The Coronavirus Pandemic and the Free Society

Janis Joplin, who famously and incorrectly sang "Freedom's just another name for nothing left to lose".

When in trouble
Or in doubt
Run in circles
Scream and shout!

Phrase common with field artillerymen in the 1980s

When in danger
When in doubt
Run in circles
Scream and Shout

Infantry Journal, Vol 35, pg 369 (1929)

Pandemic

A plague doctor wearing the special costume of such doctors at the time. The costume was thought to protect the wearer against the plague.  If it seems weirdly creepy, it's probably just about as effective as wearing a surgical mask in a public place.

Pandemic:

A pandemic is the worldwide spread of a new disease.

World Health Organization.

An epidemic of disease, or other health condition, that occurs over a widespread area (multiple countries or continents) and usually affects a sizeable part of the population.

U.S. Department of Health and Human Services.

Pandemic refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.

U.S. Center for Disease Control.

Pandemic: An epidemic (a sudden outbreak) that becomes very widespread and affects a whole region, a continent, or the world due to a susceptible population. By definition, a true pandemic causes a high degree of mortality (death) 

By contrast:  

• An epidemic affects more than the expected number of cases of disease occurring in a community or region during a given period of time. A sudden severe outbreak within a region or a group as, for example, AIDS in Africa or AIDS in intravenous drug users. 
• An endemic is present in a community at all times but in low frequency. An endemic is continuous as in the case of malaria in some areas of the world or as with illicit drugs in some neighborhoods. 

The word "pandemic" comes from the Greek "pan-", "all" + "demos," "people or population" = "pandemos" = "all the people." A pandemic affects all (nearly all) of the people. By contrast, "epi-" means "upon." An epidemic is visited upon the people. And "en-" means "in." An endemic is in the people.

Web MD*

The other day I asked:

Is there a Coronavirus epidemic and if there is, will it become a pandemic?

My question aside, it's been pretty obvious the last few days there is in fact a Coronavirus pandemic.

Moreover, we're now living through something that only the absolutely oldest of us have experienced and they are too  young to remember it, a pandemic of a lethal virus with a death rate of over 2%, which is all the more than the infamous Spanish Flu of 1918-1919 had.

The Spanish Flu.

So that in fact makes this a serious matter.

Covid 19 has a high "attack rate" as its a virus that none of us have (probably) been exposed to or been exposed to a sufficiently related virus as to have a degree of immunity to.  The exception seems to be the very young, who are exposed to coronaviruses all the time as the common cold is in fact a corona virus.  In the modern world where large numbers of the very young are placed in common child care daily, and of course where those below 18 years of age are commonly in school, their systems, which are naturally stout, seem to perhaps have a degree of immunity.

The rest of us do not and therefore the infection rate is vast.  According to one estimate 30% of the American public is likely to get it. Andrea Merkel of Germany predicts that 60% to 70% of the Germans will get it.

As most responsible leaders note, that doesn't mean that most will die or anything near that.  For most infected people this is nothing more than a cold. For some it'll be a bad cold But a killer cold it won't be.

And we don't really know the mortality rate.  It's been estimated at around 3.4% which some take comfort in, but my guess is that it's below that.  Still, if it has the same mortality rate as the Spanish Flu it's rate will be a seemingly mere 2%, and it killed millions.

In fact, simply math shows why.  If, and its only an if, 100,000,000 Americans get covid 19, which is a predicted infection rate, that means 2,000,000 deaths at the Spanish Flu rate.  If the mortality rate really is 3.4%, which I doubt, that means 3,400,000 deaths.  Almost all would be elderly, as the Chinese death rates didn't exceed 3% until the age 60 to 69 age group.  Below that, it was always less than 2%, and unlike the Spanish Flu, the rates for younger adults is around .2%.

That's not the Great Plague, but it's more deaths in the general population from a virus than Americans have ever experienced before.  We've never had 2,000,000 deaths due to an outside source in a single year ever.  Although frankly, because its so concentrated in the elderly, and its not in double digits until the 80 year old plus bracket, its extremely unlikely to hit that toll in the US.  One thing we've done, that the Chinese have not, is to warehouse the elderly, which means of course that if it hits such a location, it's potentially severely bad, but that at the same time it should be easier to isolate them to keep that from occurring.

But it is something to take seriously.

It's also not something to panic about.

Let's be honest with ourselves, as a free society, we can't do that much about it.  We don't work that way.

That's the dirty grim secret of free societies, they're really risky.

Indeed, Kris Kristofferson was completely wrong when he penned Me And Bobby McGee's line;

Freedom's just another word for nothing else to lose.

The opposite is true. Freedom means you can lose everything.

We've had a post here on risk recently in this context.  But here's the part we didn't address.  One thing we accept in American society is that we're willing to exchange freedom for risk.  The entire Western World does that, but we do it more than most.

We let people drive and own cars in their mid teens. The Chinese only let individuals own cars within the last couple of decades. We don't require travel permits to travel within the interior of the country.  We let people write and say what they want.  We don't ban any religions and we don't ban political parties.  We let people buy guns.  We let people with absurd anti vaccination theories avoid vaccinating their children so they die of illnesses.

We don't do any of that, as we value freedom.  Plenty of other countries have restrictions on some or even all of these things.  And while we rarely think of it this way, one of the real features of despotism is that freedom is exchanged for safety and security.  People didn't support the Nazis in Germany, the fascists in Italy, or the Communist in Russia as they thought they'd make the world riskier.  No, people were willing to exchange freedom for the promise of security.  Less risk is what they wanted.

I note all of that as we often forget that the cries to "do something" about any one problem, in our society, have to be addressed in the context of a society that's willing to exchange risk for freedom. We accept car accidents, violence, and even occasional absurdity in exchange for it, we value it so much.

So when comparisons are made to China, get real.  The Chinese don't have a history of individual freedom and they are willing to accept a government that locks down an entire city  We aren't.

Nor are comparisons to Italy appropriate.  Italy is an ancient culture whose achievements are now ancient as well. That's to their credit.  But it's also the case that locking down an entire rural region of the country and telling people to stay home is something that the culture is comfortable with.  Italians don't feel restless if they aren't on the move.  Americans seemingly are, which is to our discredit, but it's part of the culture.  Italians don't feel that everything needs to be open 24 hours per day, seven days a week, or even open at all.  Americans do.

And what all this means is that the general level of panic we're now exhibiting needs to be tempered, or we need to reconsider what we're generally willing to tolerate as a society.  My guess is that we're not willing to accept that much change on anything, really.

None of which means that these aren't really weird times.

Indeed, I've never seen anything like it.

In my half century+ I've seen the country fight four major wars and a host of smaller spats.  For most of my early years the country was fighting a war bigger than any of the last three for my entire first two decades plus it was in a Cold War that was really serious.  I've lived through the scary inflation of the 1970s, the hostage crisis in Iran, the Great Recession of the last decade, and only one thing, I think, compares to this, and that was the collapse of the Soviet Union.  That event felt absolutely momentous.  Indeed, as one law school colleague noted, it made a person here feel like they were doing nothing at all as the Berlin Wall came down.

But a lethal pandemic?  Well, its absolutely surreal.

No wonder the initial reactions inclined either towards absolute panic or completely ignoring it.  It's just too weird.  And its getting weirder.  Last night, President Trump addressed the nation on it:

My fellow Americans: Tonight, I want to speak with you about our nation's unprecedented response to the coronavirus outbreak that started in China and is now spreading throughout the world. 

Today, the World Health Organization officially announced that this is a global pandemic. 

We have been in frequent contact with our allies, and we are marshalling the full power of the federal government and the private sector to protect the American people. 

This is the most aggressive and comprehensive effort to confront a foreign virus in modern history. I am confident that by counting and continuing to take these tough measures, we will significantly reduce the threat to our citizens, and we will ultimately and expeditiously defeat this virus. 

From the beginning of time, nations and people have faced unforeseen challenges, including large-scale and very dangerous health threats. This is the way it always was and always will be. It only matters how you respond, and we are responding with great speed and professionalism. 

Our team is the best anywhere in the world. At the very start of the outbreak, we instituted sweeping travel restrictions on China and put in place the first federally mandated quarantine in over 50 years. We declared a public health emergency and issued the highest level of travel warning on other countries as the virus spread its horrible infection. 

And taking early intense action, we have seen dramatically fewer cases of the virus in the United States than are now present in Europe. 

The European Union failed to take the same precautions and restrict travel from China and other hotspots. As a result, a large number of new clusters in the United States were seeded by travelers from Europe. 

After consulting with our top government health professionals, I have decided to take several strong but necessary actions to protect the health and wellbeing of all Americans.

To keep new cases from entering our shores, we will be suspending all travel from Europe to the United States for the next 30 days. The new rules will go into effect Friday at midnight. These restrictions will be adjusted subject to conditions on the ground. 

There will be exemptions for Americans who have undergone appropriate screenings, and these prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval. Anything coming from Europe to the United States is what we are discussing. These restrictions will also not apply to the United Kingdom. 

At the same time, we are monitoring the situation in China and in South Korea. And, as their situation improves, we will reevaluate the restrictions and warnings that are currently in place for a possible early opening. 

Earlier this week, I met with the leaders of health insurance industry who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments, and to prevent surprise medical billing. 

We are cutting massive amounts of red tape to make antiviral therapies available in record time. These treatments will significantly reduce the impact and reach of the virus.

Additionally, last week, I signed into law an $8.3 billion funding bill to help CDC and other government agencies fight the virus and support vaccines, treatments, and distribution of medical supplies. Testing and testing capabilities are expanding rapidly, day by day. We are moving very quickly. 

The vast majority of Americans: The risk is very, very low. Young and healthy people can expect to recover fully and quickly if they should get the virus. The highest risk is for elderly population with underlying health conditions. The elderly population must be very, very careful. 

In particular, we are strongly advising that nursing homes for the elderly suspend all medically unnecessary visits. In general, older Americans should also avoid nonessential travel in crowded areas. 

My administration is coordinating directly with communities with the largest outbreaks, and we have issued guidance on school closures, social distancing, and reducing large gatherings. 

Smart action today will prevent the spread of the virus tomorrow. 

Every community faces different risks and it is critical for you to follow the guidelines of your local officials who are working closely with our federal health experts -- and they are the best. 

For all Americans, it is essential that everyone take extra precautions and practice good hygiene. Each of us has a role to play in defeating this virus. Wash your hands, clean often-used surfaces, cover your face and mouth if you sneeze or cough, and most of all, if you are sick or not feeling well, stay home. 

To ensure that working Americans impacted by the virus can stay home without fear of financial hardship, I will soon be taking emergency action, which is unprecedented, to provide financial relief. This will be targeted for workers who are ill, quarantined, or caring for others due to coronavirus. 

I will be asking Congress to take legislative action to extend this relief. 

Because of the economic policies that we have put into place over the last three years, we have the greatest economy anywhere in the world, by far. 

Our banks and financial institutions are fully capitalized and incredibly strong. Our unemployment is at a historic low. This vast economic prosperity gives us flexibility, reserves, and resources to handle any threat that comes our way. 

This is not a financial crisis, this is just a temporary moment of time that we will overcome together as a nation and as a world. 

However, to provide extra support for American workers, families, and businesses, tonight I am announcing the following additional actions: I am instructing the Small Business Administration to exercise available authority to provide capital and liquidity to firms affected by the coronavirus. 

Effective immediately, the SBA will begin providing economic loans in affected states and territories. These low-interest loans will help small businesses overcome temporary economic disruptions caused by the virus. To this end, I am asking Congress to increase funding for this program by an additional $50 billion. 

Using emergency authority, I will be instructing the Treasury Department to defer tax payments, without interest or penalties, for certain individuals and businesses negatively impacted. This action will provide more than $200 billion of additional liquidity to the economy. 

Finally, I am calling on Congress to provide Americans with immediate payroll tax relief. Hopefully they will consider this very strongly. 

We are at a critical time in the fight against the virus. We made a life-saving move with early action on China. Now we must take the same action with Europe. We will not delay. I will never hesitate to take any necessary steps to protect the lives, health, and safety of the American people. I will always put the wellbeing of America first. 

If we are vigilant -- and we can reduce the chance of infection, which we will -- we will significantly impede the transmission of the virus. The virus will not have a chance against us. 

No nation is more prepared or more resilient than the United States. We have the best economy, the most advanced healthcare, and the most talented doctors, scientists, and researchers anywhere in the world. 

We are all in this together. We must put politics aside, stop the partisanship, and unify together as one nation and one family. 

As history has proven time and time again, Americans always rise to the challenge and overcome adversity. 

Our future remains brighter than anyone can imagine. Acting with compassion and love, we will heal the sick, care for those in need, help our fellow citizens, and emerge from this challenge stronger and more unified than ever before. 

God bless you, and God bless America. Thank you.

President Trump is correct that we've seen things like this before. . . as human beings, and we'll see them again, but Americans haven't seen a thing like this since 1919 and we're ill prepared to grasp it psychologically.  And blaming this on other nations and cultures is quite misplaced.   Former Governor of New Jersey Chris Christie noted, on last week's Meet The Press, that when he ordered a nurse who flew into New Jersey with symptoms of SARS (I think) quarantined he was roundly criticized for violating her civil rights.  That's how we tend to think, or at least how we think until the point of overreaction. And that seems where we are now, overreaction.

The Governor of New York called out the New York National Guard to go to New Rochelle New York, where there's been a covid 19 outbreak in a retirement home.  The NBA has suspended the rest of its season.  Universities are shutting down or going to on line instruction for the rest of the semester.

In Central Wyoming, there's been a run on toilet paper for no discernible reason. And on hand sanitizer as well, with that product actually providing some service for the first time in its history.

On Wall Street there's a panicky sell off.

Electronic snake oil salesmen, who previously shilled magic foods that promised to cure what ills you, or at least let you eat as much as you wanted and still get thin, now promise to prevent the coronavirus with their dubious products.

And it'll only get more like this.

Surreal times.

 And yet, in our society, people are still going to travel and they're still going to go to work sick.