CommentsGELFAND’S WORLD--We have reached the point at which public evaluation of Donald Trump’s behavior vis a vis the Corona virus is now appropriate.
I will continue my practice of referring to the ever-excellent work of Kevin Drum, who has put together the timeline that compares Trump’s response to the epidemic with China’s initial response. It is painfully clear that the U.S. government could have reacted earlier and more effectively. Instead, Trump did what he has always done – he began by denying that there was a problem, then mocked those who claimed otherwise, and only much later responded at some sort of rational level. As of the middle of March, when the case load was obviously growing, he was still officially denying that there was much of a problem.
On April 11, a New York Times article by Lipton et al laid bare the ugly story – that high ranking officials in the administration had been warning of the coming catastrophe, while Trump, unsurprisingly, concentrated on his image rather than taking action. “He could have seen what was coming: Behind Trump’s failure on the virus” is the title of the NYT article.
The response to the epidemic was in keeping with pretty much every other element of the Trump presidency: There has been a nearly complete contempt for science – that is to say, for facts, data, and irrefutable conclusions – and a grasping onto politically motivated political positions that benefit his rich friends and his corporate sponsors. Thus the mocking, contemptuous rejection of the truth about global warming, not to mention his refusal to accept that his government has ever been anything but perfect in its handling of the environment, of justice, or of the law in general. This history is in keeping with his more recent handling of the Covid-19 epidemic.
The one difference is that Trump was finally put into a position where the immediate realities forced him to get along with scientific thinking and with expert medical and scientific professionals. Compare his response to global warming, where he said that he did not believe it. This didn’t cost him much politically. On the other hand, with the demonstrable risk of a severe epidemic getting out of control, there was a limit to how long he could dither.
But dither he did, as Kevin Drum’s timeline and the NYT article demonstrate. The probable result is that tens of thousands of Americans will die what would have been preventable deaths.
The one guy that Trump can’t get to for now
Dr Anthony Fauci is in the most privileged position of any appointee of the Trump era, because for Trump to fire him now would result in a political firestorm reminiscent of Nixon’s Saturday Night Massacre. Over the weekend, Fauci admitted that the U.S. government could have acted more quickly, and this would have saved lives. As the network news reported, the administration then claimed that Trump had led boldly from the start. Yeah. Right.
However, the American right wing, ever protective of the Trump image, has ginned up a call to fire Dr Fauci. CNN has been reporting how Trump actually retweeted a call to do just that. Somehow, in spite of the presidential play-acting, nothing much has changed in the Trump personality. The inner bully still emerges.
What’s happening in the real world of the epidemic? Assumptions that need to be questioned
Flattening the curve was a strategy to save lives because it would keep the number of sick people below the level that would overwhelm the medical system. The strategy has succeeded so far in reducing the load on our hospitals, but there is one critical assumption that may be incorrect. The idea was that medical care would save lives. Based on anecdotal accounts – particularly from NYC – it is not clear that ventilator assistance is actually saving very many people. Most of the Covid-19 patients who get put on ventilators don’t get off of them. There seems to be a road to recovery and a road to failure, and it is not clear that the health care system has been able to steer people towards recovery once they get on the wrong track.
Still, what with all the ad hoc medical experimentation going on, there may emerge some sort of treatment that can save a fraction of the people suffering the worst symptoms. An even better alternative would be a treatment for early cases that prevents people going down the wrong track at all.
Not a lot of talk about vaccines, although lots of companies are working on them
There is also an assumption that does not seem to be getting picked up in the popular press or the television news. The approach that has protected us from other once-fatal diseases such as smallpox, tetanus, and measles has been vaccination. If a vaccine (or several different vaccines) is proved to work, then we will have an end to the epidemic just as soon as enough doses are created. In that case, slowing down the epidemic through curve flattening is a sure method of saving lives. The problem is that (a) we don’t as yet know when we will have a vaccine that can be put into production, and (b) how long it will take to manufacture several hundred million doses.
The emergence of an effective vaccine that is administered via a widespread campaign will do two things for our nervous population: (a) it will create the beginnings of herd immunity, so the spread of the disease is curtailed substantially and (b) it will most likely protect you personally within 10 or 14 days after you get the shot.
One last assumption that is yet to be evaluated pro or con:
We have different levels and types of immunity. Everybody is familiar with the idea that exposure to some new germ (or a vaccine that mimics that germ) will eventually result in the immune system creating antibodies that (through a complex process) will ultimately result in the destruction of the invading organisms. But there are other types of immunity, including what is referred to as innate immunity. In brief, we are built in a way that resists invasion by microorganisms, and we have cells that are capable of going after some invaders even in the absence of the adaptive immune response.
It may be that a substantial number of humans (half maybe?) will resist the virus pretty well, to the extent of walking around without obvious symptoms. That is one of the concerns (nightmares?) of the medical profession, because a mobile source of Covid-19 virus particles (me and you perhaps) -- multiplied by the thousands – means that the entire population will be exposed fairly rapidly. In this scenario, we will reach that happy condition called herd immunity more rapidly, but at the cost of the rest of the population getting really sick and some of them dying. In this scenario, there will be tens of thousands of Typhoid Mary’s walking around, unaware that they have the virus, and giving it to everyone else. This may, in fact, be what has caused such a rapid increase in the case loads along both coasts.
(Bob Gelfand writes on science, culture, and politics for CityWatch. He can be reached at [email protected])
-cw
