Matthew J. Edlund M.D.

Getting Healthy Now

Defending the Right to Infect

How do we get out of lockdown?

Posted Apr 23, 2020

WHO model of Coronavirus
Source: WHO

Life was strange. Now it’s bizarre.

Isn’t it odd the number one nation in the world for COVID-19 cases and deaths (the U.S.) also has the most demonstrations against lockdowns working to prevent them?

Not really. Especially when you find out who’s organizing them.

The conundrum is perhaps most simply understood studying a single photo. It shows a Denver anti-lockdown demonstrator in her SUV confronting a man in scrubs and mask (presumably a health care worker). Arms across his chest, he blocks her path, an image with many similarities to the June 4, 1989 demonstrator in Tiananmen Square.

Fed Up

Americans are fed up with the lockdowns. Try to imagine the response of this woman and millions of others who want them over:

I can’t pay my mortgage. I soon may not have money for food. I’m sick of being locked up, of video games and reruns. I’m frustrated by spending a week trying to get on unemployment sites like Florida’s, only to watch it fail (don’t feel too bad; state employees I know seconded to help you can’t get on the official site either). I applied for the PPP program and my bank sends me a note saying they’re “working tirelessly for you” before they tell me the money’s gone and I need reapply. I want my life back, now!

Contrast that with the health care worker:

I’m working the intensive care units without proper protective equipment. I come home every night wondering whether I’ll infect my wife and child. And these people want to bring us more people to die? Do you know what it’s like treating somebody young and healthy who waltzes in yakking on their cellphone and you find their oxygen saturation is 50% and an hour later they’ve crashed, intubated with BP 60 over palp and none of the drugs I use do a damn thing except provoke arrhythmias? Do I have to bring body bags into people’s living rooms to wake them up? Don’t they get it—they can have no symptoms and give Grandma this lethal disease?

How do you create such opposing ideas?

Easy. As writers like Michael Specter explain, it comes from the top. On March 22nd, Dr. Anthony Fauci told a television audience to “hunker down more than as a country than we are doing.” The immediate tweet by the president was “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF.”

One of the first rules you learn about handling an epidemic: Make clear recommendations of what people need to do, then explain to them why. Repeat. People defeat epidemics, especially people united to fight them.

Some folks don’t agree with such recommendations, however. Demonstrators against lockdowns might have been surprised to learn they would be defended for breaking the law by the same firm representing the president. Or that some of the nation’s richest citizens paid for some of the organizing.

Sadly, the anti-lockdown default plan, building up herd immunity, has not succeeded. Visit Britain. Originally old folks like myself were to be sequestered for months while those younger went about business as usual, building up immunity and the post-Brexit economy. Until Prime Minister Boris Johnson saw the epidemiology models and did a dramatic U-turn, telling everyone to stay inside. Don’t see friends. Don’t see family. Out only for food and medical need.

The move came too late. A few days after he, his pregnant partner, and health minister were infected. As the pandemic roared through the country retired health workers, the same folks who were supposed to stay inside and isolate were asked to volunteer on the front lines.

Many did and died. More will join them. Quite a few of those deceased were foreign-born, the kinds of immigrants the government says Britain no longer wants.

For the virus doesn’t respond to rhetoric. It’s like an alien. You can’t talk and threaten it away. It doesn’t care about passports, political affiliation, your job status. It infects and kills without thought.

Which is why it’s so sad so many out there, like the soon to be 70-year-old lieutenant governor of Texas, are willing to “take the bullet” to aid the economy. Does he believe there should be a constitutional amendment, a “right to infect?"

He and others don’t comprehend that your health is my health. That I can be happily going to the hair salon and pick up the virus that kills my neighbor or my granddad. That people won’t want to go to restaurants where people ate and later died of COVID-19.

That we’re all in this together. Which is how we’ll beat it.

The Way Out

Britain’s chief medical officer recently stated he can’t see lockdown like conditions stopping until 2021.

But other places don’t have severe lockdowns. Taiwan has had six COVID-19 deaths. Korea now has case days in the single digits. They’re working, living, succeeding.

Why reinvent the wheel? Why not do what works elsewhere? And make it our own and build on it?

Here are a few things we can do right now:

Set up a National Health Crisis Center. Have it coordinate testing, tracing, tracking, and social isolation, the last so family members don’t infect each other. Publish guidelines for national tracing and tracking questionnaires. Take a tiny piece of the trillions of stimulus money and get the hundreds of thousands of tracers and trackers we’ll need paid for. Set up work for the millions of volunteers who wish to help. It’s awful feeling powerless against the virus. People want to fight back.

Then coordinate this new public health infrastructure to fight SARS-CoV-2 and future pandemics. Expect more disasters, as nations weakened by pandemics historically experience further economic and physical shocks.

Fund the international epidemiology training the Administration cut as soon as it took power, despite advice from the military that it was a very bad idea. The U.S. should not be in the back of the bus, telling everybody they’re “on their own.” We should lead. This pandemic is global, just like the supply of our food and medical equipment. If we don’t eradicate or at least control this virus anywhere, it will come back and hit us. Cooperation is not merely better than confrontation; it’s necessary for the future of everybody. This isn’t just good business, it’s survival.

Do what Bill Gates suggests and spend money on vaccine production facilities of different kinds before we know which vaccine will work. Will it waste money? Sure. Will it save lives? Perhaps millions.

Use the present pandemic to learn what works for national and international responses to our other present disaster, global climate change. This pandemic has taught us the cost of constant denial. What do you do when Miami constantly floods? When hurricanes go from routinely category 5 to 6? When the Southwest continues experiencing the worst drought in 12 centuries? How do you move to New York City?

The virus teaches us we are all vulnerable. But as Taiwan and South Korea have shown, unity builds strength.

The Declaration of Independence declares the right to life, liberty, the pursuit of happiness. Rather than a right to infect, it’s better to invoke the right to stay alive.

We do it together. We already know what happens when we don’t.