https://gusskinnerconsulting.com/ Volume 5 – Issue #87 https://www.gphsconsulting.com/
The cruise industry has long acknowledged the cumulative negative impact of illness outbreaks. COVID-19 presents a frightful situation. From a public health perspective, though, we shift from Distress to Redress and Address. Leader-SHIP is the newsletter that interweaves media articles and cruise industry responses to provide guidance on actions being taken against the novel coronavirus. It negates forces of disruption and decline with measures for steadfastness ultimately having you enhance the practice of public health in your own life and of those around you.
PLEASE NOTE THIS ISN’T A COMPLETE LISTING OF MEDIA ARTICLES BUT A SNAPSHOT ONLY.
In this Issue: - Cruise Shutdown Leaves Southeast Alaska Without Its Economic Lifeblood - Are cruise operators paying attention to the latest food trends? - Canada & New England Cruise Season Sharply Affected by Coronavirus Pandemic - Royal Caribbean will cancel all sailings through July 31 due to coronavirus - Cruise ship workers take action in defiance of company threats - After days of drifting at sea, Royal Caribbean cruise ship arrives in Jamaica with workers - America’s Patchwork Pandemic Is Fraying Even Further (Full Article)
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22 May, 2020: Cruise Shutdown Leaves Southeast Alaska Without Its Economic Lifeblood It's quiet on the docks in Ketchikan. In this Southeast Alaska town that depends on cruise ships to make ends meet, that's worrisome. Patti Mackey is the head of the Ketchikan Visitors Bureau. Any other May, she said, these docks would be abuzz. "There would be several thousand people in Ketchikan at the same time getting ready to see the town — and spend their money," Mackey said. It was supposed to be a record year. More than 1.2 million cruise passengers were projected to visit. They would have pumped $190 million into Ketchikan's economy. Those tourists would have supported numerous businesses throughout the region — from souvenir shops to jewelry stores to tour operators. Across Southeast Alaska, tourists were forecast to spend nearly $800 million this summer, supporting 8,000 jobs in a region with 70,000 full-time residents. Continue Reading…. https://www.npr.org/2020/05/19/858075536/cruise-shutdown-leaves-southeast-alaska-without-its- economic-lifeblood
22 May, 2020: Are cruise operators paying attention to the latest food trends? Paying attention to ongoing food trends can help cruise operators to ensure they’re meeting the demands of their guests, whether by considering the health, environmental, or ethical impact of the dishes they serve, or providing authentic, local culinary experiences. Food is a vital component of the tourism experience. “All travellers eat and drink,” World Food Travel Association founder and executive director Erik Wolf says. “But not all travellers visit museums, go shopping or play golf.” But what food trends can the cruise industry expect to see over the next 12 months, how might they benefit by implementing these trends, and which operators are leading the way?
In the UK, for example, 2%-3% of the population follow a vegan or vegetarian diet, while 34% of all Britons have reduced their meat consumption. However, the hospitality industry has been slow to react, with those following a plant-based diet often limited to just a few dishes when eating out. While that has been the case on many large cruise ships, various niche operators have been catering to this market for some time, offering tourists cruise experiences that are “100% aligned with their ethical lifestyle”, according to Vegan Culinary Cruises director of development Sean O’Callaghan. “Unlike major cruise lines offering minimal plant-based choices for compassionate passengers, Vegan Culinary Cruises makes the entire experience of cruising vegan-friendly,” O’Callaghan says. Continue Reading…. https://www.ship- technology.com/features/cruise-food-trends/
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22 May, 2020: Canada & New England Cruise Season Sharply Affected by Coronavirus Pandemic Ports along the U.S. East Coast and the Canadian Maritimes are reeling from a sharp drop in tourism and cruise calls, as the COVID-19 coronavirus pandemic cuts into the region's already-short season. Typically running from late April until late October, the Canada and New England cruise season kicks into high gear in the fall, when people from around the world flock to the region to witness its legendary "fall colors" as leaves change during September and October.
In past years, however, the region has worked hard to expand its cruise season. Voyages to the Maritimes are popular during the summer months, and ports like Boston, Montreal and Quebec have established themselves as popular turnaround ports for other voyages, including transatlantic crossings and explorations of the U.S. eastern seaboard. A multitude of factors are affecting the industry in the region, from cruise lines canceling sailings to regulations and local laws on both sides of the border. At stake: an economic driver that brings millions of dollars in associated revenue to cities and towns in both countries.
Atlantic Canada Ports Hit Hard Montreal and Halifax, two of Eastern Canada's largest ports of call, have been affected heavily by the loss of cruise traffic. Montreal is utilized as a port of call and turnaround port on selected itineraries, while Halifax serves as one of the primary marquee ports on the traditional weeklong Canada & New England runs from both Boston and New York.
"In a normal year, the overall economic benefit associated with the cruise industry in Halifax is about $170 million," Lane Farguson, Manager, Media Relations & Communications with the Port of Halifax told Cruise Critic. "That's overall economic benefit for Halifax and the surrounding area. With the loss of about half our cruise calls so far, it is reasonable estimate to cut that economic benefit in half. Certainly, it's a challenging time for the cruise industry and all aspects of the economy. "
"Initially, we were projecting 203 vessels carrying approximately 350,000 cruise guests from April 11 to November 3, 2020," said Farguson. "We have lost a little more than half of our scheduled cruise calls since the start of the season was announced."
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Farguson noted that the cruise industry brings about $170 million in economic benefits to Halifax and the surrounding area. With the loss of roughly half the expected cruise season so far, the Port of Halifax is estimating that that economic benefit will be similarly affected.
A similar situation is playing out in Montreal. The largest city in Quebec is a major turnaround hub for cruises along the St. Lawrence River and out into the Canadian Maritimes and beyond. "The cruise season in Montreal is hard hit, as it is everywhere else in the world," says Mélanie Nadeau, Director of Communications for the Montreal Port Authority. "At present, given that cruise ships cannot come to Canada until July 1 and given the cancellations recently announced by certain cruise lines for the entire season, 61,000 international passengers are expected to miss Montreal out of an initial total estimate of 97,000 passengers for the 2020 season." Nadeau noted that some cruise lines have yet to cancel their scheduled calls on September and October. The Montreal Port Authority is waiting to see how the decisions of local government authorities may affect these calls. Cruise calls generate approximately $30 million annually in revenue for the city of Montreal.
Border, Regulatory Challenges Much like Alaska, cruise travel on the traditional Canada & New England itinerary is complicated by a myriad of factors. Not the least of which is the Passenger Vessel Services Act, which mandates than any foreign-flagged vessel departing from and returning to a U.S. port must first stop at a 'distant foreign port'. This means that all cruise ships leaving from ports like Boston and New York must include a foreign port of call before returning. Calls on Halifax and Saint John, New Brunswick are popular choices. But with Canada closed to cruise ship travel until at least July 1 on the advice of Transport Canada, roundtrip voyages from the United States are, for now, an impossibility.
"As far as what happens after July 1, we will continue to monitor the situation and take direction from the Public Health Agency of Canada in consultation with Transport Canada regarding cruise operations at the Port of Halifax," Farguson said. "We have been working very closely with officials since the onset…to make the most of the remainder of the season. "
The U.S. Centers for Disease Control and Prevention has further issued a ban on cruises from the United States until July 24, as the result of a ruling that was issued on April 9. Any Canada & New England voyages, as the currently exist, would be unlikely to start before August.
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One glimmer of hope - however small - would be the possibility that cruise ships could perform closed- loop voyages from Canada that do not visit the United States but instead rely solely on Canadian ports of call. Royal Caribbean had planned a handful of such journeys prior to the coronavirus pandemic aboard Empress of the Seas, which is still set to depart roundtrip from Montreal this September and October to ports that include St. John's and Corner Brook, Newfoundland; Sydney, Nova Scotia; Saguenay, Quebec; and Quebec City.
Vessels departing from Canadian ports to Canadian ports are not subject to the laws of the U.S Passenger Vessel Services Act, nor directives from the U.S. CDC - - though they must answer to Transport Canada and directives from the Public Health Agency of Canada. There is also the basic issue of the border between Canada and the United States, which remains closed to all nonessential air, land and sea traffic until at least June 21. With the United States carrying a COVID-19 caseload of 1.5 million compared with Canada's 70,072 as of May 19, 2020, the border between the two countries will likely remain shut to nonessential travel for some time.
Maine: Not Ready for Cruises Along the eastern seaboard of the United States, Maine has come out among the strongest opponents of cruise ships returning this season, with Bar Harbor and Portland electing to cancel calls throughout the spring and into summer.
The port of Bar Harbor, Maine is one of the most popular ports of call on the Canada & New England run. Nestled by the sea and graced with small-town charm, fresh lobster and nearby Acadia National Park, tourists around the world flock to the quintessential maritime town.
Concerned about being inundated with cruise ship passengers potentially carrying COVID-19, Bar Harbor council moved quickly and early to cancel all cruise ship calls through the end of June, citing vocal opposition from residents. Much of council was quick to agree, though the Bangor Daily News quoted Councillor Gary Friedmann as saying that it was important to look at the big picture, noting that plenty of tourists arrive in Bar Harbor by means other than cruise ships. All cruise ship calls up to and including August 31, 2020 have since been cancelled by Maine governor Janet Mills, according to the latest Bar Harbor Port Schedule. This affects small coastal vessels as well as large-scale cruise ships.
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Maine officials have indicated that no ships carrying over 50 people this summer will be allowed to call on ports in the state. That directive won't be revisited until September. "While this statement does not entail an outright cancellation of remaining calls on the schedule for July and August, it does suggest they are unlikely to be permitted given the anticipated restrictions outlined in Maine's phased reopening," Sarah Flink, spokesperson for CruiseMaine, tells Cruise Critic. "It may be possible to see some limited return of cruises this fall, as part of the industry's phased resumption of sailing. At this point, however, it's too early to say whether all the cards will fall into place for that to happen in 2020."
Bar Harbor was expected to have 199 cruise ship calls and 299,432 passengers this year -- roughly twice what larger Portland, Maine was scheduled to welcome. Following the cancellation of all calls until September 1, the last ship on the town's 2020 cruise schedule is Silversea's Silver Whisper, currently scheduled to anchor in Frenchman Bay off the town center on Tuesday, November 3.
A 2017 report on the economic impact of the cruise industry in Bar Harbor noted that "cruise ship passengers had an estimated annual economic impact…of $20.2 million in local spending, 379 jobs (full- and part-time, and seasonal) and $5.4 million in labor income." That was in addition to the $686,472 worth of passenger fees collected by the Town of Bar Harbor in 2016. "In addition to the valuable economic impact cruisers bring during the fall "shoulder" season, cruise also brings many first-time visitors to the state, hailing from a wide geographic range across the U.S. and even internationally," says Flink. "This kind of exposure to new visitors, particularly from afar, builds Maine's profile as a world-class destination." A similar economic impact will be felt in big cities on the eastern seaboard. Boston -- which started courting cruise operators in 1986 with the opening of Cruiseport Boston and a 13-ship inaugural season -- was expecting record numbers of passengers this season following 2019, where the port welcomed over 400,000 passengers for the first time.
Cruiseport Boston was poised to have four cruise lines homeporting in Boston for the first time ever, with Celebrity Cruises joining Holland America Line, Norwegian Cruise Line and Royal Caribbean in offering voyages that depart from Boston. "The demand for cruising in New England continues to be strong and attracts visitors from all over the world", said Massport Port Director Mike Meyran in a December 2019 press release on the cruise port's season. "We are making smart investments at the Flynn Cruiseport Boston to maximize the use of the terminals and accommodate future growth in homeport and port-of- call passengers."
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Looking Ahead The enduring popularity of the Canada & New England itineraries, along with their newfound resilience to operate in months that were once considered an unthinkable shoulder season, should help ports along Eastern Canada and the United States weather the storm. But like most travel sectors impacted by the effects of the COVID-19 coronavirus pandemic, recovery could be a slow, multi-year process. "When the time is right, CruiseMaine hopes to see a strong return of cruising to our state and our region, though we all appreciate that it will take time to define and implement what is sure to be a "new normal" both on and off the ship," says CruiseMaine's Sarah Flink. "We know that the return of cruising in Maine will require a great deal of community engagement and education. Our cruise line partners know we will need their support in rebuilding the confidence of our local residents and elected officials, and we all agree that the first step in this rebuilding effort will be clarity and transparency about the new health and safety protocols once they are ready."
For the Port of Halifax, any return to operations is also contingent on the Port being able to provide the same quality service it has been providing to passengers for decades now. "While the future of 2020 is uncertain, the Halifax Port Authority understands the importance of Halifax as a marquee cruise port not only for the cruise industry but also for the greater economic contribution to Atlantic Canada," concludes Halifax's Farguson. "The return of cruise will be important to stimulating the economic recovery of the tourism and hospitality industry, and the many associated small tourism-based businesses in Atlantic Canada." "Cruise passengers can rest assured knowing they will be greeted warmly, and experience that legendary Nova Scotia hospitality that our tourism sector is built on," says Farguson. Source: https://www.cruisecritic.com/news/5358/
22 May, 2020: Royal Caribbean will cancel all sailings through July 31 due to coronavirus During a call with investors, Royal Caribbean International CEO Michael Bayley announced on Wednesday the cruise line will cancel all sailings through July 31, 2020 due to the coronavirus pandemic. Continue Reading…. https://www.royalcaribbeanblog.com/2020/05/20/royal-caribbean-will-cancel-all-sailings-through-july- 31-due-coronavirus
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22 May, 2020: Cruise ship workers take action in defiance of company threats On Friday, May 15, crew members on board the Royal Caribbean Cruise Line’s (RCCL) Majesty of the Seas staged a protest on the upper deck of the ship, demanding answers from the captain as to when they would be sent home. The protest came amidst a crisis in the cruise industry, in which some 200,000 workers worldwide have been stranded at sea as a result of the response by their employers, as well as global governments, to the coronavirus pandemic. As the WSWS reported last week, a large percentage of these crew members have now surpassed their 70th day at sea, many without pay, and some quarantined in rooms with no sunlight or fresh air and with minimal contact with the outside world.
The protest on the Majesty followed a hunger strike by crew members on board RCCL’s Navigator of the Seas beginning on May 7, in which 15 workers from Romania refused to eat until the company guaranteed their transit home. One striking worker, speaking anonymously to the Miami Herald, noted, “We started this hunger strike because someone needs to do something. […] The point is our mental health. The mental health is dropping down.”
The worker gave their statement in the context of an April 30 incident on RCCL’s Jewel of the Seas in which a crew member jumped overboard after remaining stuck on the ship since the beginning of the pandemic. Since the initial Herald report, there has been an additional crew member death from jumping overboard on the Regal Princess, one confirmed suicide on the Carnival Breeze, as well as several non-COVID-19 related deaths on other ships, which are widely suspected to have also been suicides.
Protesters on the Majesty displayed signs reading, “How many more suicides you need?” and “Do you sleep well, M. Bayley?” The latter sign refers to Michael Bayley, the CEO of RCCL, whose spokespersons in prior statements with the Miami Herald have complained of the costs of crew repatriation as being “too expensive.”
The Majesty of the Seas ship management has already taken action against these protesters. A worker currently on board reported to crew-center.com that the Majesty’s security forces telephoned individual crew cabins listing the names of the protesters to all other crew as an intimidation tactic. “It is [a] serious retaliation, and [it goes] against human rights, because all of us, like free people, have [the] right to say our opinion,” the worker explained. “We just want [the] world to hear us, because all of us want to be back home with our families.”
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Another worker onboard the Majesty spoke to the WSWS anonymously, also for fear of retaliation from RCCL. “This was a peaceful protest to express our discomfort and unhappiness with our company,” the worker said. “But here on board, courage is not a good thing—people get labeled as trouble-makers for it. If you stand out from the crowd and you are not as obedient as expected, then you’re a problem.” Gan Sungaralingum, from Mauritius, a watch specialist for the onboard shops on the stranded Island Princess, spoke to the WSWS about the conditions faced by crew members worldwide. “In this situation, everyone should be home. Most seafarers are providing for their families. At this time, they should be with their wives, and husbands, their sons, and their daughters.”
Sungaralingum continued, “Both the governments and the cruise industry are responsible for this situation. Authorities, for example, like the CDC [Centers for Disease Control and Prevention] are allowing ships to come into their waters for fuel and supplies, but few governmental agencies are coordinating a push to have their own nationals returned as soon as possible. Instead, they are only issuing guidelines to the cruise ship companies and therefore, further preventing their own citizens from going home. In response, the cruise companies find really roundabout solutions to repatriating their crew rather than complying with the guidelines and incurring expenses.”
One example of such guidelines were the ones issued by the US Coast Guard in early April, in conjunction with the CDC, forbidding travelers from cruise ships to board commercial flights. Instead, companies would be required to charter private transportation for their employees returning home, at the company’s own expense. “My girlfriend is a Japanese citizen. We were originally together on the Sky Princess, and then we were separated—they put her on the Emerald Princess after I arrived here on the Island Princess,” Sungaralingum explained. “She is now in Barbados where the ship awaits other stranded crew members, and it is estimated that she will not get home until July. Instead of spending the money to get crew direct flights home, companies are threatening crew for speaking to the press. Meanwhile, we’re mentally and emotionally drained. Just send us home.
“When the pandemic first struck in early-March, all of the borders were open. There was a period in which everybody could have been sent home safely, and inexpensively. Instead, the companies only sent workers home whose contracts were ending soon, while keeping everyone else on board. Every cruise line then reassured everybody, ‘okay, we’re working on getting you home shortly,’ until it was too late.
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“The companies have tried to cover their tracks by giving stranded crew members good food, and putting them up in nice, passenger cabins. They’re trying to blind everybody but they had already failed from the beginning.”
For nearly two months, crew members of all nationalities have experienced obstacle after obstacle to returning home. Between the companies’ blatantly irresponsible policies in regards to keeping ships staffed during the initial outbreak, the bargaining between corporations and port authorities in terms of repatriation expenses, and worldwide governments’ outright refusal to fight for the basic rights of their citizens, the situation facing ship workers is the result of the capitalist system’s failure to provide for the basic needs of the world’s population.
Speaking about the workers’ hunger strike on the Navigator of the Seas, Sungaralingum said, “A lot of people tend to resist struggle for fear of their livelihoods. But we don’t need to fear now because the world is changing. If we stay in these old ways, nothing is ever going to get better, so we need to hear everybody’s voice. People who are afraid of retaliation and not getting to work need to know that if you stay silent, we’re still all going to suffer. Everybody needs to come out in front.” Source: https://www.wsws.org/en/articles/2020/05/19/crui-m19.html
22 May, 2020: After days of drifting at sea, Royal Caribbean cruise ship arrives in Jamaica with workers Hundreds of stranded Jamaican cruise ship workers finally arrived back home Tuesday after a tense high seas standoff between Jamaica and Royal Caribbean Cruises Ltd. over how to repatriate them, and months of being trapped on board. Jamaica Prime Minister Andrew Holness announced late Monday that his government and the cruise company had finally reached an agreement over the reentry of “the largest number of Jamaicans at any one time” since the outbreak of the COVID-19 pandemic.
The plan, he said, involves a phased disembarkation over several days of the 1,044 crew members on board Royal Caribbean’s Adventure of the Seas ship to give the government time to test everyone and place people in government-mandated quarantine. “The Ministry of Health and Wellness will recreate a sterile zone around the port to conduct testing,” Holness said. “The cruise ship workers will be disembarked in groups of 200, every 48 to 72 hours and after testing, will be taken to the Grand Bahia Principe [hotel] where they will be accommodated.” Holness said the 48 to 72 hours is to allow for COVID- 19 testing results to be available. Persons who test positive for the disease caused by the novel
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coronavirus will be moved into a state quarantine facility until they recover. All others will be allowed to go home to self-quarantine for 14 days. Those at home will have to agree to cellphone tracking to ensure that they are in self isolation. They will also be required to check in via video multiple times a day while in quarantine.
The Adventure of the Seas ship was based in Fort Lauderdale’s Port Everglades before the cruise industry shut down amid the COVID-19 pandemic on March 13. Cruise companies docked their ships as quickly as possible and worked to get all passengers home. Two months later, more than 100,000 crew ship workers remain stuck at sea. The Adventure of the Seas dropped off crew members in the Dominican Republic and Haiti last week, and remained off the island’s coast before moving to Jamaica Tuesday morning. The return of the crew members has been controversial in Jamaica, where critics have said the government is not moving fast enough. In early April, the government denied entry to dozens of crew members from another cruise ship that was in Jamaican waters because of concerns about the risk of COVID-19 spread.
Holness said the government has been in talks with Royal Caribbean since April 21 on the repatriation of Jamaican ship workers. Health Minister Christopher Tufton told the Miami Herald that he has been working with Royal Caribbean to develop a safe way to manage the return of the more than 1,000 Jamaicans at once without overwhelming the health system. “What we’ve been discussing is not that we do not want to, or would not take any Jamaicans, as we believe they have a right to their country,” Tufton said. “It really has been a discussion around on the approach and protocols that would have to apply: the quarantine arrangements, testing, collecting samples. When you have large numbers it’s that much more difficult.”
On Sunday, after hearing that the Adventure of the Seas was headed toward Jamaica, Tufton issued a statement saying no formal approval had been granted for the disembarking of any individuals at any Jamaican port and the negotiations were still ongoing with the cruise line. The disembarkation of the crew, he said, had to be done with “due consideration for the required testing, the quarantine of individuals.” Jamaica currently has 520 confirmed infections of COVID-19 and nine deaths, and for the second day Tuesday, recorded no new cases while also registering its largest number of recoveries, 14, since it first confirmed the virus on March 10. The country’s approach to the reentry of cruise workers has been no different than that of the 200 or so nationals who have started to return by air, Tufton said. “There are thousands of Jamaicans in North America and in Europe and elsewhere, including those on these vessels,
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who would like to come to Jamaica and they have had to wait based on the approach and management of the COVID response here,” he said. “All of these reentries to date have been managed to mitigate against the spread, particularly if these incoming passengers are coming from countries where the virus has been fairly significant. “
The risk that cruise ships themselves present for COVID-19 spread isn’t lost on him. “The reality is the cruises do have a reputation for not being as infection free. So, the vessel itself is also a concern,” said Tufton. Cruise ships continue to experience COVID-19 outbreaks. At least 12 crew members tested positive for COVID-19 on MSC Cruises’ Preziosa ship in the Caribbean last week, and at least two tested positive on the Disney Wonder earlier this month. Jamaica’s concerns over cruise ship workers spreading the novel coronavirus is shared by other governments in the region, each of which has negotiated its own set of protocols with the cruise companies. Grenada, for example, requires that all of its returning crew be tested. It has also asked the cruise companies to underwrite the cost of quarantine, though the government acknowledged that after saying they would, the companies have reneged on doing so. In St. Vincent and the Grenadines, Prime Minister Ralph Gonsalves and Carnival Cruise Line temporarily disagreed over the terms of repatriating 92 Vincentians on the Carnival Glory earlier this month, Gonsalves told local media. He said he requested that the cruise line issue every person a rapid test as part of the government’s eight-point “Protocol for the Repatriation of Vincentian Crew Persons.” After a brief delay, the ship agreed to the terms and disembarked the crew.
Days later, when the Carnival Glory dropped crew members off in Grenada, the company complied with the testing protocol there. In both countries, all tested negative, said Carnival spokesperson Chris Chiames. “We have always complied with any local requirements or protocols related to the debark of our crew,” he said. Royal Caribbean did not respond to a request for comment about whether it will be helping to fund the quarantine for returning Jamaican crew members. In Royal Caribbean’s correspondence with Haitian authorities to get authorization to return 85 Haitian citizens last week, the company presented no evidence that workers had been tested for COVID-19. The company said that workers were healthy, had received daily temperature checks and had been quarantined for a minimum of 14 days on the ship.
While Haiti took the company’s word and let the crew return home without its mandated quarantine or evidence of a COVID-19 test, Tufton said Jamaica wouldn’t be taking any chances. “We have to ensure
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that our procedures are applied; we’re not prepared to take the word of the cruise lines, or anybody else for that matter,” he said. Jamaica, Tufton said, was told that the 46 crew members from TUI Cruises’ Marella Discovery 2 cruise ship who arrived in the country last week from Europe had all tested negative for COVID-19. Six, however, later turned up positive after Jamaica tested them and placed them in quarantine. TUI Cruises, a 50 percent Royal Caribbean joint venture, did not immediately respond to a request for comment. “Our public health system is very cautious and indeed unwilling to accept the word and even the documentation around testing of our persons being quarantined on the vessel as a basis to allow untested entry,” he said.
In the meantime, Royal Caribbean, he said, has agreed to dock the vessel for a period of time to allow the crew to disembark every couple of days. The government has acquired 400 additional rooms to isolate them at the Bahia Principe hotel in Runaway Bay. Holness said he is not insensitive to the plight and frustrations of the cruise ship workers. In addition to those being disembarked, there are 900 other Jamaicans still stuck at sea. “It is a situation that I deeply empathize with. I get the voice notes as well,” he said. Source: https://www.miamiherald.com/news/nation-world/world/americas/article242834881
22 May, 2020: America’s Patchwork Pandemic Is Fraying Even Further The coronavirus is coursing through different parts of the U.S. in different ways, making the crisis harder to predict, control, or understand.
Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here. There was supposed to be a peak. But the stark turning point, when the number of daily COVID-19 cases in the U.S. finally crested and began descending sharply, never happened. Instead, America spent much of April on a disquieting plateau, with every day bringing about 30,000 new cases and about 2,000 new deaths. The graphs were more mesa than Matterhorn—flat-topped, not sharp-peaked. Only this month has the slope started gently heading downward.
This pattern exists because different states have experienced the coronavirus pandemic in very different ways. In the most severely pummeled places, like New York and New Jersey, COVID-19 is waning. In Texas and North Carolina, it is still taking off. In Oregon and South Carolina, it is holding steady. These trends average into a national plateau, but each state’s pattern is distinct. Currently, Hawaii’s looks like a child’s
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drawing of a mountain. Minnesota’s looks like the tip of a hockey stick. Maine’s looks like a (two-humped) camel. The U.S. is dealing with a patchwork pandemic.
The patchwork is not static. Next month’s hot spots will not be the same as last month’s. The SARS-CoV- 2 coronavirus is already moving from the big coastal cities where it first made its mark into rural heartland areas that had previously gone unscathed. People who only heard about the disease secondhand through the news will start hearing about it firsthand from their family. “Nothing makes me think the suburbs will be spared—it’ll just get there more slowly,” says Ashish Jha, a public-health expert at Harvard. Meanwhile, most states have begun lifting the social-distancing restrictions that had temporarily slowed the pace of the pandemic, creating more opportunities for the virus to spread. Its potential hosts are still plentiful: Even in the biggest hot spots, most people were not infected and remain susceptible. Further outbreaks are likely, although they might not happen immediately. The virus isn’t lying in a bush, waiting to pounce on those who re-emerge from their house. It is, instead, lying within people. Its ability to jump between hosts depends on proximity, density, and mobility, and on people once again meeting, gathering, and moving. And people are: In the first week of May, 25 million more Americans ventured out of their home on any given day than over the prior six weeks. Related Stories
Our Pandemic Summer Why the Coronavirus Is So Confusing How the Pandemic Will End I spoke with two dozen experts who agreed that in the absence of a vaccine, the patchwork will continue. Cities that thought the worst had passed may be hit anew. States that had lucky escapes may find themselves less lucky. The future is uncertain, but Americans should expect neither a swift return to
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normalcy nor a unified national experience, with an initial spring wave, a summer lull, and a fall resurgence. “The talk of a second wave as if we’ve exited the first doesn’t capture what’s really happening,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. What’s happening is not one crisis, but many interconnected ones. As we shall see, it will be harder to come to terms with such a crisis. It will be harder to bring it to heel. And it will be harder to grapple with the historical legacies that have shaped today’s patchwork.
I. The Patchwork Experience A patchwork pandemic is psychologically perilous. The measures that most successfully contain the virus—testing people, tracing any contacts they might have infected, isolating them from others—all depend on “how engaged and invested the population is,” says Justin Lessler, an epidemiologist at Johns Hopkins. “If you have all the resources in the world and an antagonistic relationship with the people, you’ll fail.” Testing matters only if people agree to get tested. Tracing succeeds only if people pick up the phone. And if those fail, the measure of last resort—social distancing—works only if people agree to sacrifice some personal freedom for the good of others. Such collective actions are aided by collective experiences. What happens when that experience unravels?
“We had a strong sense of shared purpose when everything first hit,” says Danielle Allen, a political scientist at Harvard. But that communal mindset may dissipate as the virus strikes one community and spares another, and as some people hit the beaches while others are stuck at home. Patchworks of risk and response “will make it really hard for the public to get a crisp understanding of what’s happening,” Rivers says. In one future scenario, the nation splinters. When national news diverges from local reality, “suspicions about whether the epidemic was a hoax will find fertile ground in places with a more ambiguous experience of the disease,” says Martha Lincoln, a medical anthropologist at San Francisco State University. Confused people will retreat to the comfort of pre-existing ideologies. The White House’s baseless attempts to claim victory will further divide the already fragmented states of America. “In the face of medical uncertainty, people make decisions by returning to their own groups, which are very polarized,” says Elaine Hernandez, a sociologist at Indiana University Bloomington. “They’ll want to avoid being stigmatized, so they’ll follow what people in their networks are doing [even if] they don’t really want to go out.”
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Prevention is physically rewarding in the long term, but not emotionally rewarding in the short term. People who stay home won’t feel a pleasant dopamine kick from their continued health. Those who flock together will feel hugs and sunshine. The former will be tempted to join the latter. The media could heighten that temptation by offering what Lincoln calls “disparity in spectacle.” Fringe exceptions like anti- lockdown protests and packed restaurants, she says, are more dramatic and telegenic than people responsibly staying at home, and so more likely to be covered. The risk is that rare acts of incaution will seem like normal behavior.
“There’s a natural saturation point for images of health systems in crisis,” Lincoln adds, and newly overwhelmed hospitals might be ignored in favor of fresher narratives. The local media are better positioned to pick up the nuances of a patchwork story, but of the counties that had reported cases of COVID-19 by early April, 37 percent had lost their local newspaper in the past 15 years. If the virus does indeed resurge and states need to shut down again, people may not comply, because they’ll be misinformed and distrustful.
A second future is also possible. “When this outbreak began in China, everyone said, Thank God it’s not here,” Jha says. “It moved to Western Europe and people said, They have government-run health care; that won’t happen here. Then it hit New York and Seattle, and people said, It’s the coasts. At every moment, it’s more tempting to define the other who is suffering, as opposed to seeing the commonalities we all share.” But as the virus spreads, Americans may run out of others to discriminate against. “Crises are political only until they are personal,” wrote the journalist Elaina Plott, in a piece about a Louisiana woman who convinced her conservative friends to take the coronavirus seriously after her own husband fell sick. Similarly, President Donald Trump’s claims that the virus will go away on its own will ring false to supporters who know someone fighting for breath.
There are signs that this is happening. While Trump’s popularity predictably surged during the crisis, his “rally around the flag” boost was a blip compared with the prolonged peaks of other leaders. Polls have also shown that pandemic partisanship is narrowing, with Democrats and Republicans more united in how seriously they view the threat. Beth Redbird, a sociologist at Northwestern University, has been surveying 200 people a day since mid-March, and “70 to 75 percent of people support most social-distancing measures,” she says. “Those are really large numbers in a society where 52 percent is often viewed as
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huge support. We rarely see that outside of authoritarian polling. Americans are by and large reading information in a very similar way.”
Economic indicators support this view. Even in conservative states, activity plummeted before leaders closed businesses, and hasn’t rebounded since restrictions were lifted. As such, Redbird doesn’t share the widely held fear that Americans have become inured to social distancing and will refuse to suffer through it again. The bigger risk, she says, is that demoralizing bouts of shutdowns and re-openings will nix any prospect of economic recovery. “You only get to say Go out, trust me once,” she says. “They won’t believe you the second time.”
Both possible futures are confounded by three aspects of COVID-19 that make the pandemic hard to grasp, and that are amplified by the patchwork effect. First, the disease progresses slowly. It seems to take an average of four or five days, and a maximum of 14, for an infected person to show symptoms. Those symptoms can take even longer to become severe enough for a hospital stay, and longer still to turn fatal. This means that new infections can take weeks to manifest in regional statistics. May’s declining cases are the result of April’s physical distancing, and the consequences of May’s reopenings won’t be felt until June at the earliest. This long gap between actions and their consequences makes it easy to learn the wrong lessons.
Second, the pandemic is shaped by many factors. Social distancing matters, but so do testing capacity, population density, age structure, wealth, societal collectivism, and luck. Many countries that successfully controlled the coronavirus used masks; New Zealand did not. Many had decisive leaders; Hong Kong did not. It is easy to look at a patchwork and create just-so stories about why one place succumbed while another triumphed. But no single factor can explain differences across nations or regions.
Third, the disease spreads unevenly. Some cases infect no one, and others infect many. In Washington State, a choir member infected 51 fellow singers during a few hours of rehearsal. In Ghana, a worker in a fish factory infected 533 colleagues. These “super-spreader events,” which are rare but pivotal, become especially important when cases dip. They mean that an untroubled region may continue that way for some time, but that once cases start growing, they can really grow. If a state reopens and sees no immediate spike in cases, is that because it was justified, because insufficient time has passed, because other things went right, or because unlucky super-spreader events
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haven’t yet happened? In a patchwork, these questions will be asked millions of times over, and many answers will be wrong.
The COVID-19 pandemic is not a hurricane or some other disaster that will come and go, signaling an obvious moment when recovery can begin. It is not like the epidemics of fiction, which get worse until, after some medical breakthrough, they get better. It is messier, patchier, and thus harder to predict, control, or understand. “We’re in that zone that we don’t see movies made about,” says Lindsay Wiley, a professor of public-health law at American University.
II. The Patchwork Response A patchwork was inevitable, especially when a pandemic unfolds over a nation as large as the U.S. But the White House has intensified it by devolving responsibility to the states. There is some sense to that. American public health works at a local level, delivered by more than 3,000 departments that serve specific cities, counties, tribes, and states. This decentralized system is a strength: An epidemiologist in rural Minnesota knows the needs and vulnerabilities of her community better than a federal official in Washington, D.C.
But in a pandemic, the actions of 50 uncoordinated states will be less than the sum of their parts. Only the federal government has pockets deep enough to fund the extraordinary public-health effort now needed. Only it can coordinate the production of medical supplies to avoid local supply-chain choke points, and then ensure that said supplies are distributed according to need, rather than influence. Instead, Trump has repeatedly told governors to procure their own tests and medical supplies.
Michael Kilkenny of the Cabell-Huntington Health Department, in West Virginia, says his state found itself short on swabs, disinfectant, and protective equipment; unable to compete in the global market; and abandoned by the White House. “It felt terrible,” he says. “We’ve been making homemade masks, or using bleach solutions. We had to fend for ourselves.” While reporting on pandemics in the Democratic Republic of Congo in 2018, I heard health-care workers repeatedly joke that the 15th article of the country’s constitution is “Débrouillez-vous”—French for “Figure it out yourself.” It’s a droll resignation that when resources are scarce, the government won’t fix your problems, and it’s on you to make do. The U.S., a country that’s more than 400 times wealthier, has seemingly adopted “Débrouillez-vous” as national policy.
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Even health officials in well-off states aren’t comfortable with a situation in which preparedness has more to do with wealth and connections than need. “We have everything we need,” says Angela Dunn, the state epidemiologist for Utah, where Governor Gary Herbert moved quickly to buy and secure tests and supplies. “But we did it in a very capitalistic way, and that’s not the best way to deal with a pandemic.” States have tried to level the playing field on their own. Wyoming ended up with few cases but a glut of testing reagents, which it provided to Colorado and Utah when those states saw spikes, Dunn says. “There’s a small barter system, but it’s not sustainable and it doesn’t work at scale,” she says. “I don’t know if Colorado is lacking supplies. If they have a huge spike, that’ll impact Utah. It’s in our interests to make sure everyone’s protected, and without federal coordination, that’s hard to do.”
In some cases, the federal government has actively undermined the states. Charlie Baker, the Republican governor of Massachusetts, tried to buy protective equipment, but was thrice outbid by the federal government; he ended up using the New England Patriots’ jet to fly 1.2 million masks over from China, many of which turned out to be faulty. When Larry Hogan, Maryland’s Republican governor, procured 500,000 tests from South Korea, he kept them guarded in an undisclosed location so they wouldn’t be seized by the feds. This is not federalism working as intended, where different tiers of government work together. Instead of devolving control to the states, the Trump administration has ceded the U.S. to the virus.
The U.S. now heads into summer only slightly more prepared to handle the pandemic that cost it so dearly in the spring. According to the COVID Tracking Project at The Atlantic, the U.S. is now testing 366,000 people a day—a record high. But experts estimate that the country needs 500,000 to several million daily tests. Here, too, a patchwork is apparent. An analysis by NPR and Harvard’s Global Health Institute showed that in early May, only nine states were doing sufficient testing, and another 31 weren’t even halfway to their requisite threshold.
“I would have hoped for more, considering the cost of that time,” says Natalie Dean, a statistician at the University of Florida. Stay-at-home orders were necessary but ruinous, economically and emotionally. Their purpose was to buy time for the country to catch its breath, steel its hospitals, and roll out a public- health plan capable of quashing the virus. Many such plans exist. Umpteen think tanks and academics have produced their own road maps for dialing society back up. These vary in their details, but are united
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in at least having some. By contrast, the Trump administration’s guidelines for “opening up America again” are so bereft of operational specifics that they’re like a cake recipe that simply reads, “Make cake.”
The Centers for Disease Control and Prevention prepared a more detailed guide but was blocked from releasing it by the White House, according to an Associated Press report. The guidance it has released seems carefully worded to avoid the term guidelines, as if it’s “trying to fly under the radar,” Wiley says. “The abdication of federal responsibility has left states with little choice but to ease the most disruptive physical-distancing measures without the testing data that would make us more confident that cases won’t rapidly surge.” (The CDC finally and quietly released a slightly abridged version of its fuller report on Tuesday.)
The Trump administration “isn’t known for consistency of messaging, so we’ll never put our full faith in that,” says Kilkenny of West Virginia. “We pretty much ran our own state here.” At the time of this writing, only five states and the District of Columbia are still under some form of lockdown. A few, such as Alaska, Hawaii, and Montana, eased restrictions after their caseloads had fallen to low single digits. Idaho is reopening cautiously, despite being one of the less affected states.
Georgia went all in on April 24, reopening gyms, restaurants, theaters, salons, and bowling alleys at a point when it had five of the 10 counties with the highest COVID-19 death rates nationwide, and was testing just a fifth as many people as it needed to. By contrast, Utah revived businesses a week later, when it had more than enough tests for everyone with symptoms, all their contacts, high-risk groups, and even random slices of the populace. Still, Dunn, the state epidemiologist, is nervous. “If we could stick it out for even a couple more months of stricter social distancing, it would do us a world of benefit,” she says. “There are embers everywhere, and they could ignite any moment.” Some states never put their fires out at all: Texas, Alabama, Kansas, Arizona, Mississippi, North Carolina, Wisconsin, and others all reopened while cases were still rising.
“It’s inevitable that we’ll see stark increases in infections in the next weeks,” says Oscar Alleyne of the National Association of County and City Health Officials. The experiences of other countries support that view. Success stories like South Korea, China, Singapore, and Lebanon all had to renew or extend social- distancing measures to deal with new bursts of cases. And they had all restrained the virus to a much
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greater extent than the U.S., which despite having just 4 percent of the world’s population has 31 percent of its confirmed COVID-19 cases (1.5 million) and 28 percent of its confirmed deaths (92,000).
In a connected country, flare-ups that begin in reckless states can easily spread into more cautious ones. Cellphone data, for example, reveal that after Georgia businesses revved back into action, more than 60,000 extra visitors poured in from neighboring states every day. Genetic studies show the risks of such movements. By using patterns of mutations to reconstruct the pandemic’s path, researchers have shown that most of New York’s cases likely stemmed from one introduction from Europe in mid-February. Most of Louisiana’s cases arose from just a couple of introductions from within the U.S. Just a few travelers can spark substantial outbreaks in new places.
To mitigate such risks, about two dozen states have asked out-of-town arrivals to self-quarantine for 14 days. But tighter restrictions would be a logistical and legal nightmare. States can regulate what happens within their borders, but have limited powers to control travel across them. Congress could potentially do so, but it’s unclear if the courts would uphold any restrictions. The right to travel is supported by Supreme Court precedents, but in 1965, the Court ruled that said right “does not mean that areas ravaged by flood, fire or pestilence cannot be quarantined” if unlimited travel would jeopardize the safety of the nation.
Legality aside, domestic-travel bans are of limited use. Even China’s extraordinary quarantine of Wuhan merely delayed the virus from reaching other parts of the mainland by three to five days. Much like social distancing, such measures only buy time. The better strategy is not to try and prevent the virus from traveling, but to build a public-health system nimble enough to catch it when it arrives. Don’t build one big wall; instead, ready a thousand nets.
In this, the U.S. is also behind. Prevented health threats are less visible than present ones, which means that successful public-health departments tragically make the case for their own diminishment. Since 2008, underfunded local departments have lost more than 50,000 jobs. Even now, Cincinnati’s health department has furloughed 36 percent of its staff. “How can you have a system that’s meant to be at the front line of the defense while it’s losing the staff it needs?” Alleyne asks.
Some states are trying to make up for these losses by hiring battalions of contact tracers. These people will call every infected person, talk through their needs, ask for names of anyone they’ve had close or
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prolonged contact with in the past two days, and call those contacts, too. The process isn’t complicated, but it is laborious. Experts have estimated that the U.S. needs 100,000 to 300,000 contact tracers, and the nation has been slow to recruit them. Selena Simmons-Duffin of NPR reported that only North Dakota had recruited enough as of May 7, although six more states and the District of Columbia were set to.
Things are improving, though. When Danielle Allen of Harvard canvassed several mayors in mid-April, they weren’t taking contact tracing seriously. When she spoke with them again in May, “they were on top of it,” she says. “I was blown away by how much changed in three weeks.” New York State alone is planning to hire 6,000 to 17,000 contact tracers, while California is aiming for 20,000. “This really is the best tool we have to manage the pandemic until we have a safe and effective vaccine,” says Crystal Watson at the Johns Hopkins Center for Health Security.
Will this system, combined with mask wearing and hand-washing, be enough to contain a patchwork pandemic? Complicating matters, people with COVID-19 can spread the coronavirus before showing symptoms. And yet, that hasn’t fazed other countries. South Korea has been rightly praised for its success, and though one nightclub-goer recently sparked a surge of at least 168 cases, the country seems to have contained this new outbreak too. Basic public-health measures have similarly worked in countries as diverse as Iceland, Jordan, Singapore, Germany, and New Zealand. And they have suppressed epidemics of the past, from smallpox in the 19th century to Ebola in 2014. “Some silver bullet isn’t going to save us. We can save ourselves,” says Gregg Gonsalves, an epidemiologist at Yale. “We have very old-school tools that beat fucking smallpox.” But those very old-school tools must also contend with old-school problems, which are difficult to recognize, let alone beat.
III. The Patchwork Legacy The current patchwork is not random. Nor is it solely the consequence of America’s actions in 2020. It has emerged from a much older, deeper patchwork. U.S. policies that evicted Native Americans from their own lands have long left indigenous peoples with insufficient shelter, water, and resources, making them vulnerable to infectious diseases like smallpox, cholera, malaria, dysentery, and now COVID-19. Up to 40 percent of the 170,000-person Navajo (Diné) Nation have no running water; they can’t effectively wash their hands. About 30 percent have no power; they burn coal or wood for heat, resulting in irritated lungs that are vulnerable to a respiratory pandemic—a problem exacerbated by uranium mining on their lands.
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Chronic underfunding has saddled them with crowded living conditions through which the virus easily spreads, dispersed health-care facilities that are low on beds and ventilators, and high rates of chronic conditions that increase the odds of dying from COVID-19. “The lack of basic services on the reservation isn’t due to our choosing to live this way,” wrote Wahleah Johns, a Diné woman, in The New York Times. “It’s because treaties and federal policies dictate how we live.”
Thanks to traumas that accrued over generations and stressors that accrue over individual lives, the Navajo Nation has more per capita cases of COVID-19 than any U.S. state and nine times as many per capita deaths as neighboring Arizona. While Arizona has loosened its distancing restrictions, the Navajo Nation has been forced to tighten its orders.
Black Americans have fared little better. After the Civil War, white leaders deliberately kept health care away from black communities. For decades, former slave states wielded political influence to exclude black workers from the social safety net, or to ensure that the new wave of southern hospitals would avoid black communities, reject black doctors, and segregate black patients. “Federal health-care policy was designed, both implicitly and explicitly, to exclude black Americans,” wrote the journalist Jeneen Interlandi for The New York Times’ 1619 Project.
This is one reason why the U.S. still relies on employer-based insurance, which black people have always struggled to access. Such a system “was the only fit for a modernizing society that could not abide black citizens sharing in societal benefits,” wrote my colleague Vann Newkirk II. Over the past century, every move toward universal health care, and thus toward narrower racial inequities, was fiercely opposed. The Affordable Care Act, which almost halved the proportion of uninsured black Americans below the age of 65, was most strongly fought by several states with large proportions of black citizens.
Last year, when the Global Health Security Index graded every country on its pandemic preparedness, the United States had the highest overall score, 83.5. But on access to health care specifically, it scored just 25.3. (Out of 195 countries, it tied with The Gambia for 175th place.) That is at least partly the consequence of letting segregationist tenets influence the allocation of health care. “The resulting arrangement all but guarantees an inadequate national response to a national crisis,” wrote Amy Kapczynski and Gregg Gonsalves of Yale.
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In almost every state, COVID-19 disproportionately infects and kills people of color—a pattern that Ibram X. Kendi has called “a racial pandemic within the viral pandemic.” Pundits have been quick to blame poor health or unsafe choices, without considering the roots of either. Racism in policing means that many black people don’t feel safe wearing the masks that would protect their neighbors. Racism in medicine means that black patients receive poorer health-care than white ones. Racism in policy has left black neighborhoods with less healthy food and more pollution, and black bodies with higher rates of diabetes, heart disease, stress, and what the demographer Arline Geronimus calls “weathering”—poor health that results from a lifetime of discrimination and disadvantage. “When America catches a cold, black people get the flu,” says Rashawn Ray, a sociologist at the University of Maryland. “In 2020, when America catches COVID-19, black people die.”
These inequities will likely widen. Even before the pandemic, inequalities in poverty and access to health care “were concentrated in southern parts of the country, and in states that are politically red,” says Tiffany Joseph, a sociologist at Northeastern University. Not coincidentally, she says, those same states have tended to take social-distancing measures less seriously and reopen earlier. The price of those decisions will be disproportionately paid by black people.
Vulnerability to COVID-19 isn’t just about frequently discussed biological factors like being old; it’s also about infrequently discussed social ones. If people don’t have health insurance, or can afford to live only in areas with poorly funded hospitals, they cannot fight off the virus as those with more advantages can. If people work in poor-paying jobs that can’t be done remotely, have to commute by public transportation, or live in crowded homes, they cannot protect themselves from infection as those with more privilege can.
These social factors explain why the idea of “cocooning” vulnerable populations while the rest of society proceeds as normal is facile. That cocooning already exists, and it is a bug of the system, not a feature. Entire groups of people have been pushed to the fringes of society and jammed into potential hot zones. Of the 100 largest clusters of COVID-19 in the U.S., nearly all have occurred in prisons, meatpacking plants, nursing homes, and psychiatric or developmental-care facilities. (The only exceptions are a naval vessel and three power plants; the infamous Grand Princess cruise is only No. 148 on the list.)
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These places, along with homeless shelters and immigrant detention centers, are hubs for outbreaks that can easily spread to the surrounding communities. Prisons and nursing homes have staff and visitors who live in nearby towns. Large prisons, in particular, are usually situated in rural areas with small community hospitals that can be easily overrun by an outbreak. And many employees in nursing homes and meatpacking plants are immigrants who care for the nation’s elderly and process its steaks while also being cut off from health care by the Trump administration’s policies. They are both more likely to get sick, and less likely to get better.
This point cannot be overstated: The pandemic patchwork exists because the U.S. is a patchwork to its core. New outbreaks will continue to flare and fester unless the country makes a serious effort to protect its most vulnerable citizens, recognizing that their risk is the result of societal failures, not personal ones. “People say you can’t fix the U.S. health system overnight, but if we’re not fixing these underlying problems, we won’t get out of this,” says Sheila Davis of Partners in Health. “We’ll just keep getting pop- ups.”
Leaders can specifically place testing sites in poor, black, and brown communities, rather than the rich, white areas where they tend to be concentrated. New York Governor Andrew Cuomo, for example, is turning 24 churches in low-income areas into testing centers, while Maryland Governor Larry Hogan placed a testing facility in the heart of the predominantly black Prince George’s County. Officials can remove people from risky environments: Leann Bertsch, who directs the North Dakota Department of Corrections, has argued that prisoners should be freed if they are over 50, have serious illnesses, or are within two years of parole or release. A bipartisan group of 14 senators has made a similar call for decarceration.
Policies can also support people in protecting themselves. Essential workers earn low hourly wages and cannot afford to miss a shift, even if they have symptoms. “The only way to prevent them from going to work is to give them paid sick leave,” Ray says. The same goes for a minimum living wage, hazard pay, universal health care, stipends for people who are self-isolating, debt moratoriums, rent freezes, food assistance, and services to connect people with existing support. The pandemic discourse has been dominated by medical countermeasures like antibody tests (which are currently too unreliable), drugs (which are not cure-alls), and vaccines (which are almost certainly at least a year away). But social solutions like paid sick leave, which two in three low-wage workers do not have,
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can be implemented immediately. Imagine if the energy that went into debating the merits of hydroxychloroquine went into ensuring hazard pay, or if the president, instead of wondering out loud if disinfectant could be injected into the body, advocated for health care for all? “We have decades of social- science research that tells us these things work,” says Courtney Boen, a sociologist at the University of Pennsylvania. “It’s a question of political will, not scientific discovery.”
And while a vaccine will protect against only COVID-19 (if people agree to take it at all), social interventions will protect against the countless diseases that may emerge in the future, along with chronic illnesses, maternal mortality, and other causes of poor health. “This pandemic won’t be the last health crisis the U.S. faces,” Boen says. “If we want to be on better footing the next time, we want to reduce the things that put people at risk of being at risk.”
Of all the threats we know, the COVID-19 pandemic is most like a very rapid version of climate change— global in its scope, erratic in its unfolding, and unequal in its distribution. And like climate change, there is no easy fix. Our choices are to remake society or let it be remade, to smooth the patchworks old and new or let them fray even further. Source: https://www.theatlantic.com/health/archive/2020/05/patchwork-pandemic-states-reopening- inequalities/611866/
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