newyorker--2020-03-24--It’s Time to Establish a New Reconstruction Finance Corporation

The stock market fell again on Monday , despite the Federal Reserve announcing yet more measures to stabilize the credit markets and the economy .
Wall Street is waiting for Republicans and Democrats on Capitol Hill to agree on a huge spending bill that will provide essential financial support for households , firms , and local governments affected by shutdowns related to the coronavirus .
One of the major sticking points in the negotiations is how to assist large corporations that have seen their revenues collapse , such as airlines and hotels .
Memories of the Wall Street bailout of @ @ @ @ @ @ @ this stalemate isn ’ t surprising .
The original Senate Republican bill , which was released last Thursday , contained two hundred and eight billion dollars for corporate bailouts .
By Sunday evening , when Mitch McConnell forced a vote on a new bill , the bailout figure had expanded to more than five hundred billion dollars , with this huge sum being apportioned to two separate proposals .
Under the first one , the Treasury Department , under Secretary Steven Mnuchin , would reportedly be given a budget of seventy-five billion dollars @ @ @ @ @ @ @ industries .
The second program would operate through the Fed .
The Treasury Department would provide the central bank with four hundred and twenty-five billion dollars in capital , and the Fed would use this money as the basis of a mammoth lending program for firms of all shapes and sizes .
“ We can lever up to four trillion dollars to help everything from small business to big business get through the next ninety to one hundred and twenty days , to win this war , ” Mnuchin said on Fox News @ @ @ @ @ @ @ these schemes would work are vague .
Democrats said the new bill would give Mnuchin and the Fed total discretion about how the money would be distributed , with little transparency or oversight .
They criticized the proposal as a “ slush fund , ” which Mnuchin and Donald Trump could use to bail out favored companies .
News outlets reported that the federal government wouldn ’ t even have to identify the aid recipients for up to six months .
On Monday , Mnuchin pushed back , saying people had misunderstood how @ @ @ @ @ @ @ may have a point , but even in parts of the Fed there may not be much enthusiasm for his proposal .
After it lent large sums to Bear Stearns and A.I.G .
during 2008 and 2009 , the Fed faced a lot of criticism .
Judging by their actions so far in this crisis , the Fed chairman , Jerome Powell , and his colleagues would prefer to focus on stabilizing the credit markets by purchasing and underwriting baskets of financial assets , rather than lending to individual companies .
Unless we @ @ @ @ @ @ @ , which could accentuate the coming slump , we need a way to support them in a reasonable and transparent manner that minimizes the scope for political cronyism .
Fortunately , history provides a template for how to conduct corporate bailouts in times of acute stress .
Using the Depression-era Reconstruction Finance Corporation as a model , Congress should set up a Coronavirus Finance Corporation to help get us through the current crisis .
At the beginning of 1932 , Herbert Hoover ’ s Administration set up the Reconstruction Finance Corporation , which @ @ @ @ @ @ @ R.F.C.
, to provide assistance to stricken banks and railroads .
A year later , the Administration of the newly elected Franklin Delano Roosevelt greatly expanded the R.F.C.
’ s scope .
For the rest of the nineteen-thirties and throughout the Second World War , the institution provided vital financing for businesses , agricultural interests , public-works schemes , and disaster relief .
“ I think it was a great success—one that is often misunderstood or overlooked , ” James S. Olson , a historian at Sam Houston State University , in Huntsville @ @ @ @ @ @ @ It ’ s a good model .
It slowed down the mindless liquidation of assets that was going on and which we see some of today.
” There were four keys to the R.F.C.
’ s success : independence , leverage , leadership , and equity .
Established as a quasi-independent federal agency , it was overseen by a board of directors that consisted of the Treasury Secretary , the chairman of the Fed , the Farm Loan Commissioner , and four other people appointed by the President .
“ Under Hoover , @ @ @ @ @ @ @ Roosevelt the majority were Democrats , ” Olson , who is the author of a detailed history of the Reconstruction Finance Corporation , said .
“ But , even then , you still had people of opposite political affiliations who were forced to interact and coöperate every day.
” The fact that the R.F.C .
operated at arm ’ s length from the Treasury and the White House gave it credibility , and the bipartisan nature of its board won it support on Capitol Hill .
Congress originally endowed it with a capital @ @ @ @ @ @ @ it was empowered to leverage , or multiply , by issuing bonds and other securities of its own .
If we set up a Coronavirus Finance Corporation , it could do the same thing without directly involving the Fed , although the central bank might well end up buying some of its bonds .
Initially , the R.F.C .
didn ’ t publicly announce which businesses it was lending to , which led to charges of cronyism .
In the summer of 1932 , more transparency was introduced , and when F.D.R .
@ @ @ @ @ @ @ competent and public-minded person to run the agency : Jesse H. Jones , an entrepreneur and philanthropist from Texas .
Jones was a Democrat , but he was best known as a business visionary who built the Houston Ship Channel , which transformed the city ’ s economy , and the owner of the Houston Chronicle .
He had only an eighth-grade education , and he proved to be an extremely able and energetic administrator .
Olson told me he regards Jones as “ one of the great unsung heroes of the Great @ @ @ @ @ @ @ with the banking system seemingly on the verge of collapse , the R.F.C .
played a key role in stabilizing things .
Roosevelt announced a bank holiday , during which Congress passed the Emergency Banking Act , which empowered the R.F.C .
to purchase preferred stock in banks that desperately needed finance .
The switch from loans to equity gave taxpayers a stake in the enterprises they were bailing out , and it also gave the banks more time to recover , because there was no fixed date for repayment .
Together with @ @ @ @ @ @ @ which was part of a separate banking act , the R.F.C .
stopped the panic and restored confidence in the system .
“ All you have to do is look at the number of bank failures , ” Olson noted .
“ Before March , 1933 , it was in the hundreds , and it went down to the tens.
” With good will on both sides , there is no reason that Congress couldn ’ t act upon these lessons .
Distancing the administration of the bailouts from the White House and @ @ @ @ @ @ @ corruption .
Providing assistance in the form of equity , rather than loans , would give the taxpayer a stake in the success of the scheme .
( Last week , Trump himself said that he supports this idea . )
It might be difficult to find a successor to Jones—someone whom both parties regard as an honest and independent-minded patriot—to run the new agency , but it shouldn ’ t be impossible .
( Step forward , Warren Buffet ?
Or a younger version of him ? )
The important thing is @ @ @ @ @ @ @ bailout framework that could operate at scale and maintain public support .
A Coronavirus Finance Corporation could be the answer .
• How to practice social distancing , from responding to a sick housemate to the pros and cons of ordering food .
• How people cope and create new customs amid a pandemic .
• What it means to contain and mitigate the coronavirus outbreak .
• How much of the world is likely to be quarantined ?

The stock market fell again on Monday, despite the Federal Reserve announcing yet more measures to stabilize the credit markets and the economy. Wall Street is waiting for Republicans and Democrats on Capitol Hill to agree on a huge spending bill that will provide essential financial support for households, firms, and local governments affected by shutdowns related to the coronavirus. One of the major sticking points in the negotiations is how to assist large corporations that have seen their revenues collapse, such as airlines and hotels.
Memories of the Wall Street bailout of 2008–2009 are still fresh, and so this stalemate isn’t surprising. The original Senate Republican bill, which was released last Thursday, contained two hundred and eight billion dollars for corporate bailouts. By Sunday evening, when Mitch McConnell forced a vote on a new bill, the bailout figure had expanded to more than five hundred billion dollars, with this huge sum being apportioned to two separate proposals.
Under the first one, the Treasury Department, under Secretary Steven Mnuchin, would reportedly be given a budget of seventy-five billion dollars to provide loans to specific companies and industries. The second program would operate through the Fed. The Treasury Department would provide the central bank with four hundred and twenty-five billion dollars in capital, and the Fed would use this money as the basis of a mammoth lending program for firms of all shapes and sizes. “We can lever up to four trillion dollars to help everything from small business to big business get through the next ninety to one hundred and twenty days, to win this war,” Mnuchin said on Fox News, on Sunday.
Details of how these schemes would work are vague. Democrats said the new bill would give Mnuchin and the Fed total discretion about how the money would be distributed, with little transparency or oversight. They criticized the proposal as a “slush fund,” which Mnuchin and Donald Trump could use to bail out favored companies. News outlets reported that the federal government wouldn’t even have to identify the aid recipients for up to six months.
On Monday, Mnuchin pushed back, saying people had misunderstood how the Treasury-Fed partnership would work. He may have a point, but even in parts of the Fed there may not be much enthusiasm for his proposal. After it lent large sums to Bear Stearns and A.I.G. during 2008 and 2009, the Fed faced a lot of criticism. Judging by their actions so far in this crisis, the Fed chairman, Jerome Powell, and his colleagues would prefer to focus on stabilizing the credit markets by purchasing and underwriting baskets of financial assets, rather than lending to individual companies.
Unless we are willing to let troubled corporations collapse, which could accentuate the coming slump, we need a way to support them in a reasonable and transparent manner that minimizes the scope for political cronyism. Fortunately, history provides a template for how to conduct corporate bailouts in times of acute stress. Using the Depression-era Reconstruction Finance Corporation as a model, Congress should set up a Coronavirus Finance Corporation to help get us through the current crisis.
At the beginning of 1932, Herbert Hoover’s Administration set up the Reconstruction Finance Corporation, which is often referred to by the initials R.F.C., to provide assistance to stricken banks and railroads. A year later, the Administration of the newly elected Franklin Delano Roosevelt greatly expanded the R.F.C.’s scope. For the rest of the nineteen-thirties and throughout the Second World War, the institution provided vital financing for businesses, agricultural interests, public-works schemes, and disaster relief. “I think it was a great success—one that is often misunderstood or overlooked,” James S. Olson, a historian at Sam Houston State University, in Huntsville, Texas, told me. “It’s a good model. It slowed down the mindless liquidation of assets that was going on and which we see some of today.”
There were four keys to the R.F.C.’s success: independence, leverage, leadership, and equity. Established as a quasi-independent federal agency, it was overseen by a board of directors that consisted of the Treasury Secretary, the chairman of the Fed, the Farm Loan Commissioner, and four other people appointed by the President. “Under Hoover, the majority were Republicans, and under Roosevelt the majority were Democrats,” Olson, who is the author of a detailed history of the Reconstruction Finance Corporation, said. “But, even then, you still had people of opposite political affiliations who were forced to interact and coöperate every day.”
The fact that the R.F.C. operated at arm’s length from the Treasury and the White House gave it credibility, and the bipartisan nature of its board won it support on Capitol Hill. Congress originally endowed it with a capital base of five hundred million dollars that it was empowered to leverage, or multiply, by issuing bonds and other securities of its own. If we set up a Coronavirus Finance Corporation, it could do the same thing without directly involving the Fed, although the central bank might well end up buying some of its bonds.
Initially, the R.F.C. didn’t publicly announce which businesses it was lending to, which led to charges of cronyism. In the summer of 1932, more transparency was introduced, and when F.D.R. entered the White House he found a competent and public-minded person to run the agency: Jesse H. Jones, an entrepreneur and philanthropist from Texas. Jones was a Democrat, but he was best known as a business visionary who built the Houston Ship Channel, which transformed the city’s economy, and the owner of the Houston Chronicle. He had only an eighth-grade education, and he proved to be an extremely able and energetic administrator. Olson told me he regards Jones as “one of the great unsung heroes of the Great Depression.”
In March, 1933, with the banking system seemingly on the verge of collapse, the R.F.C. played a key role in stabilizing things. Roosevelt announced a bank holiday, during which Congress passed the Emergency Banking Act, which empowered the R.F.C. to purchase preferred stock in banks that desperately needed finance. The switch from loans to equity gave taxpayers a stake in the enterprises they were bailing out, and it also gave the banks more time to recover, because there was no fixed date for repayment. Together with the subsequent introduction of bank-deposit insurance, which was part of a separate banking act, the R.F.C. stopped the panic and restored confidence in the system. “All you have to do is look at the number of bank failures,” Olson noted. “Before March, 1933, it was in the hundreds, and it went down to the tens.”
With good will on both sides, there is no reason that Congress couldn’t act upon these lessons. Distancing the administration of the bailouts from the White House and the Treasury Department would alleviate concerns about corruption. Providing assistance in the form of equity, rather than loans, would give the taxpayer a stake in the success of the scheme. (Last week, Trump himself said that he supports this idea.) It might be difficult to find a successor to Jones—someone whom both parties regard as an honest and independent-minded patriot—to run the new agency, but it shouldn’t be impossible. (Step forward, Warren Buffett? Or a younger version of him?) The important thing is to move quickly and create a transparent bailout framework that could operate at scale and maintain public support. A Coronavirus Finance Corporation could be the answer.
A Guide to the Coronavirus


newyorker--2020-03-25--Highly Relatable Fantasies for Everyone

Highly Relatable Fantasies for Everyone

I have ten times my upper-body strength and spend a whole day climbing trees in the woods .
I never fall , and no one thinks it ’ s weird that a grown woman is eating a packed lunch in a forty-foot sycamore .
I ’ m back at summer camp , but , this time , I have boobs and shave my legs .
During the swim test , I achieve the highest level , Dolphin , which means that I can swim to the farthest dock without a life vest .
Later , while on that far-out dock @ @ @ @ @ @ @ , Sergio , says that my back dive is the best he ’ s ever seen .
I make pottery in a small town in Marin County and have a mastiff named Harriett who lives , without medical complications , until she is thirty-five .
Everyone who was ever mean to me in middle school comes to a book signing for my début novel , and I inscribe each of their copies with the words “ Keep dreaming , xo ” while asking , “ Who should I make this out to ?
@ @ @ @ @ @ @ and wake to find that someone has made me oatmeal with peaches in it .
I decide , against my better judgment , to shop at the expensive grocery store .
I can ’ t control myself and select the most outrageous rich-people foods I can find : twenty-five-dollar cherries , fourteen-dollar cheese wedges , gluten-free pastas , and glass-bottled cashew milks .
I get in line to pay , and the woman in front of me is that lady who almost hit me with her car while I was jaywalking across La @ @ @ @ @ @ @ looks at me .
I look at her .
We both remember .
Wordlessly , she pays for my groceries , and we leave .
I fall asleep in a canoe reading “ East of Eden ” and don ’ t get sunburned .
A machine is invented that can turn your thoughts into ice creams you ’ re in the mood for .
My hair is red , and it works .
It ’ s 2003 , and I ’ m twelve , and at the mall with some friends .
We @ @ @ @ @ @ @ of clothes and bought matching choker necklaces at Claire ’ s .
We go to the food court and order cheeseburgers , fries , and milkshakes .
I spill mustard on my shirt , and we all laugh—classic me !
A woman in a chic black dress and angular glasses approaches us and asks our names .
She says she loves our “ energy ” and asks us if we ’ ve ever considered modelling .
We look around at each other and then all say , with a giggle , “ No @ @ @ @ @ @ @ us that we ’ re all uniquely gorgeous and that , despite our vastly different body types and bone structures , we are exactly what she ’ s looking for for her new PacSun campaign .
We sign the contract immediately ( and don ’ t tell our parents , so that no one can say no ) .
During the shoot , which we skip school for , we eat pepperoni pizza , and I ’ m required to spill mustard on my blouse .
The money from the campaign , which @ @ @ @ @ @ @ of our college tuitions .
I am diagnosed with an incurable disease , which I die from , and everyone is very sad .
But—plot twist—reincarnation is real , and I come back as a celebrity ’ s pet bird .
I ’ m at a bar in Tulsa , and the sun is setting .
The sky is pink and yellow and blue .
I order a Martini—dry and extra-dirty .
It ’ s been a long day on set .
What I do on set does not matter for the purposes @ @ @ @ @ @ @ you must know , I ’ m the writer/director/producer .
The Martini comes , and I gaze out the window .
Sparrows perch on a telephone wire , and a few cars creep by .
On the jukebox , “ Silver Springs , ” by Fleetwood Mac , is playing .
In my peripheral vision , I see a familiar face leaning over the bar top .
How do I know him ?
From the small Italian café where I was a barista one summer ?
From that semester at sea ?
( @ @ @ @ @ @ @ we unfortunately just don ’ t have time for right now . )
He tells a corny but also slightly highbrow joke to the bartender , and I remember .
It ’ s John Mayer .
He ’ s fresh off a gig in town , looking for some local flavor , Jackson Maine style .
We talk for an hour about Impressionist painters and eighties movies .
He tells me I ’ m really funny , to which I reply , “ I know.
” He touches my hand and I draw @ @ @ @ @ @ @ .
“ It ’ s been great , ” I say , “ but I already have everything I need.
” He looks to the clouds , now deep crimson and folding over the plains .
He smiles back and says , “ You know what ?
So do I.
” I eat the last olive in my Martini , throw on my oversized jean jacket , and exit the bar without paying .
The rainforest isn ’ t on fire and our democracy isn ’ t crumbling and cell phones were never @ @ @ @ @ @ @ for practical purposes , just not in this self-destructive , attention-commodifying way .
I ’ m really good at spatial navigation all of a sudden , and , even though the world isn ’ t exactly “ fixed ” ( can it ever be ? )
, there ’ s this understanding that we ’ re all in this together , and it ’ s by and large peaceful .
Also , I have a smaller nose .

I have ten times my upper-body strength and spend a whole day climbing trees in the woods. I never fall, and no one thinks it’s weird that a grown woman is eating a packed lunch in a forty-foot sycamore.
I’m back at summer camp, but, this time, I have boobs and shave my legs. During the swim test, I achieve the highest level, Dolphin, which means that I can swim to the farthest dock without a life vest. Later, while on that far-out dock, the hot counsellor whom everyone liked, Sergio, says that my back dive is the best he’s ever seen.
I make pottery in a small town in Marin County and have a mastiff named Harriett who lives, without medical complications, until she is thirty-five.
Everyone who was ever mean to me in middle school comes to a book signing for my début novel, and I inscribe each of their copies with the words “Keep dreaming, xo” while asking, “Who should I make this out to?”
I sleep through the entire night and wake to find that someone has made me oatmeal with peaches in it.
I decide, against my better judgment, to shop at the expensive grocery store. I can’t control myself and select the most outrageous rich-people foods I can find: twenty-five-dollar cherries, fourteen-dollar cheese wedges, gluten-free pastas, and glass-bottled cashew milks. I get in line to pay, and the woman in front of me is that lady who almost hit me with her car while I was jaywalking across La Cienega Boulevard four years ago. She looks at me. I look at her. We both remember. Wordlessly, she pays for my groceries, and we leave.
I fall asleep in a canoe reading “East of Eden” and don’t get sunburned.
A machine is invented that can turn your thoughts into ice creams you’re in the mood for.
My hair is red, and it works.
It’s 2003, and I’m twelve, and at the mall with some friends. We’ve just tried on a bunch of clothes and bought matching choker necklaces at Claire’s. We go to the food court and order cheeseburgers, fries, and milkshakes. I spill mustard on my shirt, and we all laugh—classic me! A woman in a chic black dress and angular glasses approaches us and asks our names. She says she loves our “energy” and asks us if we’ve ever considered modelling. We look around at each other and then all say, with a giggle, “No . . . .” She tells us that we’re all uniquely gorgeous and that, despite our vastly different body types and bone structures, we are exactly what she’s looking for for her new PacSun campaign. We sign the contract immediately (and don’t tell our parents, so that no one can say no). During the shoot, which we skip school for, we eat pepperoni pizza, and I’m required to spill mustard on my blouse. The money from the campaign, which is wildly successful, pays for all of our college tuitions.
I am diagnosed with an incurable disease, which I die from, and everyone is very sad. But—plot twist—reincarnation is real, and I come back as a celebrity’s pet bird.
I’m at a bar in Tulsa, and the sun is setting. The sky is pink and yellow and blue. I order a Martini—dry and extra-dirty. It’s been a long day on set. What I do on set does not matter for the purposes of this fantasy, but, if you must know, I’m the writer/director/producer. The Martini comes, and I gaze out the window. Sparrows perch on a telephone wire, and a few cars creep by. On the jukebox, “Silver Springs,” by Fleetwood Mac, is playing. In my peripheral vision, I see a familiar face leaning over the bar top. How do I know him? From the small Italian café where I was a barista one summer? From that semester at sea? (These are fantasies within this fantasy that we unfortunately just don’t have time for right now.) He tells a corny but also slightly highbrow joke to the bartender, and I remember. It’s John Mayer. He’s fresh off a gig in town, looking for some local flavor, Jackson Maine style. We talk for an hour about Impressionist painters and eighties movies. He tells me I’m really funny, to which I reply, “I know.” He touches my hand and I draw it back, offering a sincere smile. “It’s been great,” I say, “but I already have everything I need.” He looks to the clouds, now deep crimson and folding over the plains. He smiles back and says, “You know what? So do I.” I eat the last olive in my Martini, throw on my oversized jean jacket, and exit the bar without paying.
The rainforest isn’t on fire and our democracy isn’t crumbling and cell phones were never invented, though we still use technology for practical purposes, just not in this self-destructive, attention-commodifying way. I’m really good at spatial navigation all of a sudden, and, even though the world isn’t exactly “fixed” (can it ever be?), there’s this understanding that we’re all in this together, and it’s by and large peaceful. Also, I have a smaller nose.


newyorker--2020-03-25--A Historian’s View of the Coronavirus Pandemic and the Influenza of 1918

In the late summer of 2005 , I packed a small bag and headed to New Orleans , to help cover Hurricane Katrina for this magazine .
I flew into Houston—the airport in New Orleans was closed—and the book I read on the flight was John M. Barry ’ s “ Rising Tide : The Great Mississippi Flood of 1927 and How It Changed America.
” It was already becoming clear that the terrible storm that had ravaged the South in 1927 resonated with what was happening again in the cities and towns along the Gulf of Mexico .
And @ @ @ @ @ @ @ COVID-19 pandemic , another of Barry ’ s books , published in 2004 , becomes invaluable : “ The Great Influenza : The Story of the Deadliest Pandemic in History.
” Barry lives in an airy house in the French Quarter of New Orleans .
His living room is bright .
There are tall windows that let in the afternoon sun .
I know these details of interior design in the way of the moment—that is , we talked the other day via Zoom , that vital means of connection at a time @ @ @ @ @ @ @ seventy-two , and cheerfully allowed that , although he and his wife have gone out briefly for quick , careful strolls in the neighborhood , they are mainly holed up at home .
Like everyone .
And discipline is the necessary thing .
At a time of containment , “ straying can kill , ” he said .
The Spanish-flu epidemic of 1918 was ruthless .
It killed somewhere between fifty million and a hundred million people—and that was in a far less populated , dense , mobile , and globalized world .
@ @ @ @ @ @ @ governments and populations that do not act with alacrity and discipline will suffer for it .
Barry and I talked a long time about the parallels between 1918 and 2020 , about what we know about the two viruses ; about the similarities and differences between the two pandemics ; about how best to cope with COVID-19 and what the virus , and our response to it , portends .
It is the duty and obsession of the historian to focus entirely on the past .
Here , John M. Barry , who @ @ @ @ @ @ @ than anyone , speculates , as well , on what the new coronavirus means for our lives in the future .
• How to practice social distancing , from responding to a sick housemate to the pros and cons of ordering food .
• How people cope and create new customs amid a pandemic .
• What it means to contain and mitigate the coronavirus outbreak .
• How much of the world is likely to be quarantined ?
• Donald Trump in the time of coronavirus .
• The coronavirus is likely @ @ @ @ @ @ @ before a vaccine could be widely available .
• We are all irrational panic shoppers .
• The strange terror of watching the coronavirus take Rome .

In the late summer of 2005, I packed a small bag and headed to New Orleans, to help cover Hurricane Katrina for this magazine. I flew into Houston—the airport in New Orleans was closed—and the book I read on the flight was John M. Barry’s “Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America.” It was already becoming clear that the terrible storm that had ravaged the South in 1927 resonated with what was happening again in the cities and towns along the Gulf of Mexico. And now, in the time of the COVID-19 pandemic, another of Barry’s books, published in 2004, becomes invaluable: “The Great Influenza: The Story of the Deadliest Pandemic in History.”
Barry lives in an airy house in the French Quarter of New Orleans. His living room is bright. There are tall windows that let in the afternoon sun. I know these details of interior design in the way of the moment—that is, we talked the other day via Zoom, that vital means of connection at a time of mandated physical distance. Barry is seventy-two, and cheerfully allowed that, although he and his wife have gone out briefly for quick, careful strolls in the neighborhood, they are mainly holed up at home. Like everyone. And discipline is the necessary thing. At a time of containment, “straying can kill,” he said.
The influenza epidemic of 1918 was ruthless. It killed somewhere between fifty million and a hundred million people—and that was in a far less populated, dense, mobile, and globalized world. The new coronavirus is aggressive, and governments and populations that do not act with alacrity and discipline will suffer for it.
Barry and I talked a long time about the parallels between 1918 and 2020, about what we know about the two viruses; about the similarities and differences between the two pandemics; about how best to cope with COVID-19 and what the virus, and our response to it, portends. It is the duty and obsession of the historian to focus entirely on the past. Here, John M. Barry, who knows the deadliest pandemic in history better than anyone, speculates, as well, on what the new coronavirus means for our lives in the future.
A Guide to the Coronavirus


newyorker--2020-03-25--Ben Purkert Reads Jorie Graham

Ben Purkert Reads Jorie Graham

Ben Purkert joins Kevin Young to read “ Notes on the Reality of the Self , ” by Jorie Graham , and his own poem “ News.
” Purkert began contributing poetry to The New Yorker in 2012 , and his début poetry collection , “ For the Love of Endings , ” was published in 2018 .
Below is an automated transcript of this podcast episode .
Kevin Young : You ’ re listening to The New Yorker poetry podcast .
I ’ m Kevin Young , poetry editor of The New Yorker magazine .
As you may know @ @ @ @ @ @ @ poets to select a poem from The New Yorker archive to read and discuss .
Then they read a poem of their own that 's appeared in the magazine .
My guest today is Ben Purkert , who began contributing poems to our pages in 2012 and whose debut poetry collection “ For the Love of Endings ” was published in 2018 .
Ben , welcome .
Thanks so much for being here .
Ben Purkert : Yeah , thanks for having me .
Kevin Young : So the poem you ’ ve @ @ @ @ @ @ @ on the Reality of the Self , ” by Jorie Graham .
What drew you to this poem ?
Ben Purkert : Jorie ’ s work is tremendously meaningful for me .
Jorie also as a person is meaningful for me .
She was my teacher .
I love her work , particularly for the way she can sort of just fix her gaze to something and , you know , it should be boring .
It ’ s just you ’ re looking at a river .
There ’ s nothing inherently @ @ @ @ @ @ @ her mind is such that .
.
.
I do n't know , I find myself reading with rapt attention .
So I love how she sort of takes this scene and makes it more than what you might expect .
Kevin Young : Well , why do n't we hear the poem from our archives ?
Here 's Ben Purkert reading “ Notes on the Reality of the Self , ” by Jorie Graham .
[ “ Notes On The Reality of the Self.
” ] Kevin Young : That was “ @ @ @ @ @ @ @ , ” by Jorie Graham , originally published in the August 24 , 1992 , issue of the magazine .
So I was struck hearing that poem , how much it ’ s a poem about looking , obviously .
And , as you said it , it starts with just a river , but it really is about language about the body and how the invisible roils .
And I love how the fourth line , she says “ this dance of non-discovery , ” which of course , is , like @ @ @ @ @ @ @ Of course , it ’ s followed by “ all things are / possible , ” but it almost takes this emptiness to encourage this thought .
How do you take this looking , which she does better , as you said , than almost anyone , right ?
Ben Purkert : I mean , I think there are things that are being discovered all along the way of this poem , and the way it sort of meanders and moves , not unlike a river .
I mean , I think that @ @ @ @ @ @ @ impossibility of Jorie ’ s work is the fact that , you know , as I said before , I think this poem should be boring , right ?
There ’ s nothing to call attention to this moment as being a seminal moment in one ’ s own understanding of who they are and what the self is and the reality of the self .
But I guess what I ’ m so drawn to is that , in this poem and in a lot of Jorie ’ s poems where there @ @ @ @ @ @ @ a body of water , nothing is static .
The river is changing all the time , of course .
But also the speaker .
My favorite lines from the poem , I think , are “ I see it from here and then / I see it from here.
” And when I read that , every part of me wants it to be “ there.
” Right ?
“ I see it from here and then I see it from there.
” But that 's not what it says .
So @ @ @ @ @ @ @ a little bit , you know , you can change even if you stay in place , even if you don ’ t necessarily get a different perspective on the river , you ’ re not the same person that you were even a millisecond before .
Kevin Young : Well and it sort of plays with that old adage , you know , “ you never step in the same river twice.
” Kevin Young : But it ’ s like the self is the river , not just this external thing @ @ @ @ @ @ @ , right after that , where it says , “ Is there a new way of looking— / valences and little hooks— ” I mean , I love the dashes .
Kevin Young : “ inevitabilities , proba- / bilities ?
” And in fact , there ’ s a break in between “ proba ” -break- “ bilities.
” And there ’ s this kind of .
.
.
You called it meandering ; it ’ s almost , to me , also fragmented in its lurching forward .
Ben Purkert : @ @ @ @ @ @ @ .
I mean I think different readers would hear it differently .
I hear in it a sort of vulnerability or uncertainty , like , Have they invented some new way of looking ?
Am I doing it wrong ?
Like , you know .
“ Valences and little hooks ” —it almost sounds like there ’ s been some , like , technological innovation .
But , of course , you know , as you said , we ’ ve been looking at things the same way , you know , since @ @ @ @ @ @ @ me that , of course , there isn ’ t .
Kevin Young : Well , and then she says “ inevitabilities , ” which are different than probabilities .
Kevin Young : You know , and “ probabilities ” —those do n't even make it on one line , you know ?
It 's “ proba- / bilities.
” Ben Purkert : I mean , I do n't want to read too much into this , but “ inevitabilities , proba- / bilities.
” I mean , it makes me feel like @ @ @ @ @ @ @ to quantum mechanics , or like .
.
.
I mean , this is the first poem in her book “ Materialism.
” So a lot of these questions around , you know , nothing is virtual , all as possible—I mean , I think she ’ s really wrestling here .
And this is not an easy poem .
I don ’ t find it an easy poem to read or necessarily engage with .
But I think it ’ s really questioning , you know , what is consciousness ?
What @ @ @ @ @ @ @ it matter ?
Is it material ?
Or is it something that lives above or outside ?
Kevin Young : That ’ s a good question .
Do you have the answer ?
Ben Purkert : Kevin , can you tell me ?
That ’ s why I 'm here .
Kevin Young : Well , it makes me think of a few things .
One of the things I came to understand about poems—I don ’ t know , somewhat early on—is that really what you ’ re seeing or what you @ @ @ @ @ @ @ a mind at work .
Kevin Young : You know , and hers , of course , is so special .
But she also announces what she ’ s doing : “ Notes on the Reality of the Self.
” And a different poet might have only had an interior monologue .
But I think it ’ s almost the river that , as I said , is the self .
And then also becomes , kind of , a way or an occasion to meditate , which is , again , you @ @ @ @ @ @ @ that does that or ancient Chinese poetry or romanticism .
You know , it ’ s also in this rich tradition of thinking about the self in nature .

Photograph by Siddhartha Sinha
Ben Purkert joins Kevin Young to read “Notes on the Reality of the Self,” by Jorie Graham, and his own poem “News.” Purkert began contributing poetry to The New Yorker in 2012, and his début poetry collection, “For the Love of Endings,” was published in 2018.
Below is an automated transcript of this podcast episode.
Kevin Young: You’re listening to The New Yorker poetry podcast. I’m Kevin Young, poetry editor of The New Yorker magazine. As you may know, on this program, we ask poets to select a poem from The New Yorker archive to read and discuss. Then they read a poem of their own that's appeared in the magazine. My guest today is Ben Purkert, who began contributing poems to our pages in 2012 and whose debut poetry collection “For the Love of Endings” was published in 2018. Ben, welcome. Thanks so much for being here.
Ben Purkert: Yeah, thanks for having me.
Kevin Young: So the poem you’ve chosen to read today is “Notes on the Reality of the Self,” by Jorie Graham. What drew you to this poem?
Ben Purkert: Jorie’s work is tremendously meaningful for me. Jorie also as a person is meaningful for me. She was my teacher. I love her work, particularly for the way she can sort of just fix her gaze to something and, you know, it should be boring. It’s just you’re looking at a river. There’s nothing inherently dramatically interesting about that, except that her mind is such that . . . I don't know, I find myself reading with rapt attention. So I love how she sort of takes this scene and makes it more than what you might expect.
Kevin Young: Well, why don't we hear the poem from our archives? Here's Ben Purkert reading “Notes on the Reality of the Self,” by Jorie Graham.
[“Notes On The Reality of the Self.”]
Kevin Young: That was “Notes on the Reality of the Self,” by Jorie Graham, originally published in the August 24, 1992, issue of the magazine. So I was struck hearing that poem, how much it’s a poem about looking, obviously. And, as you said it, it starts with just a river, but it really is about language about the body and how the invisible roils. And I love how the fourth line, she says “this dance of non-discovery,” which of course, is, like, to me, not true. Of course, it’s followed by “all things are / possible,” but it almost takes this emptiness to encourage this thought. How do you take this looking, which she does better, as you said, than almost anyone, right?
Ben Purkert: I mean, I think there are things that are being discovered all along the way of this poem, and the way it sort of meanders and moves, not unlike a river. I mean, I think that’s sort of like the amazing impossibility of Jorie’s work is the fact that, you know, as I said before, I think this poem should be boring, right? There’s nothing to call attention to this moment as being a seminal moment in one’s own understanding of who they are and what the self is and the reality of the self. But I guess what I’m so drawn to is that, in this poem and in a lot of Jorie’s poems where there's, you know, looking at a body of water, nothing is static. The river is changing all the time, of course. But also the speaker. My favorite lines from the poem, I think, are “I see it from here and then / I see it from here.” And when I read that, every part of me wants it to be “there.” Right? “I see it from here and then I see it from there.” But that's not what it says. So for me, that calls into question a little bit, you know, you can change even if you stay in place, even if you don’t necessarily get a different perspective on the river, you’re not the same person that you were even a millisecond before.
Kevin Young: Well and it sort of plays with that old adage, you know, “you never step in the same river twice.”
Ben Purkert: Right.
Kevin Young: But it’s like the self is the river, not just this external thing. I love that moment, too, right after that, where it says, “Is there a new way of looking— / valences and little hooks—” I mean, I love the dashes.
Ben Purkert: Yeah.
Kevin Young: “inevitabilities, proba- / bilities?” And in fact, there’s a break in between “proba”-break-“bilities.” And there’s this kind of . . . You called it meandering; it’s almost, to me, also fragmented in its lurching forward.
Ben Purkert: And also, I hear . . . I mean I think different readers would hear it differently. I hear in it a sort of vulnerability or uncertainty, like, Have they invented some new way of looking? Am I doing it wrong? Like, you know. “Valences and little hooks”—it almost sounds like there’s been some, like, technological innovation. But, of course, you know, as you said, we’ve been looking at things the same way, you know, since forever. Yeah. So it strikes me that, of course, there isn’t.


newyorker--2020-03-25--Why Is Russia’s Coronavirus Case Count So Low?

In the past two weeks , I ’ ve observed from afar as various places around the world to which I have a personal attachment registered a grim uptick in coronavirus cases , and then , in response , effectively shut down .
In Southern California , my mother was the first person I knew to self-quarantine ; next were friends in Paris , who , in the span of forty-eight hours , went from eating lunch in cafés and planning a trip to Germany to hunkering down with their young children ; then it was the turn of friends @ @ @ @ @ @ @ I lived for nearly a decade .
During this time , Moscow , the city where I have lived for eight years , has felt like an unlikely outlier .
Life here has definitely become stranger , but it is far from completely upended .
As of Tuesday , Russia has four hundred and ninety-five official cases of COVID-19 , a small fraction of the number of cases in major European countries or in the United States .
Vladimir Putin has offered general assurances that the situation in Russia is “ under control @ @ @ @ @ @ @ s mayor , a Putin loyalist , has closed schools and cancelled public events , the daily ebb and flow of the city hasn ’ t changed all that dramatically .
I ’ ve mostly stayed at home , but the metro is still running , and shops and restaurants are open .
The luxury department store Tsum is having one of its best years for sales in recent memory .
Half my friends are observing some form of self-quarantine ; the other half doesn ’ t get what the fuss is about—or @ @ @ @ @ @ @ t .
It is unclear whether the Russian state has been lucky , smart with preëmptive measures , or dangerously incompetent—or some combination of all three .
In the case of incompetence , Russia ’ s seemingly small figures will soon be replaced by colossal ones .
In recent days , I ’ ve spoken to doctors , epidemiologists , and patients , to try and get a handle on whether Russia will be the next Italy , with an overwhelmed public-health system , or Japan , with its relatively flat and steady @ @ @ @ @ @ @ , without having planned for it , Russian society , which is not nearly as defined by shoulder-to-shoulder public mixing as many European ones , had some advantages in weathering the early phase of the pandemic .
Russia shares a twenty-six-hundred-mile border with China , but its most populous cities have fewer and less extensive ties with China than do many places in Europe .
( Russian–Chinese trade topped a hundred billion dollars last year , but much of that came in oil and gas deliveries , a very different type of contact @ @ @ @ @ @ @ the many factories of northern Italy with a large Chinese labor force . )
Russia is vast , with a relatively less developed transit infrastructure than European countries of similar populations .
As a result , Michael Favorov , a doctor and public-health expert who previously oversaw C.D.C .
programs in Eastern Europe and Central Asia , told me , “ I wouldn ’ t expect a single outbreak in Russia but , rather , several , each with its own geography and developmental stages.
” It is also not impossible that Russia @ @ @ @ @ @ @ with an admirable degree of foresight and care .
In January , Russia shut down its land border with China .
Beginning in February , passengers arriving to Moscow by plane from virus hot spots , such as China , Iran , and South Korea , were met by a phalanx of medical workers in protective gear administering tests .
People who came from Europe—before those flights were cancelled—had their temperatures taken and were sent home for a mandatory fourteen-day quarantine .
I talked to three people who developed symptoms while they were @ @ @ @ @ @ @ , and who were put into isolation wards in a hospital in a Moscow suburb—a measure in line with recommendations from the World Health Organization to test and isolate .
( I heard mixed reviews of this hospital , in the suburb of Kommunarka , which has become the city ’ s main coronavirus hub .
One patient told me that he was “ very impressed ” ; another complained that the swab she gave at the airport was lost and that she had to wait days to give another . )
In @ @ @ @ @ @ @ Russia ’ s have a head start in tracking citizens—one man in Moscow , who had returned from Italy on the same plane as someone who later tested positive , was fined after cameras equipped with face-recognition technology caught him violating his mandatory quarantine by taking out the garbage .
As I heard a political scientist acknowledge last week on Echo of Moscow , an independent , liberal radio station , “ The fact that a certain regime is headed for a dead end in the long run doesn ’ t mean it @ @ @ @ @ @ @ tactical level.
” Melita Vujnovic , the W.H.O .
representative in Moscow , recently told CNN , “ Testing and identification of cases , tracing contacts , isolation—these are all measures that W.H.O .
proposes and recommends , and they were in place all the time.
” As of this moment , Russia , a country of a hundred and forty-four million people , claims to have carried out a hundred and sixty-five thousand coronavirus tests in total , about half the number that were performed in the United States .
Russia has @ @ @ @ @ @ @ is some evidence of a much larger outbreak of the coronavirus than the official statistics appear to suggest .
According to Russia ’ s own statistics agency , the number of pneumonia cases in Moscow grew by thirty-seven per cent this January , compared with the same time last year .
Anastasia Vasilyeva , the head of the independent Doctors Alliance trade union , said , “ It ’ s impossible to know the real situation , but one thing we know for sure : the state is ready to manipulate medical statistics @ @ @ @ @ @ @ Putin announced a drive to lower the death rate from cardiovascular disease , after which hospitals reported a year-to-year drop in death from heart-related illness—and a nearly equivalent rise in deaths from rare or unclassifiable diseases .
Similar manipulations may be at work now .
On March 10th , a seventy-five-year-old man died at the hospital in Kommunarka .
He had been undergoing chemotherapy treatment and recently returned from Italy .
His cause of death was recorded as “ adrenal hemorrhage ” —meaning that his death was not formally attributed to the coronavirus @ @ @ @ @ @ @ the truth , ” Vasilyeva said .
“ We can only assume.
” On March 19th , a seventy-nine-year-old professor in Moscow died of pneumonia ; initially , Russian officials linked her cause of death to the coronavirus , but later changed it to “ blood clot.
” In recent days , stories about wards overflowing with pneumonia patients have circulated on Russian social media .
As Vasiliy Vlassov , an epidemiologist and professor at the Higher School of Economics , in Moscow , pointed out , even if there is nothing to @ @ @ @ @ @ @ much wider outbreak , the country ’ s infection curve is just beginning .
“ For now , we ’ re way over on the left , ” he said .
“ The question is , as it builds out to the right , will the curve be linear or exponential ?
” Vlassov also noted that , although official case numbers remain relatively low , they are growing at an alarming rate , doubling every two days , compared with every three or more days in Europe .
Vlassov also explained that @ @ @ @ @ @ @ more sensitive test and is allowing testing to be carried out by a larger number of laboratories around the country ; the upward curve may therefore reflect not only new cases but the true scale of already existing ones .
Increasingly , public figures are suggesting that Russia ’ s official count is likely too low .
Moscow ’ s mayor , who is leading Russia ’ s response to the coronavirus , told Putin on Tuesday , “ Nobody knows the real picture .
In reality , there are far more people @ @ @ @ @

In the past two weeks, I’ve observed from afar as various places around the world to which I have a personal attachment registered a grim uptick in coronavirus cases, and then, in response, effectively shut down. In Southern California, my mother was the first person I knew to self-quarantine; next were friends in Paris, who, in the span of forty-eight hours, went from eating lunch in cafés and planning a trip to Germany to hunkering down with their young children; then it was the turn of friends and colleagues in New York, where I lived for nearly a decade. During this time, Moscow, the city where I have lived for eight years, has felt like an unlikely outlier. Life here has definitely become stranger, but it is far from completely upended. As of Tuesday, Russia has four hundred and ninety-five official cases of COVID-19, a small fraction of the number of cases in major European countries or in the United States.
Vladimir Putin has offered general assurances that the situation in Russia is “under control,” and, although Moscow’s mayor, a Putin loyalist, has closed schools and cancelled public events, the daily ebb and flow of the city hasn’t changed all that dramatically. I’ve mostly stayed at home, but the metro is still running, and shops and restaurants are open. The luxury department store Tsum is having one of its best years for sales in recent memory. Half my friends are observing some form of self-quarantine; the other half doesn’t get what the fuss is about—or, rather, their employers don’t.
It is unclear whether the Russian state has been lucky, smart with preëmptive measures, or dangerously incompetent—or some combination of all three. In the case of incompetence, Russia’s seemingly small figures will soon be replaced by colossal ones. In recent days, I’ve spoken to doctors, epidemiologists, and patients, to try to get a handle on whether Russia will be the next Italy, with an overwhelmed public-health system, or Japan, with its relatively flat and steady growth curve.
It is possible that, without having planned for it, Russian society, which is not nearly as defined by shoulder-to-shoulder public mixing as many European ones, had some advantages in weathering the early phase of the pandemic. Russia shares a twenty-six-hundred-mile border with China, but its most populous cities have fewer and less extensive ties with China than do many places in Europe. (Russian–Chinese trade topped a hundred billion dollars last year, but much of that came in oil and gas deliveries, a very different type of contact than one finds in, say, the many factories of northern Italy with a large Chinese labor force.) Russia is vast, with a relatively less developed transit infrastructure than European countries of similar populations. As a result, Michael Favorov, a doctor and public-health expert who previously oversaw C.D.C. programs in Eastern Europe and Central Asia, told me, “I wouldn’t expect a single outbreak in Russia but, rather, several, each with its own geography and developmental stages.”
It is also not impossible that Russia handled the early days of the pandemic with an admirable degree of foresight and care. In January, Russia shut down its land border with China. Beginning in February, passengers arriving to Moscow by plane from virus hot spots such as China, Iran, and South Korea were met by a phalanx of medical workers in protective gear administering tests. People who came from Europe—before those flights were cancelled—had their temperatures taken and were sent home for a mandatory fourteen-day quarantine. I talked to three people who developed symptoms while they were waiting at home for their test results, and who were put into isolation wards in a hospital in a Moscow suburb—a measure in line with recommendations from the World Health Organization to test and isolate. (I heard mixed reviews of this hospital, in the suburb of Kommunarka, which has become the city’s main coronavirus hub. One patient told me that he was “very impressed”; another complained that the swab she gave at the airport was lost and that she had to wait days to give another.) In theory, heavily policed authoritarian systems like Russia’s have a head start in tracking citizens—one man in Moscow, who had returned from Italy on the same plane as someone who later tested positive, was fined after cameras equipped with face-recognition technology caught him violating his mandatory quarantine by taking out the garbage. As I heard a political scientist acknowledge last week on Echo of Moscow, an independent, liberal radio station, “The fact that a certain regime is headed for a dead end in the long run doesn’t mean it may not have some advantages on the tactical level.” Melita Vujnovic, the W.H.O. representative in Moscow, recently told CNN, “Testing and identification of cases, tracing contacts, isolation—these are all measures that W.H.O. proposes and recommends, and they were in place all the time.”
As of this moment, Russia, a country of a hundred and forty-four million people, claims to have carried out a hundred and sixty-five thousand coronavirus tests in total, about half the number that were performed in the United States. Russia has fewer acknowledged cases than Luxembourg—and yet there is some evidence of a much larger outbreak of the coronavirus than the official statistics appear to suggest. According to Russia’s own statistics agency, the number of pneumonia cases in Moscow grew by thirty-seven per cent in January, compared with the same time last year. Anastasia Vasilyeva, the head of the independent Doctors Alliance trade union, said, “It’s impossible to know the real situation, but one thing we know for sure: the state is ready to manipulate medical statistics for political purposes.” In 2015, Putin announced a drive to lower the death rate from cardiovascular disease, after which hospitals reported a year-to-year drop in death from heart-related illness—and a nearly equivalent rise in deaths from rare or unclassifiable diseases. Similar manipulations may be at work now. On March 10th, a seventy-five-year-old man died at the hospital in Kommunarka. He had been undergoing chemotherapy treatment and recently returned from Italy. His cause of death was recorded as “adrenal hemorrhage”—meaning that his death was not formally attributed to the coronavirus. “We’ll never know the truth,” Vasilyeva said. “We can only assume.” On March 19th, a seventy-nine-year-old professor in Moscow died of pneumonia; initially, Russian officials linked her cause of death to the coronavirus, but later changed it to “blood clot.”
In recent days, stories about wards overflowing with pneumonia patients have circulated on Russian social media. As Vasiliy Vlassov, an epidemiologist and professor at the Higher School of Economics, in Moscow, pointed out, even if there is nothing to suggest that Russia is covering up a much wider outbreak, the country’s infection curve is just beginning. “For now, we’re way over on the left,” he said. “The question is, as it builds out to the right, will the curve be linear or exponential?” Vlassov also noted that, although official case numbers remain relatively low, they are growing at an alarming rate, doubling every two days, compared with every three or more days in Europe. Vlassov also explained that Russia has recently begun to use a more sensitive test and is allowing testing to be carried out by a larger number of laboratories across the country; the upward curve may therefore reflect not only new cases but the true scale of already existing ones. Increasingly, public figures are suggesting that Russia’s official count is likely too low. Moscow’s mayor, who is leading Russia’s response to the coronavirus, told Putin on Tuesday, “Nobody knows the real picture. In reality, there are far more people who are infected.”
As the epidemic continues to spread, Russia may have a harder time tracking people who have caught the coronavirus at work, on the metro, or from relatives. Sergey Netesov, the head of the bionanotechnology, microbiology, and virology laboratory at Novosibirsk State University, who was previously a researcher at Vector—the state laboratory that developed the first coronavirus test in Russia—told me, “These are the most dangerous carriers, and I’m worried this contingent is not being caught at all, at least not yet.” For every story I heard that suggested a thorough, even overly paranoid, approach—one friend told me of a neighbor who was tested after other residents in their building heard her repeatedly coughing in the stairwell and called the city’s coronavirus hotline—I heard another story that conveyed a less encouraging image, such as that of a nineteen-year-old college student in Moscow who was refused a test, despite experiencing a fever and a persistent cough, even after her university dorm was closed for fear of coronavirus infection. I spoke to a man in Volgograd, a city in southern Russia, who told me that he had come down with pneumonia late last month. At the hospital, doctors told him that rates of pneumonia in the city were ten times higher than in previous years—every second or third patient seemed to be suffering from the ailment, they said. “I couldn’t stop coughing,” the man told me. “I was running out of breath every hundred metres—it reminded me of what I’d heard everyone talking about.” Doctors asked him whether he’d been in contact with anyone who had recently been in China or Europe—as far as he knew, he hadn’t—but they didn’t test him for the coronavirus. Stories like this, Vasilyeva said, may suggest either a purposeful coverup or simply a lack of know-how, equipment, and testing abilities, especially in smaller cities and more far-flung regions.


newyorker--2020-03-25--The Coronavirus and What’s at Stake in a Name

In 2009 , at the height of the H1N1 pandemic , a group of researchers in the U.S. and Canada decided to test whether public-health interventions might limit disease-induced prejudice along with disease itself .
In one part of the study , members of both vaccinated and unvaccinated groups were asked to read an article that amplified the threats of the pandemic , then complete a survey that assessed their attitudes toward immigrants .
The vaccinated subjects , it turned out , exhibited less prejudice than their unvaccinated counterparts .
In another part of the study , the researchers determined @ @ @ @ @ @ @ “ the seasonal flu vaccine involves injecting people with the seasonal flu virus ” —increased prejudice in subjects concerned about disease , whereas defining it in terms of protection— “ the seasonal flu vaccine protects people from the seasonal flu virus ” —had no such effect .
Initiatives that minimize disease , the researchers concluded , might also end up minimizing discrimination .
Eula Biss cites this imperfect but telling research in “ On Immunity , ” her mesmerizing book about vaccination , which observes that an innate wariness of perceived out-groups—immigrants , @ @ @ @ @ @ @ to an ancient disease-prevention mechanism .
Evolutionary psychologists refer to a “ behavioral immune system ” that attunes humans to physical differences or unfamiliar behavior , even when it poses no risk .
This tendency peaks at moments of particular vulnerability : one study , from 2007 , suggests that pregnant women exhibit more xenophobia than usual during the early stages of gestation .
Biss quotes Susan Sontag , who wrote that syphilis “ was the ‘ French Pox ’ to the English , morbus Germanicus to the Parisians , the Naples sickness @ @ @ @ @ @ @ to the Japanese.
” It is no help that popular perceptions of disease depend on metaphors of foreign infiltration .
As the anthropologist Emily Martin writes in “ Flexible Bodies , ” textbooks and magazines tend to depict the body as a site of warfare between “ ruthless invaders and determined offenders.
” It was only a matter of time before Donald Trump enlisted such language to serve his nativist agenda .
Although COVID-19 , the disease caused by the novel coronavirus , has killed more than twenty thousand people and affected countries @ @ @ @ @ @ @ fixation on its origins in Wuhan , China , has encouraged a rash of anti-Asian bigotry in the United States .
Acknowledging such harassment during a White House briefing on Monday night , Trump urged the public to “ protect our Asian-American community.
” But this paltry call for tolerance hardly compensates for the prejudice that he and other figures on the right have helped foment .
This month , Trump has taken to referring to COVID-19 as the “ Chinese virus , ” presenting the label as a corrective to Beijing officials @ @ @ @ @ @ @ the source of the outbreak .
Countering misinformation , though , is hardly the same thing as implicating an entire people .
Last week , an Asian-American journalist reported that a member of the President ’ s staff called COVID-19 the “ kung flu ” to her face .
This Wednesday , the Washington Post reported that representatives of the G-7 countries failed to agree on a joint statement about the pandemic , because the Trump Administration insisted on using the term “ Wuhan virus.
” “ China is to blame , because @ @ @ @ @ @ @ snakes and dogs and things like that , ” Senator John Cornyn , Republican of Texas , said in a recent videotaped interview , defending Trump ’ s label .
“ These viruses are transmitted from the animal to the people , and that ’ s why China has been the source of a lot of these viruses , like SARS , like MERS , the swine flu.
” Cornyn ’ s statement is startling in its ignorance—neither MERS , which stands for Middle East Respiratory Syndrome , nor the 2009 strain of @ @ @ @ @ @ @ swine flu , is thought to have originated in China—but he is not wrong to connect Trump ’ s fearmongering nickname for the novel coronavirus to the stories of pandemics past .
The history of disease offers numerous examples of how ill-chosen names can instigate undue prejudice toward particular ethnic or religious communities .
In 2015 , the World Health Organization issued a set of best practices for naming new infectious diseases , in order to reduce the potential for stigma .
Its recommendations discouraged basing nomenclature on geographic locations ( Japanese encephalitis @ @ @ @ @ @ @ ) , species of animals and food ( monkeypox ) , or cultural and occupational references ( Legionnaires ’ disease ) .
( The W.H.O .
also warned against certain terms— “ unknown , ” “ fatal , ” “ epidemic ” —that incite unnecessary fear . )
“ This may seem like a trivial issue to some , but disease names really do matter to the people who are directly affected , ” Keiji Fukuda , at the time the organization ’ s assistant director-general for health security , said in a @ @ @ @ @ @ @ .
weeks to land on the name COVID-19 , which stands for “ coronavirus disease 2019.
” ) Much of the old nomenclature has turned out to be not only stigmatizing but inaccurate .
The Ebola virus , for instance , was named after a river that sits about forty miles from Yambuku , the Congolese village where researchers first investigated the disease , in 1976 .
In his memoir , “ No Time to Lose , ” Peter Piot , the doctor whose team worked toward the discovery of the virus , @ @ @ @ @ @ @ during an “ entirely fatigued state , ” choosing as an eponym a natural landmark rather than risking the reputation of an entire country .
( Piot later learned that he had a bad map : the Ebola River is not even the closest river to Yambuku . )
The Spanish flu , which coincided with the First World War , was so named because Spain , which remained a neutral power , had no qualms about covering its outbreak , whereas Germany , France , the U.K. , and the U.S. suppressed @ @ @ @ @ @ @ Most evidence suggests that Spain was not the first country to witness an outbreak , nor was it the hardest hit . )
During the 2009 outbreak of H1N1 , which came to be called the swine flu because it resembled other viruses that commonly affected pigs , pork farmers reported huge losses in their industry .
Though the illness was likely developed through a combination of animals , China and Russia banned pork imports , and health officials in Egypt ordered the widespread culling of hundreds of thousands of pigs , ravaging @ @ @ @ @ @ @ swine farmers , almost all of whom were among the Christian minority .
In the U.S. , perhaps no disease better illustrates the perils of disease naming than AIDS , which , in its early days , was sometimes called “ gay cancer.
” Epidemiologists have argued that this label exacerbated the government ’ s disastrous response , allowing officials to recast the outbreak as a “ niche liberal issue , ” in the words of one study , rather than the epidemic that it remains today .
The comparison between COVID-19 and @ @ @ @ @ @ @ one thing , the American government delayed confronting the AIDS epidemic for years , not weeks .
Still , it ’ s hard not to see a similarity between the recent reports of harassment against Asian-Americans and the stigmatization that gay people suffered in the wake of the AIDS outbreak .
Carol Goldin , a researcher at Rutgers University , wrote , in 1994 , that aligning any disease so closely with a single group “ allows the rest of society to simultaneously assign blame , and , through contrast , define their @ @ @ @ @ @ @ , is not simply a civil-rights issue but “ a serious health threat ” : it allows those outside of the targeted group to consider themselves exempt from risk .

In 2009, at the height of the H1N1 pandemic, a group of researchers in the U.S. and Canada decided to test whether public-health interventions might limit disease-induced prejudice along with disease itself. In one part of the study, members of both vaccinated and unvaccinated groups were asked to read an article that amplified the threats of the pandemic, then complete a survey that assessed their attitudes toward immigrants. The vaccinated subjects, it turned out, exhibited less prejudice than their unvaccinated counterparts. In another part of the study, the researchers determined that defining vaccination in terms of contamination—“the seasonal flu vaccine involves injecting people with the seasonal flu virus”—increased prejudice in subjects concerned about disease, whereas defining it in terms of protection—“the seasonal flu vaccine protects people from the seasonal flu virus”—had no such effect. Initiatives that minimize disease, the researchers concluded, might also end up minimizing discrimination.
Eula Biss cites this imperfect but telling research in “On Immunity,” her mesmerizing book about vaccination, which observes that an innate wariness of perceived out-groups—immigrants, ethnic minorities, people with visible disabilities—amounts to an ancient disease-prevention mechanism. Evolutionary psychologists refer to a “behavioral immune system” that attunes humans to physical differences or unfamiliar behavior, even when it poses no risk. This tendency peaks at moments of particular vulnerability: one study, from 2007, suggests that pregnant women exhibit more xenophobia than usual during the early stages of gestation. Biss quotes Susan Sontag, who wrote that syphilis “was the ‘French Pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese.” It is no help that popular perceptions of disease depend on metaphors of foreign infiltration. As the anthropologist Emily Martin writes in “Flexible Bodies,” textbooks and magazines tend to depict the body as a site of warfare between “ruthless invaders and determined offenders.”
It was only a matter of time before Donald Trump enlisted such language to serve his nativist agenda. Although COVID-19, the disease caused by the novel coronavirus, has killed more than twenty thousand people and affected countries around the world, Trump’s fixation on its origins in Wuhan, China, has encouraged a rash of anti-Asian bigotry in the United States. Acknowledging such harassment during a White House briefing on Monday night, Trump urged the public to “protect our Asian-American community.” But this paltry call for tolerance does not compensate for the prejudice that he and other figures on the right have helped foment. This month, Trump has taken to referring to COVID-19 as the “Chinese virus,” presenting the label as a corrective to Beijing officials’ claims that the American military was the source of the outbreak. Countering misinformation, though, is hardly the same thing as implicating an entire people. Last week, an Asian-American journalist reported that a member of the President’s staff called COVID-19 the “kung flu” to her face. This Wednesday, the Washington Post reported that representatives of the G-7 countries failed to agree on a joint statement about the pandemic, because the Trump Administration insisted on using the term “Wuhan virus.” “China is to blame, because the culture where people eat bats and snakes and dogs and things like that,” Senator John Cornyn, Republican of Texas, said in a recent videotaped interview, defending Trump’s label. “These viruses are transmitted from the animal to the people, and that’s why China has been the source of a lot of these viruses, like SARS, like MERS, the swine flu.”
Cornyn’s statement is startling in its ignorance—neither MERS, which stands for Middle East Respiratory Syndrome, nor the 2009 strain of H1N1, the official name of the swine flu, is thought to have originated in China—but he is not wrong to connect Trump’s fearmongering nickname for the novel coronavirus to the stories of pandemics past. The history of disease offers numerous examples of how ill-chosen names can instigate undue prejudice toward particular ethnic or religious communities. In 2015, the World Health Organization issued a set of best practices for naming new infectious diseases, in order to reduce the potential for stigma. Its recommendations discouraged basing nomenclature on geographic locations (Japanese encephalitis), proper names (Creutzfeldt-Jakob disease), species of animals and food (monkeypox), or cultural and occupational references (Legionnaires’ disease). (The W.H.O. also warned against certain terms—“unknown,” “fatal,” “epidemic”—that incite unnecessary fear.) “This may seem like a trivial issue to some, but disease names really do matter to the people who are directly affected,” Keiji Fukuda, at the time the organization’s assistant director-general for health security, said in a statement. (It took the W.H.O. weeks to land on the name COVID-19, which stands for “coronavirus disease 2019.”)
Much of the old nomenclature has turned out to be not only stigmatizing but inaccurate. The Ebola virus, for instance, gets its name from a river that sits about forty miles from Yambuku, the Congolese village where researchers first investigated the disease, in 1976. In his memoir, “No Time to Lose,” Peter Piot, the doctor whose team worked toward the discovery of the virus, admits that they made a hasty decision while in an “entirely fatigued state,” choosing a natural landmark as an eponym to avoid risking the reputation of an entire country. (Piot later learned that he had a bad map: the Ebola River is not even the closest river to Yambuku.) The Spanish flu, which coincided with the First World War, was so named because Spain, which remained a neutral power, had no qualms about covering its outbreak, whereas Germany, France, the U.K., and the U.S. suppressed accounts to preserve public morale. (Most evidence suggests that Spain was not the first country to witness an outbreak, nor was it the hardest hit.) During the 2009 outbreak of H1N1, which came to be called the swine flu because it resembled other viruses that commonly affected pigs, pork farmers reported huge losses in their industry. Though the illness was likely developed through a combination of animals, China and Russia banned pork imports, and health officials in Egypt ordered the widespread culling of hundreds of thousands of pigs, ravaging the livelihood of the country’s swine farmers, almost all of whom were among the Christian minority.
In the U.S., perhaps no disease better illustrates the perils of disease naming than AIDS, which, in its early days, was sometimes called “gay cancer.” Epidemiologists have argued that this label exacerbated the government’s disastrous response, allowing officials to recast the outbreak as a “niche liberal issue,” in the words of one study, rather than the epidemic that it remains today. The comparison between COVID-19 and AIDS is imperfect at best: for one thing, the American government delayed confronting the AIDS epidemic for years, not weeks. Still, it’s hard not to see a similarity between the recent reports of harassment against Asian-Americans and the stigmatization that gay people suffered in the wake of the AIDS outbreak. Carol Goldin, a researcher at Rutgers University, wrote, in 1994, that aligning any disease so closely with a single group “allows the rest of society to simultaneously assign blame, and, through contrast, define their own innocence.” This, she added, is not simply a civil-rights issue but “a serious health threat”: it allows those outside of the targeted group to consider themselves exempt from risk.
It’s not clear that anyone, anywhere in the world, can at this point reasonably claim exemption from the threat of COVID-19, least of all the countless Americans flouting the social-distancing measures intended to protect them and their communities. The terror of Trump’s finger-pointing is not only that it will surely exacerbate the misdirected anger and violence against Asians and Asian-Americans; it’s that his jingoism undermines the collective effort that’s essential to slowing the virus’s spread. In her book, Biss likens immunity to “a garden we tend together,” urging readers to acknowledge that we owe our health, in part, to one another. Overcoming a pandemic, let alone preventing it, requires a mutual interdependence that is inimical to Trump’s world view. Last Thursday, a photographer from the Washington Post captured an image of a printout of the President’s remarks from a press conference; on the page, “corona” was crossed out with a black marker, replaced with the word “Chinese.” As the crisis worsens in the weeks to come, this image will stand as a small but apt encapsulation of our President’s pathologically misplaced priorities.
A Guide to the Coronavirus


newyorker--2020-03-25--How Doctors Live with the Risks of the Coronavirus

Reports from northern Italy often lighten the news , but lately they have leadened it .
Last Saturday , The New England Journal of Medicine published an alarmed dispatch from a group of doctors at the Papa Giovanni XXIII hospital , in Bergamo .
“ Our own hospital is highly contaminated , and we are far beyond the tipping point , ” Dr. Mirco Nacoti and his twelve co-authors wrote .
They were concerned not just about the condition of their hospital but about the safety of hospitals in general—about the role that the medical system could play , under @ @ @ @ @ @ @ coronavirus .
“ We are learning that hospitals might be the main COVID-19 carriers , as they are rapidly populated by infected patients , facilitating transmission to uninfected patients , ” the Bergamo doctors wrote .
The situation in their own hospital was bad , and that of outlying hospitals in the region was worse : patients were lying on mattresses on the floor , and medications and oxygen were unavailable .
Cemeteries were overwhelmed , “ which will create another public health problem.
” In the midst of an epidemic , the @ @ @ @ @ @ @ patient-centered care in a hospital could no longer do the job ; an entirely different model , which they called “ community-centered care , ” was needed , in which more health care would be delivered outside of the hospital , through community surveillance , home care , and mobile clinics .
If the first wave of concern about hospitals in the pandemic has been about their capacity to absorb the coming surge of patients , this report hinted at a second , in which the focus might be on how to prevent @ @ @ @ @ @ @ worked there , from transmitting the virus themselves .
Over the past few days , the news from American hospitals on the front lines of the pandemic has emphasized the lack of personal protective equipment .
There aren ’ t nearly enough swabs , which in a dark twist turned out to be produced mainly in northern Italy .
There also aren ’ t enough simple surgical masks , or the more protective N95 masks , or gowns .
As the number of cases rose into the tens of thousands last week , @ @ @ @ @ @ @ supply the necessary gear .
Some of these efforts had a slightly whimsical flavor , such as the message on the website of Providence St. Joseph Health , which operates fifty-one hospitals , mostly in the West : “ For those in the Seattle area with a willing heart , the ability to sew , and a sewing machine , we have an opportunity to make masks now.
” Others were more pragmatic .
Peter Slavin , the president of Massachusetts General Hospital , spoke with NBC ’ s Boston affiliate to try @ @ @ @ @ @ @ N95 masks .
“ We have vast numbers of 3-D printers in this country .
The formula for making these masks is available online for free , ” Slavin said .
I spoke with Slavin on Monday morning , and he told me that he wasn ’ t sure whether the right historical analogy was “ the Manhattan Project , or the Marshall Plan , or Dunkirk , but we need to unleash the imaginative energy of people around the country to solve this problem.
” The public has answered these pleas , @ @ @ @ @ @ @ , large and tiny , have been devoting themselves to the gown- and mask-making cause .
“ I mostly talk about movies on here , ” a screenwriter and podcaster named Jeffrey Zhang wrote on Twitter on Friday , “ but here goes .
We are currently pivoting our factory to solely make surgical masks and other medical garments in short supply .
We can make 2 million masks a day , and are looking to help in any way possible.
” The head of R. & D. for a publicly traded medical-supply @ @ @ @ @ @ @ direct message saying that he was cold-calling ventilator companies , offering to help with production , and was looking for leads .
( I ’ d written a piece last week about how doctors were navigating ventilator limits . )
A guy in my fantasy basketball league made a similar plea on the league message board—he was going to start manufacturing personal protective equipment , and he needed contacts .
Slavin said that so many people had responded to his call for P.P.E .
manufacturers that Mass General had set up a new @ @ @ @ @ @ @ Every high school seemed to have a 3-D printer , and every high-school science club seemed to want to help .
Slavin said , “ Managing this outpouring of support has , ironically , strained the system even further.
” He sounded relaxed , capable of noticing ironies , which may have been professional habit but was itself reassuring .
Acquiring more personal protective equipment was part of a larger effort , he said , to help protect the staff and keep the hospital from becoming a vector for transmission .
Units are @ @ @ @ @ @ @ they are at hospitals across the country ; all staff are required to wear surgical masks at all times and some entrances to the hospital have been closed , so that anyone entering can be channelled past hand-hygiene stations and put on a mask .
The intent of all these changes is to provide an inward-facing form of protection , to insulate the staff against getting sick , but also an outward-facing one , to insulate the public .
Slavin said , “ Not only do we want to keep our health-care workers @ @ @ @ @ @ @ , we also don ’ t want them infecting patients.
” The other day , another article in The New England Journal of Medicine caught my eye—an essay written by a young emergency-medicine physician in San Francisco named Christian Rose , who mentioned that in Wuhan , forty-one per cent of COVID-19 transmissions had taken place within hospitals .
Rose quoted a W.H.O .
official named Mike Ryan , who said , “ We ’ ve always said that the real point of entry for a coronavirus is a busy emergency room.
” @ @ @ @ @ @ @ own realization that , by helping patients sick with COVID-19 , he also made it more likely that he would end up transmitting the virus himself .
Rose lives with his wife and mother-in-law , who has a chronic lung condition , making her especially vulnerable to COVID-19 .
Once Rose was potentially exposed to the virus , at Kaiser Permanente ’ s San Francisco hospital , he stayed with a colleague until his wife set up a basement isolation room .
Should he inadvertently infect his mother-in-law , Rose wrote , “ @ @ @ @ @ @ @ she would most likely wind up on a mechanical respirator in an intensive-care unit , probably on the thirteenth floor at U.C.S.F.
, where I trained several years ago .
.
.
.
It is not unlikely that she would die , that this invisible invader , this microscopic enemy would be the end of her story .
All this just because I came home.
” I reached Rose , who has a mustache and a pensive manner , at home last week , after he had returned from a night shift at @ @ @ @ @ @ @ t yet overwhelmed , he said , but there were already some logistical tensions : there were seventeen separate instructions for putting on COVID-protective gear , Rose said , and eleven separate instructions for taking them off .
“ Last night , I had a very sick patient who needed C.P.R.
, and I spent almost four minutes , like two rounds of C.P.R.
, getting the stuff brought to me so I could go in the room , ” he said .
The guidance about when to use protective gear and when @ @ @ @ @ @ @ and stressful .
“ Humans are fallible , ” Rose said .
“ You need to not say , ‘ Hey , maybe a N95 mask works , maybe it doesn ’ t , but it doesn ’ t matter because we don ’ t have enough anyway , but if you have one maybe re-use it.
’ You should just tell them , ‘ We have them .
Here ’ s a mask .
Use it .
And please don ’ t touch your eyes .
’ ”

Reports from northern Italy often lighten the news, but lately they have leadened it. Last Saturday, The New England Journal of Medicine published an alarmed dispatch from a group of doctors at the Papa Giovanni XXIII hospital, in Bergamo. “Our own hospital is highly contaminated, and we are far beyond the tipping point,” Dr. Mirco Nacoti and his twelve co-authors wrote. They were concerned not just about the condition of their hospital but about the safety of hospitals in general—about the role that the medical system could play, under extreme pressure, in spreading the new coronavirus.
“We are learning that hospitals might be the main COVID-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients,” the Bergamo doctors wrote. The situation in their own hospital was bad, and that of outlying hospitals in the region was worse: patients were lying on mattresses on the floor, and medications and oxygen were unavailable. Cemeteries were overwhelmed, “which will create another public health problem.” In the midst of an epidemic, the physicians argued, the familiar model of patient-centered care in a hospital could no longer do the job; an entirely different model, which they called “community-centered care,” was needed, in which more health care would be delivered outside of the hospital, through community surveillance, home care, and mobile clinics. If the first wave of concern about hospitals in the pandemic has been about their capacity to absorb the coming surge of patients, this report hinted at a second, in which the focus might be on how to prevent the hospitals, and the people who worked there, from transmitting the virus themselves.
Over the past few days, the news from American hospitals on the front lines of the pandemic has emphasized the lack of personal protective equipment. There aren’t nearly enough swabs, which in a dark twist turned out to be produced mainly in northern Italy. There also aren’t enough simple surgical masks, or the more protective N95 masks, or gowns. As the number of cases rose into the tens of thousands last week, hospitals began issuing open calls to help supply the necessary gear. Some of these efforts had a slightly whimsical flavor, such as the message on the website of Providence St. Joseph Health, which operates fifty-one hospitals, mostly in the West: “For those in the Seattle area with a willing heart, the ability to sew, and a sewing machine, we have an opportunity to make masks now.” Others were more pragmatic. Peter Slavin, the president of Massachusetts General Hospital, spoke with NBC’s Boston affiliate to try to galvanize a grassroots development program for N95 masks. “We have vast numbers of 3-D printers in this country. The formula for making these masks is available online for free,” Slavin said. I spoke with Slavin on Monday morning, and he told me that he wasn’t sure whether the right historical analogy was “the Manhattan Project, or the Marshall Plan, or Dunkirk, but we need to unleash the imaginative energy of people around the country to solve this problem.”
The public has answered these pleas, in volume. All kinds of entities, large and tiny, have been devoting themselves to the gown- and mask-making cause. “I mostly talk about movies on here,” a screenwriter and podcaster named Jeffrey Zhang wrote on Twitter on Friday, “but here goes. We are currently pivoting our factory to solely make surgical masks and other medical garments in short supply. We can make 2 million masks a day, and are looking to help in any way possible.” The head of R. & D. for a publicly traded medical-supply company in Silicon Valley sent me a direct message saying that he was cold-calling ventilator companies, offering to help with production, and was looking for leads. (I’d written a piece last week about how doctors were navigating ventilator limits.) A guy in my fantasy basketball league made a similar plea on the league message board—he was going to start manufacturing personal protective equipment, and he needed contacts.
Slavin said that so many people had responded to his call for P.P.E. manufacturers that Mass General had set up a new team to handle all of them. Every high school seemed to have a 3-D printer, and every high-school science club seemed to want to help. Slavin said, “Managing this outpouring of support has, ironically, strained the system even further.” He sounded relaxed, capable of noticing ironies, which may have been professional habit but was itself reassuring. Acquiring more personal protective equipment was part of a larger effort, he said, to help protect the staff and keep the hospital from becoming a vector for transmission. Units are being established for COVID-19 patients, as they are at hospitals across the country; all staff are required to wear surgical masks at all times and some entrances to the hospital have been closed, so that anyone entering can be channelled past hand-hygiene stations and put on a mask. The intent of all these changes is to provide an inward-facing form of protection, to insulate the staff against getting sick, but also an outward-facing one, to insulate the public. Slavin said, “Not only do we want to keep our health-care workers safe and healthy for their own health, we also don’t want them infecting patients.”
The other day, another article in The New England Journal of Medicine caught my eye—an essay written by a young emergency-medicine physician in San Francisco named Christian Rose, who mentioned that in Wuhan, forty-one per cent of COVID-19 transmissions had taken place within hospitals. Rose quoted a W.H.O. official named Mike Ryan, who said, “We’ve always said that the real point of entry for a coronavirus is a busy emergency room.” Rose’s essay centered on his own realization that, by helping patients sick with COVID-19, he also made it more likely that he would end up transmitting the virus himself. Rose lives with his wife and mother-in-law, who has a chronic lung condition, making her especially vulnerable to COVID-19. Once Rose was potentially exposed to the virus, at Kaiser Permanente’s San Francisco hospital, he stayed with a colleague until his wife set up a basement isolation room. Should he inadvertently infect his mother-in-law, Rose wrote, “Her lung reserve is so low that she would most likely wind up on a mechanical respirator in an intensive-care unit, probably on the thirteenth floor at U.C.S.F., where I trained several years ago. . . . It is not unlikely that she would die, that this invisible invader, this microscopic enemy would be the end of her story. All this just because I came home.”
I reached Rose, who has a mustache and a pensive manner, at home last week, after he had returned from a night shift at Kaiser Permanente. The hospital wasn’t yet overwhelmed, he said, but there were already some logistical tensions: there were seventeen separate instructions for putting on COVID-protective gear, Rose said, and eleven separate instructions for taking them off. “Last night, I had a very sick patient who needed C.P.R., and I spent almost four minutes, like two rounds of C.P.R., getting the stuff brought to me so I could go in the room,” he said. The guidance about when to use protective gear and when to avoid doing so could be bewildering and stressful. “Humans are fallible,” Rose said. “You need to not say, ‘Hey, maybe a N95 mask works, maybe it doesn’t, but it doesn’t matter because we don’t have enough anyway, but if you have one maybe re-use it.’ You should just tell them, ‘We have them. Here’s a mask. Use it. And please don’t touch your eyes.’ ”
Early on in the crisis, Rose told me, he’d noticed that his colleagues were feeling somewhat removed from their friends and family outside of the hospital, because they were experiencing the stress and risk of the crisis before anyone else. “What to me was weird was noticing that a lot of us felt really alone,” Rose said. “It’s just this lost feeling that all of my emergency colleagues—the nurses, the techs—feel, where we know how bad it can be, but society doesn’t feel it yet.” The longer the hospitals are preoccupied with the COVID-19 pandemic, of course, the more medical risk the general population will absorb. Right now procedures and preventative scans are being cancelled. Postpone a chemotherapy session, and the risk that your cancer might metastasize rises; postpone it twice, and then three times, and the risk rises again and again. By making the hospitals ever so slightly less safe, the P.P.E. crisis subtly increases the risk to everyone of a sick person visiting the hospital, in the same way that a side effect might elevate the risk of prescribing a drug.
That gap between the doctors and the public still exists, Rose said, but it has closed somewhat. Perhaps, eventually, the public would undergo the same psychological adjustments that health-care providers had. “We know that people change the more exposure they have to risk—so people will feel really stressed out at first and then it normalizes.” Rose said, “Your brain just changes the way you live with that. And all of a sudden you start to normalize things that are really abnormal.” Rose sounded grateful for the past couple of weeks, when COVID-19 patients had trickled in, and he and his colleagues had had the chance to practice the seventeen steps for donning protective gear, as well as more consequential maneuvers, to reduce the risk that they might spread the virus. “It’s like everyone feels on the roller coaster before you go over the drop,” Rose said. “It’s, like, you’re about ready.”
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