As a kind of partial response to Mike’s call for sense testimony about the coronavirus pandemic, here’s this:
Reality Arrives to the Trump Era
“How should they have given a thought to anything like plague, which rules out any future, cancels journeys, silences the exchange of views.” Photo: Miguel Medina/AFP via Getty Images
Plagues routinely start with denial. In his great novel, The Plague, Albert Camus describes a scene at the very beginning, after several rats in a town started dying identical deaths:
‘These rats, now?’ the magistrate began. [Doctor] Rieux made a brief movement in the direction of the train, then turned back toward the exit. ‘The rats?’ he said. ‘It’s nothing.’ The only impression of that moment which, afterwards, he could recall was the passing of a railroadman with a box full of dead rats under his arm.
This is not to excuse the negligence of the Trump administration and the CDC. But it helps explain it. Plagues are such an enormous disruption of regular life that it is always hard to accept that we are engulfed in one. This is why plagues, of course, always tend to have the advantage over people. Soon enough, however, the direness of the situation began to set in:
In a very few days the number of cases had risen by leaps and bounds, and it became evident to all observers of this strange malady that a real epidemic had set in … Everybody knows that pestilences have a way of recurring in the world; yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky … In this respect our townsfolk were like everybody else, wrapped up in themselves … They went on doing business, arranged for journeys, and formed views. How should they have given a thought to anything like plague, which rules out any future, cancels journeys, silences the exchange of views.
Those of us who have already been through a plague experience in our lives know this all too well. As the clear signs of a new and deadly epidemic began to emerge among gay men in the early 1980s, most people ignored or downplayed or even joked about it, and many of those most at risk shut their eyes.
Randy Shilts, in his epic tale of this nightmare, And the Band Played On, relays the first guidance from the American Association of Physicians for Human Rights: “Sensitive to concerns that the group not be ‘sex-negative,’ the guidelines assured gay men that there was nothing wrong with having sex, but they should check their partners for KS lesions, swollen lymph nodes, and overt symptoms of AIDS.” Even the Gay Men’s Health Crisis in New York — an activist group formed to confront the reality of this new plague — put “the accumulated wisdom of homosexual physicians in one phrase: ‘Have as much sex as you want, but with fewer people and HEALTHY people.’” Even though it was by then clear that asymptomatic carriers were just as capable of transmitting the virus, denial was too strong.
In San Francisco in early 1983, epidemiologists had a curious resemblance to the CDC now. After the first quarter’s AIDS incidence report came out, Shilts writes:
Dr. Andrew Moss concluded that ‘in some cohorts of gay men in San Francisco, AIDS incidence rates in the thirty and forty year old groups are now of the order of 1 to 2 percent.’ Only later would studies show that by this time in 1983, the 62 percent of gay men who still engaged in risky behavior had at least a 25 percent chance of being intimate with someone infected with the new virus.
So the estimate was off by a factor of ten, which informed my decision to self-isolate a week ago.
Bathhouses — which facilitated even higher rates of transmission — stayed open. The gay press needed the ads from the bathhouses, and the bathhouses were profitable; and the liberationist culture that had only recently emerged simply could not concede that liberation, in this instance, was laced with death.
The same denialism can be see in Camus:
That the regulations now in force were inadequate was lamentably clear … The only hope was that the outbreak would die a natural death; it certainly wouldn’t be arrested by the measures the authorities had so far devised … There was enough for immediate requirements, but not enough if the epidemic were to spread.
Which is the case with ICU beds right now in the U.S. Even when the deaths mounted in The Plague, the public resisted facing the reality:
Our townsfolk apparently found it hard to grasp what was happening to them. There were feelings all could share, such as fear and separation, but personal interests, too, continued to occupy the foreground of their thoughts. … It was only as time passed and the steady rise in the death-rate could not be ignored that public opinion became alive to the truth … These figures, anyhow, spoke for themselves. Yet they were still not sensational enough to prevent our townsfolk, perturbed though they were, from persisting in the idea that what was happening was a sort of accident, disagreeable enough, but certainly of a temporary order.
“A lot of people think that goes away in April, with the heat,” President Trump said on February 10. “It’s going to disappear one day, it’s like a miracle,” he said over two weeks later. “It will go away, just stay calm,” he insisted as recently as this past Tuesday. Many of his supporters declared the epidemic a hoax, or insisted it was nothing more than the regular flu — even though it is estimated to be at least ten times as lethal. Yes, these denialist declarations are driven by tribal politics. But they exist beyond the Trump cult, and are also propelled by the ancient human resistance to accepting that our normal lives are over, that we live in a new paradigm, and there is no escaping it.
It’s like watching a movie when the screen suddenly and unaccountably slips out of focus, or keeps freezing for a few seconds, and you wait for the reel to be corrected, or get back to where it was, but it doesn’t. After a while, you begin to realize that this is the movie, that you will have to learn to watch it in a new way, and that waiting for a return to normal is a delusion — a very human delusion, but false nonetheless.
It is rare that the authorities act swiftly enough and drastically enough to stop a plague from growing. Even with the difficult-to-catch HIV retrovirus, by the time it was very clear that the best course of action was no sex or very safe sex, the die was cast. Plagues are dynamic things and are fueled by complacency. With this coronavirus, which is far, far easier to catch, we had obvious warning signs from China, but assumed a travel ban would keep the U.S. safe. We had a chance to roll out WHO testing kits, to ensure that if there were an outbreak in the U.S., it could be contained. But the Trump administration decided to produce an American version of the test, which was screwed up by errors, delaying it for weeks. And so we had no real grip on the spread or incidence of the virus, which is asymptomatic in most cases to begin with. We had no idea where it was, and we still don’t. It might have been possible to contain the illness even a few weeks ago. But we were flying as blind as the authorities in 1918 — even with 21st century technology. So now we have a pandemic that can only be managed rather than stopped.
And this is not entirely a function of the Trump administration’s incompetence. Look at Italy. What’s needed is a set of draconian measures at a time when the epidemic is still small, and normal life is in full swing. But in a period when relative normalcy still prevails, such draconian measures will inevitably seem completely panicky for most, slowing economic activity and growth and making a government instantly unpopular. In Western democracies, this makes a plague far harder to stop. Appeasement of plagues, like appeasement of dictators, never works.
President Trump is not the only complacent figure. In Britain and Germany, Prime Minister Boris Johnson and Chancellor Angela Merkel have all but resigned themselves to an inevitable culling of the population, and have imposed few draconian measures by fiat. Only yesterday, Johnson was unwilling to shut down soccer matches — before the soccer authorities decided to do it on their own.
And if you want to see a classic example of how a virus spreads, just look at the House of Commons, where the entire political class crams into a tiny space cheek by jowl — even after several members of Parliament, and the the Health Secretary, have already fallen ill. Watch this video of a health minister coughing and spluttering at the despatch box. It’s madness. But the alternative — a suspension of Parliament; measures to end all public gatherings, restaurants and bars, and theater productions; mandatory self-quarantining for everyone, sick or well, for a couple of weeks — seemed utterly bonkers even a few days ago. But they would have helped a lot a month ago.
With Trump, we have a deeper crisis, of course. Trump is incapable of admitting error, numb to any form of empathy, narcissistic even in a communal crisis, and immune to any kind of realism. He simply cannot tell anyone bad news. And he cannot keep a story straight, which is essential for public health. His only means of communication is deceptive salesmanship. He defunded the federal body designed to tackle such emergencies, and his Cabinet is packed with incompetence, corruption, and fealty. He cannot summon trust among at least half the country, and he has willfully destroyed confidence in the public institutions we desperately need to get through this.
In this, he is a typical man-at-the-bar pontificator, or shock-jock tweeter, whose strange theories are matched only by his own refusal to be tested for the virus, even though we now know he has been exposed. He is in charge of public health but can still blithely say something completely untrue — like everyone coming into the U.S. is being tested, or that anyone who wants a coronavirus test can get one, to give two damning examples. Rather than concede a failure, Trump will always lie. He is utterly unfit to be president, and always has been. We had a chance to remove him from office before a catastrophe struck, but the Senate kept him in power. This is their responsibility too.
It’s still unfair to blame all this on one man, when we have all been complacent because we are human, and the way we have responded is almost exactly how almost every community in the past has responded as plagues set in. But from here on out, we have to grapple with the fact that we are on our own. Trump is singularly incapable of addressing this credibly or effectively, with anything like the right mix of realism and hope the crisis demands.
He is immune to data, resistant to any facts that might suggest his own administration’s failure, and his prime-time address was deeply unsettling and off-kilter. We have been so, so lucky to have avoided a major crisis for the last three years, but our luck has now run out. We can rarely halt a plague, but we can manage one with the least human collateral damage. It seems to me that we may be headed, instead, for another 1918, mitigated only by antibiotics to deal with the bacterial infections that a century ago piggybacked on viral infections and multiplied the victims.
The only thing we now know for certain is that a description of this era as surreal is now out of date. At some point, reality was bound to step in, of course, and it’s been quite amazing how long we have been able to postpone it. But this is now as real as it gets. And it is just the beginning.