Wednesday, March 09, 2022

"Incalculable" . . . Times 10

How Did This Many Deaths Become Normal?
The U.S. is nearing 1 million recorded COVID-19 deaths without the social reckoning that such a tragedy should provoke. Why?
Ed Yong, The Atlantic, March 8, 2022 (my emphasis)
The United States reported more deaths from COVID-19 last Friday than deaths from Hurricane Katrina, more on any two recent weekdays than deaths during the 9/11 terrorist attacks, more last month than deaths from flu in a bad season, and more in two years than deaths from HIV during the four decades of the AIDS epidemic. At least 953,000 Americans have died from COVID, and the true toll is likely even higher because many deaths went uncounted. COVID is now the third leading cause of death in the U.S., after only heart disease and cancer, which are both catchall terms for many distinct diseases. The sheer scale of the tragedy strains the moral imagination. On May 24, 2020, as the United States passed 100,000 recorded deaths, The New York Times filled its front page with the names of the dead, describing their loss as "incalculable." Now the nation hurtles toward a milestone of 1 million. What is 10 times incalculable?

Many countries have been pummeled by the coronavirus, but few have fared as poorly as the U.S. Its death rate surpassed that of any other large, wealthy nation—especially during the recent Omicron surge. The Biden administration placed all its bets on a vaccine-focused strategy, rather than the multilayered protections that many experts called for . . . In a study of 29 high-income countries, the U.S. experienced the largest decline in life expectancy in 2020 and, unlike much of Europe, did not bounce back in 2021. It was also the only country whose lowered life span was driven mainly by deaths among people under 60. Dying from COVID robbed each American of about a decade of life on average. As a whole, U.S. life expectancy fell by two years—the largest such decline in almost a century. Neither World War II nor any of the flu pandemics that followed it dented American longevity so badly.

Every American who died of COVID left an average of nine close relatives bereaved. Roughly 9 million people—3 percent of the population—now have a permanent hole in their world that was once filled by a parent, child, sibling, spouse, or grandparent. An estimated 149,000 children have lost a parent or caregiver. Many people were denied the familiar rituals of mourning—bedside goodbyes, in-person funerals. Others are grieving raw and recent losses, their grief trampled amid the stampede toward normal. . . .

After many of the biggest disasters in American memory, including 9/11 and Hurricane Katrina, "it felt like the world stopped," Lori Peek, a sociologist at the University of Colorado at Boulder who studies disasters, told me. . . . "900,000 deaths felt like a big threshold to me, and we didn't pause," Peek said. Why is that? Why were so many publications and politicians focused on reopenings in January and February—the fourth- and fifth-deadliest months of the pandemic? Why did the CDC issue new guidelines that allowed most Americans to dispense with indoor masking when at least 1,000 people had been dying of COVID every day for almost six straight months? . . .

To grapple with the aftermath of a disaster, there must first be an aftermath. But the coronavirus pandemic is still ongoing . . . As tragedy becomes routine, excess deaths feel less excessive. Levels of suffering that once felt like thunderclaps now resemble a metronome's clicks—the background noise against which everyday life plays. The same inexorable inuring happened a century ago: In 1920, the U.S. was hit by a fourth wave of the great flu pandemic that had begun two years earlier, but even as people died in huge numbers, "virtually no city responded," wrote John M. Barry, a historian of the 1918 flu. "People were weary of influenza, and so were public officials. Newspapers were filled with frightening news about the virus, but no one cared."

Fatalism has also been stoked by failure. Two successive administrations floundered at controlling the virus, and both ultimately shunted the responsibility for doing so onto individuals. . . .

America is accepting not only a threshold of death but also a gradient of death. Elderly people over the age of 75 are 140 times more likely to die than people in their 20s. Among vaccinated people, those who are immunocompromised account for a disproportionate share of severe illness and death. Unvaccinated people are 53 times more likely to die of COVID than vaccinated and boosted people; they're also more likely to be uninsured, have lower incomes and less education, and face eviction risk and food insecurity. Working-class people were five times more likely to die from COVID than college graduates in 2020, and in California, essential workers continued dying at disproportionately high rates even after vaccines became widely available. Within every social class and educational tier, Black, Hispanic, and Indigenous people died at higher rates than white people. If all adults had died at the same rates as college-educated white people, 71 percent fewer people of color would have perished. People of color also died at younger ages: In its first year, COVID erased 14 years of progress in narrowing the life-expectancy gap between Black and white Americans. Because death fell inequitably, so did grief: Black children were twice as likely to have lost a parent to COVID than white ones, and Indigenous children, five times as likely. Older, sicker, poorer, Blacker or browner, the people killed by COVID were treated as marginally in death as they were in life. Accepting their losses comes easily to "a society that places a hierarchy on the value of human life, which is absolutely what America is built on," Debra Furr-Holden, an epidemiologist at the Michigan State University, told me. . . .

Well before COVID, nursing homes were understaffed, disabled people were neglected, and low-income people were disconnected from health care. The U.S. also had a chronically underfunded public-health system that struggled to slow the virus's spread; packed and poorly managed "epidemic engines" such as prisons that allowed it to run rampant; an inefficient health-care system that tens of millions of Americans could not easily access and that was inundated by waves of sick patients; and a shredded social safety net that left millions of essential workers with little choice but to risk infection for income. Generations of racist policies widened the mortality gap between Black and white Americans to canyon size . . .

How much of this extra mortality will the U.S. accept? The CDC's new guidelines provide a clue. They recommend that protective measures such as indoor masking kick in once communities pass certain thresholds of cases and hospitalizations. But the health-policy experts Joshua Salomon and Alyssa Bilinski calculated that by the time communities hit the CDC's thresholds, they'd be on the path to at least three daily deaths per million, which equates to 1,000 deaths per day nationally. . . .

Even when the potential benefits are clear, there's no universal algorithm that balances the societal disruption of a policy against the number of lives saved. Instead, our attitudes about preventing death revolve around how possible it seems and how much we care. About 40,000 Americans are killed by guns every year, but instead of preventing these deaths, "we have organized ourselves around the inevitability of gun violence," Sonali Rajan of Columbia University's Teachers College said on Twitter. . . .

Stephan Lewandowsky, from the University of Bristol, presented a representative sample of Americans with two possible post-COVID futures—a "back to normal" option that emphasized economic recovery, and a "build back better" option that sought to reduce inequalities. He found that most people preferred the more progressive future—but wrongly assumed that most other people preferred a return to normal. As such, they also deemed that future more likely. This phenomenon, where people think widespread views are minority ones and vice versa, is called pluralistic ignorance. It often occurs because of active distortion by politicians and the press, Lewandowsky told me. . . . "This is problematic because over time, people tend to adjust their opinions in the direction of what they perceive as the majority," Lewandowsky told me. By wrongly assuming that everyone else wants to return to the previous status quo, we foreclose the possibility of creating something better.

No comments: