Images of bars and restaurants packed with maskless people fill the news along with new daily records of coronavirus cases in states across the country. As an infectious disease physician and hospital epidemiologist, I’m disheartened to see people reject, and even flout, the advice of experts.
Americans are being asked to adopt simple precautions that science has shown will help our nation slow the spread of the pandemic and, in turn, restore our economy and lives to something resembling normalcy. But it seems that, more than in any other country, the message isn’t getting through. This, I believe, is as much a reflection of the failure of those delivering the message — medical professionals, government officials, and the media — as of those ignoring it.
The actions that need to be taken to effectively control the pandemic are not — and have never been — about each of us as individuals. They’re not even about our higher-risk grandparents. They’re about us, the American people.
The early message to the public was that these extreme measures were being undertaken to “flatten the curve” of infections over time. By slowing transmission of the virus from person to person, we would be able to chop off the top section of the curve, which represents the point at which the number of infected people overwhelms hospitals and they cannot provide care to everyone who needs it.
Even with a flattened curve, there will still be, over time, many deaths from Covid-19. But there wouldn’t be unnecessary deaths due to the unavailability of ICU beds, ventilators, or other limited resources for patients who need them: the grandmother with Covid-19, of course, but also individuals with other conditions requiring medical care, like the 6-year-old with an asthma attack, the 19-year-old who has had a motorcycle accident, and the 40-year-old stricken by a heart attack. Curve flattening does not aim to prevent all people from getting the disease, but rather to prevent too many of them from getting the disease all at once.
Without appropriate intervention, like stay-at-home orders, mask mandates, and the closure of certain businesses, people will be turned away from hospitals, as we saw in China. Doctors will have to decide which patients get potentially lifesaving ventilators, as we witnessed in Italy and recently even in Texas. While we can’t prevent all deaths from Covid-19, countries like Germany, Taiwan, and New Zealand show us that we can keep transmission in check if we can get everyone to buy into a proactive, clear, consistent national strategy and message. Critical measures, including staying home, physical distancing, wearing a face covering when in public, and keeping your hands clean are not designed to keep you safe — although they do. Rather, they’re meant for the greater good.
Unfortunately, our message is not being framed this way by those charged with conveying it, which is at the very core of our country’s struggle with its response to the virus. Epidemiologists, infectious disease physicians, public health authorities, and others have been speaking to the public since the early days of the pandemic. But our message has changed too much and too often, quickly evolving from “flatten the curve” to something very different.
Most people, as it has turned out, are more concerned with protecting themselves and their families than flattening the curve. So we used — and in some instances capitalized on — those fears to strengthen the message about the importance of staying home. While this may have been effective in the short-term, it is hurting the country now.
The focus on benefits to society was lost, and a vocal subset of the population began to claim infringement of their civil liberties over not being permitted to choose to expose themselves to the virus.
The 24-hour news cycle requires fresh stories and angles. When a story like the coronavirus pandemic goes on for months, it’s inevitable that media outlets will be desperate for new ideas. But the media moved on too quickly from the top-level message: explaining what we as a society need to do to get back to normal. Instead, the airwaves, newspapers, and websites became flooded with niche stories on topics like, “Should we wipe down our grocery bags with bleach?” or “Is it safe to go to a barbecue this summer?”
While stories like these may garner readers, they detract from the real goal and strengthen the individual, self-preserving mindset and approach to the pandemic.
In any crisis, clear, consistent, calming, compassionate messaging from local, state, and national leaders is pivotal to people coming together to overcome adversity. The U.S. has failed terribly on this front. I find it incredible that the greatest public health crisis in a century has been politicized to the point where compliance with science-based directives often reflects purely partisan preferences.
The coronavirus doesn’t pick sides. If our elected leaders are unable to put political motivations aside and deliver consistent messages for the benefit of the nation’s health, we will all suffer for it.
States like New York and Massachusetts show us that strong leadership and a population willing to follow recommendations on social distancing and wearing face coverings for the greater good can be effective at keeping case numbers low, even after a massive surge and following a gradual reopening.
We have dug ourselves into a deep hole. Despite having less than 5% of the world’s population, the U.S. has about 25% of the world’s coronavirus cases and 20% of deaths. Uniting on the singularly important goal of getting the American people to understand what we are trying to achieve would be a good start toward finding a way out. Only then will people be willing to temporarily relinquish some of their precious personal liberties for the good of our nation. Once we are on the same page again, we need a coordinated governmental response to take this virus down. If we fail, the collective physical and financial health of Americans will remain at great risk for the foreseeable future.
Shira Doron is an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston.
It is natural that “Most people, …, are more concerned with protecting themselves and their families …” And the best protection you can get is to have _everybody_ follow the rules such as staying-at-home, social distancing, wearing masks etc. So I think the private and public good are well aligned here, and appeals to both motivations can and should be used. However, with one of the two political parties in this countries openly telling us that we all should be rugged individualists, looking out for ourselves and decrying the ‘nanny state’ it is understandable that some public health officials concluded that a message emphasizing individual benefits of the rules were more likely to be accepted.
It certainly didn’t help that President Trump thought it in his interest to downplay the severity of the epidemic and made it into a political issue, thus undercutting the efforts of so many competent public health officers.
(And most media reporting on all of it ‘evenhandedly.’)
Herd immunity is pretty good protection. And to get that you need people to get the disease. Ideally those would be young people for whom it doesn’t present much risk. Life is much more complicated than following the rules, not least of which is figuring out which rules.
Right or wrong, this discussion should not be necessary. Because personal risk of exposure and getting infected = load x virility / immunity, attention to each of these 3 concepts are paramount, i.e. ventilate (dilute with outside air, filter with HEPA and exhaust with fans), disinfect (by blowing away and with sunlight; not carcinogenic chemicals) and build immune function (diet, sun & fresh air, exercise, sleep and relaxation). Aerosolized virus hangs like cigarette smoke; just think avoidance and ventilation. And, the 1st focus, based on these principles, should be on those with comorbidities.
I’m sorry but the author lost all credibility when they mentioned the use of “lifesaving ventilators”. Medical professionals agree that placing COVID patients on a ventilator is the wrong course of action.
Having recovered from the laughing fit over so many wild, oblivious / selfish comments all I can say is : the writer of the article is 100% right. Good luck, America, with the very worst numbers of any nation in the world. Really, why would anyone in this disastrous time be proud to be American?
Asking whether or not now is the time to be proud to be an American is certainly your right and relatively harmless in small group discussion. But that kind of question in the media is politicizing the pandemic, is part of the problem, and is what this article does.
I saw an interesting comment lately… ‘Those willing to trade freedom for safety deserve neither’.
Thank you for your article. we are definitely lacking a plan 🙁
Comments are closed.