The Fourth Surge? The Fifth? Guess what: It’s still not safe out there!

The US recently passed a million deaths from COVID-19. There have been a lot of articles marking this dubious milestone, notably in the NY Times as in this Briefing by Jonathan Wolfe, and this Daily podcast.  The Wolfe piece includes two important graphics, one showing the number of new cases by day. It also contains shows hospitalizations and deaths, and makes the several “waves” very clear. And that this Spring’s wave is huge. The second graphic shows deaths, by time and by race/ethnicity in the key non-child, not old, age range of 25-54. A lot of deaths, and while the particular minority group that is most affected varies among the different surges, Blacks and Latinos are disproportionately dying.

A million people is a lot of deaths. It is, as Wolfe points out, more Americans than have died in all the wars in our nation’s history. It is more people than have died in any other country. It remains about 20% of the world’s deaths. I have often written about how the US healthcare system is far inferior to that of many other countries, particularly the wealthy ones that are our appropriate comparison group. It is unfortunate that this area, where we are but certainly should not want to be #1, demonstrates our lack of an effective public health system and the inadequate coverage for healthcare of so much of our population.

 

It demonstrates more than that, as anyone can tell you, regardless of the group that their political position demands be blamed. People are getting out more, mingling more, interacting more, going to physical workplaces more – and getting infected more. Not a day has gone by recently where I have not heard from a friend or relative about something that they did for the first time in a long time – go to a concert, or to an indoor restaurant, or get together with a group of people in someone’s home. And every single one of these stories has ended with someone, the friend or relative or one of the people that they interacted with, getting sick and testing positive (and possibly, likely, others to follow). I have learned more than I ever expected to about the unreliability of home test kits, which have sometimes been falsely negative two or three times in a sick person before the result of a more definitive test came back a couple of days later. The amount of virus (“antigen” if you want to be cool) that you need to make you sick is less than that required to generate sufficient antibody (what your body makes to fight the virus) to turn these tests positive.

It is tempting to say people are behaving badly or stupidly, but what is true is that people’s behaviors – tentative or full-throttle efforts to move back to a “normal” pre-pandemic life – have increased the number of infections. And that the increase in the number of infections leads to an increase in the number of hospitalizations and deaths. These are sometimes, but not always, in the people adopting the “risky” behavior. Sometimes they are in the people (often older, sicker, more vulnerable) that they live with.

Both my wife and I have traveled abroad recently, and it makes us nervous. She went to India, and we both are now in Europe. We tried to be as safe as we could on an airplane where the pilot and staff announce regularly that “you are not required to wear a mask, but please respect the decision of other people to mask or not mask”. I guess that means that there have been at least arguments, and likely fights, on planes over this issue. A federal judge in the US, in the middle of this current surge in infections, ruled that the government could not require people to wear masks on planes, and the administration did not appeal it. Thus, in traveling from India, through Dubai, everyone was masked until my wife got off at O’Hare – and most people were not. There are legal scholars who disagree with this judge’s ruling, but the key point, whether you agree with it or not, is that she ruled that the Constitution does not give the federal government the right to require people to wear masks on planes. She did not rule (and of course, could not rule!) that not wearing a mask was safe. This distinction seems to be lost on many people.

Including judges, of course. We just learned that 70 New York State judges went to a retreat in Montauk, NY, and that (as of May 19) 20 of them have tested positive for COVID, and many are sick. And there will likely be more. The fun of that retreat included a big karaoke party, a really effective way to spread the droplets that cause the infection. And these are the people who issue the rulings about what is allowed and what is not. Makes me feel really secure; how about you?

On a more chilling note, a close relative just told me about a longtime friend who has not been vaccinated,  won’t do it, and refuses to wear a mask. But he does not refuse to travel or to go out and interact with others, even in settings where evidence of vaccination is required. He lies and says he is vaccinated. “Luckily” for him (and, of course, unluckily for the rest of us!) he shares his father’s name, so he uses his father’s evidence of vaccination to access these venues. Think about that. Think about how reassured you are when you are with a group of acquaintances and “everyone” is vaccinated or tested negative. Or are on a plane where “everyone” has had to present proof of vaccination. Do you feel secure? You should, actually, at least feel more secure. The odds are very much lower in these settings. And in private groups, of course you trust your friends and relatives. On the other hand, it might not be everyone. One of them might be this guy. Or one of the thousands, probably millions, like him.

Recently, a ruling by a federal judge has blocked the federal government from ending Title 42, a public health regulation invoked by Trump to keep migrants coming from Mexico out of the US  based upon the possibility of their bringing in COVID, which has been continued until now. But it is not migrants who are spreading COVID; it is infected Americans who have not been vaccinated, will not wear masks, and openly mingle in public (and private) places.

In small villages in India everyone is wearing a mask. At O’Hare, or your local restaurant, or even on an airplane or in a convocation of judges, people are not. Luckily they are vaccinated. Unless, of course, they’re not. Since people’s desire to “open up more” began, early in the pandemic, I have been saying “opening = death”. Vaccines have helped a lot, and there area lot fewer deaths and hospitalizations when folks are vaccinated even when they are infected.

Sadly, there are too many people who are doing their best to try to make it worse.

SCOTUS, Roe, Reproductive Rights, and All Our Freedoms: We must act

 

Politico, and now other outlets such as the NY Times,  have reported on a 98-page draft opinion from the Supreme Court that, in no uncertain terms, overturns both Roe v Wade and Casey and removes federal protection for abortion rights. While it is true that this is a draft and individual justices’ final decisions could change, the fact that 5 of the justices (Alito, who wrote it, Thomas, Gorsuch, Kavanaugh, and Coney Barrett) signed on to it makes it unlikely that the final decision will change. The only uncertain vote is that of Chief Justice Roberts, but he is no longer the swing vote he once was; the only difference is whether the vote to say that women have no Constitutional right to control their own bodies would be 6-3 or 5-4.

And, absolutely, let us be clear: that is what overturning the 50-year old Roe decision would mean, that the majority of the justices on the Supreme Court will have ruled that the control over a woman’s body, on whether she has to continue a pregnancy regardless of the circumstances, is in the hands of others. It may be Congress, state legislatures, governors, husbands or other relatives, churches that they may or may not belong to or believe in, petty pettifoggers, vicious misogynists, non-vicious misogynists (?), and folks with their own right-wing agendas, but not the women themselves. When Roe was decided, Justice Blackmun, who wrote the opinion, said abortion should be a decision made by a woman and her doctor. That was itself a bit paternalistic, but it was 50 years ago; I think the way that still should be read is “with adequate medical advice”, understanding the potential (or likely) risks involved in the decision that the woman makes. And ONLY the woman whose body involved should be able to make!

The majority of justices on the Supreme Court obviously do not believe this, along with a substantial minority – but definitely a minority – of the American people (most polls put support for Roe at about 70%). Their anti-abortion movement, well funded by multi-millionaires and billionaires, and supported by both the Catholic Church and many fundamentalist Protestant sects, seems to have finally won their cause after 50 years of reactionary fighting to impose their will on everyone else. It is a coup, be certain of that. It was, most immediately, made possible by the fact that Donald Trump got to name 3 Supreme Court justices, through the hypocritically evil behavior of Mitch McConnell the GOP Senate majority, which decided both to block President Obama’s appointment of Merrick Garland, not even holding hearings, 9 months before his term expired, and then approving Trump’s appointment of Amy Coney Barrett just weeks before the election he lost! This alone should be enough to make everyone who cares about reproductive rights, women’s rights, LGBTQ+ rights, voting rights, any rights, pull out all stops to make sure that the predicted Republican victory in November does NOT happen, that McConnell (and I make no analogies since anything you might compare him to would be insulted by the comparison) does NOT again become Majority Leader. The Democrats are far from perfect, but every justice who voted to repeal was appointed by a Republican, and it was the Republican majority in the Senate that facilitated the appointment of the last three. The SCOTUS opinion will say that the decision is Congress’ and there is no possibility that legislation maintaining women’s rights will get 60 votes in the Senate, or even 50 given Joe Manchin. The pundits and pollsters are all predicting a big INCREASE in GOP seats in November. Unless we do something about it.

Make no mistake: this SCOTUS decision is that the opinions of some people are worth more than the lives of others. No one who is opposed to abortion has ever been required to get one by the decision of Roe. Of course, there were many “mental disabled” people or others judged incompetent who were required to get them in the past, vicious abuse in itself. Ironically, the issue is that the same logic is now being applied to ALL women; they do not have the Constitutional right to make their own decisions about their own bodies.  As Susan Matthews in Slate writes, Justice Alito could not find a justification for the right to abortion in the Constitution because “The Constitution was not written for women”. It didn’t even give them the vote!

Although it does not change the core issue, the choice of words in the debate has been unfortunate; anti-abortion people use the term “murder” of “babies” while abortion rights advocates have used the term “choice”, as if it were a matter of convenience, or what color bedspread to get. It isn’t. It is about the decision to carry a pregnancy, something that is medically risky even in the lowest risk people (but a risk that most people who want to have a baby gladly accept), to give birth, to probably raise a child, to completely change their life, to possibly be unable to care for already-born children, to give birth to a child of a rapist (perhaps incestuous rapist), to give birth to a child already unable to survive because of genetic or other malformations occurring in utero, etc., etc., being only the right of the woman who is pregnant, and not that of anyone else. Consulting them – family, friends, doctors, is fine, but the decision needs to be that of the woman alone, not the state legislature.

This decision, if it stands, will not end abortion in the US, as it will send us back to pre-Roe times when the decision was left to the states (indeed, several states had legalized abortion before Roe). So, abortion will likely remain legal in states like NY, CA, MA, IL, etc. But other states, including of course TX and FL, which have already passed draconian restrictions on access to abortion, will almost undoubtedly make it illegal again, along with many others. It has been estimated that abortions will decrease by 14% (“only”) but if this is true, it has to be taken in the context of geographic access. Women with money from TX, FL, and other states that severely limit access to abortion may be able to travel to another state, but poor women, on whom the burden always falls the hardest, will find it much more difficult or impossible, as will teenagers, including those who are pregnant as a result of incestuous rape (see “Who gets abortions in America”, by Sanger-Katz, Miller and Bui, originally published in the NY Times Dec 21, 2021 and republished on May 3, 2022). Health and healthcare are already incredibly inequitable in the US, and this decision will make it much worse. Jill Filipovic, writing in Substack, provides a number of other concerning likely outcomes,  including that there will be a 21% increase in maternal mortality!

And if that were not enough – more than enough – to get your blood boiling,  get you out to the streets, the likelihood that this will end with abortion approaches zero. Many of the opponents of abortion rights also oppose other reproductive rights, including cheap and easy access to contraception and sex education in schools. This would be illogical if preventing abortions were truly their goal, as it is precisely access to these two factors that are universally associated with lower abortion rates – see ‘Scandinavia’. When abortions were illegal in countries such as Ireland, sex education and contraception were also severely restricted – and the abortion rate was higher than in say, Denmark. But the women receiving these abortions, illegally, were at much higher risk. These arguments, however, get little traction, since those who would restrict all reproductive rights are doing it for other reasons – maybe they hate sex, maybe they hate women, but they surely believe that they know better and freedom is not important to them. If this is hypocrisy – they will fight for the right to own and carry a gun or not wear a mask – hypocrisy is not important to them either.

And it will not end with reproductive rights and contraception. Certainly the rights of LGBT+ people will be even more infringed. And our rights to read books and have our children learn science and history. And our right to vote. Listen to the far-right carry on about restrictions on their freedoms, but think about the freedoms that are at the core of the US and on which we depend.

And most important, these are freedoms we can no longer can passively depend on. If you don’t fight for them, they won’t be there.