Americans are not used to being told “no”.
No–you may not go out to the movies, restaurants, beauty parlors, bars or amusement parks. All enjoyable luxuries, but hardly essential.
No–you will not enjoy graduation ceremonies or proms. Sadly a first taste of deprivation for many young people.
No–you cannot infect others by your negligent activities of community exposures, not wearing a mask or keeping distance. Truly a sneak peek into the psyche of many who not only ignore such orders or suggestions, but actively protest against it–sometimes armed–as if their lives are more important than any others…a twisted version of our common rights.
No—your State can not reopen places of congregation unless you have met Federal guidance criteria of at least Phase 1, i.e. a prior 2 week decline in infection as indicated by tested new cases. Of course you might not have the test kits needed, but hopefully you are working on that
“NO!” is not an utterance anyone takes kindly to.
But it seems that few average Americans really understand deprivation on any level, nor any degree of the self-control needed for delayed gratification. They did not grow up in times it was required of nearly everyone, and therefore never really learned how to do it…or more importantly now perhaps, why to do it.
Our poorer residents and disenfranchised demographic groups certainly understand, but they are too busy being front line or essential workers to give it extra thought. They work and worry, try to follow suggested distancing and protection, and hope to stay healthy enough to maintain access to enough food and shelter for themselves and family members…
Or to have health resources available for them to access when they fall ill.
A novel thought by a Midwest writer watching ridiculous levels of close proximity protests, opined that we should make these people and any who eschew safe sequester and distancing to hold large warning flags high on poles like tourist groups when they are out in public, identifying themselves, so in the short run we would know who to give a wide berth, and in the longer run, who to deny overwhelmed hospital resources if rationing became necessary.
No–you cannot congregate for either incredibly sad or uplifting reasons. No group attendance to grieve at funerals, or congregating to witness and enjoy weddings, or lining sidewalks and every inch along streets to gaze upwards at Blue Angel displays.
But religious communities continue their funeral practices and throngs of people not used to restricting any of their comforts or desires, gleefully clump together in cities across the US to watch for the hugely expensive aerial displays of ‘thank you’ to healthcare institutions. They wear face masks, wash groceries and stay indoors otherwise, yet run to the streets with no masks and congregate for an air show! It is as if we live in a country of residents all with split personalities…
No–you may not have sports this year/season nor other spectator competitions. You may have to actually skip a year. Fans jammed into arenas are not a welcome sight during a pandemic.
But teams and owners are bucking back, trying to make new deals for play time, contracts and even best testing of their team members. Perhaps some extra volunteer work could fill the apparently enormous amount of time viewing, playing or gambling on sports in the US.
Do they really not understand, or just wish to loudly register their distaste for any “no” order?
But the lack of real understanding starts at the top. And this is especially true of our putative leadership in the White House. They push back at every chance they have had to do a better job, or to educate the public of their responsibilities, and all the while disavowing their scientists, intelligence community and health experts, instead staging unnecessary distraction events, theories and alarming measures.
A few recent examples, although more spring up daily…
You cannot ensure the food supply chain while having 100s of line workers ill.
You need to test them, isolate any infected, track them and meanwhile provide healthy ones with PPE and OSHA environmental controls in the workplace.
What do they do instead?
Mount legal remedies for owners of plants to refuse workers testing, sick leave and protection against dismissal-for-cause if they are too ill or fearful to work, thereby disallowing worker’s ability to file for unemployment insurance
I recommend Trump and advisors be required to stand on a meat packing line for 15 minutes without PPE.
You cannot visit public places without wearing a face mask. And of course, primary among these locations would be hospitals.
What did our VP Pence do? Convince Mayo clinic to host his photo op standing within a few feet of a recovering patient with not only the patient, but all others in the room wearing face masks, but not him! (There are more people than Pence to blame—where were the apparently frightened or bullied minds of the hospital administrators allowing this to happen?)
I recommend Trump and Pence and others be made to stand and watch an ICU through the glass with patients dying on ventilators, or grab a mask and gown and sit for a while in the triage area of any large hospital emergency room as arrivals gasp for breath and beg for care. It is obvious they do not actually know what this looks like—the actual vision of anyone in the throes of severe COVID-19 illness. They have no informed empathy at all for the plight of those with disease burden, only wooden scripted words.
We cannot get enough reagents and test-kit materials to allow widespread testing unless the Defense Production Act is invoked for manufacturers in the US to ramp up their production for these materials and their use in our country. Instead Trump continues to refuse to apply this power to anything that does not benefit him or his campaign donors.
We don’t have an adequate antibody test (even yet). So we should not change our protective behaviors, but meanwhile the inevitable has happened. The White House grabbed onto their one seemingly tangible means for suggesting wholesale opening of the economy based solely on these tests for Phase 1. How many tests? Who cares? Which ones? No matter. How accurate? Who knows? Just take one–or don’t. It seems ‘don’t’ would be preferred as the experiment progresses.
The government has remained in no hurry to even have, acquire, manage or dispense widespread standardized accurate testing. Indeed they refused offers of Germany and the WHO for complete and accurate tests at an early stage for US contagion. Now we can not catch up to our needs. Remember what this means when you see any numbers posted: no tests, no cases, no problem.
You should not open malls and wholly non-essential businesses, parading economic needs as those that outweigh likely rebound of cases and deaths and overwhelmed healthcare systems while your region or State has not met minimal status or reduction parameters and could not in any way meet ramped up needs of more surging illness. But here we are: May 1 and doing exactly that in nearly half of the country and not one of those States have met even the Phase I criteria. Calling these administration health orders ‘guidance’ has not served us well, nor workers at plants with owners ignoring CDC and OSHA ‘guidance’.
So we begin the great experiment of more disordered rationale at the risk of 1,000s of more lives lost, and primarily because of wishful thinking, delusional claims and a populace not used to denying themselves anything for any reason.
Transmission by asymptomatic people is likely very widespread. Varied incubation times elapse before a person may develop symptoms serious enough to request or warrant testing, if they can get access. One infected person can even remain test-positive for 5 or more weeks; it is unclear for what portion of this time they are infective. These new transmission/illness intervals would encompass all of May. Watch the news carefully during these next weeks of the rush of “opening” progress. Stay home as much as you can and remain smart when venturing out for only necessary reasons. Let’s hope Memorial Day does not become known for another reason.
Pamela Getson is a PhD biostatistician with a BS in physiology. She was Director of the Statistical Core Group of Children’s Hospital while on Faculty at the George Washington University School of Medicine/Pediatrics. She now lives in St. Michaels. In addition to teaching and research, she designed and evaluated clinical trials, and later served as a senior math/biostat reviewer of data submitted in support of new biologic vaccines at the FDA/CBER. Now living on the shore permanently in retirement, she primarily assists with her husband’s new interest in oyster gardening and resumption of their love of sailing and nature.