Sunday, March 22, 2020

Speed Of Response; Five Stages Of Grief

     One of the complaints that I keep encountering almost everywhere, from fairly reasonable people and conspiritards alike is, "Why didn't The Government do more, sooner?"

     In part, this is rooted in an odd corner of American Exceptionalism that wants our President, Party leaders and Congressthings to be bigger than life.  If we approve of them, they're philosopher-kings, wise, well-informed and malevolent; if we disapprove of them, they're crafty, malevolent Bond villains.

     What these two characterizations have in common is they describe people who are extremely smart and extremely competent.

     Think back to the kids who were in student government when you were in High School or college.  They're weren't nerds or geeks; they were often fairly bright.  But they were almost never the most bright, and were rarely gifted with great abilities in math or the sciences.

     Those are the people who grew up to run for office.  Other than a certain need for approval, and often a preoccupation with appearances, they're just about average.  They're not Bond villains.  They're not philosopher-kings.  If you compare the whole lot of them to an equal number of randomly-chosen citizens, they two groups will be neither more benevolent or more malevolent than one another.

     So we've got these more-or-less ordinary people, with their individual personalities, and along comes news of a new virus in China.  There are a number of reasons why this happens in China a lot -- population density, the sale of live animals for food and lower food-safety standards among them -- but the important thing is that it does.  It's one item of a hundred in the morning briefing and it's not unusual.

     Time passes and the news out of China's not looking good, but the Chinese government swears they've got a handle on it. By SHOT Show, Tam and I were speculating about the unfortunate confluence of SHOT and the Chinese New Year, which brings a huge influx of Chinese tourists to Vegas and throughout the world.  I warned her to carry hand sanitizer while attending and to not lick any strange door handles.  And we laughed.  --Politicians in the U. S. were not much more worried.

     And it is at this point that I'd like to mention a handy tool for understand how people deal with huge and tragic changes in their world.  It's really just a list of general tendencies in a certain chronological order, but it's a useful to understanding how people react to things like, oh, the Hindenberg disaster, 9/11, WW II, or the coronavirus pandemic: The Five Stages Of Grief. 

     They run like this:
     1.  Denial -- "This isn't happening."
     2.  Anger -- "We're gonna get the people who did this to us!"
     3.  Bargaining -- Can we do only a little, and make this happen less?  What about...?
     4.  Depression -- "Game over.  We're doomed!"
     5.  Acceptance -- "This is happening, and here's what we can do to deal with it."

     You can take, for the easiest possible example, President Trump's public reactions to the pandemic, and map them right into this (with a quick skip over "depression;" he's not really the depressive type).  From what I was seeing from FEMA, they went through much the same process -- as an agency, a few days or even a week ahead of the President; but worrying about disaster response is their only job, so they would be leading.

     This is why we got the official response we got, why the UK had the response they had, and so on around the world: it took time to grasp what what was going on and to accept it.  There was a sudden change in plans in the UK as news came out of Italy.  The UK had hoped to isolate the elderly and let the remainder of the population develop immunity by exposure. Italy had attempted a somewhat relaxed version of that and it failed dramatically.

     About that failure -- people keep mentioning the death rate from this virus as if that was the only effect.  Well, it is bad, worse than a typical flu season, but yeah, it's not so bad -- unless  it happens over a very short period of time.  Flu season runs all winter and a bit longer at start and end.  The other problem is for every death, figure ten or more afflicted who need ventilators to survive; figure 20 - 25 who need hospital care.  If it all comes at once, it adds up to far more patients than we have beds available.  This is the problem; this is why there is such a big effort to slow the spread, to flatten the curve.  The death rate won't change; the number of people who need hospital care and breathing support won't change -- but they won't all need it at once.

     The other complaint I see,  even from the press, is about the shortage of PPE.  Why don't we have enough masks, gloves and gowns?  And that comes right back to the scale of the pandemic; we have enough of those for normal times; State and Federal-level stockpiles have enough to deal with a "normal" disaster -- hurricane, tornado, flood, earthquake, even an outbreak of anthrax or smallpox.  A nationwide pandemic is a whole order of magnitude greater.  Maybe two.

     A related issue is the recent restriction in testing to people being admitted to hospitals (and a few exceptions).  Why would they do that?  Here's why: The supply of tests isn't the problem.  The supply of PPE is the problem: the only sure way to keep the test sites from becoming disease vectors is to discard PPEs after every sample is taken.  Line up five hundred people to get a Q-tip up the nose and you've burned through a thousand gloves and possibly five hundred masks and gowns.  Those are needed for people working with the known-infected.  There may be shortcuts; maybe the testers can slather on sanitizing gel between every sample -- but they don't dare get any on the sample!

     So here we are.  The country reacted pretty quickly, in a series of drastic-feeling steps.  Maybe it wasn't as quick as you would have preferred.  It was as quick as the ordinary people in government could manage.  Maybe it was quick enough. 

     Ask me in another week.  Ask me in another month.

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