Compassion fatigue is about to set in. Don't succumb.
The mind-boggling scale of 100,000 deaths
This week, President Trump presented Americans with what his administration considers to be a realistic scenario: by the time the COVID-19 outbreak is over, somewhere between 100,000 and 200,000 Americans will be dead. That is "a very low number," Trump explained to the press, adding that if fewer than 200,000 people die, he will consider his administration to have done "a very good job."
Well, will they have? It's hard to wrap your head around a number like "100,000," much less "200,000" or "2.2 million" — the latter being the projection of the highly-regarded Imperial College study in the "absence of any control measures," as well as the point of comparison by Trump for his projection being a success. But while the president has dramatically moved his own goalposts, having claimed a mere three weeks ago that 14,000 people dying is a "disaster," it should go without saying that the conservative estimate of 100,000 people dead is not, in fact, "a very good job." It is cataclysmic. It is also difficult to comprehend — it means 100,000 mothers, fathers, children, grandparents, cousins, neighbors, friends, teachers, health care workers, heroes, villains, billionaires, and homeless are gone forever. As the outbreak wears on and the death toll climbs, it is imperative that we do not stop reminding ourselves what the numbers truly mean — that we do not lose sight of the fact that while one death is a tragedy, a million are too.
Predictions for how many people will die by the time the outbreak is over run the gamut, so it's difficult to pin down exactly what sort of numbers we're actually talking about. Dr. Anthony Fauci described the estimate of between 100,000 and 200,000 as "middle-of-the-road," NPR reports, while the higher-end estimates of 1 to 2 million dead are "not impossible, but very, very unlikely," thanks to the growing lockdown measures being implemented across the country. The Imperial College study estimated 2.2 million dead in a scenario where no measures — like social distancing or the prohibition of nonessential businesses and gatherings — were taken, so it's a bit misguiding to begin with. But some still think even the upper-end estimate of 200,000 is naïve; Dr. Neil M. Ferguson, an epidemiologist who is "regarded as one of the best disease modelers in the world," told The New York Times on March 20 that the best case scenario at this point is 1.1 million deaths in the United States.
But let's stick with the most optimistic number for the moment: Trump's 100,000. That is a mind-bogglingly huge loss, the equivalent of 66 Titanics sinking, or 41 Pearl Harbors. It's only about 16,000 or so short of the number of Americans who died in the first World War. According to The New York Times' calculator, if 109,000 people die — still vastly fewer than the upper end of the White House's estimate — coronavirus would be more deadly for Americans than diabetes, drug overdoses, pneumonia, the flu, and car crashes this year. It would be the sixth greatest overall cause of death in the country, and a top-10 cause of death for anyone over 50, or under 19. If 480,000 people die — that being the number presented by public heath researcher Dr. James Lawler to hospital executives, and quoted by the Times — COVID-19 would be the third leading cause of death in the country behind only heart disease and cancer, and with more total American victims than U.S. soldiers who died in World War II. If over 1.1 million people die, COVID-19 would have more victims than soldiers who died during the Civil War, or citizens who died during the 1918 Spanish Influenza. It would also be the leading cause of death in the country, with nearly as many fatalities as heart disease and cancer combined.
Those are just numbers, though; even with context, they are elusive to grasp. The human psyche isn't built to comprehend tragedy at such a scale, and there is a real danger to succumbing to the belief that 100,000 or more dead is in fact "very good" and "very low." What does 100,000 people even look like? (If each person was a second, it'd total more than 27 hours; if each person was a star, it'd take 50 clear night skies to see them all). And thus, here we are, falling prey to two of our most seductive coping mechanisms when faced with calamity: compassion fatigue, and psychic numbing.
Compassion fatigue is a phrase more commonly used in relation to disaster relief, when too much bad news in the media eventually exhausts the empathy of readers or potential donors. What's alarming is that the fatigue sets in fast; in a study by economists Philip Brown and Jessica Minty, cited by Psychology Today, "donations to disaster victims made through the internet peaked approximately one week after the disaster. From then on, fatigue kicked in ... By the end of three weeks post-disaster, donations had slowed to a trickle." While Americans are going through a catastrophe distinctly different than, say, a hurricane devastating some far-away city — this is more like the entire world is in a hurricane together, and it's going to last months — we're nevertheless reaching the end of our "compassion" window right about now. Particularly for those Americans who are lucky enough to not have had their own lives or loved ones threatened by COVID-19, it can be wearying to maintain a heightened sense of alarm and care about some anonymous 100,000.
Psychic numbing is also a challenge. Numbers like 100,000 are difficult to care about; we can understand abstractly that it's horrifying, but it's also sterile and detached. A number doesn't tell you about the excruciating pain of "effectively drowning" as the virus takes over your body, or about husbands who never get to say goodbye to their wives, or about decisions made by anguished doctors over who gets to live, and who's going to die. "The reported numbers of deaths represent dry statistics, 'human beings with the tears dried off,' that fail to spark emotion or feeling and thus fail to motivate action," writes University of Oregon psychologist Paul Slovic, specifically in reference to our reaction to atrocities like genocide, although it also applies here.
What's even more terrifying is how few people it takes dying for us to start losing the ability to muster empathy; as Slovic and his colleagues found, "'compassion fade' can occur when an incident involving a single person expands to as few as two people." Slovic, though, is not the first to have studied this phenomenon; it was first observed after the incomprehensible toll of the Hiroshima bombing (in which 146,000 people died, in the middle range of the White House's coronavirus estimates). There, numbness was beneficial; it helped first responders and survivors to not become paralyzed with trauma. But also, as psychologist Robert Ornstein and biologist Paul Ehrlich once argued, and as Paul Slovic and his son Scott Slovic have paraphrased, "we were, in a sense, cave men and cave women, struggling to deal with modern problems, like nuclear annihilation, to which our minds were not suited."
Our minds are not suited for a tragedy of this scale either. That is both a blessing and a curse — a blessing, in that we need to be able to move forward somehow, and function as a society, to help as many as people as possible now and to so restore whatever we can for those left after. It is a curse, too, because we are at a loss for grasping the magnitude of what is happening, and it is our compassion and empathy that make us human.
Just listen to that number: One hundred thousand. Do not let anyone tell you it is nothing. Don't accept it as the toll that must dutifully be paid. Do not forget that many of those deaths will have been preventable. Do not lose your ability to be horrified, do not lose your ability to grieve. Even if only briefly, for a moment, for a pause, for a heartbeat, remember that each person in that 100,000 will have had a life, as precious and real as your own.
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