Observation Update: The Good, Bad and Ugly

A long month into the COVID 19 crisis has revealed the best and worst of America and Americans.
Currently the United States has more COVID infections (500,000+) and deaths (21,000+) than any other nation on earth. And, while the actual rate of infections and deaths are now questionable, infection and death are still daily events.
The pandemic has proven that our nation and our leaders were not prepared for something that was developing news as early as December 2019. Our intelligence community warned the senior administration in December. Further briefings continued throughout January 2020, expanding the scope of participants and the details of the impact of the virus. By late January, the novel coronavirus was a subject on the nightly news.
As a historian, I know that we have a great deal of information on mass illnesses, epidemics and pandemics. The United States has encountered multiple viruses in its history from its founding to the present. George Washington encountered smallpox during the Revolutionary War, and he made several important decisions to protect his troops which might have helped him win the war. During the Civil War, the majority of soldiers died from diseases from wounds not from bullets or cannons. In the late 19th century the United States encountered diseases, especially malaria, in the Caribbean during the Spanish American War, and two decades later during World War I the nation was engulfed in the Great Flu Pandemic. More recently, the nation has been involved in fighting Polio, HIV/AIDS, SARS, and Ebola.  All of these situations should serve as points of reference for the Trump Administration.
As a student of the history of science, I know that there are scientific researchers who study diseases and viruses. The scientific community has a wealth of knowledge that should be consulted. At the beginning of the 20th century the nation developed public health as a national concern. I believe that public health should be restored to the center of our health discussions.

Here is what I know:
President Trump engages in the practice of downward social comparison. He tends to blame others for things that might be his fault. While I feel that the nation has never been prepared for a large scale disaster, it was not left unprepared. The Obama Administration gave the Trump Administration a 69-page pandemic playbook during the transition. That administration had a bureaucracy in place to deal with disasters. The Trump Administration closed that office and dismantled that bureaucracy.
President Trump is not a fan of the World Health Organization nor the United Nations. He has neglected their guidelines concerning epidemics and climate change. Both topics are aligned in the spread of COVID 19. The WHO has stigma protocols that asks nations not to associate viruses with nations or geographical regions. The Trump administration has insulted the Chinese government and its people by calling COVID 19 the Wuhan Virus and the China Virus. It was so bold as to ask the G7 nations to support using that terminology in its formal literature. Given America's reliance on China for many products, including ventilators and medical equipment, that action does not seem advantageous.
Under President Trump's leadership, the federal government was slow to react. There wasn't and still isn't a national policy. Measurement of the virus and its progress was left to the WHO, CDC and non-governmental organizations. Only when it was obvious that the situation was out of control did the president create a task force, but then he refused to allow scientists to lead it. Travel bans were partly effective and Congress was hamstrung by its own factional disputes. The federal government was hesitant to enact the war powers to request manufacturers to mass produce equipment for health care workers and hospitals. The president did not request a national shelter in place policy. Social distancing is not enforced (and it is a concept that is missing at presidential press conferences where the president's team is huddled around him). It is important to point out that epidemiologists calculate that without restrictions an infected person has the potential to infect over 1,000 people in a six-week period. With quarantine restrictions and guidelines an infected person can reduce contact to less than 120 people during a six-week period.
Citizen behavior has gone unchecked. Hoarding of goods (toilet tissue, paper towels, hand sanitizer, bread, soup, water, thermometers, and Tylenol) could have been prevented by administrative policies. Additionally, gatherings supporting viral transmission from sporting events to weddings have occurred without reservation.  "Knucklehead behavior" as defined by Phil Murphy, New Jersey's governor, continues unchecked.
Testing, the type and scope, was slow to emerge and even now less than 1% of all Americans have been tested. Access to testing was questionable. First responders and the sick could not get tested, while NBA athletes, celebrities and politicians could. Despite the president's pronouncements everyone could not get a test if they wanted one!

Here is what I've learned:
Our views are formed by local policies and personal experiences. Living in the New York Tri-State area has warped my views. I know people who have had the virus and have recovered and I know people who have died. In this part of the country it is hard not to be touched by the virus on a daily basis. It is hard to watch news mediums that compare COVID 19 to the flu and suggest that it is not a threat. It was equally difficult to see college students on Florida beaches during Spring Break knowing that some of my students are fighting for their lives against this invisible plague. I also have countless friends who are unemployed or furloughed solely because of their choice of employment and governmental policy. Yet, I am grateful for the actions of Governors Murphy, Cuomo, and Lamont for confronting the challenges posed by the spread of the virus.

Within New Jersey, county governments distributed testing in different ways which led to different results. In some places there were drive-up facilities, in others people waited online, and in others people had to go to private Urgent Care Centers. Tests were evaluated by different companies. (Which means that companies were paid differently for testing) For example three friends living in the state's two most infected counties were tested in the same week. One was tested by nose swab and received his results by phone within three days. Two friends living in another county were tested by mouth and nose, but waited more than a week for their results.
Each of the fifty states has been able to pursue its own policies toward combatting the virus from purchasing equipment, setting local policies, and taking care of the sick. In the most pro-active states, there were partnerships between the government, civic organizations, charities, corporations and the public. Schools and colleges closed buildings and delivered instruction online. Corporations and charities donated supplies to the schools and some of the needy. Retail stores also went online and offered services that they didn't in the past. However, some businesses had to close and systematically placed thousands out of work. Over 16 million Americans are now unemployed.
Governors have become the most powerful people in politics. However, in the development of their COVID policies, they are pushing their states towards bankruptcy. Will the federal government, which has given away billions in a tax cut and now given away trillions in COVID bills have to produce additional COVID bills be able to bail out the states? Perhaps this is the major reason why President Trump needs to re-open the economy!

What history suggests:
There is no tax money coming into the state and federal governments. President Trump needs to consider a New Deal type of recovery. Our economy has experienced a downturn that many thought unimaginable. It is akin to a depression. This is not a simple issue that can be changed with full employment. Many doubt that the economy will come roaring back when the virus is held in check, and that opening the nation is more than saving the economy. This is a public health issue, a mental health issue, and a consumer confidence issue.  Consumers will have to spend tremendous amounts to make up for lost revenues. But everyone has lost a part of their savings and financial resources. They will be anxious about spending so quickly. People are also grieving in a variety of ways and going back to work is not going to resolve those psychological problems. Adults will respond differently than children. 9/11 may serve as a good reminder of the signs of human behavior. People may be afraid to go on vacation or get on planes or cruise ships. Children may not readily want to go back to school, college students may not be able to afford to return to school, and state governments may not have the finances to support public education and institutions.
Most public health experts believe that President Trump should not try to open the country before September. National recovery, they calculate, will probably take 18 to 24 months. And that is important because most viruses have more than one wave or phase. If what people are defining as the first wave will take place in April, when will we see the next wave? What do our predictive models suggest about the rates of infection at the end of that period? Our current type of testing has only produced positive and negative results. People who have survived the virus may have the antibodies that may help them in the future. When will antibody testing occur? What is the percentage of people who have those antibodies? What is the length of their immunity? Will it be weeks, months or a year?
Critics have noted that immigrant communities and communities of color are harder hit than more affluent communities. In urban centers, especially in New York City, Newark, Chicago, Philadelphia and New Orleans, statistics highlight race, employment, and density as key factors in rates of infection.  Outside of physicians, police, and firefighters, for example, 70% of New York City's first responders and municipal workers are people of color.  As a result, in cities that mirror New York, African Americans and Latino communities have greater rates of infection and death. In more rural areas, where there are small or no medical facilities, once someone becomes infected the rate of infection spreads. The absence of quality health care increases mortality rates. Similarly, Native American communities have also been hard hit. Tribal lands, often poverty ridden, are experiencing high rates of infection. Major sources of revenue, like casinos, have been closed.
In times where there are financial stressors and general anxieties, classism and racism usually increase. There are two major types of racial aggression occurring on a national level. One is the scapegoating of Asian Americas as the cause for the virus and the social and economic disruptions. The other is the abuse of African American and Latino workers as a disposable service class during the pandemic. Both cases are escalating and have led to an increase of hate crimes.  Over 100 crimes have been reported weekly since the declaration of the pandemic.
A third type is the further criminalization of people of color where they are seen as potential threats to middle class white Americans. This has been used as a reason for the closing of Chinese restaurants, and an increase of handguns and firearm sales. History informs us that American society will continue to mistreat and disrespect people of color in terms of medical care and place the burden of the societal ills on them.

In conclusion, COVID 19 calls for further action. It demands a national policy that does more to support local governments and address the needs of working classes and people of color. A priority needs to include widespread testing and more equipment for healthcare workers. The virus also raises the need for future planning. There is a need for national public health reform, medical reform and health insurance for all. President Trump still has time to respond. However, he is running out of time. His reactions need to be articulate and well-defined. They should not be tied to politics or the stock market but rather to the basic needs of a nation at risk.

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