America as a whole is in coronavirus hell. At time of writing, new cases were up 82 percent over the last two weeks, to almost 50,000 per day. Florida alone is routinely posting more new cases than the entirety of the European Union. While deaths have so far not spiked, it's only a matter of time.
However, it's not entirely bad. A handful of Northeastern states have managed to get things under control — especially Massachusetts, which has managed a tentative reopening without seeing a spike in new cases so far, despite some significant anti-police brutality protests weeks ago. There the government did it by following expert guidance and learning from other countries who have managed the outbreak well. It might be outside the grasp of most of the rest of the country, but it isn't particle physics.
The basic strategy is the same one we have seen work across the world. First, Massachusetts locked down hard to contain the initial surge of virus, and boosted its hospital capacity to keep them from being overwhelmed. Then the government set up a test-trace-isolate system — ramping up testing to catch new cases, tracing the contacts of everyone who had been infected, and putting them in quarantine either at home or in adapted hotels in some cities. This hit some bumps early on, but now it seems to be working well. Meanwhile, state authorities continually reinforced the importance of hygiene and mask-wearing, and remarkably, the population actually listened. Finally, reopening was conditioned on actually meeting the metrics recommended by national and international guidelines — the state has repeatedly delayed moving along its plan to make sure all the indicators are in the right place before proceeding.
Today, Massachusetts residents are enjoying the partial return of normal life, and on June 29 the state saw the first day with no COVID-19 deaths since the start of the pandemic. It remains to be seen whether they will be able to return fully to normal — given what has been seen elsewhere, I would be extremely wary about opening up full indoor service at bars and restaurants — but it's a proof of concept. The virus works in the U.S. like it does everywhere else, and a competent state response can stop the spread, and get at least some ways back towards normal.
Now, Massachusetts has some particular advantages. It is wealthy, has a high density of public health institutions which have helped out with containment, and is one of the few states whose administrative capacity has not been deliberately destroyed by conservatives. It is also geographically surrounded by other states that are similarly sort of functional, not run by conspiratorial fruitcakes, and now have the virus in hand. Governor Charlie Baker is a Republican, but he at least grasps that if he governs as a Trump lickspittle, he'll be tossed out on his ear (and Democrats have a veto-proof majority in both chambers of the state legislature in any case).
On the other hand, nothing about this strategy would be impossible for a poorer state. Much, much poorer countries like Vietnam have managed to contain the pandemic very well. West Virginia (the poorest state) could follow Massachusetts' lead if it cared to.
But there's the rub. A sensible containment and reopening strategy requires foresight, patience, and courage that are vanishingly rare among American politicians. Leaders have to see a step or two ahead to recognize that if the virus is not under control before they start reopening, cases will explode and they will be forced to lock back down anyway. They have to resist a certain epidemic of childish, foot-stomping demands for things to go back to normal immediately. At the same time they must set up an efficient test-trace-isolate bureaucracy.
In other words, instead of just automatically doing whatever the most well-funded interest group is telling them, and trying to scapegoat others for any resulting disasters, leaders must actually lead.
The current crop of American politicians in both parties typically avoid governing if they can possibly help it. Most Republican states have, of course, failed spectacularly. Indeed, Florida Governor Ron DeSantis insists that he will not shut his state back down despite being in the grips of a terrible outbreak that is rapidly accelerating. But many Democrats have also failed in the same way — New York had a shattering outbreak because Governor Andrew Cuomo and Mayor Bill de Blasio dragged their feet on closing down, and now California is suffering a serious one because Governor Gavin Newsom gave in to pressure to reopen before the state was ready. Most important, President Trump has done basically nothing of consequence on containment, nor has he helped states do so.
Meanwhile, Massachusetts shows the population must come to understand and follow public health guidelines, above all the necessity of wearing masks at least when they are indoors in a public space. This is already a steep task thanks to the inexplicable anti-mask crusade from many American public health authorities earlier this year — probably a big reason why a large swathe of the population has been careless about wearing them, regardless of partisan affiliation. But worse, a significant minority of conservatives now view masks as an intolerable infringement of their liberty. At a guess, this is some combination of reflexively doing the opposite of what liberals recommend, inscrutable psycho-sexual complexes (some anti-mask protesters call them a "submission muzzle"), and general hostility at the idea of enduring even the slightest inconvenience to help others.
This view is of course totally at odds with any serious notion of liberty. To adapt a famous aphorism, your freedom to spray forth a fog of disease particles ends at the tip of my nose. Moreover, anyone seriously concerned about government tyranny would logically be a lot more concerned with, say, the epidemic of lawless police violence, or the NSA's dragnet surveillance program. Conservatives by and large don't object to those things because they don't infringe on the cosseted suburban lifestyle they view as their birthright. This version of "liberty" (a minority view even among conservatives, to be sure) amounts to the ability to go to Cheesecake Factory at any time even if doing so kills half a dozen other people. Only Trump could possibly deflate conservative anti-mask sentiment, but so far he refuses to wear one himself.
Taken together, these factors present a gigantic obstacle for other states looking to follow the lead of Massachusetts. But the example is there, and perhaps more and more states will gradually take heed. In the meantime, America is learning a different lesson: what happens when government cannot tie its shoes and a big chunk of the citizenry has driven itself completely loopy.
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