Not Taking Social Distancing Seriously Enough
Too many people still don't understand the idea behind 'flattening the curve.' That includes our President.
President Trump has declared a national state of emergency. So have several states. Schools across America are closed for the next few weeks. And many companies are allowing telework at an unprecedented rate. We still may not be doing enough.
Certainly, Trump himself isn’t.
A report in yesterday’s WaPo is headlined “Trump is breaking every rule in the CDC’s 450-page playbook for health crisis.” It focuses on rules CDC wrote in the aftermath of the post-9/11 Anthrax scare for crisis communication.
The fundamental principles behind good public health communication are almost stunningly simple: Be consistent. Be accurate. Don’t withhold vital information, the CDC manual says. And above all, don’t let anyone onto the podium without the preparation, knowledge and discipline to deliver vital health messages.
There’s a whole lot more there but OTB readers likely need no convincing on this front. When I saw the headline yesterday, I assumed it was about all of the ways Trump is ignoring the best practices for social distancing, with all the handshakes and meet-and-greets.
The NYT gives a case study of one such instance with “On a Saturday Night in Florida, a Presidential Party Became a Coronavirus Hot Zone.”
It was a lavish, festive, carefree Saturday evening at Mar-a-Lago a week ago in what in hindsight now seems like a last hurrah for the end of one era and the beginning of another. In the days since then, the presidential estate in Florida has become something of a coronavirus hot zone. A growing number of Mar-a-Lago guests from last weekend have said they are infected or put themselves into quarantine.
A week later, the White House physician announced on Saturday night that the president had tested negative for the virus, ending a drama that played out for days as Mr. Trump refused repeatedly even to find out whether he had contracted it after exposure to multiple infected people.
The result came less than 24 hours after the White House put out a misleading midnight statement saying there was no need for such a test at roughly the same time the president by his own account was actually undergoing one in deference to public pressure.
But either way, the Mar-a-Lago petri dish has become a kind of metaphor for the perils of group gatherings in the age of coronavirus, demonstrating how quickly and silently the virus can spread. No one is necessarily safe from encountering it, not senators or diplomats or even the most powerful person on the planet seemingly secure in a veritable fortress surrounded by Secret Service agents.
There’s a whole lot more but, again, you get the idea.
The President’s poor communication and personal example in this crisis may well explain why Americans writ large aren’t taking the crisis seriously enough.
NYT columnist Charlie Warzel urges “Please, Don’t Go Out to Brunch Today.”
[M]any younger Americans seem unfazed by the pandemic. Though they may be working from home or practicing social distancing during the day, it appears American night life is continuing without much interruption.
In Seattle, where one hospital is reportedly preparing for Northern Italy levels of infection and already running low on some supplies, bars in the Capitol Hill neighborhood have been full of people. On Friday evening, a Twitter search for the phrase “the bars are packed” yielded hundreds of tweets from cities like Baltimore; Columbus, Ohio; Los Angeles and New York City. On Saturday in Chicago, one reporter tweeted a photo of a line around the block for a St. Patrick’s Day bar crawl at 8 a.m.
While the federal government has issued some guidance for older and high-risk Americans, the administration has offered little definitive advice for how stringently low-risk people should isolate. And so it seems that for many it’s business as usual.
Continuing the weekend tradition of packing the bars is selfish and reckless during this pandemic. It will speed up the spread of the virus, increasing the suffering for older and more vulnerable people and for the medical workers who will be caring for them. Though the virus appears dramatically less fatal for those under 50, younger, healthier people can still contract the virus, not show symptoms and infect at-risk populations.
Asaf Bitton, the executive director of Ariadne Labs in Boston, wants us to know that “Social Distancing is Not a Snow Day.” He recommends several steps that government officials and individuals need to take to flatten the curve. One in particular shows the magnitude of what he’s asking:
2. No kid playdates, parties, sleepovers, or families/friends visiting each other’s houses and apartments.
This sounds extreme because it is. We are trying to create distance between family units and between individuals. It may be particularly uncomfortable for families with small children, kids with differential abilities or challenges, and for kids who simply love to play with their friends. But even if you choose only one friend to have over, you are creating new links and possibilities for the type of transmission that all of our school/work/public event closures are trying to prevent. The symptoms of coronavirus take four to five days to manifest themselves. Someone who comes over looking well can transmit the virus. Sharing food is particularly risky — I definitely do not recommend that people do so outside of their family.
We have already taken extreme social measures to address this serious disease — let’s not actively co-opt our efforts by having high levels of social interaction at people’s houses instead of at schools or workplaces. Again — the wisdom of early and aggressive social distancing is that it can flatten the curve above, give our health system a chance to not be overwhelmed, and eventually may reduce the length and need for longer periods of extreme social distancing later (see what has transpired in Italy and Wuhan). We need to all do our part during these times, even if it means some discomfort for a while.
I must admit, I’m not yet fully complying.
As noted in a post last Sunday, my wife and I followed our custom of going out to dinner the night before. We haven’t done so since and are unlikely to for awhile. We did get takeout for the family last night, which is less risky but still against Bitton’s advice. (But the restaurant still had plenty of patrons dining in. They were not separated by six feet.)
Moreover, while several of us were dubious of the wisdom of it, we nonetheless attended a long-scheduled work-related social gathering. And, while some awkwardly avoided it, most still shook hands and hugged people in greeting. It’s going to take a while for intellect to overcome instinct in that regard.
Nor have I canceled playdates. My 16-year-old stepdaughter was already bored yesterday after an unexpected school closure Friday and I actually urged her to invite a friend over for the afternoon. And my 8-year-old has a playdate with a longtime friend from our old neighborhood this afternoon; I’m not going to cancel it.
Dan Drezner encapsulated social distancing really well in a column last week explaining “Why the coronavirus response seems so outsize.”
What is being asked of healthy people — people who even if they contract the virus are unlikely to get too sick — is to nonetheless change their behavior in costly ways so they reduce the risk of spreading the virus to more people. Or as Johns Hopkins School of Advanced International Studies professor Johannes Urpelainen put it with respect to travel cancellations: “If you are a healthy adult, you are not canceling your event or travel or conference because of yourself — but because of the more vulnerable people who will suffer if you become a vector.”
Of course, all these cancellations and disruptions will have real-world economic effects. These cannot and should not be ignored, and measures need to be taken to ameliorate those effects. Still, the reason so many precautions are being taken is because health is more of a public good than is commonly realized. Making small sacrifices is a social tax that the healthy can and should pay so the vulnerable do not die.
I don’t think we’ve grasped that yet as a society. My local school superintendent, an intelligent and highly-educated man, hasn’t figured it out. That may well be true of a lot of military leaders. While the Secretary of Defense has issued draconian travel restrictions, most of us are still going about our-day-to-day work lives on the basis that we’re in a low-risk population and the mission must go on.
Some of this is simple human nature. People aren’t going to inconvenience themselves unless they’re forced to do so or really, really understand why it’s necessary and embrace the rationale.
The fact that our national leadership has been so abysmally poor is a major detriment in achieving that understanding. Indeed, because Trump, his supporters in Congress, and the right-wing media complex have followed his lead in downplaying the crisis until too late, it has been nearly impossible for expert advice to take hold.
Relatedly, the best advice keeps changing, creating a lag effect. We’ve gone, in the span of a week or so, from “avoid gatherings of 1000 people” to “cancel playdates with the kid next door.” We’re just not wired to change our hard-wired behaviors that quickly.