Thursday, July 16, 2020

The Band Plays On

At the height of the AIDS epidemic in 1987, San Francisco Chronicle journalist Randy Shilts published And the Band Played On: Politics, People, and the AIDS Epidemic a book that chronicled the early spread of HIV and AIDS, highlighting the governmental indifference and apathy that allowed the epidemic to get worse. (It was made into a TV docudrama in 1993.) 

Since then, the world has experienced severe but relatively localized calamities such as SARS and Ebola. One would think the lessons from those experiences might have been taken to heart by those with political power, those with the ultimate responsibility for public health. I suspect they were in fact taken seriously by some - just not by the political party that would be in power in Washington and many states when the global coronavirus covid-19 pandemic would once again challenge government leaders to actually lead. 

Around the beginning of March, as the approaching pandemic was finally intruding into our consciousness, I mentioned at a meeting that I thought the U.S.should imitate Italy and just shut everything down. I was, of course, roundly mocked for this and was told to calm myself down. Then, within another week, we were in fact largely shut down. It was a harrowing time for many, but by May the pressure was already on to reopen everything, which largely happened in May and June, with consequences we are now experiencing.  We have all seen the graphs that highlight how at one point the U.S. and the E.U. (comparable in population size) were experiencing about the same number of cases but are way apart now, with the U.S. having the most cases in the entire world. What went wrong?

Well, obviously, had we used the lockdown period to augment our testing and tracing capabilities, and had we reopened less precipitously, and had everyone acted sensibly and observed proper precautions like wearing masks and maintaining physical distance, then our situation today might very different. Obviously, there has been a catastrophic failure of political leadership on the part of the president and his political party. In her now famous book about her uncle, Mary Trump noted that he has "never needed to acquire expertise in order to attain or retain power (which partly explains his disdain for the expertise of others)." She also suggests his inadequate response to the pandemic early on was "because of his fear of appearing weak or failing to project the message that everything was 'great,' 'beautiful,' and 'perfect.' The irony is that his failure to face the truth has inevitably led to massive failure anyway. In this case, the lives of potentially hundreds of thousands of people will be lost and the economy of the richest country in history may well be destroyed."

Obviously, leadership matters. To quote Shakespeare: if these men do not die well, it will be a black matter for the king that led them to it.

If the president had shown even modest leadership and empathy, then others, with greater skill and expertise, might have been empowered to assist him in a common endeavor, and ordinary Americans (or at least most of them) would have done whatever they would have been called upon to do. Instead, however, the failure at the top has allowed free expression to the worst elements of American exceptionalism - deplorable libertarian nonsense and a nonsensical populist denigration of science and expertise - evidenced, for example, in the widespread failure of so many to cooperate with such minimal but essential behaviors as wearing face masks whenever in proximity to others.

Even now, with cases increasing alarmingly all around us, I constantly encounter people without masks, not observing physical distance, etc. 

And the Band Plays On.

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