Tuesday, March 16, 2021

Right Behind You. II

Viceroy (left) vs. monarch, a famous case of adaptive evolution; the monarch, with its diet of milkweed, tastes horrible to birds; the viceroy has evolved to mimic the monarch look so the birds assume, wrongly, that it tastes bad too. In much the same way as David Brooks has learned to mimic the style of socially conscious, compassionate humanism, so that inattentive liberals will swallow his Tory authoritarianism, which they'd spit out if it was coming from Russell Kirk. Photos via Treehugger

(continuing from yesterday)

Indeed, the pandemic didn't even come from China, really, as New Yorkers ought to know:

What few people realize is that, yes, the virus originated in China, but the true focus of the epidemic that spread to the world was actually in northern Italy,” says [epidemiologist François] Balloux, who has observed the pandemic from London. “We think it happened in Asia first. But the countries that were seeded most massively, the countries that were hardest hit, were not the countries that had the most contact with China. Many of the countries that were hardest hit were the countries that had contact with northern Italy.”

Orientalism was one of the things that made it happen—the idea that it's the sort of thing that happens in countries where people eat bats, not in places like rich, clean Lombardy, and the idea that there was something hysterically authoritarian in the reactions in China itself, with the sudden massive total lockdown of Wuhan, a city of 11 million people, and also in Taiwan, Vietnam, Singapore (which shut down before the virus had even been detected there), and South Korea. 

In fact, as Wallace-Wells points out, it was extremely unusual on the part of the Chinese government to respond that way, and the West should have taken that as a sign of how serious it was (compared to the restrained response to the original SARS outbreak in 2003).

Instead, the West waited to find out how serious it was—which was too long to wait, when it takes two weeks from infection to hospitalization and another two weeks from hospitalization to death. Even where really serious lockdown measures were taken, as in North Italy itself, or New York City, they came too late (after days of Cuomo dithering as he tried to figure out how best to sabotage de Blasio), and failed to match the lockdown with adequate testing and tracing (apparently Italy's Veneto region actually succeeded in using quarantine, test, and trace to keep the virus inside a single 3000-person village and kill it there, but authorities next door in Lombardy learned nothing from the experience). And ended it, of course, under economic pressure because they'd failed to protect the population against that, too soon, in a pattern that's still repeating itself all over Europe and the Americas: wait, take half-measures, give up, rinse and repeat.

They had failed to heed the advice given by WHO's executive director for health emergencies, Mike Ryan, in a Geneva press conference almost exactly a year ago, 13 March:

When it came to this pandemic, he said, speaking in a clipped Irish lilt, the lessons were the same: “Be fast. Have no regrets. You must be the first mover. The virus will always get you if you don’t move quickly.” He continued, “If you need to be right before you move, you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. And the problem in society we have at the moment is everyone is afraid of making a mistake, everyone is afraid of the consequence of error. But the greatest error is not to move. The greatest error is to be paralyzed by the fear of failure.”

And what Vietnam and New Zealand had in common, as I was starting to say before I so rudely interrupted myself, was to recognize that, and jump on the situation. Why?

The closest Wallace-Wells comes to stating the problem, in my opinion, is in a quotation from the Harvard epidemiologist Michael Mina, a consistent advocate of assaulting the disease with constant testing, even if it means using the not-very-reliable rapid tests, a remarkably literal interpretation of Ryan's advice (being really fast and somewhat wrong is more effective than being somewhat fast but perfectly right):

“We have an enormous focus on medicine and individual biology and individual health. We have very little focus as a group of nations on prioritizing the public good. We just don’t. It’s almost taboo — I mean, it is taboo. We have physicians running the show — that’s a consistent thing, medical doctors across the western European countries, driving the decision-making.” The result, he says, has been short-sighted calculations that prioritize absolute knowledge about everything before advising or designing policy about anything....

In the East Asian and Pacific countries, they didn't wait for WHO's tardy guidance; they leapt in with what they already knew—masking, distancing, and quarantining, alongside massive testing and tracing as soon as the tests became available—and didn't look back, and didn't quit. And they didn't let doctors run the show, with their heroic focus on the individual, but public health officials:

throughout America and Europe, there has been a tendency to regard anything that didn’t offer perfect and total protection against transmission as needlessly risky behavior — outdoor exercise, socializing with masks, holiday travel with a negative test in hand. If you’re advising a single, vulnerable patient, Mina suggests, it might make sense to propose staying at home through a surge, but it’s not necessarily useful advice for everyone, and neglects to offer practical guidance for how to navigate a pandemic world in favor of an indefinite, exhausting, abstinence-only piece of quasi-propaganda. That’s not really public health, he says, it’s medicine.

And that, I think, is where we tumble into a theme that belongs at Rectification Central, and in fact with our study of David Brooks, of all things. Because one of the things that compels me about David Brooks is the way his wrongness sometimes comes so close to being right, like a viceroy butterfly to a monarch, as when he harps on the unhappy individualism of modern man, his elevation of his own interests above those of the group, and the consequent decay of social trust.

Brooks is almost on to something there, but he doesn't quite make it, in the first place because he's sentimentalizing—shedding, as Milan Kundera put it somewhere, an unearned tear; speaking from a position of privilege while pretending it doesn't exist. In fact he's talking exclusively to his comfortably-off peers, urging them to be unselfish, or more likely to congratulate themselves over how unselfish they already are, and reducing the less fortunate to pure objects of sympathy ("feeling alongside", in contrast to intersubjective empathy, "feeling into"), not really people in the full sense of the word at all. And in this way he ends up writing advertising copy for the Tory hierarchy where the best people are always in the upper ranks, helping those in the lower ranks because they're good, and the lower ranks don't really have anything to give back except taking the advice to marry early and work a boring job.

The way Mina works that distinction between medicine and public health suggests an unsentimental way of covering the territory: starting with the recognition that community actually exists (contrary to the well-known views of Baroness Thatcher), as a thing, populated no doubt with individuals, but a kind of ecological thing in its own right, in which we are all literally dependent on one another. There's nothing wrong with medicine, taking care of individuals, whose needs must be respected and rights guaranteed, but the job of public policy is to protect the whole thing, the "general welfare" as Mr. Madison knowingly called it.

One of the things I always struggled with in our Euro-American understanding of what we were experiencing with Covid was the built-in class distinction between those of us who could afford to stay home, earning our keep as well as we could in the Cloud or the ether, and the "essential workers" whose importance to society became unexpectedly evident as they made it possible for us to shelter in place, selling us groceries and wine and cooked food, and working up a similacrum (Blogger's text editor doesn't believe this is a real word, underlining it with red dots, what's up with that?) of healthcare, education, and public safety if not altogether the real thing. The exterminator and the plumber were available, masked, and the radio and television were engineered for us. Some of those people were seriously endangering their lives, and some weren't, but they were living by a different pandemic code than we were (except for geezers like me and the obese and diabetic and immunocompromised, of course), and so were those who couldn't earn their living at all, because their jobs had vanished, who Democrats have been able to help out quite a bit though not enough.

Did the successful countries in Asia and Oceania and the far north of Europe handle that differently? Were they able to move faster because they somehow started with the rules for everybody and then carved out the necessary exceptions? Or was that a kind of indirect consequence of giving the decision power to scientists rather than doctors? "Faith in science" is what the newspapers claim for Australia and Iceland, while Finland has a "long tradition of people coming together during a crisis" and a huge institutionalization of preparedness in comparison to Sweden, going back to World War II; Vietnam also evoked war, making handwashing an act of patriotism, and clear communication, and "solidarity" alongside a good deal of local autonomy. (We could also think about countries that began with rapid and decisive action but weren't quite successful in the long run—Sweden, which failed to take care of nursing home residents, and Japan, which wasn't able to build up its healthcare system enough to cope.)

Could we talk about an even broader kind of "socialism" than the one I was trying for in February, as the hard-headed and scientific recognition that we're literally, not figuratively, all in this together? Being able to understand, for example, that the health of undocumented immigrants literally, not figuratively, affects your health and mine? And making public policy accordingly? And you might even say Democrats' very integrative approach to the pandemic, under Joe Biden's leadership, is conceived that way. It's certainly fast, and big, and, even if a couple of the hundred ideas may not be great, as Mike Ryan said, no regrets!


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