Saturday, January 29, 2022

Plague notes

Miniature by Pierart dou Tielt illustrating the Tractatus quartus by Gilles li Muisit (Tournai, c. 1353). The people of Tournai bury victims of the Black Death. Wikimedia Commons.

That obnoxious David Leonhardt bothsidesery in The New York Times

Millions of Republican voters have decided that downplaying Covid is core to their identity as conservatives, even as their skepticism of vaccines means that the virus is killing many more Republicans than Democrats.

Millions of Democrats have decided that organizing their lives around Covid is core to their identity as progressives, even as pandemic isolation and disruption are fueling mental-health problems, drug overdoses, violent crime, rising blood pressure, and growing educational inequality. As David Hogg, a gun-control activist, tweeted last year, “The inconvenience of having to wear a mask is more than worth it to have people not think I’m a conservative.”

is pretty obnoxious indeed. 

Insisting that everybody in the car wear a seatbelt, even in the back seat, even when you're only driving a mile to the mall and seatbelts are uncomfortable, may be irrational, though I don't think it is, but it is not the same kind of irrationality as refusing to wear one and attempting to make seat belt requirements illegal. Overstating the danger of falling victim to a pandemic disease that has actually killed close to a million fellow citizens and is currently killing 2,500 Americans per day (it hit almost 4,000 day before yesterday), if anybody is overstating it, is not the same as denying that there's any danger at all worth worrying about and working to outlaw public health measures designed to slow it down. 

And with all respect to David Hogg, who turns 22 in April, most of us are who are wearing masks at the moment don't think of it as part of our personal branding strategy. I really don't think he does either, though I know enough Instagram-era kids to understand it is a thing. I think, like the rest of us, he's mainly focused on staying outside of the chain of transmission of this horrifyingly contagious virus, which almost certainly won't kill him but might well kill somebody else through him, whether it's some old idiot vaccine refuser or an innocent toddler (280 kids under 5 have died of Covid in the US since the pandemic began, which is not a small number if one of them is your kid), or somebody through that toddler, like her annoying Trumpy vaccine-refusing grandfather, who doesn't deserve to die just because he's an idiot.

Does Leonhardt know what kinds of mental health problems are cropping up in the pandemic? His HHS link doesn't work, but I think it was meant to be this:

The pandemic confronted children, adolescents, and young adults with unprecedented challenges and trauma, disrupting major elements of their daily lives. Since the pandemic began, symptoms of anxiety, depression, and other mental health concerns have increased exit disclaimer icon among young people. And, tragically, it is estimated that more than 140,000 children exit disclaimer icon in the U.S. had lost a parent or grandparent caregiver to COVID-19 as of June 2021.

My bold. Nobody's saying the learning loss and delayed socialization and worse things aren't bad! In other news, medicine often tastes really lousy, and also recovering from surgery, or a broken leg, or a stroke, is no picnic. Should we keep kids from cancer treatments that require long hospital stays, on the grounds that it might lead to depression, or poorly developed social skills? We don't think about it! We treat the cancer and try to catch up afterwards!

It's not nice that pandemics have awful consequences, even beyond the basics of killing some large proportion of your population and disrupting your economy, affecting high blood pressure and suicide rates. Even David Brooks understood, when he warned us back in May 2020, pandemics are going to hard, for everybody:

Above all, endurance is living with uncertainty. Sometimes, it’s remaining quiet in the face of uncertainty because no conjecture will really tell you what is coming. Endurance is the knowledge that the only way out is through and whatever must be borne will be borne.

The best advice back then was on ways of getting through it quickly: with test-trace-isolate programs, school closures, lockdowns, flattening the curve, as we said, while scientists develop the vaccine. But in particular in the US we were never really able to follow through on anything before the vaccine actually arrived—we kept  saying "Well, it's basically over," and giving up at whatever it was:

It was the school closures that lasted the longest—not so much, by the way, because of the ruthless and omnipotent teachers' unions, as because of parents, and particularly lower-income parents and people of color who resisted sending their kids back, as in this survey from March 2021:

Across the country, about 41% of parents said they want their child to participate only in distance learning under the current Covid-19 conditions, while 35% prefer fully in-person instruction and 21% would like a hybrid model that combines both in-person school with online classes, according to a nationally representative survey of parents by the USC Center for Economic and Social Research conducted from Jan. 20-Feb. 17.

What’s more, there’s a wide difference of opinion among parents of different racial, ethnic and socioeconomic backgrounds. About 46% of white parents nationwide said they wanted in-person school, compared with 14% of Black and 29% of Latino parents. Higher-income parents were also more likely to say they wanted their kids to be back on campus compared with those earning less.

In California, recently ground zero for the pandemic in the U.S., parents are more reluctant to have their children return to the classroom. Only 14% of parents wanted in-person classes compared to 65% of parents who prefer remote-only instruction under current conditions, according to the same USC survey. Out of 1,330 adults who responded to the question, 455 were from California and demographics reflected the state’s overall population.

Not, I think, that they had no concerns about their kids' mental health, but that they did have genuine fear over community spread, above all in communities that had been hit especially hard already, already vulnerable from conditions like asthma and diabetes, many in multigenerational households, and many, as the vaccine rollout began, in neighborhoods where it was hard to find and short of time to get it done in. They may have been wrong, as Leonhardt thinks, to worry less about the mental health issue than these matters, but they weren't being irrational.

In any case it seems to me what's really been bad for children is the continual backtracking—opening schools just a bit too early and shutting them down again, and constantly disrupting the routine every time there's another outbreak. Much wider availability of tests, like they had in South Korea or Germany from very early on, would have made a huge difference, but no effort at all was made on that in the US until very recently, and in places like Florida the authorities are still fighting it, for Trumpy reasons.

The original wrong decisions were the ones made 2020; if school districts had stood tougher then there'd be no reason to talk about shutting schools now. Now we're living with the consequences of irrationality on the other side.

Meanwhile, it's not like anybody is still threatening school closures, and Leonhardt shouldn't be encouraging those who imagine otherwise. That's irrational too:

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