is not the only physician who could no longer afford day care for his children after the pay cut. (Because so many people are delaying care out of fear of Covid-19, hospitals are running out of money.) Precisely when we should be doing everything in our power to make physicians’ lives easier, we’re making things more stressful.
We could end the shutdown without even needing to evoke the horrible trolley-problem-esque calculations of triage. Arguments could be made that even if it led to triage it might be worthwhile to end the shutdown – the increase in mortality would be the percentage of triaged cases that could have survived if they’d been treated, and we as a nation might decide that this number was acceptable to prevent the harms described above – but with a careful plan, we need not come to that.
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9: “Don’t the antibody tests have a lot of false positives?“
False positives are a big problem when a signal is small. I happen to like a lot of John Ioannidis’s work – I think his paper “Why Most Published Research Findings Are False” is an important contribution to the literature – but I agree that the Santa Clara study isn’t particularly convincing.
When I read the Santa Clara paper, I nodded and thought “That sounds about right,” but I knew my reaction was most likely confirmation bias at work.
Which is why, in the essay, I mostly discussed antibody studies that found high percentages of the population had been infected with Covid-19, like the study in Germany and the study in the Italian town of Robbio. In these studies, the signal was sufficiently high that false positives aren’t as worrisome.
In Santa Clara, when they reported a 2% infection rate, the real number might’ve been as low as zero. When researchers in Germany reported a 15% infection rate, the real number might’ve been anywhere in the range of 13% to 17% – or perhaps double that, if the particular chips they used had a false negative rate similar to the chips manufactured by Premier Biotech in Minneapolis.
I’m aware that German response to Covid-19 has been far superior to our bungled effort in the United States, but an antibody tests is just a basic ELISA. We’ve been doing these for years.
Luckily for us, we should soon have data from good antibody studies here in the United States. And I think it’s perfectly reasonable to want to see the results of those. I’m not a sociopath – I haven’t gone out and joined the gun-toting protesters.
But we’ll have this data in a matter of weeks, so that’s the time frame we should be talking about here. Not months. Not years. And I’ll be shocked if these antibody studies don’t show widespread past infection and recovery from Covid-19.
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10: “What about the political ramifications of ending the shutdown?“
I am, by nature, an extremely cautious person. And I have a really dire fear.
I’m inclined to believe that ending the shutdown is the right thing to do. I’ve tried to explain why. I’ve tried to explain what I think would be the best way to do it.
But also, I’m a scientist. You’re not allowed to be a scientist unless you’re willing to be proven wrong.
So, yes. I might be wrong. New data might indicate that writing this essay was a horrible mistake.
Still, please bear with me for a moment. If ending the shutdown soon turns out to be the correct thing to do, and if only horrible right-wing fanatics have been saying that we should end the shutdown soon, won’t that help our current president get re-elected?
There is a very high probability that his re-election would cause even more deaths than Covid-19.
Failing to address climate change could kill billions. Immigration controls against migrants fleeing war zones could kill millions. Weakened EPA protections could kill hundreds of thousands. Reduced access to health care could kill tens of thousands.
And, yes, there are horrible developments that neither major political party in the United States has talked about, like the risk that our antibiotics stop working, but I think it’s difficult to argue that one political party isn’t more dangerous than the other, here.
I feel pretty confident about all the scientific data I’ve discussed above. Not as confident as I’d like, which would require more data, but pretty confident.
I feel extremely confident that we need to avoid a situation in which the far right takes ownership of an idea that turns out to have been correct. And it’ll be dumb luck, just a bad coincidence. The only “data” they’re looking at are stock market numbers, or maybe the revenue at Trump-owned hotels.
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EDIT: I also wrote a more careful explanation of the takeaways of the Harvard study. That’s here if you would like to take a look!
My spouse recently sent me a link to the article “Concerns with that Stanford study of coronavirus prevalence” by Andrew Gelman, a statistician at Columbia University. From reading this article, I got the impression that Gelman is a good mathematician. And he raises some legitimate concerns.
First, some background: in case you haven’t noticed, most of the United States is operating under a half-assed lockdown. In theory, there are stay-at-home orders, but many people, such as grocery store clerks, janitors, health care workers, construction workers, restaurant chefs, delivery drivers, etc., are still going to work as normal. However, schools have been closed, and most people are trying to stand at least six feet away from strangers.
We’re doing this out of fear that Covid-19 is an extremely dangerous new viral disease. Our initial data suggested that as many as 10% of people infected with Covid-19 would die.
That’s terrifying! We would be looking at tens of millions of deaths in the United States alone! A virus like this will spread until a majority of people have immunity to it – a ballpark estimate is that 70% of the population needs immunity before the epidemic stops. And our early data suggested that one in ten would die.
My family was scared. We washed our hands compulsively. We changed into clean clothes as soon as we came into the house. The kids didn’t leave our home for a week. My spouse went to the grocery store and bought hundreds of dollars of canned beans and cleaning supplies.
And, to make matters worse, our president was on the news saying that Covid-19 was no big deal. His nonchalance made me freak out more. Our ass-hat-in-chief has been wrong about basically everything, in my opinion. His environmental policies are basically designed to make more people die. If he claimed we had nothing to worry about, then Covid-19 was probably more deadly than I expected.
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Five weeks have passed, and we now have much more data. It seems that Covid-19 is much less dangerous than we initially feared. For someone my age (37), Covid-19 is less dangerous than seasonal influenza.
Last year, seasonal influenza killed several thousand people between the ages of 18 and 49 in the United States – most likely 2,500 people, but perhaps as many as 5,800. People in this age demographic account for about 10% of total flu deaths in the United States, year after year.
Seasonal influenza also killed several hundred children last year – perhaps over a thousand.
There’s a vaccine against influenza, but most people don’t bother.
That’s shocking.
Seasonal influenza is more dangerous than Covid-19 for people between the ages of 18 and 49, but only 35% of them chose to be vaccinated in the most recently reported year (2018). And because the vaccination rate is so low, our society doesn’t have herd immunity. By choosing not to get the influenza vaccine, these people are endangering themselves and others.
Some people hope that the Covid-19 epidemic will end once a vaccine is released. I am extremely skeptical. The biggest problem, to my mind, isn’t that years might pass before there’s a vaccine. I just can’t imagine that a sufficient percentage of our population would choose to get a Covid-19 vaccine when most people’s personal risk is lower than their risk from influenza.
When I teach classes in jail, dudes often tell me about which vaccines they think are too dangerous for their kids to get. I launch into a tirade about how safe most vaccines are, and how deadly the diseases they prevent.
Seriously, get your kids vaccinated. You don’t want to watch your child die of measles.
And, seriously, dear reader – get a flu vaccine each year. Even if you’re too selfish to worry about the other people whom your mild case of influenza might kill, do it for yourself.
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We already know how dangerous seasonal influenza is. But what about Covid-19?
To answer that, we need data. And one set of data is unmistakable – many people have died. Hospitals around the world have experienced an influx of patients with a common set of symptoms. They struggle to breathe; their bodies weaken from oxygen deprivation; their lungs accumulate liquid; they die.
Many people have been put on ventilators, but that’s often the beginning of the end. Most people put on ventilators will die. Among patients over 70 years old, three quarters who are put on ventilators will die.
For each of these patients saved, three others are consigned to an agonizing death in the hospital, intubated among the flashing lights, the ceaseless blips and bleeps. At home, they’d die in a day; in the hospital, their deaths will take three weeks.
And the sheer quantity of deaths sounds scary – especially for people who don’t realize how many tens of thousands die from influenza in the United States each year.
Or, consider: cigarette smoking causes 480,000 deaths per year in the United States, including 41,000 people who die from second-hand smoke exposure. Those 41,000 aren’t even choosing to smoke! But cigarettes kill them anyway.
Indeed, when people die of Covid-19, it’s often because their lungs fail. Smoking is obviously a major risk factor for dying of Covid-19 – a significant portion of reported Covid-19 deaths could be considered cigarette deaths instead. Or as air pollution deaths – and yet, our current president is using this crisis as an opportunity to weaken EPA airquality regulations.
Air pollution is a huge problem for a lot of Black communities in the United States. Our racist housing policies have placed a lot of minority neighborhoods near heavily polluting factories. Now Covid-19 is turning what is already a lifelong struggle for breath into a death sentence.
I would enthusiastically support a shutdown motivated by the battle for clean air.
But if we want to know how scary this virus is, we need to know how many people were infected. If that many people died after everyone in the country had it, then Covid-19 would be less dangerous than influenza. If that many people died after only a hundred thousand had been infected, then this would be terrifying, and far more dangerous than influenza.
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Initially, our data came from PCR testing.
These are good tests. Polymerase chain reaction is highly specific. If you want to amplify a certain genetic sequence, you can design short DNA primers that will bind only to that sequence. Put the whole mess in a thermocycler and you get a bunch of your target, as long as the gene is present in the test tube in the first place. If the gene isn’t there, you’ll get nothing.
PCR works great. Even our lovely but amnesiac lab tech never once screwed it up.
So, do the PCR test and you’ll know whether a certain gene is present in your test tube. Target a viral gene and you’ll know whether the virus is present in your test tube. Scoop out some nose glop from somebody to put into the test tube and you’ll know whether the virus is present in that nose glop.
The PCR test is a great test that measures whether someone is actively shedding virus. It answers, is there virus present in the nose glop?
This is not the same question as, has this person ever been infected with Covid-19?
It’s a similar question – most people infected with a coronavirus will have at least a brief period of viral shedding – but it’s a much more specific question. When a healthy person is infected with a coronavirus, the period of viral shedding can be as short as a single day.
A person can get infected with a coronavirus, and if you do the PCR test either before or after that single day, the PCR test will give a negative result. Nope, no viral RNA is in this nose glop!
And so we know that the PCR test will undercount the true number of infections.
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When we look at the age demographics for Covid-19 infections as measured by PCR test, the undercount becomes glaringly obvious.
Consider the PCR test data from the Diamond Princess cruise ship. To date, this is our most complete set of PCR data – everyone on board was tested multiple times. And from this data, it appears that very few children were exposed to the virus.
Friends, it is exceedingly unlikely that such a low percentage of children were exposed to this virus. Children are disgusting. I believe this is common knowledge. Parents of small children are pretty much always sick because children are so disgusting.
Seriously, my family has been doing the whole “social distancing” thing for over a month, and yet my nose is dripping while I type this.
Children are always touching everything, and then they rub their eyeballs or chew on their fingers. If you take them someplace, they grubble around on the floor. They pick up discarded tissues and ask, “What’s this?”
“That’s somebody’s gross kleenex, is what it is! Just, just drop it. I know it’s trash, I know we’re not supposed to leave trash on the ground, but just, just drop it, okay? Somebody will come throw it away later.”
The next day: “Dad, you said somebody would throw that kleenex away, but it’s still there!”
Bloody hell. Children are little monsters.
It seems fairly obvious that at least as high a percentage of children would be infected as any other age demographic.
But they’re not showing up from the PCR data. On the Diamond Princess cruise ship, the lockdown began on February 5th, but PCR testing didn’t begin until February 11th. Anyone who was infected but quickly recovered will be invisible to that PCR test. And even people who are actively shedding viral particles can feel totally well. People can get infected and recover without noticing a thing.
We see the same thing when we look at the PCR data from Italy. If we mistakenly assumed that the PCR data was measuring the number of infections, and not measuring the number of people who were given a PCR test while shedding viral particles, we’d conclude that elderly people went out and socialized widely, getting each other sick, and only occasionally infected their great-grandchildren at home.
Here in the United States, children are disgusting little monsters. I bet kids are disgusting in Italy, too. They’re disgusting all over the world.
A much more likely scenario is that children spread this virus at school. Many probably felt totally fine; some might’ve had a bad fever or the sniffles for a few days. But then they recovered.
When they got their great-grandparents sick – which can happen easily since so many Italian families live in multigenerational homes – elderly people began to die.
So we know that the PCR test is undercounting the true number of infections. Unless you’re testing every person, every day, regardless of whether or not they have symptoms, you’re going to undercount the number of infections.
In a moment, we can work through a way to get a more accurate count. But perhaps it’s worth mentioning that, for someone my age, Covid-19 would seem to be about as dangerous as influenza even if we assumed that the PCR data matched the true number of infections.
If you’re a healthy middle-aged or young person, you should not feel personally afraid.
That alone would not be an excuse to go out and start dancing in the street, though. Your actions might cause other people to die.
(NOTE & CORRECTION: After this post went up, my father recommended that I add something more about personal risk. No one has collected enough data on this yet, but he suspects that the next most important risk factor, after smoking and age, will be type 2 diabetes. And he reminded me that many people in their 30s & 40s in this country are diabetic or prediabetic and don’t even realize it yet. Everyone in this category probably has elevated risk of complications from Covid-19.)
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After you’ve been infected with a virus, your body will start making antibodies. These protect you from being infected again.
Have you read Shel Silverstein’s Missing Piece book? Antibodies work kind of like that. They have a particular shape, and so they’ll glom onto a virus only if that virus has outcroppings that match the antibody’s shape. Then your body sees the antibodies hanging out on a virus like a GPS tracker and proceeds to destroy the virus.
So to make an antibody test, you take some stuff that looks like the outcroppings on the virus and you put it on a chip. Wash somebody’s blood over it, and if that blood contains antibodies that have the right shape to glom onto the virus, they’ll stick to the chip. All your other antibodies, the ones that recognize different viruses, will float away.
An antibody test is going to be worse than a PCR test. It’s easier to get a false positive result – antibodies are made of proteins, and they can unfold if you treat them roughly, and then they’ll stick to anything. Then you’ll think that somebody has the right antibodies, but they don’t. That’s bad.
You have to be much more careful when you’re doing an antibody test. I wouldn’t have asked our lab tech to do them for me.
An antibody test is also going to have false negatives. A viral particle is a big honking thing, and there are lots of places on its surface where an antibody might bind. If your antibodies recognize some aspect of the virus that’s different from what the test manufacturers included on their chip, your antibodies will float away. Even though they’d protect you from the actual virus if you happened to be exposed to it.
If you’re a cautious person, though – and I consider myself to be pretty cautious – you’d much rather have an antibody test with a bunch of false negatives than false positives. If you’re actually immune to Covid-19 but keep being cautious, well, so what? You’re safe either way. But if you think you’re immune when you’re not, then you might get sick. That’s bad.
Because antibody tests are designed to give more false negatives than false positives, you should know that it’d be really foolish to use them to track an infection. Like, if you’re testing people to see who is safe to work as a delivery person today, use the PCR test! The antibody test has a bunch of false negatives, and there’s a time lag between the onset of infection and when your body will start making antibodies.
If you use the antibody test on a bunch of people, though, you can tell how many were infected. And that’s useful information, too.
In the town of Robbio in Italy (pop. 6,000), the PCR test showed that only 23 people had been infected with Covid-19. But then the mayor implored everyone to get an antibody test, and 10% of people had actually been infected with – and had recovered from – Covid-19. Most of them couldn’t even recall having been sick.
I don’t know who made the tests used in Robbio – maybe they were a little better, maybe they were a little worse. Based on my experience, I wouldn’t be so surprised if the true infection rate with Covid-19 in that town was really just 10% – nor would I be surprised to hear that the chips had a high false-negative rate and that the infection rate was 20% or more.
If you calculate the fatality rate of Covid-19 in Italy by assuming that the PCR tests caught every infection, you’d get a terrifying 10%.
If you instead assume that many other towns had a similar infection rate to Robbio, you’ll instead calculate that the fatality rate was well under one percent.
Italy has higher risk than the United States due to age demographics, smoking rates, and multigenerational households – and even in Italy, the fatality rate was probably well under one percent.
When researchers in Germany randomly chose people to take a Covid-19 PCR test (many of whom had no symptoms), they found that 2% of the population was actively shedding virus – a much higher number of cases than they would have found if they tested only sick people. And when they randomly chose people to take an antibody test, they found that 15% had already recovered from the infection (again, many of whom had never felt sick). According to these numbers – which are expected to be an undercount, due to false negatives and the time lag before antibody production – they calculated a case fatality rate of 0.37%.
That would be about three-fold more dangerous than seasonal influenza.
In the United States, our bungling president gutted the CDC, leaving us without the expertise needed to address Covid-19 (or myriad other problems that might arise). During the first few months of this epidemic, very few people managed to get a PCR test. That’s why our data from the PCR tests is likely to be a dramatic undercount – indeed, when we finally started producing accurate tests, the apparent growth in Covid-19 caseload superimposed with the growth in test availability.
In the absence of good PCR data, we have to rely on antibody data to track infections after the fact. Which is why a town in Colorado with zero reported infections, as measured by PCR, had sufficiently widespread exposure that 2% of the population had already recovered from Covid-19.
Yes, there were problems with the Stanford study’s data collection – they displayed advertisements to a random selection of people, but then a self-selected subset responded. The pool of respondents were enriched for white women, but Santa Clara’s outbreak probably began among Asian-Americans. And we all know that random sampling doesn’t always give you an accurate depiction of the population at large – after all, random polling predicted that a competent president would be elected in 2016.
Now look at us.
It’s also likely that people with a poor understanding of the biology could misinterpret the result of the Stanford study. They found that PCR tests had undercounted the infection rate in Santa Clara county, at the time of this study, by 85-fold.
It would be absurd to assume that you could simply multiply all PCR results by 85 to determine the true infection rate, but some people did. And then pointed out the absurdity of their own bad math.
In places where more people are being tested by PCR, and they’re being tested more often, the PCR results will be closer to the true infection rate. If you gave everyone in the United States a PCR test, and did it every day, then the PCR data would be exactly equal to the true infection rate.
If we had data like that from the beginning, we wouldn’t have been scared. We would’ve known the true case fatality rate early on, and, also, at-risk people could’ve been treated as soon as they got infected. We’d be able to save many more lives.
In Italy, it seems like Covid-19 is three- or four-fold more dangerous than seasonal influenza. My guess is that Italy might have had about 50,000 deaths if they hadn’t enacted the lockdown.
In the United States, on a population level, Covid-19 is probably also more dangerous than seasonal influenza. But there’s a big difference in terms of the distribution of risk.
10% is roughly the proportion of young people who die of seasonal influenza. But only 1% of Covid-19 deaths are people younger than 35. The news reports don’t always make clear how much the risk of Covid-19 is clustered in a small segment of the population.
This has serious implications for what we should do next. If we were dealing with a virus that was about three-fold more dangerous than seasonal influenza for everyone, we might just return to life as normal. (Indeed, we carried on as normal during the bad years when seasonal influenza killed 90,000 people instead of last year’s 30,000.)
Because the risk from Covid-19 is so concentrated, though, we can come up with a plan that will save a lot of lives.
Healthy people under retirement age should resume most parts of their lives as normal. Schools should re-open: for students, Covid-19 is much less dangerous than seasonal influenza. I think that people should still try to work from home when possible, because it’s the right thing to do to fight climate change.
At-risk people should continue to isolate themselves as much as possible.
This sounds crummy, but at-risk people would just continue to do the thing that everyone is doing currently. And the plan would save many lives because the epidemic would end in about 3 months, after the virus had spread to saturation among our nation’s low-risk cohort.
Their data are easy enough to understand. In each of these graphs, they show a blue box for how long social distancing would last, and then four colored lines to represent how many infections we’d see if we did no social distancing (black), medium quality social distancing (red), good social distancing (blue), or excellent social distancing (green).
So, from top to bottom, you’re looking at the graphs of what happens if we do a month of social distancing … or two months … or three, or four … or forever.
And you can see the outcomes in the panels on the right-hand side. The black line shows what would happen if we did nothing. Infections rise fast, then level off after the virus has reached saturation. There are two important features of this graph – the final height that it reaches, which is the total number of severe cases (and so a good proxy for the number of deaths), and the slope of the line, which is how fast the severe cases appear. A steeper hill means many people getting sick at the same time, which means hospitals might be overwhelmed.
So, okay. Looking at their graphs, we see that social distancing saves lives … if we do it forever. If you never leave your house again, you won’t die of Covid-19.
But if social distancing ends, it doesn’t help. The slopes are nearly as steep as if we’d done nothing, and the final height – the total number of people who die – is higher.
(Often, one of their curves will have a gentler slope than the others — usually the good-but-not-excellent social distancing seems best. So you’d have to pray that you were doing a precisely mediocre job of not infecting strangers. Do it a little better or a little worse and you cause people to die. This isn’t an artifact — it’s based on the density of uninfected people when social distancing ends — but let’s just say “mathematical models are wonky” and leave it at that.)
In a subsequent figure, the Harvard team tried to model what might happen if we occasionally resumed our lives for a month or so at a time, but then had another shutdown. This is the only scenario in which their model predicts that social distancing would be helpful.
Even in the extreme case that we mostly stayed in our homes for the better part of two years, social distancing would case more deaths from Covid-19 than if we had done nothing.
That’s not even accounting for all the people who would die from a greater risk of domestic violence, hunger, drug addiction, suicide, and sedentary behavior during the shutdown.
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When our data was limited, the shutdown seemed reasonable. We wouldn’t be able to undo the damage we’d done by waiting.
Except, whoops, we waited anyway. We didn’t quarantine travelers in January. The shutdown didn’t begin March, when the epidemic was well underway in many places.
Now that we have more data, we should re-open schools, though. For most people, Covid-19 is no more dangerous than seasonal influenza. We already have enough data from antibody testing to be pretty confident about this, and even if we want to be extremely cautious, we should continue the shutdown for a matter of weeks while we conduct a few more antibody studies. Not months, and certainly not years.
At the same time, we need to do a better job of protecting at-risk people. This means providing health care for everyone. This means cleaning our air, staunching the pollution that plagues low-income neighborhoods. This might mean daily medical checkups and PCR tests for people who work closely with at-risk populations.
Our country will have to be different in the future, but mostly because we, as a people, have done such a shitty job of creating justice and liberty for all. We need to focus on addressing the inequities that we’ve let fester for generations. That’ll help far more than using a bandanna to cover up your smile.
I should preface these remarks by stating that my political views qualify as “extremely liberal” in the United States.
I’m a well-trained economist – I completed all but the residency requirement for a masters at Northwestern – but I don’t give two shits about the “damage we’re doing to our economy,” except insofar as financial insecurity causes psychological harm to people in poverty. Our economy should be slower, to combat climate change and inequality.
One of my big fears during this epidemic is that our current president will accidentally do something correctly and bolster his chances of reelection. The damage that his first term has already caused to our environment and our judiciary will take generations to undo – imagine the harm he could cause with two.
And yet, in arguing that our response to the Covid-19 epidemic is misguided, I seem to be in agreement with our nation’s far right.
As far as I can tell, the far right opposes the shutdown because they’re motivated by philosophies that increase inequality. Many of them adore Ayn Rand’s “Who will stop me?” breed of capitalism, as though they should be free to go outside and cough on whomever they want. They dislike the shutdown because they think our lives are less important than the stock market.
By way of contrast, I care about fairness. I care about the well-being of children. I care about our species’ future on this planet. It’s fine by me if the stock market tanks! But I’ve written previously about the lack of scientific justification for this shutdown, and I’m worried that this shutdown is, in and of itself, an unfair response.
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Quarantine could have prevented this epidemic from spreading. If we had acted in December, this coronavirus could have been contained. But we did nothing until several months after the Covid-19 epidemic began in the United States.
Then schools were closed: first for two weeks, then a month, then the entire year.
Stay-at-home orders were issued: first for two weeks, then extended to a month. No data supports the efficacy of these orders – haphazard, partial attempts at social distancing, from which certain people, like my buddy doing construction for a new Amazon facility, have been exempted. And no metrics were announced that might trigger an end to the shutdown.
Currently, the stay-at-home orders last until the end of April. But, as we approach that date, what do people expect will be different? In the United States, we still can’t conduct enough PCR tests – and even these tests yield sketchy data, because they might have false negative rates as high as 30%, and they’re only effective during the brief window of time — perhaps as short as one week — before a healthy patient clears the virus and becomes invisible to testing.
Based on research with other coronaviruses, we expect that people will be immune to reinfection for about a year, but we don’t know how many will have detectable levels of antibody in their blood. As of this writing, there’s still no serum test.
The Italian government is considering the dystopian policy of drawing people’s blood to determine if they’ll be eligible for a permit to leave their homes. If you were worried about the injustice that the virus itself imposed on people who are elderly or immunocompromised, this is worse!
We know, clearly, that the shutdown has been causing grievous harm. Domestic violence is on the rise. This is particularly horrible for women and children in poverty, trapped in close quarters with abusers. The shutdown is creating conditions that increase the risk of drug addiction, suicide, and the murder of intimate partners.
We don’t know whether the shutdown is even helping us stop the Covid-19 epidemic. And we still don’t know whether Covid-19 is scary enough to merit this response. As of this writing, our data suggest that it isn’t.
Covid-19 is a rare breed, though: a communicable disease where increased wealth correlates with increased risk.
And so we’re taking extreme measures to benefit the most privileged generation to ever walk the face of this Earth, at the cost of great harm to vulnerable populations. This is why I feel dismayed.
Hopefully I can present some numbers simply enough to explain.
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Many diseases are more likely to kill you if you’re poor.
Malaria kills between 400,000 and one million people every year. The vast majority are extremely poor, and many are children – the World Health Organization estimates that a child dies of malaria every thirty seconds.
Wealth protects against malaria in two ways. Wealthy people are less likely to live in parts of the world with a high prevalence of malaria (most of the deaths each year occur in Africa and India), and wealthy people can buy effective anti-malarial medications.
I took prophylactic Malarone when I visited Ecuador and India. Lo and behold, I did not get sick.
I believe Malarone costs about a dollar per day. I am very privileged.
HIV kills between 700,000 and one million people every year. Again, the vast majority are poor. HIV is primarily transmitted through intimate contact – exposure to blood, needle sharing, or sex – so this virus rarely spreads across social boundaries in stratified communities.
In the United States, HIV risk is concentrated among people living in our dying small towns, people without homes in inner cities, and people trapped inside the criminal justice system.
It seems that these people are all easy to ignore.
Wealth will protect you even if you do contract HIV. We’ve developed effective anti-retroviral therapies. If you (or your government) can pay for these pills, you can still have a long, full life while HIV positive. About 60% of the people dying of HIV happen to have been born in Africa, though, and cannot afford anti-retrovirals.
Even the myriad respiratory infections that plague our species – of which Covid-19 is but one example – are more likely to kill you if you’re poor. The World Health Organization lists the top causes of death for people living in low-income versus high-income countries. The death rate from respiratory infections is twice as high for people living in low income countries.
The second-highest cause of death among people in low-income countries is diarrhea. Diarrhea kills between one million and two million people each year, including about 500,000 children under five years old.
These deaths would be easy to treat and even easier to prevent.
Seriously, you can save these people’s lives with Gatorade! (Among medical doctors, this is known as “oral rehydration therapy.”) Or you could prevent them from getting sick in the first place by providing clean water to drink.
We could provide clean water to everyone – worldwide, every single person – for somewhere between ten billion and one hundred billion dollars. Which might sound like a lot of money, but that is only one percent of the amount we’re spending on the Covid-19 stimulus bill in the United States.
We could do it. We could save those millions of lives. But we’re choosing to let those people die.
Because, you see, wealthy people rarely die of diarrhea. Clean water is piped straight into our homes. And if we do get sick – I have, when I’ve traveled – we can afford a few bottles of Gatorade.
Instead, wealthy people die of heart disease. Stroke. Alzheimer’s. Cancer.
If you’re lucky enough to live past retirement age, your body will undergo immunosenescence. This is unfortunate but unavoidable. In old age, our immune systems stop protecting us from disease.
Age-related immunosenescence explains the high prevalence of cancer among elderly people. All of our bodies develop cancerous cells all the time. Usually, our immune systems kill these mutants before they have the chance to grow into tumors.
Age-related immunosenescence also explains why elderly people die from the adenoviruses and coronaviruses that cause common colds in children and pre-retirement-age adults. Somebody with a functional immune system will get the sniffles, but if these viruses are set loose in a nursing home, they can cause systemic organ failure and death.
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I haven’t seen this data presented yet – due to HIPAA protections, it can’t easily be collected – but Covid-19, on average, seems to kill wealthier people than influenza.
On a personal level, wealth will protect you from Covid-19. We know that early treatment saves lives, which is a reason why Germany’s death rate is so low, and wealthy people are less likely to postpone going to the hospital. Wealthy people can afford the medications that might keep you out of the ICU. Wealthy people are less likely to experience the stresses, sleep loss, and discrimination that have caused disproportionate numbers of Black people in the United States to succumb to Covid-19.
But on a population level, wealth is correlated with increased risk.
Part of this wealth gap is due to age. Currently we don’t have enough data to know exactly where the risk curves for seasonal influenza and Covid-19 intersect, but it seems to be around retirement age. If you’re younger than retirement age, seasonal influenza is more deadly. If you’re older than retirement age, Covid-19 is more deadly.
And in the United States, if you’re older than retirement age, you’re more likely to be wealthy.
Covid-19 is also more dangerous if you’re already sick. A study of Covid-19 deaths found that 97% of the people killed were already sick with at least one serious medical condition. The average person killed by Covid-19 had 2.7 other serious diseases.
Because these people were receiving expensive medical care, they were able to survive despite their other diseases. Imagine what would have happened if these people had chanced to be born in low-income countries: they would already be dead.
This is a tragedy: all over the world, millions of people die from preventable causes, just because they had the bad luck of being born in a low-income country rather than a rich one.
We don’t have data on this yet, but it’s likely that Covid-19 will have a much smaller impact in Africa than in Europe or the United States.
When my father was doing rounds in a hospital in Malawi, his students would sometimes say, “We admitted an elderly patient with …” And then my father would go into the room. The patient would be 50 years old.
Covid-19 is particularly dangerous for people in their 80s and 90s. Great privilege has allowed so many people in Europe and the United States to live until they reached these high-risk ages.
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Our efforts to “flatten the curve,” in addition to increasing many people’s risk of death (from domestic violence, suicide, and the lifelong health repercussions of even a few months of sedentary living), will save relatively few lives, even among our country’s at-risk population.
The benefit of this shutdown is simply the difference between how many people would die if we did nothing, compared to how many people will die if we “flatten the curve.”
Assuming that our efforts to flatten the curve succeed – and neglecting all the other risks of this strategy – we’ll be able to provide ventilation to everyone. But there will still be a lot of deaths. The shutdown will not have helped those people. The shutdown is only beneficial for the small number who would be treated in one scenario, would not be treated in another, and who actually benefit from the treatment.
Their lives matter, too. Many of us have a friend or relative whose life was cut short by this. But something that we have to accept is that we all die. Our world would be horrible if people could live forever. Due to immunosenescence, it becomes increasingly difficult to keep people alive after they reach their late 70s and 80s.
And the priorities of elderly people are different from mine. I care deeply about the well-being of children and our planet’s future. That’s why I write a column for our local newspaper discussing ways to ameliorate our personal contribution to climate change. That’s why my family lives the way we do.
These priorities may be quite different from what’s in the short-term best interests of an 80-year-old.
Schools are closed. Children are suffering. Domestic violence is on the rise. All to protect people who have experienced such exceptional privilege that they are now at high risk of dying from Covid-19.
Our national response to Covid-19 is being directed by a 79-year-old doctor. I haven’t gotten to vote in the presidential primary yet, but if I get to vote at all, I’ll be allowed to choose whomever I prefer from a selection of a 77-year-old white man or a 78-year-old white man. Then comes the presidential election, where there’ll be an additional 73-year-old white man to choose from.
It makes me wonder, what would our national response be like if we were facing a crisis as risky as Covid-19, but where elderly people were safe and children were most at risk?
And then I stop wondering. Because we are facing a crisis like that.
Worldwide, people are making huge sacrifices to quell the Covid-19 outbreak. The burden of these sacrifices falls disproportionately on young people.
Across the United States, universities have closed for the year. My governor has announced that all elementary and high schools will be closed at least until May 1st. Bars, restaurants, and malls have been forced to shut down – their employees have been laid off.
Graduating during a recession greatly reduces people’s lifelong earnings. Young people who have the bad luck of entering the workforce in the next few years will suffer the consequences of this shutdown for their entire lives.
Childhood development has an urgency unmatched by other stages of life. When children don’t learn to socialize at the appropriate age, they will always struggle to catch up with their peers. Across the country, huge numbers of children were first learning to read in kindergarten and the early grades. Now they’re watching television. (My kids, too.) With schools closed until May, and summer break coming soon after, they might be watching TV for months. They’ll have to work harder to match other people’s educational achievements, for their entire lives.
Many students depend on school meals to stave off hunger. Kids on free & reduced-price lunch often dread holiday weekends – now, not only have their educations been yanked away, but they’re also suffering through worse food insecurity. Schools and communities are scrambling to provide resources.
Everyone is being asked to stay at home, to keep at least six feet away from other people.
The cost of social isolation is lower if you’re established in a white-collar or professional career. Many office workers can work from home. The people who were cleaning those offices, or selling coffee and bagels to people on their way to work, get laid off.
The cost of social isolation is lower if you have enough money to stock up on supplies. The cost of social isolation is much lower if you’re retired.
Everyone is being asked to make sacrifices, but young people are sacrificing more.
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This pandemic wouldn’t be as bad if people could be tested for the virus. We could quarantine the sick and staunch the spread. But U.S. citizens don’t have access to a test.
As the virus reached into the United States in late January, President Trump and his administration spent weeks downplaying the potential for an outbreak. The Centers for Disease Control [a government agency gutted by our current president] opted to develop its own test rather than rely on private laboratories or the World Health Organization.
The outbreak quickly outpaced Mr. Trump’s predictions, and the C.D.C.’s test kits turned out to be flawed, leaving the United States far behind other parts of the world – both technically and politically.
Anyone who is currently younger than 22 – the people who are being made to sacrifice most during this crisis – was not allowed to vote in the 2016 election.
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I was too young to understand the 1980s HIV crisis, but I imagine that it was at least as scary as the Covid-19 pandemic for the people at risk.
That virus was inevitably fatal. The deaths were agonizing. Rampant homophobia and cultural stigmatization – even in the medical community – meant there were few places to seek help.
The only way to keep safe was to make sacrifices. Fooling around is fun, but it seemed like it might kill you. To stay alive, you’d have to tamp down your desire.
But if you made that sacrifice, you’d be safe. The people making sacrifices were the people who’d benefit.
What about now, during the Covid-19 pandemic?
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My whole family probably contracted Covid-19. There’s no way to know for sure, because at that time the U.S. didn’t even have tests for people experiencing the acute phase of the illness, and there’s still no antibody test to check whether someone was exposed to the virus in the past.
I fell sick on February 10th. I had a pretty bad case, it seems. I had to take high doses of naproxen, but the week-long fever still left me dizzy at times. The only way I could breathe well enough to sleep soundly was by taking puffs of my spouse’s albuterol inhaler. My joints ached so much that it hurt whenever I went running even three weeks later.
My children were sick on February 11th and February 13th. Each napped for half the morning and then felt better. They’d spiked a high fever, but these lasted less than a day.
Young people are being forced to make tremendous sacrifices. They will suffer the consequences of this disruption to their education for their entire lives. But they aren’t the people who benefit.
Young people have very little risk from Covid-19. It’s no fun to be sick, but when my children contracted what I assume to be Covid-19, it was no worse than any of dozens of other coughs or colds they come down with each year.
Most teenagers – whose lives are being up-ended by school closings – could contract Covid-19 and be totally fine.
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My spouse asked, “What would you do about it? Not months ago, but if you were handed this crisis today?”
My answer was the same as always. We should enact a wealth tax – preferably a global wealth tax to undermine the tax havens – and use it to fund a guaranteed basic income.
Using a global wealth tax to fund a guaranteed basic income would help address the persistent inequities caused by historical injustice – it would be a sensible form of reparations. It would provide a buffer against the economic insecurity caused by automation and the gig economy. It would transfer money away from the people who drew salaries during the years when we really ravaged our environment, and give it to the people who must now settle for a lower standard of living due to climate change.
Right now, there’s another rationale. Young people are making huge sacrifices during this pandemic; older people receive the benefit. A wealth tax used to fund guaranteed basic income would provide some recompense for the sacrifices of young people.
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My family is practicing “social isolation,” although it hasn’t been mandated yet. My children are willingly making sacrifices for the benefit of others, insofar as a four- and six-year-old understand what’s happening. And yet I’ve seen little acknowledgement in the news of the enormous, selfless sacrifice that children are making – that young people across the country are being forced to make.
They will endure the consequences of this sacrifice for their entire lives. This sacrifice almost exclusively benefits others. And yet there’s been no talk of recompense. No gesture of gratitude from the people who benefit toward the people who are paying the costs.
Which, unfortunately, is how our country has often worked.
I
assume that you, personally, have never clear-cut and burned a patch of the
Amazon rain forest. Neither have I. The number of people who have done the actual
cutting is vanishingly small compared to the world’s population.
I also assume that you enjoy living in a world where the Amazon rain forest exists — certainly more than you’d enjoy living in a world where it had all been slashed and burned. If we lose the Amazon rain forest, climate change might spiral out of control, flooding coastal cities worldwide and causing desertification in much of the interior United States. If we lose the Amazon rain forest, huge numbers of species will go extinct, including a wide variety of medicinal plants that we’ve only begun to investigate.
And
the rain forest is beautiful. Future
generations would feel an ache of want – likely compounded with a mix of
jealousy and anger – if they saw photographs of the Amazon rain forest after it
were gone.
When
I was in elementary school, my third grade class sponsored a patch of the
Amazon rain forest. In retrospect, I’m
not sure what this entailed. We raised
money and sent it off in an envelope. I
don’t remember whether we ever saw photographs of “our” forest, whether the
arrangement was supposedly akin to a rental or purchase of those trees.
I
have no idea who received our sponsorship money, but the general idea that
money should be sent from the U.S. to Brazil is actually correct. Many of the world’s problems would be easier
to address if we used a global wealth tax to fund a guaranteed basic income for
everyone. At the very least, if there
are natural resources that benefit all of humanity, then countries that are
currently wealthy because they ravaged their environments should pay to encourage
other nations not to accrue wealth through extractive industries.
Some people in Brazil would be wealthier if the Amazon rain forest were destroyed. Everyone in the world would suffer as a result. If we – everyone outside Brazil – would prefer that the rain forest not be destroyed, we should compensate Brazilians for the foregone short-term economic benefits.
Unless
you are fantastically wealthy, you personally will be unable to enact this
policy on your own. If I decided to
split my family’s entire annual income among the people of Brazil, each would
get 2% of a penny … and my family would be left with nothing.
A
guaranteed basic income is the right policy, but it’s not something that I can
accomplish as an individual.
In We Are the Weather, Jonathan Safran Foer discusses how each one of us can help preserve the Amazon rain forest today. We as a people should strive for political solutions to the world’s problems, but we as individuals shouldn’t make choices that exacerbate those very problems. It would seem hypocritical to lobby for fines against littering if we continued to blithely toss candy bar wrappers onto the ground.
Foer
describes how painful it feels to recognize this hypocrisy in himself. This sensation grows more intense as he
watches his children grow in a world that is becoming increasingly dangerous.
“But
what kind of father prioritizes feeling good over doing good?”
Foer
knows that he could choose to help. Each
day, he could act in a way that makes his children’s world safer.
He
often doesn’t.
“There
is a far more pernicious form of science denial than Trump’s: the form that
parades as acceptance. Those of us who
know what is happening but do far too little about it are more deserving of the
anger. We should be terrified of
ourselves. We are the ones we have to
defy. … I am the person
endangering my children.”
Photo by Joelle Hernandez on Flickr, whose caption from this 2007 photograph reads, “On a few occasions Brazilians told me that ‘People thousands of miles away are contributing to our deforestation.'”
Even
if the meat or cheese you eat was not imported from Brazil, by choosing to eat
it, you are reinforcing the social norm that is causing the Amazon rain forest
to be destroyed.
Eating meat is pleasurable. A good cheese pizza can be divine. Humans evolved as omnivores, and the tastes of meat and cheese are particularly delicious. Choosing not to eat these foods would be a sacrifice.
Foer has tried to be a vegetarian for decades. He has previously written about the animal welfare arguments against eating meat; now he’s written about the environmental arguments. He knows that eating meat is immoral – the cow suffered to produce it, and Foer’s own children will suffer a worse climate as a consequence.
But
this knowledge isn’t enough. He still
surreptitiously buys cheeseburgers.
“So
why hasn’t vegetarianism become any easier after thirty years? Why has it become harder? I crave meat more now than I have at any
point since I became a vegetarian.”
Foer
wishes that there were a social norm to eat only foods made from plants.
Eating
meat is pleasurable. Eating cheese is
pleasurable.
Injecting
heroin is pleasurable too. Driving a car
while drunk is pleasurable. Heck, even
cruising down the road while everybody else pulls aside for the ambulance
behind you would be pleasurable.
In our culture, there’s a social norm to pull aside for ambulances. Even though it would be more pleasurable to keep driving, most people don’t.
Meats
and cheeses are responsible for somewhere between 20% and 50% of all
climate-change-causing emissions.
(There’s a wide range in that estimate because, although it’s incontestable that it takes more land to produce meats and cheeses than it does to make equivalent foods from plants, it’s debatable what would be done with all that extra land if people changed their diets. If the extra space would be used to restore forests, then animal agriculture is responsible for 50% of climate change. If the extra space would be kept as grass – setting aside the curious question of why – then animal agriculture causes only 20% of climate change. Only 20%. By way of comparison, all the world’s cars, trucks, and airplanes together cause less than 15% of climate change. You can look at the appendix to We Are the Weather for an explanation of these numbers, or even glance at Donald Trump’s EPA website for some pie charts with identical information.)
The current administration has gutted the EPA, and compelled their staff scientists to restate their findings in the weakest ways possible … and these are the numbers still posted on their website.
If every gasoline-powered car was replaced with a hybrid vehicle – instantly, world-wide – greenhouse gas emissions would be about 96% of what they are currently. If that was the only change we made, our planet would be toast.
If
we all followed a social norm to eat food made from plants, greenhouse gas
emissions could be 50% of what they are currently. With no other changes, humanity would
survive. Our planet would remain
habitable for our children, and our grandchildren.
Pleasure
matters. I’m an atheist, and I’m well
aware that the eventual heat death of the universe means humanity will
go extinct eventually. I don’t believe
you can make a viable philosophical argument for existence based on helpfulness
or social connections alone – your life needs to be pleasurable, too.
Your
life can be pleasurable without meat or cheese.
I support responsible hedonism.
Good food is a joy, but you can eat well while making only choices that
protect our planet. Most people think
that sex is great fun, but we have a social norm that you should enjoy your
sexuality only with other consenting adults.
Groping a beautiful stranger might be more fun than eating cheese – in
our culture, a social norm restrains us.
Foer
wishes that we, as a people, could choose better. He’s been struggling to eat food made from
plants. But he doesn’t struggle to
restrain himself from murder, or theft, or groping his students. In those instances, our social norms make it
easy to do the right thing.
And you can still be a hedonist while eating plants! If you’re ever in Chicago, you should stop by my dear friend Auntie Ferret’s vegan deep-dish pizza restaurant, or use Happy Cow to find a decadent plant-based restaurant near you.
Deep dish pizza, mac and cheese, nachos and more — all vegan at Kitchen 17.
Recently, my hometown of Bloomington’s farmers market has been covered Fox News and The New York Times. Not because the vegetables sold here are particularly deserving of national attention. The market was deemed newsworthy because one of the farm stands is run by outspoken white supremacists.
Although Bloomington is a fairly liberal college town, this region has a sordid history of hate. The national Klan headquarters is less than 30 minutes away – when I was in college, the campus diversity coordinators warned students not to stop in that town, not even to buy gas. Even right here in Bloomington, there was a fracas at the local high school recently because some students decided to honor a friend who’d died by using cremation ashes to print bumper stickers – but they printed stickers of the Confederate flag.
Teaching poetry in the
local jail has made me much better at recognizing supremacist imagery. Most people know that the Confederate flag is
bad news, but I’ve gotten to see a wider range of hateful symbols tattooed onto
people’s flesh.
COs bring twelve people to
each week’s class – often two to four will be Black (in a town where the total
population is approximately 4% Black or African-American), and the rest are
usually white guys. It’s pretty common
for one or two of the white guys to have visible supremacist
tattoos. Which doesn’t even include
questionable stuff like the dude who got an poke and stick of the words “White
Trash” in elaborate two-in-tall cursive letters during his time there. Tattooing runs afoul of the jail’s “no self
mutilation” policy, but most COs studiously overlook the guys’ rashy red skin
and burgeoning designs.
When I’m there, we often
read poetry that directly addresses racial injustice. I’ve brought stuff by Reginald Dwayne Betts,
Ross Gay, Terrance Hayes, Adrian Matejka, and Tracy Smith. Sometimes these lead to good
discussions. Sometimes our class gets
totally derailed.
In one of the poems titled “American Sonnet for My Past and Future Assassin,” Hayes pulls off a stunning trick. The same line is included twice, but the word “haunted” changes from a verb into an adjective after the language slides into a less formal diction. It’s a beautiful moment. The first time I brought this poem, we talked about the clinginess of the past, the way not only our own histories but also the histories of our forebears can stalk us through time.
The next time I brought
this poem, several guys reacted by saying that Black people don’t talk right. Then they went off about sagging pants. All this from southern-accented white guys
whose missing-toothed, meth-mouthed mumbles and guffaws I could barely
comprehend.
We had to quickly move on.
Or there was the time when
we read Betts’ “Elegy with a City in It,” a fantastic poem that uses a spare,
stark set of words and sounds to simultaneously evoke both the deprivations of
the inner city and the epic grandeur of The Iliad, which uses a
similarly constrained lexicon.
Many gone to the grave:
men awed
by blood, lost in the
black
of all that is awful:
think crack and
aluminum. Odd
what time steals,
or steals time: black
robes, awful
nights when men offed in
the streets awed
us.
If you read the poem
aloud, you’re chanting the same phonemes over and over, but their meanings
twist and turn as they spill from your tongue.
That’s what I wanted to discuss.
Instead, a few guys
latched onto lines like
Black,
Mario, Charles, they all
blackened
the inside of a coffin …
and this offended them because “white people have it bad, too!” As though Betts could not describe Black pain without trivializing their own. Soon somebody was saying “All lives matter” and that he’d voted for our current president. This guy was in jail because he’d been caught selling heroin to support his own habit. The president he’d voted for had recently recommended executing drug dealers.
Somebody else shook his
head and muttered, “y’all are fucking [stupid].”
We moved on.
In my classes, I work with a wide range of ages – sometimes guys as young as seventeen, sometimes men in their sixties. My spouse, as a high school teacher, works with younger people – anywhere from fourteen to eighteen years old. But ideology can set in early. My spouse has had students whose families were prominent in the Klan.
At the beginning of the
year, she asks each student to fill in the paper silhouette of a head with
words and pictures of what inspires them to succeed. She then posts these along the ceiling of her
classroom. Several times, she’s had to
ask kids to erase supremacist imagery.
So it isn’t terribly
surprising that some farmers at our local market have hateful beliefs. Right-wing supremacist movements are major
terrorist organizations in this country, and they do a lot of recruiting. As our nation has become slightly less
horrible, though, many of these people learned to be circumspect. They maintain a divide between their private
and public language.
People who rely upon
public, liberal venues like our farmers market can’t be too outspoken with
their hate.
Indeed, the white supremacist farmers who were recently outed tried to be circumspect. But they must have felt lonely, and they grew too careless. Under a pseudonym, they posted on the Identity Evropa message board. This is a website devoted to the ideologies that have inspired the vast majority of terrorism in the United States. Theoretically, this is a venue where people get to cultivate their hatred anonymously. But one of their compatriots was caught painting swastikas on a synagogue (see image below) and blew their cover. Sort of. The vandal was interrogated by the FBI, and his remark unveiling the farmers’ pseudonym was buried deep in a 200-page sentencing document.
Through assiduous work, a
team of activists was able to prove that these farmers were white supremacists.
The activists who had
worked so hard to gather evidence were obviously against hate. They wanted to take action. But the plan they favored wasn’t very
flashy. They would organize a boycott of
that farm stand. They also proposed that
the city use the sellers’ farmers market fees to fund grants for people of
color, with the understanding that our nation’s long history of racism has
inequitably skewed the demographics of agricultural land holdings.
To stay at the farmers
market, the supremacists would have had to support a cause they loathed … and
they were making less and less money here.
I was told that, during the boycott, the farmers had begun padding their
bins, bringing fewer vegetables each week so that they could still appear to be
selling out their stock.
Unfortunately, the tropes
of social media have changed public discourse in our country. I assume it’s relatively uncontroversial to
claim that social media prizes style over substance. Quiet, careful plans are at a disadvantage in
the attention economy.
As word spread that these
farmers were white supremacists, patrons demanded that they be banned from our
market. People of color now felt unsafe
in that space, for obvious reasons.
There’s a difference between the perceived threat level felt by a
pale-skinned activist and by somebody who is recognizably a member of a racial
minority.
The mayor, whose spouse is
a constitutional law professor, rightly argued that the farmers would be able
to sue the city on a First Amendment case.
Still, people felt that we
had to do something more visible. Passively
allowing outspoken white supremacists to hawk their tomatoes at our market would
seem to be tacitly endorsing their political stance.
Everybody has a right to
believe whatever garbage they want. Do
you sincerely believe that people of northern European descent have a genetic
inclination toward greater intelligence?
You’re wrong, and you’re a jerk, but you’re allowed to believe that.
The problem is that white
supremacist organizations like Identity Evropa use terrorism to back their
asinine beliefs. Implicit threats of
violence, delivered by people known to stockpile military-grade weaponry, are
different from “mere” hate.
If these farmers couldn’t
be banned, then we’d hold signs in front of their booth. Eventually, a protester was arrested – the
police had asked her to stand in a designated “announcements” area instead of
in the middle of the market – and, as always happens following an arrest, her
home address was published online.
She was soon inundated
with death threats.
As coverage of the dispute increased, right-wing militia types were also drawn to our town. Three percenters, unaffiliated gun nuts, other supremacists – they began to support that farm, undermining the boycott. And these radical Protestant faux-constitutional terrorists made sufficiently credible threats of mass violence that our mayor had to shut down the entire market for two weeks at the height of the growing season. Other farmers were suffering.
Calm, careful behavior
from the original activists – assiduously combing through those lengthy, dull
documents, not to mention their efforts to infiltrate local supremacists’
in-person social circles – had undoubtably helped. Hateful ideologies were exposed, and efforts
were made to impose consequences.
But then our visible
protests made matters worse. We’ve
helped the proponents of hate to make more money.
And, now that we’ve drawn attention to them, we’ve inadvertently connected these white supremacists with their allies. They will no longer need to post on public forums, which was the only reason that activists were able to prove that they supported these ideologies in the first place. Now these supremacist farmers are invited speakers at right-wing events.
As this whole struggle was unfolding, my spouse and I participated in a poetry reading. We shared poems written by people in our local jail. We were joined by one of the authors, a man who had just been released after five months inside. He described what it was like to write while he was there – breathing fresh air in the outdoor rec courtyard only nine times in five months, having access to a pencil sharpener only once each week, and feeling forced to confess to a crime that he swears he hadn’t committed because they promised to release him for time served.
Our audience clapped for
the poems and stared aghast during our banter, which is probably as it should
be.
We closed our set with a
piece from M.G. This poem was written in
February, before the public turmoil regarding our farmers market began. At a moment when so many of us were warily watching
that space, it seemed important to remind people that there have always been
watchful eyes gazing at the market.
The farmers market is just
down the street from our five-story county jail.
Frank Brown Cloud 
