Monday, April 6, 2020

The contradictions and dilemmas of the coronavirus pandemic

I have no doubt whatsoever that in some centers, COVID-19 is wreaking havoc with the health care system.  News media coverage of (say) New York City's hospitals is bad enough (to say nothing of other centers around the world), but confirmation comes from the rates being offered to part-time nurse contractors to work there.  Right now, a traveling nurse can earn up to $100 an hour for a short-term contract in a NYC hospital, plus free lodging in a decent hotel, and in some cases even a free hired car.  That's astounding compared to their regular rates - and hospitals wouldn't be willing to pay those figures if the need wasn't desperate.

Nevertheless, there are other centers where the coronavirus simply hasn't taken hold to the same extent.  It may yet do so - we don't know - but the picture there is very different.  The Last Refuge notes:

There’s something really odd, a profound disconnect of sorts, between what the media is sharing and the reality of what the general public is reporting from their own experience.

According to most national media hospitals are overwhelmed with coronavirus patients.

U.S. media claim doctors and nurses are collapsing under the stress and strain of conditions they describe as “war zones” in the battle against COVID-19.

. . .

However, there is a disconnect ... For every media claim of overwhelmed hospital war-zones, there are a dozen reports from actual workers, nurses, doctors and medical personnel reporting exactly the opposite; and yes, a disparity in reporting even in the New York metropolitan area.

Medical personnel in Wisconsin, Missouri, California, Florida, Colorado, Oregon, Georgia New Jersey, and every region in the USA are reporting there are few to no patients in their facility and the medical staff is being laid-off, or told to go home and/or stay home, because there is nothing to do.

How the heck is this level of profound disconnect possible?

There's more at the link.

The Last Refuge asked its readers to report on what they were seeing in their own areas, with their own health care facilities.  At the time of writing these words, there were 835 responses, with more still coming in.  It makes interesting reading to click over there and see them for yourself.

I think this is why President Trump is resisting calls from the media and the left-wing establishment to impose a national quarantine, or state of emergency, or whatever you want to call it.  He's well aware that the impact of the pandemic is far from uniform.  This country is, frankly, too large and diverse to impose a "one-size-fits-all" solution from on high, even if the federal nature of our republic didn't make it basically impractical to do so.  The same applies to most states.  In New York, for example, two-thirds of the state's population lives in the New York City metropolitan area;  but the millions living outside it aren't affected to nearly the same extent by the pandemic.  Why should they have to live under the draconian conditions being imposed on NYC?

Furthermore, the President is absolutely correct, IMHO, in his stated opinion that America wasn't built to shut down.  Our national economy is already creaking under the tremendous strain imposed by the pandemic.  Unless we get back to work in fairly short order, even at the risk of greater rates of infection, we risk a complete economic meltdown that would make the Great Depression look mild by comparison.  I'm far from the only person seeing that reality.  We simply can't afford to do that - not if we want to still be a city, or a state, or a nation at the end of it.  This is the essential conflict and disagreement between those who demand that lives be protected at any and all costs, irrespective of the consequences, and those who want a more balanced view, accepting that there will be more infections - yes, and more deaths - but that this is a necessary price that has to be paid if we are to preserve our economy and our society.

I can already hear some objecting:  "It's easy for you to say that, but what if you, personally, were part of the cost?  Wouldn't you feel differently about it then?"  Yes, I probably would, from my self-focused perspective, but my feelings won't change the facts.  Life sometimes demands that we face up to reality.  Insisting on personal privilege, safety, health, etc. is all very well, but what if the cost of those things is the destruction of the nation and society in which we live?  Sooner or later, there has to come a point of decision.  At what point do individual rights and privileges override the safety, security and existence of all of us as a group?  Too many of us have refused to face up to that reality.

I can't help remembering the ancient custom in some rural African tribes.  In times of drought and famine, the older members of the tribe were - and in some cases still are - expected to leave the village, go and lie down under a tree or bush, and starve themselves to death (or be killed and eaten by the many predators to be found on that continent).  It's for the good of the others, so that scarce resources can be used to benefit those who can contribute more to the survival of the village or tribe as a whole.  That's simply the way it is, and it has been for centuries, if not millennia.  I'm sure the old people hate the idea, but they don't object, because they know and understand the reality of the situation.  Their own parents or grandparents might have done the same before them.

In our modern First World societies, we've tended to forget the ancient reminder that "In the midst of life, we are in death".  None of us is going to survive this life.  Sooner or later, death will come to us.  I'm amazed at how panic-stricken many people become at that simple realization, as if it were something ghastly and phobia-inducing.  It happens to be inevitable, and we might as well get used to that fact.  Nobody wants to die before their time - heck, most of us don't want to die even at a ripe old age! - but it's going to happen sooner or later, whether we like it or not.  The coronavirus is simply one possible cause.  All of our ancestors from a century or more ago lived with the daily possibility of death from this, or that, or the other loathsome disease.  Medical science couldn't help them much, if at all.  (Remember, it's less than 100 years since the first mass-produced antibiotic was developed;  and the iron lung, to keep alive polio victims who would certainly have died without it, was introduced at about the same time, and was in use until relatively recently.)  COVID-19 is just the latest in a long line of microbial killers to menace humankind.  It won't be the last.

That's something to keep in mind in facing up to this virus, on a national and regional level as well as our individual consciences.  We aren't divine, and don't have divine powers.  Waving an administrative or bureaucratic magic wand, and dictating that this, or that, or the other measure is essential to preserve human life, can't eradicate all the other considerations we have to take into account about our national and personal existence.  There's more to resolving this crisis than quarantines.



Eric Wilner said...

I noticed years ago that news coverage makes all disasters look the same size - so, e.g., the Boxing Day Tsunami looked about as bad on the news as the Loma Prieta Earthquake, despite actually being vastly worse.
This may be a function of news crews gravitating toward places where things are conspicuously bad, but not so bad as to be actually dangerous to the news crews.
As for consequences of the economic shutdown... well, the bogus "precautionary principle" as commonly applied presupposes that there are no adverse consequences to government-imposed restrictions. Hence, the "If it saves only one life...!" mantra, heedless of the lives that the proposed action might cost.
When it comes to this sort of lockdown, we're looking at a trolley problem in which the number of people on each track is a matter of speculation, and taking drastic action to save tens of thousands of lives could end up costing millions of lives.

McChuck said...

Two weeks after the isolation orders end, the next round of the "plague" begins. Whenever that happens, be it next week or next month.

You can't out wait a respiratory infection.

Divemedic said...

I have been getting offers for weeks. The most recent was $3,800 a week plus expenses for EMT, and $5,000 a week for paramedics in New Orleans. My son was just offered $20,000 a week for Nurse Practitioners in NYC.

Mark said...

I've been working from home for nearly a year (since I moved from NJ to PA), and most of my co-workers are in the greater NYC area (and many in NYC itself) and are now working remotely. To think that the same restrictions ought to be applied to me as to them is asinine.

My county in PA is about 750 square miles, has a population of 51,000, and has 33 confirmed COVID-19 cases. NYC (just the city, not the bedroom suburbs) is about 300 square miles, population 8.5 million, and has 122,000 confirmed cases. So NYC has 160 times the population of my county, in less than half the area, and has nearly 4,000 times the number of cases.

In a practical sense, before all this started I'd find myself within ten feet of anyone other than my wife, maybe 100-150 times per week (Wednesday darts night, church, shopping, eating out, mostly the first two). Now that number is probably less than ten per week, last week I think it was two (I had to go to the local deli to get cold cuts, I was the only customer, and there were two workers). When I commuted into NYC from NJ every day I'd literally be within ten feet of thousands of people a day, on the train, subway, walking, working.

One size really DOESN'T fit all.

Ray - SoCal said...

Masks do a lot to drop infections. Czech Republic showed that.

Good site:

Steve Parker, M.D. said...

On April 2, I published a four-point plan to prevent a prolonged economic recession or depression in the U.S. caused by unjustified fear and panic about coronavirus:

1. Young and middle-aged healthy adults go back to work now.
2. Young and middle-aged healthy adults and children return to usual social interactions and school, using 6-foot distancing and face masks if desired.
3. Extreme social distancing for those at risk for serious illness from COVID-19 for the next 2–3 months, then re-evaluate the situation. The goal is NO EXPOSURE to those who may transmit the virus to them. Protect the medically frail who are over 60, particularly if over 70 or 80.
4. Continued isolation of COVID-19 cases until they’re no longer infectious.



Beans said...

Saw an interesting piece from some site that I stupidly didn't bookmark. It was on citizen reporters in New York. Some lady went to all the 'Coronavirus Hotspots' in NYC, and kept asking the few people there, like a paramedic, or a cleaner, or the front desk person, where are all the patients and family and chaos. The answer was pretty much universally was... "What patients? There aren't that many. No panic at all." Or some form of that.

Makes one wonder exactly how much the numbers being reported are run through a panic-modifier in order to make things look far worse than they are.

Not saying the virus isn't bad. I'll let actual post-virus analysis show exactly how bad it was.

Just a very interesting observation. Makes me wonder how much is true and how much is being 'Cuomo-ed.'

BFR said...


"My county in PA is about 750 square miles, has a population of 51,000..."

Imagine how people who live in the free states think about all of this. My county is smaller; it is only 1500 square miles with a population of 3500 people. We have counties bigger than some states in the "Restricted Zone" (most anything east of the Mississippi).

Absent being told by my daughter, who was listening to the radio at the time, I would never have known that 9/11 occurred. Not to beat the horse, but it is very difficult for people who have drones flying overhead while walking in NYC, reminding them to stay 6 feet apart, to imagine living in a 1500 square mile county that does not even have one stop light.

Magson said...

One of my old HS friends is a doctor practicing in Orange county, CA. A few days back she posted a list of states that hadn't implemented statewide lockdowns with the rather hysterical opinion that the governors of those states had blood on their hands.

One of those states is Utah, where I live now. I replied to her comment that the governor had closed down all the public school statewide, but was otherwise leaving it up to the individual counties to decide on lockdown status or not, and let her know that the highest population counties (which include about 90% of the state's overall population) had all implemented the kind of lockdwon policy that she was advocating for, but the rural and farming counties had chosen not to as they didn't think it was necessary with their typical distance from being rural.

That took a bit of the wind out of her sails and I got a lame "Well, that's better than nothing" response to me, and she stopped posting in the comment thread after that, as I think she realized from what I'd said that "one size fits all ... doesn't."

OvergrownHobbit said...

It's easy for you to say that, but what if you, personally, were part of the cost? Wouldn't you feel differently about it then?"

No. Not if you had any honor. My aged mother is toast if she gets coronachan. She is the caregiver for my dad who, ditto. She isn't thrilled about being trapped in her home for who knows how many more months, plus the increased risk of dying, but she wants the country to reopen.