Thread by @ASlavitt

COVID Update November 1: When we lose someone to COVID there are things to remember. 1/

We have lost 230,000 people in the US to COVID, likely more, and it’s not slowing down soon. This is what happens. 2/

One of the profound contrasts is how something that has roots in broad community spread ends up in the most lonely of experiences. 3/

There’s no longer great mystery left as to how COVID-19 spreads. It is largely through the respiratory system and while it is an inconvenience to do so, that makes preventing and controlling it easy to understand. 4/

We want to avoid those particles when others laugh, cry, talk, and exhale. We want to avoid the places where that happened recently or with frequency where that can’t escape. 5/

In crowds of people, the odds of someone shedding that virus at just the wrong moment goes up significantly.

No one we know wants to spread the virus. 80% of the time, it’s shared without knowledge. 6/

People who are contagious are likely feeling fine. This is a significant difference with the flu. With the flu, most people stay home when contagious. At least they have a warning. Here there is no warning. 7/

The devilish thing is this causes the disease to require us to do unnatural human things—
1) to stay in or mask up when we feel ok
2) to treat everybody as if they’re potentially contagious 8/

If the virus were reduced dramatically and it spread in 1:1 highly traceable ways, that would mean we could safely go out and we could treat people as if they’re likely not contagious. 9/

That takes work and commitment but it’s very do-able. It’s not the challenge of rocket science or splitting the genome.

It’s unfortunate because it requires effort & delaying our lives, but don’t believe anyone— Mark Meadows or Scott Atlas or Trump— who says we can’t. 10/

We can. But it requires work and investment.

It requires sustained financial support from Congress that the Senate & White House have been unwilling to do so businesses can adjust or temporarily close without fear. 11/

It requires improving many of our old school building.

It requires broadband for people who don’t have it.

It requires paid medical leaves & uninterrupted unemployment benefits.

It requires a nationwide testing system & hotels be used for isolation. 12/

COVID can spread with any holes. If we don’t do the simple and basic things like that, of course it will keep spreading. 13/

COVID can do 1 of 3 things to you and you won’t know which unless you get it.

-You may be fine & hardly notice it or feel like you have the flu
-It may do longlasting damage to your heart, lungs, brain, immune or clotting system
-In some cases, you won’t survive 14/

While your odds are better if you are younger, female, fit, & with no illnesses, there are no guarantees. There is a randomness here not yet well understood.

We have some medicines that work now but not catching it in the first place is your best bet. 15/

Here is the problem. COVID (were it to have actual human characteristics) is more than patient to travel from host to host until it finds someone it does real damage to.

So even if you are in the 1st category, it is likely you are a link in a chain where someone else dies.16/

We don’t have data in the US, but the percentage of people who are the last in the chain & don’t spread COVID may be in the single digits according to experts I have asked. 17/

If things were well controlled & we were doing what we should, the vast majority should not be spreading it. 18/

If someone is hospitalized with a serious case of COVID, it is hard to trace the fault back to the original source.

Is it someone in the community who gave it to them? The person who gave it to them? The person who brought it to town? 19/

Or does it go back further? To the people who have the infrastructure & the resources to control the disease. To make it so that Americans can afford to isolate. To make the simple act of reducing spread with a mask an acceptable idea. 20/

We are getting to the point where close to one person each minute is dying. Given the infectiousness, the typical death is: alone, in an ICU bed, often on a ventilator, hopefully in the presence of a loving nurse. 21/

My friend’s father, Gerry, died this way. He lived across the country & could not be there: either to see his dad go, to bury him, or to comfort his mom. 22/

Who in the community was in the link of the chain that spread the illness to Gerry? Maybe dozens of people. Who was there at the end with Gerry? Nobody. 23/

Gerry had 4 grandkids. He had time left. He had given a lot to the country. He was a corporal in the Korean War. He told me when I was 20 that he believed we lived in a country where we looked out for one another. 24/

Gerry didn’t agree to die so someone else’s 401k would do better. Neither did the hundreds of other people that died when he did.

And the 9 direct mourners per person didn’t either. 25/

It’s never hard to find ways for the government or people who choose to to rationalize not adjusting on behalf of the other people for COVID: the economy. Jobs. Mental health. Schools. 26/

These are all things that are very important. But if we are going to name them, we need to do the things to help— invest in financial support, the mental health system, school upgrades.

Otherwise, you know what it sounds like? An excuse. 27/

It is all an excuse from people who fit decades have been telling us our greatest threat to our society is a budget deficit. Our greatest threat.

It turns out that not investing in public health, opportunity for people, a safety net & health care was a bigger threat. 28/

Making an effort during the pandemic and failing often is not only forgivable. It’s lovable. It’s laudable. Not quitting in the face of all this is noble.

But avoiding it, shirking responsibility, minimizing it, dodging responsible— those things deserve our opprobrium. 29/

By the time the loss gets to a single individual, it is easy for Trump to avoid blame, make excuses & point fingers.

But preventing this includes all of us. And begins with leadership. And empathy. And effort. And the ability to adapt. 30/

How we go forward is up to us. Donald Trump could get re-elected on the basis of the electoral college, voter suppression, judges and the post office with even less of a mandate than he had last time. 31/

If he does he will interpret his approach to date as license to entirely forget the slaughter.

It doesn’t mean we wouldn’t keep working. It does mean likely much less care, much less mask wearing, and a justification they the country really doesn’t care about all these dead.32/

I’m not predicting anything right now. I am hoping however that we can soon pull ourselves together, come to our senses and crush this little virus that’s invaded our country. And also COVID. /end