A grave crisis calls for reason and realism, not ‘an abundance of caution.’
Peggy Noonan March 12, 2020 7:27 pm ET
This coronavirus is new to our species—it is “novel.” It spreads more easily than the flu—“exponentially,” as we now say—and is estimated to be at least 10 times as lethal.
Testing in the U.S. has been wholly inadequate; history may come to see this as the great scandal of the epidemic. “Anybody that needs a test gets a test; they’re there, they have the tests, and the tests are beautiful,” as the president said last weekend, is on a par with “If you like your doctor you can keep your doctor” as a great, clueless lie.
Because of the general lack of testing we don’t have a firm sense of the number of the infected and the speed and geography of spread. Many people would be working sick, afraid of losing pay or job security if they take time off. Some would be at home, unable for financial or other reasons to see a doctor or go to a hospital.
In the past few days the World Health Organization declared a pandemic. The physician used by Congress reportedly said behind closed doors that 70 million to 150 million Americans will be infected. The Harvard epidemiologist Marc Lipsitch estimated 20% to 60% of adults world-wide might catch the disease. Cases are rising in Spain, France and Germany, where Prime Minister Angela Merkel warned that 70% of the nation could wind up infected. The president gave a major Oval Office address Wednesday night aimed at quelling fears; it was generally labeled “unsettling.” Immediately after, Tom Hanks announced that he and wife Rita Wilson have tested positive, and the National Basketball Association suspended its season after a player tested positive.
Health professionals and scientists have been on TV explaining what they know, and they’ve been impressive—crisply professional, helpful in conveying the contour of things. This week I spoke to a physician with a small practice on Long Island who’s dealing with problems on the ground.
He spoke of his biggest immediate challenge: Local health authorities are offering little practical information on how to handle patients or receive personal protective equipment—masks, gowns and gloves. “Regular doctors in a regular practice don’t have big numbers of these things,” he said. “The hospital sent out an email saying, ‘Go here if you’re having equipment trouble.’ So I did. And within an hour they said, ‘We can’t help you.’ ”
Illustration: David Gothard
“At this point we get an email every few days, and what they’re doing is planning a seminar on Covid-19, which is no practical help.” Doctors are already read in on the disease, they know what viruses are, they keep track of what’s happening in the larger sphere.
His biggest worry is that local hospitals aren’t ready—and aren’t readying—for a surge in patients. When he looks at the projections, he fears “health facility inundation and fatigue.” He worries that “routine life-threatening illnesses will not be treated adequately.” He means heart attacks, strokes, infections; he fears such patients won’t receive timely treatment “in overstressed systems.” The great danger to the elderly and immune-compromised is viral pneumonia. “They will need mechanical help, ventilators and ECMO machines”—oxygen pumps. “This system probably doesn’t have enough. Who is thinking about this?”
Hospitals need to “prepare to be inundated,” he says. “When I talk to doctors and administrators, they’re only thinking within their own walls and own offices. They’re not imagining being overrun.”
After we spoke, something came to mind I’d written months after 9/11. Everyone was asking how we could have missed the signs. I remembered the words of astronaut Frank Borman when he was asked in 1967 why NASA had not been prepared for the catastrophic launchpad fire that killed three astronauts. It was “a failure of imagination,” he said. No one imagined such a thing could happen on the ground.
That’s where I think we have been the past few weeks in this epidemic, a failure of imagination.
Scientists and doctors say the next few weeks are crucial, that the virus’s spread must be slowed. We have to slow it. We have to be health hawks.
Bite the bullet, close the schools a few weeks, and see where we are. Cancel celebrations. Marry, but have the wedding party later. Make the birthday bash twice as good next year. Put everything on pause. The need for social distancing may at this point make the difference between a hard time and hell. Work from home if you have a job that allows you to.
Get money to people who are now working sick. This is an emergency, that’s your job if you’re in Washington, make it work.
The most obvious advice in the world is still the most helpful. Don’t “wash your hands”; wash your hands like Lady Macbeth with obsessive-compulsive disorder. Wash your face. Carry hand sanitizers and use them after every interaction. Wear protective gloves—don’t be embarrassed. If you can’t get gloves, don’t touch keypads and screens at the bank or store without covering your finger with tissue. Try to cough or sneeze into two or three tissues. If you don’t have them, do it in the crook of your arm, as they say, but stop patting the other person’s coat sleeves affectionately when you don’t shake hands. That’s where their germs are.
Sometimes paranoia is just good sense.
Is all this an overreaction? If it is, we’ll recover. If we’re too cautious we’ll realize after a while and we’ll all get angry at the economic cost of it and have big arguments and fights. But we’ll be here to argue and fight.
I wrote in February that I believed the coronavirus will be bad, that it will have a bigger impact on America than we imagine, and that a lot of people will be exposed and a significant number endangered. I was beaten up a bit and fair enough—to make a prophecy is to summon animosity, especially when men are scared and especially when they see everything as political. My assertions were based on a long reading of history and a close reading of what had happened in China, then Italy.
Now it’s time to lose the two most famous phrases of the moment. One is “Don’t panic!” The other is “an abundance of caution.”
“Don’t panic” is what nervous, defensive people say when someone warns of coming trouble. They don’t want to hear it, so their message is “Don’t worry like a coward, be blithely unconcerned like a brave person.”
One way or another we’ve heard it a lot from administration people.
This is how I’ve experienced it:
“Captain, that appears to be an iceberg.” “Don’t panic, officer, full steam ahead.”
“Admiral, concentrating our entire fleet in one port seems tempting fate.” “We don’t need your alarmist fantasies, ensign.”
“We’re picking up increased chatter about an al Qaeda action.” “Your hand-wringing is duly noted.”
“Don’t panic,” in the current atmosphere, is a way of shutting up people who are using their imaginations as a protective tool. It’s an implication of cowardice by cowards.
As for “abundance of caution,” at this point, in a world-wide crisis, the cautions we must take aren’t abundant, they’re reasonable and realistic.
Reason and realism are good.