Recently in traditional time, but long ago in COVID-19
time, I somehow got involved in a discussion on Facebook with a person I didn’t
know. They had asked a mutual friend what was the “end game” for the pandemic,
since people could not put up with the restrictions placed on them
indefinitely. I said there was no end game, no one knew when it would end, and
the only thing that we could do was continue to stay home, wear masks when we
went out and social distance until – whenever. They were unsatisfied, and
pointed out to me basic human psychology, which to them meant people will put
up with inconvenience, even loss of income, for a period of time but needed to
know “until when”.
As I said, that was weeks ago and things have changed,
pretty much for the worse in most of the country. For a while you could squint
and say that the national infection rate was plateauing, but that was mostly
because New York accounted for such a high percentage, and its rate was
decreasing. Most everywhere else it was on the rise, particularly in the South
and West. I live in Arizona, where over the last week or so the rate of increase
of COVID infections has been leading the country. Not the area where you want
to be #1! This is mostly the result of early “re-opening” by a
Republican governor, Doug Ducey. With the support of the GOP majority in the legislature, he allowed bars,restaurants, hair salons, etc.to open. More than that, he issued an
executive order forbidding local government, cities and counties, from having
more restrictive rules. This effectively undercut the efforts of the more
populous cities of the state, such as Phoenix and Tucson, where I live, which
had been requiring masks and social distancing. Tucson Mayor Regina Romero had
closed restaurants and bars early on. Ducey’s illogic, characteristic of modern
Republicans, was that he favored control at the most local level of government,
except in a pandemic. Of course this made no sense; why is the state level
better in a pandemic? Following that logic policy should be made at the
federal, or even international, level.
More recently, however, he has backtracked completely and allowed
local government to make restrictive rules. Tucson and Pima County (much of
metropolitan Tucson is outside the city limits) immediately enacted
strict closure, mask and social distancing rules. The County is going to
allow public health department officials to enforce masks in restaurants when
the owners will not (by citing the owners and maybe closing them down). We will
see how well they work, if people obey them (way back on June 19, folks were
telling CNN -- published
in the Arizona Star) that they saw no reason to, and eventually if the new
surge in COVID cases and deaths begins to abate. I still cannot say when
although I (and of course most people with medical, public health, or
epidemiologic knowledge, as well as anyone who was paying attention) predicted
the dramatic upsurge in cases. Now we have what is really not a “second wave”
but a continuation of the first wave brought on by policies that were (most
generously) optimistic, or (more accurately) the result of wishful, magical
thinking enhanced by a misplaced desire to “restore the economy”. Dr. Anthony
Fauci has just said we might
expect as many as 100,000 NEW cases a day! And, of course, economically, things will be
much worse (as
noted by Paul Krugman) because the increase in disease and death, not to
mention the closures, will make the economy tank much faster. And the relief
that should have come has, typically, been insufficient for regular working
people (how far can $1200 go??) and overgenerous (to put it mildly) to large
corporations, many getting millions in bailout relief despite having billions
in the bank, and C-suite executives who bathe in greenbacks (not of the $1
variety, either!); in
Arizona the governor held on to federal relief funds without distributing them
for a long time.
Something else very big is happening in Tucson now. A huge
fire (called the Bighorn Fire because it started on about 200 acres on Bighorn
Peak after a lightning strike) that started about a month ago has continued to
grow despite heroic efforts by firefighters from across the West and indeed the
country. It is raging through the iconic Santa Catalina Mountains north of the
city; areas of the foothills have been evacuated. When I wrote about the fire
in my blog “Life,
the Universe, and a Few Things” on June 12, I had to put in an update as in
a day it had grown from 3700 to over 7000 acres. As the weeks have passed it
grows daily, and the spread is enormous. We have seen it go to 20,000, 30,000,
50,000 acres. Now that it has passed 100,000 acres, the newspaper is now
reporting it in square miles – 180
square miles as of today – which, at 640 acres/sq mi is over 115,000 acres.
Wildfires, particularly in the arid West, have become more common and more
severe (think of the 2018 Camp Fire in California) with climate change brought
on by global warming, but they are no less terrible for that. Sometimes, as
with Bighorn, the cause is natural (lightning), sometimes the random accidental
human, perhaps a camper who builds a fire where they shouldn’t or drops a
cigarette, sometimes (as in the Camp Fire) by the criminal malfeasance of corporations
(sensing a theme?) The structures most threatened in this, as most, wildfires,
are the homes built too close, too high up in the foothills, lovely locations
and views (if sometimes offensive to others) but highly at risk.
There are, you may have already noted, some parallels
between the fire and COVID. The fire is burning and spreading because the
ground is dry and because there is lots of brush that has accumulated in the
mountains since the last fires. This is kind of like the people across the
nation and the world who are susceptible to the virus. In some ways, it would
be a better metaphor for rare severe influenza, or measles before a vaccine,
when some (older) people had immunity and those who were younger didn’t, than
for a novel virus like SARS-CoV-2, but you get my point. The fire will keep
burning until it runs out of fuel, or the summer monsoon rains come, and the
firefighters’ efforts keep it from being even worse – while growing, the fire,
it is reported, is 45% controlled. The virus will continue to spread until
susceptible people are dead or immune (but whether immunity lasts and is
protective and for how long is uncertain), or there is a vaccine that is
effective and widely applied, and good leadership and government policies can
limit it from being even worse.
When there are good government policies, of course. We have
seen almost total victories in places like New Zealand, movement back from the
abyss in places like Italy and New York City, bright spots in states and cities
that have moved as aggressively to limit human interaction, the crucial part of
limiting COVID spread, as have firefighters to limit the Bighorn fire. But we
have also seen disasters from terrible policy at the national level in the US
as well as many states (including, but certainly not limited to, Arizona) and
in other countries, particularly those led by arrogant, egotistical autocrats
(see also Brazil, Russia, etc.).
The fire-virus metaphor is far from perfect, but it has some
relevance. Our response to the fire was hurt by cuts to the funding of national
parks and forests; our response to the virus was crippled by devastating
cuts to the public health infrastructure. The “end game” for the fire is
the summer monsoon rains, which will hopefully come soon. The end game for the
virus is the development, manufacture, and VERY WIDESPREAD application of an
effective vaccine. That may be on the horizon, but it is far away; even if a
great vaccine is developed the application is a humongous undertaking (heck,
in most of the US, certainly in Arizona, we can’t even effectively do testing!).
Until then, sorry about the psychology of “human nature”;
staying away from people is the only answer.
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