With each passing day it becomes more obvious how unlucky we are that one of the worst crises in American history coincides with Donald Trump’s presidency. To get out of this crisis with the least loss of life and least damage to our economy, we need a president who can steer a science-based, nonpartisan debate through the hellish ethical, economic and environmental trade-offs we have to make.
We need a president who is a cross between F.D.R., Justice Brandeis and Jonas Salk. We got a president who is a cross between Dr. Phil, Dr. Strangelove and Dr. Seuss.
Sure, Trump isn’t the only one sowing division in our society, but as president he has a megaphone like no one else, so when he spews his politics of division, and suggests disinfectants as cures, he is not only eroding our society’s physical immunity to the coronavirus but also eroding what futurist Marina Gorbis calls our “cognitive immunity” — our ability to filter out science from quackery and facts from fabrications.
As a result, the Trump daily briefing has itself become a public health hazard.
If we don’t have a president who can harmonize our need to protect ourselves from the coronavirus and our need to get back to work — as well as harmonize our need to protect the planet’s ecosystems and our need for economic growth — we are doomed.
Because this virus was actually triggered by our polarization from the natural world. And it will destroy us — physically and economically — if we stay locked in a polarized, binary argument about lives versus livelihoods.
Here is why: When you listen to Trump, one of his consistent themes is that everything was just “perfect” with our economy until — out of nowhere — this black swan, called Covid-19, showed up from China and wrecked it all. It’s true, this virus did come out of Wuhan, China, but it was anything but a black swan that no one could have expected. It was actually “a black elephant.”
The term “black elephant” was coined by environmentalist Adam Sweidan. It’s a cross between “a black swan” — an unlikely, unexpected event with enormous ramifications — and the “elephant in the room” — a looming disaster that is visible to everyone, yet no one wants to address.
Covid-19 was a black elephant. It is the logical outcome of our increasingly destructive wars against nature.
As Johan Rockström, chief scientist at Conservation International, explains: “When you simultaneously hunt for wildlife and push development into natural ecosystems — destroying natural habitats — the natural balance of species collapses due to loss of top predators and other iconic species, leading to an abundance of more generalized species adapted to live in human dominated habitats. These are rats, bats and some primates — which together host 75 percent of all known zoonotic viruses to date, and who can survive and multiply in destroyed human dominated habitats.”
As we humans have become more numerous and concentrated in cities, and as deforestation has brought these generalized species closer to us — and as countries like China, Vietnam and others in central Africa tolerated wet markets where these virus-laden species were mixed with domesticated meats — we’re seeing ever more zoonotic diseases spreading from animals to people. Their names are SARS, MERS, Ebola, bird flu, and swine flu — and Covid-19.
China, in particular, has a lot to answer for. It banned wet markets in one province after SARS in 2003, but then allowed them to reopen after SARS passed — and that apparently brought us Covid-19 out of Wuhan. (Shamefully, China reportedly still has not shut down wet markets selling wildlife.)
Add globalization to this and you have the perfect ingredients for more pandemics. We need to find a much more harmonious balance between economic growth and our ecosystems.
The same kind of harmonic approach has to be brought to our current debate about reopening the economy. One way to get there was proposed by Graham Allison, a national security expert at Harvard.
Allison wrote that we’re having this important debate about our health and economic future in an incredibly uncoordinated way. Instead, we should have federal government experts on one team offering their approach — and a Team B of independent medical, economic, public health, data and strategic analysts offering an alternative approach. And then go for the best synthesis.
For instance, Allison observed: “If we concluded that an identified group of a quarter of the population face an unacceptable risk of death from coronavirus, but that for the other 75 percent, with appropriate precautions like social distancing and masks, face no greater risk than other risks of death we accepted before coronavirus, would it be possible to design a response that protected the most vulnerable while simultaneously reopening most of the economy for others?”
Five weeks later — and fresh off three days as a volunteer emergency room doctor in the Bronx — Katz still believes that is possible. He explained to me why, starting with what he found in the emergency ward.
“You might think that health professionals are at one extreme of opinion, concerned only about the virus and favoring locking everything down, but that was not the view I encountered,” said Katz. “The view was far more centrist: respect for the infection, but equal respect for the high cost of closing down everything — to their patients, of course, but also to themselves and their families. Many were acutely concerned about layoffs, unemployment, and real desperation affecting siblings or close friends.”
That is why, Katz insists, we have to avoid minimizing the degree to which mass unemployment, poverty, hunger and despair will devastate people if the economy remains virtually shut down. At the same time, we can’t just submit to protesters demanding their governors open everything back up indiscriminately, without data or a comprehensive health strategy,
“The moment you stop respecting this virus, it will kill someone you love,” he said.
The best strategy, argues Katz, starts with what the numbers are telling us: “More and more data are telling us that Covid-19 is two completely different diseases in different populations. It is severe and potentially lethal to the old, the chronically ill and those with pre-existing conditions. It is, however, rarely life-threatening, often mild — and often even asymptomatic — among those under 50 or 60 in generally good health.”
While we still don’t yet have a perfect understanding of how the virus works — and we need to corroborate the patterns we’re seeing through more random sampling of the U.S. population both for infection and immunity — if these patterns are confirmed, then the proper strategy, argued Katz, is one of “total harm minimization” that saves the most lives and health through “vertical interdiction.”
“That means sheltering the vulnerable, while allowing those who can return to the world most safely to do so — thereby restoring the economy, supply chains, and services, while cultivating the collective protection of herd immunity that leads to the ‘all clear,’” said Katz. “That’s how we get our lives back without waiting on the long and uncertain timeline of vaccine development.”
Of course, we’ll need an army of public health workers to keep doing testing and contact tracing so we can adapt to new data, limit breakouts and protect those most likely to die or be badly harmed from Covid-19.
The bottom line is that Mother Nature has been telling us something huge in this crisis: “You let everything get out of balance and go to extremes. You ravaged my ecosystems and unleashed this virus. You let political extremism ravage your body politic. You need to get back into balance, and that starts with using the immune system that I endowed you with.”
Herd immunity, which kicks in after about 60 percent of the population is exposed to and recovers from the virus, concluded Katz, “has historically been nature’s way of ending pandemics. We need to bend with her forces, while concentrating our health services and social services on protecting those most vulnerable who need to stay sheltered until there is a vaccine.”