Forbearance
We all are observers, enjoying the privilege, from a seemingly safe and distant vantage point, of witnessing [someone else’s] life, while thinking we have the [false] luxury of time and space. We are strangers looking in from the outside. We always lose perspective, so it seems. Zoom is now within the fabric of my every day. The static meetings begin and end always on time. What I miss is the physical connection with a person, the moment before, and the moment after — meaningful, in-person interactions. We will never be able to replicate that virtually — that intimacy. I am surprised at how many people cling onto their devices: the preference for phones over humans is no longer remarkable. To listen is to miss an opportunity to promote — today’s modernism of choice. Our devices indulge our fear of intimacy by fooling us into thinking that we are connected.
I listen now constantly to Brandon Flowers — the lead vocalist of the Killers and a modern-day Hunter S. Thompson— a Mormon and pizza deliveryman who replied to a newspaper advertisement, instantly re-emerged generationally, and now commands a worldwide following of millions. This time we all say is different, Michael Jordan. Instagram of perfect cool is our religion. Sitting in the waiting room at the Chelsea and Westminster Hospital — among the highest-rated hospitals in the U.K. I am told — waiting for an attendant to offer some news and appreciating the quantum of solace before us, I’ve been finding it difficult to rise above my sadness at the many kinds of loss we are seeing and experiencing. It is difficult to comprehend the magnitude of the lives and livelihoods that have been lost to this pandemic and those that will still be lost. There is the inspiration that keeps coming from frontline workers in every field. The crucible of a crisis provides the opportunity to forge a better society. I want this time to end.
Only our mortality ultimately equalizes us and permanently connects us. It should give us a sense of proportion of what really matters in this brief existence of ours. The policy response, particularly in America, to the virus placed a historically high value on preserving lives. We are in a strange relationship with death, to the point of denying it. In America, 48,000 people kill themselves every year, and 1.4 mm attempt to kill themselves. Pessimism can be pervasively endemic.
In the pre-internet era, editorial gatekeepers curated information. But now anything goes, and sense-making involves trying to find out stuff on the internet, through search engines and social media. One of the things that makes this epidemic different from predecessors is the dominance of social media in today’s world. Social media is just a type of virus. We like to think social media has broadened our horizons, giving us access to voices we would never previously have heard, but the way we engage with these voices is very superficial. Facebook’s news feed runs on an algorithm that promotes whatever content wins the most engagement. Studies find that negative, primal emotions — fear, anger — draw the most engagement. Bad news, negative stories, are more attractive than positive news—they lead to more clicks, they lead to people being more engaged. And of course, we know that fake news travels faster than true news. So, in the current environment, unfortunately, we have generated a very heavily panic-driven, horror-driven, death-reality-show type of situation.
An initial plausible scenario—one-fifth of the American population falling ill, and a 0.5% fatality rate—would lead to 327,000 deaths or nine times that of a typical flu season.
COVID-19 is probably far less deadly than modelers were assuming. Consider the experience of the Diamond Princess cruise ship, which was quarantined Feb 4th in Japan. Nine of 700 infected passengers and crew died. Based on the demographics of the ship’s population, the American fatality rate could be as low as 0.025% to 0.625% and put the upper bound at 0.05% to 1% — comparable to that of seasonal flu. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. Sweden’s no-lockdown approach to the virus has attracted international scrutiny but the country has the highest mortality rate per capita at this stage of the epidemic.
Hope is an illusory sentiment. False hope, though, is extremely expensive. The biotech upstart said early-stage results for its experimental COVID-19 vaccine, however embryonic, are promising. The stock rocketed higher in response. Moderna, which has yet to have any drugs on the market, currently has a market value of about $30 billion. Moderna announced a fresh offering this week. Two months ago, the company’s valuation was about $8 billion. For decades, companies have endeavored to craft better and better protein therapies, leading to new treatments for cancer, autoimmune disorders, and rare diseases. Such therapies are costly to produce and have many limitations, but they’ve given rise to a multibillion-dollar industry. Moderna’s technology promised to subvert the whole biotech field, creating therapeutic proteins inside the body instead of in manufacturing plants. Its HBS-trained CEO, Stéphane Bancel, had never studied science in school. While vaccines typically work by giving a patient a tiny bit of the virus they're trying to kill, Moderna's coronavirus vaccine uses just partial genetic material from the virus, giving the body the genetic information of the virus so it can create the proteins it needs to heal itself.
Initially, our President said, “within a couple of days, (infections are) going to be down to close to zero”. America then had 15 cases. “One day, it’s like a miracle, it will disappear.” A few days afterward, he claimed: “I’ve felt it was a pandemic long before it was called a pandemic.” Our President said scientists told him that up to 2.5 million Americans could die of the disease. Now estimates suggest 135,000 Americans will die by late July. Of course, our President will tell voters that he has saved millions of lives.
Our President in his surrealism began to tout hydroxychloroquine as a cure for Covid-19 as “one of the biggest game-changers in the history of medicine!” Most clinical trials have shown the drug has no positive impact on COVID-19 patients and can harm people with heart problems. Our President suggested in late April that people could stop COVID-19, or even cure themselves, by injecting disinfectants such as Lysol or Dettol Every week since the start of the outbreak. He has said a vaccine is just around the corner. His latest estimate is that it will be ready by July. Scientists say it will take a year at best to produce an inoculation. Most say 18 months would be lucky. Even that would break all records. The previous fastest development was four years for mumps in the 1960s.
South Korea, which has a population density nearly 15 times greater and is next door to China, has lost a total of 259 lives to the disease. There have been days when America has lost 10 times that number. The country that handled the virus the best was Taiwan, which reacted extremely quickly, using digital data, and contained the pandemic, suffering barely any fatalities. The countries that had some sense of the dangers of SARS and MERS did the best in 2020. Those focused only on H1N1 did badly. They didn’t understand that a deadly and contagious virus requires a rapid response. Science has gotten significantly better, but our failure is in public policy.
The American death toll from COVID-19 is now approaching 90,000. America is now first in the world in deaths and infections. Sixty days ago, COVID-19 was not in the top 100 causes of death in the U.S. But, within six weeks it was the leading cause of death. That hasn’t happened since the 1918 flu pandemic. We just all have to confront the fact that there’s not a magic bullet short of a vaccine, that’s going to make this go away. As much pain, suffering, death, and economic disruption as we’ve had, it’s been with 5% to 20% of the people infected, and in most areas of America have been in the 5% to 10% range. That’s a long way to get to 60% to 70% to even begin to see herd immunity.
We failed to appreciate how fast the flu traveled – by boat – in 1918. Many people warned that a pandemic was possible, even likely, given global integration. This pandemic has led to the introduction of strong restrictive measures that are having a substantial effect on the global economy, including an increase in the unemployment rate worldwide. 40 percent of Americans earning below $40,000 a year had lost their jobs. Cambridge University is planning to cancel all face-to-face lectures for the entire 2020-21 academic year. The coronavirus lockdown has pummeled the American economy, with some 30 million jobs lost and trillions of dollars of output and wealth lost. The eruption of mass unemployment stay-at-home orders and social distancing together constitute one of the biggest shocks to economic demand in history.
The disease has caused fear, grief, upheaval, and loneliness; it has also led us to appreciate compassion, resilience, selflessness, and adaptability. It has laid bare the social inequalities that too many people live with day in and day out, pandemic or not, and it has caused us, as individuals and as societies, to think more deeply about the balance between self-determination and interdependence, individual freedoms and responsibility to the common good. It now feels as though we are coming to grips with the reality that this period of social distancing, isolation, challenge and uncertainty may be longer than we had hoped. We’d all like to know when it would end, but there is far more that we don’t know than what we do. Despite it all, we are not only learning forbearance, but we are also adapting and realizing that starting up again will be a gradual process and that ultimately, many aspects of life — and we ourselves — will be changed. We haven’t responded well.
Pandemics are a disaster, a great leveling like an earthquake and wars that vary in size and frequency and are extremely hard to predict. There were two pandemics – the Antonine plague in ancient Greece and the Black Death – that each killed two-thirds of the world’s population. The Spanish flu killed about 3% of global citizens, by contrast. It’s clear this pandemic is not as bad as 1918; it’s more like the flu pandemic of 1957-1958. Interestingly, that pandemic had no lockdowns and minimal closures. The economic and political impact was very minor.
Pandemics are at least a two-year event, not a four- or five-month passage. Experts are confident that a COVID-19 vaccine will eventually be developed, in part due to SARS-CoV-2’s relatively slow mutation rate—a fraction of the rate of the typical influenza virus. There are now 125 vaccines in development, and several are already advancing through clinical trials.
The best-case scenario, of course, for a return to normal is our vaccinating the entire world in 36 months. For this to happen, a super-effective, Moderna vaccine needs to be developed in the next 10 months. Second, the vaccine needs to go into large-scale clinical trials prior to the end of this year. This way, by early next year, it would be clear that the vaccine truly works. Ideally, the vaccine only requires one dose and no booster. It also would not require refrigeration, so it is easy to transport globally. The vaccine also should not need to be injected. Therefore, a supply chain of syringes and syringe disposals are not required to be built. Instead, it could be taken orally, by nasal injection, or through an intramuscular patch that attaches to the skin. If all the above milestones are met, the next key hurdle would be ensuring that the vaccine is free of patent protection, to guarantee production worldwide at multiple manufacturing sites. The final step would be to hire an army of 10 to 20 million people that are deployed worldwide to vaccinate 7.5 billion people.
The lesson from history we should embrace is that, despite the best intentions of scientists, we won’t find a vaccine for COVID-19. As in the past, this disease is something we have to manage and live with. AIDS is a 40-year-old lesson with more than 35 million deaths. The most important way to contain COVID-19 will turn out to be social distancing, more so than lockdowns. Many of the coercive measures by governments came too late. There is no guarantee that the world will have an ‘after COVID-19’ era.
From Charlottesville to COVID-19, we are experiencing ample evidence of what the long history of ‘isms’ has wrought and how much of it persists. Its adherents exploit the virus’s geographical origins to drum up racial antipathy towards Chinese people. The supremacists use fears about “white genocide” to argue for closed borders and eventually a white ethno-state. An open border is a virus! Alienated individuals, bereft of hope and belonging, become prey to demagogues, who cater to their worst prejudices.
Sometimes, it’s the consequences of disasters that are bigger than the disasters themselves. Crises expose problems, but they do not supply alternatives. Epidemics, like all disasters, have a way of revealing underlying truths about the societies they impact. They expose the fault lines in our systems, the sincerity of our relationships, and mainly the ways in which we do work or flounder together. Pandemics generally drive people apart. It is an election year in America; we certainly cannot continue to borrow $3 trillion a quarter. False hope is extremely expensive. Yes, Brandon Flowers, we are human…