What to Believe

Ten Bears (Floyd "Red Crow" Westerman): [in Lakota; subtitled] It's easy to become confused by these questions. Before we take action we need to talk about this some more at another time. That is all I have to say. This council is dismissed. Dances with Wolves (1990).

We left for a cruise vacation on February 20th. When we arrived back in port on March 1st, the world had changed.

Most of us are not scientists or trained medical experts. One of my friends ticked off the prerequisites necessary to have an opinion about the Corona virus (or, COVID-19, or any of the other labels attached), mostly classes in microbiology, epidemiology or medicine. Me - I've taken a ton of law classes, so I guess that leaves me out.

Or, does it? Isn't it part of being a grown up, of seeing something happening to your neighborhood, your state, your country and trying to be informed? So...

I'm a fan of former Defense Secretary Donald Rumsfeld's notion that one begins an inquiry by asking: What are the known-knowns, the known-unknowns and the unknown-unknowns? It comes from a substantially technical decision-making model, which I looked up and decided to ignore. This is easier for me to understand.

So, what did we know we knew?

The first known cluster of cases in the US was in a nursing home in Washington State. The facility wasn't really ready for something like this, and it blew through like a freight train. Some early news reports (circa March 8) had 70% of the staff infected. They really didn't have the appropriate gear, or training, and people who got it went downhill fast. The demographic of a care facility seemed to speak for who the disease's most vulnerable victims would be - 80s and 90s, with something else wrong with them. But, holy crap it seemed to get out of control quickly.

Then, Italy happened. One day, it was business as usual. The next, there weren't enough ventilators or hospital bed space, people were being triaged like it was a battle zone (if you were over 60, you were basically on your own) and ten percent of the folks who tested positive died. The numbers were scary for how contagious and how dangerous it seemed to be.

About this time, a cruise ship called Diamond Princess came onto the radar. It had been at sea for a while, made port calls on the "Pacific Rim" and looked like a great place to run some numbers. People were relieved that "only" twenty-something percent of the folks tested positive - meaning they were actively infectious (the final number was about 19%). Except, not all of them were sick. Whuuuuut? Only about 1.5% of those who tested positive died, and most of them were fairly old. Wait...only?

Let's see. The CDC says that between three and twenty percent of people in the US get the flu-flu each season. That's crazy, right? Don't they know?

Of course not. How many of you loyal readers got sick, stayed home, felt horrible and then got over it without going to the doctor? So, the stats are elastic. But, we have the numbers from the cruise ship, they seem reasonably related to a higher-end flu season, so let's play with them.

There are (officially) about 330 million of us living in the US. So, applying the modest numbers available from the Princess cruise ship (mumble, mumble, mumble) - holy fuck! A million people are going to die. A million people!?

Running the Italy numbers - no, I don't think I will.

So, sick people should stay home, or go to the hospital, right? That way, we can slow down the spread of... But some people, especially kids, can be asymptomatic - a fancy way of saying they look fine, they feel fine and they are little roving germ-sickles. In fact (as my daughter, who works in the international health field, suggests) 25% of people who are contagious as hell don't even know it. That doesn't count (I know, right? Common sense?) those of us with seasonal allergies saying to each other "You don't think...?" with the answer being maybe yes.

But, come on. This is America. We'll do all that doctor shit, and everything will be fine. We'll do like...World War Two. Boeing will build ventilators. Isn't that what everyone is saying? Build us some ventilators, most riki tik!

Sure. To quote the irrepressible Mark Steyn, seven out of ten ventilator patients get "carried out by the handles." That number doesn't have to be precise to be spooky as hell.

But, we have more experience with this, right? Doesn't the CDC (or, somebody) gin up a vaccine (that half of us don't take, anyway) every year? Well, what are you waiting for? Treatment - yeah, that's the ticket. Didn't President Trump say something about...well, I can't pronounce it. Doesn't that work? Let's all take that!

Where does a person turn for advice? Medical people can't agree on anything, it seems. One doctor says we're all fucked, another says "It's like chicken pox. The sooner we all get it, the sooner it will go away. This 'flatten the curve' nonsense is just delaying the inevitable." A dude who is a constitutional scholar (which should be the first clue he's clueless) said "Five hundred deaths. Six, tops," about fifty thousand deaths ago - then had the balls to write a second column explaining why his numbers were wrong, but...not his fault. 

Whew. An anesthesiologist (colloquially called a gas-passer) says it's all good, we can come out, now...but, if you actually read his essay he cherry-picks the hell out of the known data. A "former" epidemiology professor (ask my PhD wife her opinion of pure academics) says "Point zero-one percent death rate, I feel." You feel? Another guy from Stanford, who sounds like he knows what he's talking about, says antibody tests suggest maybe 50 people have been exposed and have antibodies for every 1 who has tested positive. That's great news, right? Except - "The debate is raging about whether that means a person is immune if they are positive for antibodies."

Then there is the guy who is a suspense novelist who has made all of the interview shows criticizing the CDC for being wrong about the numbers. Hey... I'm a suspense novelist! How many of you would want my opinion. And I have a doctoral degree.

Okay, it's in law.

What are Pat and I doing? Minimizing our time in the social media swamp. Wearing masks, following the rules, keeping our distance. Spending money we really don't have supporting local businesses. Trying to apply common sense and some simple rules to a complex situation. Beginning with the premise of "Assume Positive Intent" when we look at our fallible government officials and holding them to the standard of reasonableness, not perfection and certainly not clairvoyance.

And, praying. That's right. This is the first one of these she and I have sat out after four decades of public service. But, our son is a police officer. Both of our daughters work in health care - one in a hospital. All of them have young children. We pray for their safety, and look forward to the day we can hug them again.

We pray for our friends, the ones not sitting this out. Cops, firefighters, doctors and nurses. We know what you are facing. It sucks. You are in our thoughts every waking moment.

When we go to the store, when we intercept the mailman, UPS, FedEx... "Thank you for being here, for keeping it all going."

And, we pray for humanity, both the verb and the noun. Maybe, just maybe, the lesson we learn is, like the passengers on Diamond Princess, we're stuck here on this beautiful planet, together. Maybe we should start acting like that matters.