The United States faces three big challenges in dealing with this crisis as compared to other nations. We are polarized, we are decentralized, and we are vast.
Vast is not going to change. Decentralized is not going to change (very much).
There are some promising signs on polarization, but our many divides remain.
Here is what one of my readers from Missouri sent me:
St Louis City and County have a stay home order. St Charles County does not. We started having a pool built in November. Today the electrician came to work on the pool. My husband was outside talking to the electrician (with the appropriate social distancing). The electrician asked my husband what he does for a living. The man responded "thank you" for being an ER physician and then went on to ask him if this is actually really serious. "They are just blowing it out of proportion, right?" My husband educated him.
In a presidential election year, at a time when our politico-media infrastructure has stoked division for more than two decades, can there be more unity?
Right now, among the divisions that endanger our capacity to meet this challenge:
A. Rural versus urban.
B. Poor versus wealthy.
C. Healthy versus sick.
D. Renters/owners versus landlords/lenders.
E. Trump supporters versus Trump opponents.
F. States versus the Feds.
I am hearing and seeing a lot of analysis about the nature of these divides and their implications. Everyone in positions of leadership needs to try to bridge them.
Still waiting on the former presidents and first ladies.
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1. Here is an important article from STAT on the options for dealing with the coming waves/phases of the pandemic. Spoiler alert: there are a lot more hard choices headed our way.
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2. Here are two websites with a lot of good data and information, regularly updated:
The Institute for Health Metrics and Evaluation
And a strong chart from AEI comparing key cities and counties:
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3. Governors and state governments are all dealing with the twin health and economic crises right in front of them. States need to be planning for the medium and long term as well. That is of course difficult to do.
Arguably, the biggest sleeper issue for the country now is the impact the pandemic is having and will have on state and local budgets. The federal government can keep printing money and giving it to the states, but there is going to be an enormous hit on services throughout the country.
States need parallel infrastructure — public-private partnerships that can begin to plan for the future. One idea: find a former governor or two who can chair or co-chair an operation to develop ideas in health, the economy, social services, and education.
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4. The states need to be laboratories of democracy, where new ideas are put into practice that can be adopted by other states and, for some functions, by the federal government.
One area that readers have pointed to: how to best deploy those who have been infected with the virus and built up immunity?
From one reader:
What we need to be thinking about to go forward is testing all the people who have recovered for antibodies and immunity. We can't be behind the 8-ball like we were with testing for exposure. These people can go back to work ASAP and can help get the economy going again.
This Vox article does a nice job of explaining how the immunity/antibody process could work. In my mind, as people leave the shelter in place order, we could already have started to test individuals that had confirmed/suspected COVID19. Every one of them should be tested for antibodies. If we assume the virus is standard, meaning you mount an immune response and create antibodies, then you would be resistant to a re-infection in the short term. We don't know how long those antibodies last, but for the sake of argument, assume at least one year. These immune folks can go back to work/school and start getting the economy going. Maybe they all wear a green bracelet to let [for instance] everyone in the coffee shop know their barista is "safe." I would feel better about that!
These tests could be run at doctors’ offices and labs as a standard test. The government pays for it as a benefit to society to get us restarted.
Once that is up and going, we can then start testing those that might have been exposed/had contacts on a more limited basis. This might be a way to get kids back into schools.
States or non-profits could start to identify these people now and recruit them into a Health Care Corps that could provide training, employment, and services. One possible role would be to manually pump ventilation in three-hour shifts for patients for whom ventilators are not available. But there are many other functions they could perform, including checking in on patients with non-coronavirus maladies, such as heart disease.
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5. As the pro-mask movement advances, in the short term here are two good sources of information on how to make proper homemade masks:
Elegant Japanese style, requires these.
A New York Times columnist with various options.
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6. Here are the daily dispatches from Dr. Craig Smith, on the front lines in a New York hospital. They are informative, compelling, textured, and hopeful.
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7. I am hearing from a lot of readers about the ways the virus is going to impact different industries and aspects of civic life.
Take law enforcement, where many jurisdictions are now cutting back on investigation of various crimes. Still, by the nature of their work, officers must interact with the public. One reader tells me there are about 18,000 local police departments in the country (including county and state agencies). 86% of those have FEWER than 50 officers, top to bottom, with about 40 of those street patrol officers.
New York has by far the largest force in the country and can thus sustain some illness in its ranks. But other jurisdictions are obviously seriously vulnerable.
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8. I am also hearing from many of you about mental health concerns. Here is what one reader emailed me:
[It is unfortunate] how little attention has been devoted to the psychological trauma beyond, “Oh, we are lonely oh the kids are bored.” There is terror simply from losing jobs and livelihood. But the unrelenting fear of an unknown future is changing people. Instead of journalists and bloggers merely pointing this out there should be national plans for relief and guidance directed at different people—retirees who are losing their savings, students whose colleges might close, young people with no savings and no employment opportunities who can’t even move back in with their parents. It is amazing how little positivity and proactive ideas are being sent out by mainstream and social media beyond applauding health care workers. There should be PSAs addressing the ramifications from this crisis. People are feeling anxiety and panic.
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9. Some of you have already seen this video, but I wanted to circulate it widely. A doctor clearly explains how to safely bring groceries and carry-out/delivered food into the home.
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10. Great advice for entrepreneurs, founders and investors from Semil Shah. We need the strongest engines of our economy humming as quickly as possible.
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11. From K through college, it is very hard to simulate the educational experience online and impossible to provide anything like the social experience of school. I am very worried about kids whose parents simply don't have the time to help them through this.
Teachers and administrators are really going to have to step up. It is unfair to put so much of the burden on them, but there it is.
Meanwhile, J.K Rowling to the rescue! Free, fresh Potter content for children of all ages.
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Please keep replying to these emails with your thoughts, links, and best practices ideas.