interesting times

How to Live With COVID-19

Photo: Melissa Hom

“There is no wealth but life,” the great critic John Ruskin once wrote. You can hear that faith in the words of Andrew Cuomo, whose Catholic upbringing still clearly reverberates in his soul. “If it’s the public health versus the economy, the only choice is public health,” Cuomo tweeted. “You cannot put a value on human life. You do the right thing. That’s what Pop taught us.” That’s why American soldiers never leave a fellow behind, why American doctors never abandon a patient, and why American rescuers and first responders go beyond the feasible and reach for the impossible.

Epidemics make this choice explicit. At the moment, we have effectively shut down almost the entire economy to prevent the premature deaths of hundreds of thousands of our fellow citizens by a virus. We’ve made a decision to sacrifice wealth for life. And we’ve done that even as we are still in the dark regarding so much about this particular pathogen.

We still don’t precisely know how it infects people; we don’t know how many people have already had it and are now immune; we don’t know how far it has already penetrated into the population; we don’t know quite why it can quickly shut down one person’s lungs while it lingers mildly in those of another; we don’t know why it largely spares children or why it kills men at almost twice the rate as women. But in the absence of certainty, out of a modicum of caution, and facing the risk of a breakdown in the health-care system, we’ve taken (belated) steps to put life first.

It’s the right call. In my view, it’s the only call a decent society can make. It’s what it really means to be pro-life.

But then you look at the unemployment numbers, and gulp. There are costs to this collective exercise in empathy and compassion. You contemplate the rising chances of a long and devastating global depression. You look ahead to months and months more of quarantine, empty streets, crippled businesses, shrinking retirement savings, and rising poverty. And you realize that our choice for life over wealth is a little more complicated. There will come a point at which we will have to risk some lives to reopen and save the economy.

As Toby Young points out:

“During the global financial crisis of 2007–09, the suicide rate in the United States increased by 4.8% according to the Centers for Disease Control and in Europe by 6.5% according to the World Health Organisation. Philip Thomas, professor of risk management at Bristol University, has calculated that if the UK’s GDP falls by more than 6.4% per person as a result of the lockdown, more years of life will be lost than saved.”

Let’s not get hung up on whether this is accurate in its specifics (there’s a great takedown of the argument here). And let’s overlook the callousness of arguing that “spending £350 billion to prolong the lives of a few hundred thousand mostly elderly people is an irresponsible use of taxpayers’ money.” Let’s just agree nonetheless that in principle, at some point, there will be a crossover moment when quarantine and lockdown cease to have the net-positive impact they are now having. The question is simply when that cross-over occurs, and how we can get there soonest.

If we declare victory before we achieve it, we could have the worst of both worlds — a burst in new infections leading to a second shutdown, a collapse of faith in the authorities, more deaths, and a deeper depression. Letting up on an epidemic before it has run its course can create a second wave, as in 1918, and as feared in China right now, that would take the country down in the fall of an election year. At the same time, if quarantine and social distancing are stretched out too long, we could be losing more lives in the aggregate than we would be saving. We could also be risking ever-more extremist politics or even civil disorder. Gun sales are, somewhat ominously, through the roof.

What matters is the timing. Getting that right is the single biggest challenge as we go forward. But that requires a huge amount of data we don’t yet have: specifically, a much better sense of just how widespread COVID-19 is in the broader population. And we need equipment we don’t yet have: tests for the virus that are quick and easy and ubiquitous; and, perhaps more importantly, serological tests, to see who is now immune and can return to work and normal life. The British and the German governments are duly thinking of issuing immunity certificates to those who’ve recovered from the virus. If there is anyone faintly competent in the Trump administration, maybe they should think about it too. (My only worry about this idea is that it might encourage some people to go out and proactively get the virus, risking their health, just so they can get back to work.)

If we’re lucky and we find out more people have already gotten COVID-19 without the worst symptoms than we now believe, then the return to semi-normal could come more quickly. If we’re luckier still, we could get a breakthrough in treatments as doctors and nurses understand this disease better and we buy some time. At best, we could get the virus to peak at a level that does not overwhelm our medical system and manage economically until a vaccine is available. At best.

The goal is not to “beat” the virus, because it can’t be beaten. Now that it’s a pandemic, it’s here to stay. The goal is not to fight it, or wage war on it.  COVID-19 is not a rival military. The goal is to find the optimal path to living with it.

I want Anthony Fauci making that decision. Right now, as complete a shutdown as possible is the only sane option. And going forward, we should always lean on the side of the preservation of life rather than the maximization of wealth. Every life counts. And if we make that collective pro-life decision — and, mercifully, we are — we are also saying something quite profound about who we are as Americans. We are saying that the lives of the elderly, and the poor, and the vulnerable matter more, when all is said and done, than our GDP. I cannot see how such a society can go forward after such an experience without instituting the kind of universal health care that these values represent.

It’s hard to go through such ordeals without wanting them to mean something. Out of AIDS came marriage equality, a permanent shift in the relationship between gays and society. Out of this plague, let us erect in its memory another fitting monument that will never age, crumble, or pass away: health care for all.

Not Afraid — Just Smart

The evolution of the Christianist right has been quite something these past few years. In this century, the Evangelical right has embraced the cult of prosperity, the efficacy of torture, and the denial of health care to the poor. They upped the ante in 2016, of course, by embracing a pagan worshipper of Mammon, with a sideline in philandery, cruelty, gluttony, pride, deceit, envy, insatiable greed, and the foulest abuse of women. How could they top that? Well, they’re trying.

In an apparent attempt to defend a president who clearly dismissed and for too long ignored the greatest threat to the U.S. since 9/11, they’ve decided to embrace what they once called the “culture of death.” The correct response to COVID-19, many pastors have declared, is to let it rip. Social distancing is acting like “pansies,” as one put it. The elderly, instead of protecting themselves, should sacrifice what’s left of their lives to save the jobs of the young and to help Trump keep the economy going. Wealth, it appears, is far preferable to life — or at least when a Republican is president.

The most eloquent case in this vein came from one Rusty Reno, the editor of the theoconservative magazine First Things. The passionate pro-lifer writes:

There are many things more precious than life. And yet we have been whipped into such a frenzy in New York that most family members will forgo visiting sick parents. Clergy won’t visit the sick or console those who mourn. The Eucharist itself is now subordinated to the false god of ‘saving lives.’” This response, Reno argues, “creates a perverse, even demonic atmosphere. Governor Cuomo and other officials insist that death’s power must rule our actions. Religious leaders have accepted this decree … They signal by their actions that they, too, accept death’s dominion.

How is risking the deaths of hundreds of thousands “pro-life”? Reno:

The pro-life cause concerns the battle against killing, not an ill-conceived crusade against human finitude and the dolorous reality of death.” But if by ignoring “social distancing,” we individually and collectively guarantee someone’s death down the line, why is that not a kind of indirect killing?

The indomitable conservative, Peter Hitchens, brother of the late Christopher, offers a different version of this argument. The lockdown is a violation of religious freedom:

The churchwarden at the small village church where we still follow the 1662 Prayer Book, read the King James Bible, and sing proper Anglican hymns wanted to continue. He pointed out to the Church authorities that there really aren’t very many of us, and that even now we mostly manage to worship while at least seven feet away from one another, and sometimes farther. Not a chance … Such a thing has not happened in England for 800 years, since the days of Bad King John.” 

To that end, Florida’s governor, Ron DeSantis, exempted religious gatherings from the stay-at-home order he has finally managed to announce. The trouble, of course, is that no one is an island in an epidemic. Every single new case offers a new and exponential way for the virus to replicate and infect another human host. This is one of those moments, like war, when we really have to act as a collective entity. It’s temporary, but it’s vital.

Reno argues that in the 1918 epidemic, no such pansy-ass restrictions occurred:

Their reaction was vastly different from ours. They continued to worship, go to musical performances, clash on football fields, and gather with friends … That older generation that endured the Spanish flu, now long gone, was not ill-informed. People in that era were attended by medical professionals who fully understood the spread of disease and methods of quarantine. Unlike us, however, that generation did not want to live under Satan’s rule, not even for a season. They insisted that man was made for life, not death.

This is not accurate: In countless towns and cities in 1918, severe restrictions were enforced — as was the case in plagues and epidemics from the beginning of time. Across the world, according to Catharine Arnold’s Pandemic 1918, “entire cities became ghost towns as daily life ground to a halt.” In St Louis, the response was swift and tough: “In early October, city health commissioner Dr. Max C. Starkloff ordered the closure of schools, movie theaters, saloons, sporting events and other public gathering spots. Churches were told to suspend Sunday services.”

Yes, some other cities chose the Reno line. The day the first civilian casualty arrived at Boston City Hospital, according to Arnold, 4,000 men were allowed to march through the city in a freedom parade, celebrating imminent victory in the First World War. Boston subsequently saw one of the deadliest outbreaks of any city in America. Ditto in Philadelphia, where the let-it-rip types dictated policy, and 200,000 marched in a massive parade on September 28. Two weeks later, close to 8,000 people lay dead.

The other reality is that, once plagues set in, people quarantine themselves, shutting themselves in, staying away from others, wearing masks — close to ubiquitous in 1918. Is this a “demonic” impulse? The fantasy that in the past, God-fearing folk never wilted in the face of the plague, unlike us wussy moderns, is, well, a reactionary delusion. In Florence in 1630, for example, as Erin Maglaque points out in a recent London Review of Books essay, “churches were gated and Masses prohibited. Parish priests stood in the streets to hear parishioners’ confessions, through doors and windows, covering their mouths with waxed cloths to withstand the ‘seeds of disease.’” These faithful Florentines were being “demonic”? Nah. Just sane.

Yes, Christians should not cower in constant fear of death. But we don’t have to embrace it either. I’m trying to think of a version of the Gospels where Jesus meets a leper and tells him not to worry, he’s going to die some day anyway, and make the best of it; or when he tells Martha and Mary to suck it up, and accept that Lazarus is dead, and move on. He didn’t. In fact, he risked and lost his own life by raising Lazarus from the dead.

I’m also reminded of one of the most extraordinary moments in the history of the Black Death. In a northern English town called Eyam, in 1666, the local tailor received a batch of cloth from London that turned out to be infected by fleas carrying the disease. Suddenly, people started dropping dead. Two Christian pastors then made an extraordinary decision: They would quarantine the entire town, forbidding anyone from leaving — so that the plague would spare their neighbors and county. They kept up that quarantine, even as families were wiped out, and never left, losing more than half of their residents, a higher proportion than even London. But the rest of the region was spared thousands of deaths.

Those people, as devout Christians, were indeed not afraid of death. But they faced it because they wanted others to live. I have to say I find their faith a little more impressive than that of the today’s American Evangelicals.

Meth and the Tiger King

Like so many others, I spent a few nights of quarantine glued to the Netflix documentary on one Joe Exotic, Tiger King, the eccentric big-cat-zoo owner, whose fierce rivalry with his fellow lion and tiger (and liger) park entrepreneurs became legendary. (Spoiler alert: Some details of the plot are imminent.) There are many things to say about the documentary — how it might have been crafted by Christopher Guest; how, like reality shows, it exposed and callously exploited the lives of troubled people desperate for fame; how perfectly designed it was for internet memes; how appalling the abuse of wild animals always is. But what gripped me was a subtext: the intersection of homosexuality and meth.

Joe himself, along with his two young male lovers, was a meth user. If you’ve watched what this poison does to people, you can see it everywhere in the film. Joe himself is haggard, his face crinkled with meth use, his eyes flitting to and fro, his energy seemingly inexhaustible, and his descent into paranoia and madness tracks closely what meth does to the human mind and body.

I’ve learned from brutal experience that there are no casual users of crystal meth. There are people who don’t touch it, and near-instant addicts whose lives become increasingly focused on one chemical to the expense eventually of everything and everyone else. There is almost no one in between. Meth use is the gay community’s single biggest problem right now, in my judgment, and one too many of us are only too eager to keep quiet about.

In America, meth has two major demographic concentrations: among low-income whites often in rural areas and among gay men. Tiger King is a tale of when the two overlap. Joe is not bad looking, but not exactly a catch, and yet he manages to attract and retain two handsome, beautiful young men as his lovers and subsequently partners. They are, by all accounts, straight, but gay for Joe. I’m not denying or judging the truth of their love for each other, but it’s also clear to me from the documentary that they were not just gay for Joe, but gay for Joe’s meth. We watch as these two young men slowly turn into meth-heads. One, John, is in his 20s and has most of his front teeth missing — a classic sign of a chronic meth user. The other, Travis, is a pothead, but, in due course, also gets caught up in meth. Joe uses these drugs as gateways to his world and to his bed.

Meth use leads over time to bouts of rage, insanity, paranoia, madness. I don’t think you can understand why Joe’s world unravels so quickly and crazily without taking this drug into account. Travis, in particular, steadily deteriorates in front of our eyes, and in a simply staggering scene, comes into the office one day and blows his brains out. And when you realize the meth subtext, you also see how Joe is a brutal abuser of these young men — luring them in with money and drugs, in order to have sex with them. It reminds me of how Ed Buck, the big Democratic Party fundraiser, has been charged with luring men, mainly African-American, into sex by offering them meth, and even shooting them up without their consent. And it’s also a devastating reminder of the world of Matthew Shepard, who, as Steve Jimenez shows in The Book of Matt, found himself sucked into a very similar rural, underclass underworld, where madness and murder and meth were inextricably intertwined. Shepard too was sleeping with sexually ambiguous young meth heads, one of whom, after a days-long meth binge, killed Shepard with such insane, unhinged, uncontrolled brutality that only meth can fully explain it.

There is so much camp, craziness, and eccentricity in Tiger King that you can almost forget the underlying tragedy: Gay men in many parts of America are still at war with themselves, trying to find roles in a society that still does not truly accept them, and find in meth an escape that is actually a death trap. In this particular story, it ruined two lives and took another. May Travis rest in peace.

See you next Friday.

Andrew Sullivan: How to Live With the Coronavirus