The Uncomfortable or Unthinkable
Updated: Apr 10
Dear Everyone: My husband walked through the office behind me last night muttering, “I choose denial. It’s easier…” Amen, my love. It’s a pretty human thing, I think, to choose denial over the unthinkable. Frankly, it’s a pretty human thing to choose denial over the UNCOMFORTABLE. And those are our choices, America: The Uncomfortable or The Unthinkable. Threading the needle in public health messaging isn’t an easy task on a good day. On the one hand, you want people to sit up, take notice, listen, understand and then follow recommendations. With COVID-19, it becomes particularly tricky because we need EVERYONE to listen and comply for the health, economic and social well-being of our entire nation. On the other hand, you don’t want to incite panic and toilet paper hoarding (y'all know that psychologists are going to get DECADES of academic papers out of that particular phenom, right?) My home is heading into our fourth week of #RadicalSocialDistancing, and I will be completely transparent in telling you that I look at the paucity of CONFIRMED cases here in Central Illinois and even I – who have been beating this drum daily for weeks – struggle with apathy and an almost overwhelming desire to throw my hands in the air and say, “the hell with it! I miss my work, I miss my friends, I miss American Harvest, I miss date night with my husband, I miss my kids BEING ANYWHERE BUT HERE and clearly all this was overblown! Let’s get back to normal!” And then I hop online and I start reading and reviewing the first-hand accounts from my friends and colleagues in New York. Or Washington. Or Detroit. Or New Orleans. And I’m deeply, deeply ashamed of my impatience. We have incredible privilege right now, those of us living in wide-open spaces in America. Particularly in states where radical social distancing measures were put into place early, we may – just MAY – avoid the very worst of the hell that is raining down in #HotZones across the country. But let me be clear: if we avoid anything, it will be BECAUSE we are each doing our part to participate in this public health effort. This is working, and the more we participate, the more aggressively we bend that curve down, the more lives we save, and the sooner we return to normal. (As an aside, and not for nothing, I hope that when the time comes, each of us take a moment to really think about and be selective in choosing which parts of “normal” we believe are worth returning to – clearly not all, are…) It’s important to note that the timing of the implementation of social distancing mandates is going to be a critical determinant in the what the peak of this pandemic looks like in the U.S., as well as in cumulative deaths. There are four recommended measures for the #Suppression strategy I’ve referenced previously, and a minimum of 3 of 4 are required to buy time for health systems to be prepared from a capacity standpoint, and to reduce the rate of transmission and total deaths. Those 4 measures are: school closures, closing of non-essential services, shelter-in-place orders, and major travel restrictions. In Illinois and many states, at least 3:4 of these measures were implemented early, and if held in place until past the “peak,” will have been effective. PLEASE remember that if these measures work, many people are going to be overwhelmed by the temptation to shout and point and say, “LOOK! The worst did not come to pass! You shut us down and destroyed Everything for NO REASON you damn alarmist!” Don’t do that. If the worst does not come to pass, it will be because we did what we were supposed to and all the people who would have died, didn’t. You’re welcome. Of all the modelling and predictions that are being evaluated right now, the best minds, including Imperial College epidemiologist Neil Ferguson, are in general alignment with the following: 1) Because we have instituted aggressive social distancing measures, the US epidemic may now peak in approximately 2-3 weeks. It is very likely that things will continue to get worse until mid-April, particularly in New York, New Orleans and other hot zones.
2) We should expect to see a daily increase in cases nationally through the coming weeks.
3) The curve will start to flatten in the weeks after that, but because deaths lag the curve by 5-14 days, we will continue to see a rise in reported deaths.
4) Daily deaths should then begin to decline, and the curve will start trending downward.
5) If we maintain a minimum of 6 weeks of strict social distancing on the downswing, as China has done, by early June we may be able to cautiously relax social distancing measures. #ProbablyNotEaster (Please note, Neil Ferguson’s update to Parliament is being wildly misinterpreted for political reasons and in the press. Look – this is my shocked face…) Yes. Early June is a long way off, but it’s no longer Thanksgiving. We The People are changing and improving this timeline. I know this isn’t a terribly sexy call to duty. Being asked to fight for #America separately-together from home in our jammies is really not what those of us who grew up watching Red Dawn envisioned our defense of country would someday entail. But #Coronavirus is an invisible and sneaky enemy, and our only defense is each of us doing our very small part through #PatrioticIntroversion, buying time for our frontline physicians and healthcare providers and slowing community spread. Tomorrow is Sunday (I checked!) and unless something drastic happens overnight, I’ll try to take some time to write more about #Resiliency instead of this damn virus. I know so, so many of us are struggling – I am hearing from people who are scared, angry, lonely, panicking, inside-out on sleep or upside-down from doing mental gymnastics to get through the day and try and teach their kids. None of us is ok. None of us are unscathed. And we can do this. I promise. #SeparatelyTogether More soon. Keep being brave, generous and kind, always. K p.s. My two favorite words these days are "Salutogenesis" and "Stochastic." Look 'em up -- you have time. And you'll be ready for that next game of scrabble...