Politicizing the Novel Coronavirus

In late January, I started following the novel coronavirus on twitter. I have a bit of a twitter obsession, you see, and the information coming out of China was gripping. I followed news coming out of cities locked down across the country. I found virologists and epidemiologists to follow, and read analyses of the disease fatality rate. I saw references to the 2003 SARS epidemic, which I remembered only vaguely, so I went on a research spree. (I read a lot about u-traps.) I pulled out an old book I’d read years ago, on the flu pandemic of 1918.

I watched as the Princess Diamond cruise ship, with 3,700 people on board, was quarantined off of Yokohama, Japan. I followed hashtags as the number of confirmed cases onboard grew day by day, first in a trickle and then by sudden dozens. I watched as experts declared the quarantine a colossal failure. Some said we should learn from the Princess Diamond—that no quarantine should ever again be attempted on a ship.

I watched as two deaths in northern Italy, seemingly out of the blue, led to shutdowns across the region as authorities began testing residents on a massive scale, quickly finding hundreds and then thousands of confirmed cases. I watched as the death tole grew from two to nine to seventeen, and then higher. I watched as all schools in Japan were announced closed for a month, and as South Korea went on overdrive after an outbreak was discovered at an enormous megachurch, with ballooning case totals.

I want to be clear, though, about what this wasn’t.

First, I wasn’t panicking. I followed enough experts to know that the fatality rate of the disease was perhaps 2%—with a big emphasis on that perhaps—and that this is 20 times higher than the fatality rate of the flu. I also knew that the fatality rate was higher for the elderly—nearly 15% for those over 80—as well as for the immunocompromised. I knew that as many as 20% of those infected need treatment in the hospital, and that some smaller percentage need to be put on ventilators. I knew, too, how easy it is for health systems to become overwhelmed, as happened in Wuhan, China, and that this could push fatality numbers up.

Second, this wasn’t political. I started following the novel coronavirus when it was mostly limited to China. I was interested in the same way I am any time I feel I’m watching history take place, and history clearly was. I have an interest in epidemics, and in social responses to disasters. This was not about Trump.

We have reached a moment, today, when the Right is claiming the Left is politicizing the novel coronavirus, and that allegation is making me—frankly—angry.

I followed the novel coronavirus since January, and I can pinpoint the exact moment this became at all political for me. It was last Monday, February 24th, when Donald Trump posted the following tweet:

The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!

— Donald J. Trump (@realDonaldTrump) February 24, 2020

This tweet concerned me, because I had been following the progress of the novel coronavirus for weeks and I knew this was not true.

Trump sent this tweet just days after a number people died of coronavirus in northern Italy. When authorities there began testing on a larger scale, they quickly found that these deaths were only the tip of a much larger iceberg. As reporters in the United States covered this development, they increasingly noticed how little the U.S. was testing for the coronavirus. The experts I followed became increasingly worried, arguing that we likely had clusters waiting to appear, like that in northern Italy.

That was the moment Trump sent out his “the coronavirus is very much under control” tweet. I had just learned more about how little the U.S. was testing, I had just seen what happened in northern Italy, and I knew, based on all of this, that Trump had no way to actually know whether things were under control in the U.S.

I realized then that we might have a very, very big problem. I had seen China’s suppression of information and had shared the concern that we might not be able to trust their numbers. I had seen, in contrast, how transparently countries like Singapore handled the outbreak. I could see how important providing the public with speedy, comprehensive information was to quelling panic and building trust. I suddenly worried, on seeing Trump’s tweet, that we might be a China rather than a Singapore. In his tweet, Trump seemed to care primarily about the stock market. I recalled allegations that federal weather agencies were once pressured into covering for Trump when he made a mistake in stating the path of a hurricane.

Was this an example of me “politicizing” the outbreak? Maybe, but I don’t think so.

I would have been very concerned had any politician announced, that day, that everything was a-okay. I don’t want people to die from the coronavirus. I have grandparents who are both over 80 and diabetic, two factors that increase the risk of fatality from the coronavirus. I have elderly great-aunts, neighbors who are immunocompromised, and numbers family members who work in the healthcare industry. I also didn’t start following the novel coronavirus outbreak out of a desire to “own” Trump. I started following it because I was genuinely interested, and because I like to spend time reading about things on twitter.

Last Friday, Trump said the following at a rally in South Carolina:

Now the Democrats are politicizing the coronavirus. You know that, right? Coronavirus. They’re politicizing it. We did one of the great jobs. You say, ‘How’s President Trump doing?’ They go, ‘Oh, not good, not good.’ They have no clue. They don’t have any clue. They can’t even count their votes in Iowa, they can’t even count. No they can’t. They can’t count their votes.

One of my people came up to me and said, ‘Mr. President, they tried to beat you on Russia, Russia, Russia. That didn’t work out too well. They couldn’t do it. They tried the impeachment hoax. That was on a perfect conversation. They tried anything, they tried it over and over, they’ve been doing it since you got in. It’s all turning, they lost, it’s all turning. Think of it. Think of it. And this is their new hoax. But you know, we did something that’s been pretty amazing.

Trump stated that there were only 15 cases of coronavirus in the United States, and that there would have been more if he hadn’t acted early, imposing travel restrictions.

He then added this:

So a number that nobody heard of that I heard of recently and I was shocked to hear it, 35,000 people on average die each year from the flu. Did anyone know that? 35,000. That’s a lot of people. It could go to 100,000, it could be 27,000, they say usually a minimum of 27, it goes up to 100,000 people a year who die, and so far we have lost nobody to coronavirus in the United States. Nobody. And it doesn’t mean we won’t, and we are totally prepared, it doesn’t mean we won’t. But think of it. You hear 35 and 40,000 people, and we’ve lost nobody, and you wonder, the press is in hysteria mode.

Let’s run these numbers, shall we?

We lose 35,000 people on average from the flu. The novel coronavirus is 20 times more deadly than the flu. What’s 35,000 times 20? The answer is 700,000 people. But wait! Because we have the flu vaccine, and because some people have natural immunities, only one in ten people get the flu each year. We don’t have a vaccine or natural immunities for the novel coronavirus. So we actually need to multiply that number by 10. That’s 7 million fatalities, if everyone in the country gets the novel coronavirus.

Now, it’s unlikely that everyone would come down with the novel coronavirus even if containment completely fails. It’s also possible that that 2% fatality figure is high, and that the actual fatality rate is lower. It’s also the case, of course, that this many more hospital admissions, on top of all of our regular hospital admissions, would severely strain our healthcare system, and might result in those who need care for other conditions going untreated.

I don’t know how many fatalities there would actually be if we dropped all efforts at containment. I just know that the answer is high enough that we should be working very, very hard to maintain that containment.

The fact that the president doesn’t understand how these numbers work is severely concerning. It would be severely concerning no matter what party he was in. This isn’t about politics. It’s about public health. I just wish Trump realized that, because frankly, he’s the one who’s treating it like it’s political. (And perhaps that’s not surprising.)

Since Trump’s comments, at least six people have died of the coronavirus in the U.S., most of them residents of a nursing home in Washington state. Meanwhile, new cases have been discovered in California, Oregon, Washington, Massachusetts, Rhode Island, New York, Georgia, Florida, and Illinois. This includes cases that appear to be the result of community transmission, meaning that there are more undetected cases out there. Trump was wrong about everything being fine, and wrong about the U.S. having things under control. But if there’s one thing Trump never does, it’s admit that he was wrong.

Remember Trump’s comments at Friday’s rally? Comments like those have consequences. I’ll show you an example of these consequences that I noticed recently on twitter. But first, some background.

A twitter user shared a story written by someone named Alex, who says they arrived in the U.S. from Japan, which is severely affected with the novel coronavirus, three days ago, and started having symptoms—a fever, a cough, and aches. Alex went to the ER, and tests for flu and other conditions came back negative. The doctor contacted the CDC asking to test for the novel coronavirus, and was told that Alex did not meet the criteria for testing because Alex did not also have shortness of breath. The CDC said to send Alex home with a clean bill of health. Alex’s doctor was not satisfied with this, and told Alex to complete a voluntary 14-day quarantine.

Stories like this have been cropping up all over the country for weeks now. The CDC did finally change its testing criteria last week—before then you could only be tested if you traveled to China or had contact with someone confirmed to have the novel coronavirus, even as it became clear that the virus had spread beyond China. (Heck, some of the earliest cases in Germany and the United Kingdom were individuals infected in Singapore. These individuals would not have been tested in the U.S., under the CDC criteria.) And posts like Alex’s make it clear that even the CDC’s revised testing criteria is not enough.

One twitter user responded to Alex’s story with this comment:

Literally it’s the flu, these people are looking for any reason to flip out and make something political. Even if this person had coronavirus they aren’t at any major risk as they aren’t elderly or a child, so misinformed it’s wild.

I don’t know anything about this user, or whether they’re a supporter of Donald Trump, but this is just one example—I’m seeing comments like this all over twitter. Trump has convinced some portion of the public that the novel coronavirus is no big deal, and that anyone who is genuinely concerned about the virus is just someone who is out to “own” Trump. On another thread, one twitter user, fed up, wrote as follows: “Criticizing media coverage of a potential pandemic to own the libs. 2020 is crazy y’all.”

Detection of cases like Alex’s is important because even people who aren’t at major risk of dying from the novel coronavirus can infect others who are. This is why everyone should get a flu vaccine every year, even if they’re young and healthy—in any given flu season, slowing the spread and prevalence of the flu will save the lives of elderly and immunocompromised people who would have died from it had they caught it. This is also why it’s so important for Trump not to downplay the severity of the novel coronavirus.

The thing I find oddest about all the claims that those concerned about the spread of the novel coronavirus are just out there to “own” Trump is that I don’t even know that Trump is necessarily the primary cause of what’s gone wrong here. Frankly, I’m more concerned about figuring out what went wrong and how to fix it than I am about finding a single person to blame for it. (Most things are not single person problems.)

I don’t know how much of the problems with the CDC’s testing protocol had to do with the CDC being defunded—Trump fired our entire pandemic response team in 2018, and didn’t replace them—and how much has to do with red tape. Part of the problem in testing, early on, had to do with a double bind between CDC rules and FDA rules that effectively prevented states from doing any testing at all. I don’t know who created this red tape and these rules, but I doubt it was Republicans acting alone.

I’ve wondered why local authorities haven’t done more, or acted more quickly—if the CDC is immobile, couldn’t they just act on their own? I think it’s entirely possible, though, that there are federal rules and regulations that have prevented states from taking innovative action on their own. That certainly was the case with the test kits, where a double bind between the CDC and the FDA left states simultaneously unable to obtain tests from the CDC and unable to develop their own. It’s also the case that the CDC at one point sent out faulty test kits. I have no idea who is at fault for that—was it due to defunding, or to some other factor?

Something has gone badly wrong in our pandemic response system, and I don’t know exactly what it is (it’s probably multiple factors). I want answers not because I want to “own” Trump, but because I genuinely want answers! This isn’t the apocalypse virus, but what if it was? If nothing else, this disease is revealing that we are not ready. I don’t for a minute think that’s all Trump’s fault. Some of it, sure. But not all of it.

I’m less interested in assigning blame than I am in finding fixes. Did I mention that I have grandparents who are both in their eighties and have diabetes? And elderly great-aunts, and immunocompromised neighbors, and family members who work medical fields—the kind who will be first responders?

Seeing images like this concerns me:

This picture, taken at an infected nursing home in Washington state, does not show people using proper personal protection equipment. I’m also reading that they’re keeping the residents in the nursing home, even if they’re sick, and only taking them to the hospital if they become critical. I’m not sure whether or not this is true, but the absolute failure to wear protective gear displayed in the image above does not create confidence.

In South Korea, residents get an alert if someone who lives within a certain radius of them is confirmed to have the coronavirus, and a rundown of everywhere this person has been in the past three days. They close all of those places to disinfect them. In the alert, they ask all residents who have been to one of those places to come in for testing. We do not have a system that does anything like this at all. Instead, in some parts of the country officials are hiding even such simple information as simple as where newly confirmed cases lived.

I’ve seen it suggested that U.S. authorities may be bound by privacy laws that prevent this level of transparency in public information. It’s certainly possible, and that possibility is just one more reason I think we need a thorough assessment of everything that has gone wrong here. It may be that our HIPAA laws need revising, to allow greater flexibility during pandemics or other public health emergencies.

Via twitter and a variety of medical experts, I have spent the past month following the procedures put in place in China, in South Korea, in Singapore. What authorities have done here so far falls far short of these measures. And I’m not just talking about measures put in places in dictatorships like China. I’m also talking about measures put in place in other countries with western-style governments, like South Korea, Singapore, and Italy. I don’t know why our response looks so different, but it does, and that worries me.

Because it bears repeating, I have grandparents who are both in their eighties and have diabetes; elderly great-aunts; neighbors who are immunocompromised; and numerous family members who work on the frontlines of our healthcare system. I want Trump to get this right. Do you think I want my grandparents to die? God no! I want our agencies to work properly! And right now, I don’t have a lot of confidence in what I’m seeing.

When Trump looks at all of this and responds by insisting that we are winning, winning, winning, and that anyone complaining about his perfect response is perpetrating a hoax, I feel sick inside. I don’t care what party he’s from. I simply want him to care more about being competent than about looking competent.

My heart goes out to those who have already lost their parents and grandparents at the Life Care Center in Kirkland, Washington—and to those whose parents and grandparents are currently fighting for their lives. Losing a grandparent—or a parent—is never easy. You are in my thoughts, and will stay there.

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