Why America can’t rely solely on individuals to stop Covid-19

“Americans have spent much of the Covid-19 pandemic blaming one another for the coronavirus’s spread.

Don’t go to that beach or park. Don’t go to that bar or restaurant. Don’t do anything for Thanksgiving or Christmas. Wear a mask! You don’t want to kill Grandma, do you?

Public officials have joined in. Increasingly, they are blaming private gatherings, not the restaurants and bars they insist on keeping open, for the spread of the disease. In some places, such as the Dakotas, framing Covid-19 prevention as an individual responsibility became the core of the strategy to fight Covid-19. As cases and deaths climbed to among the highest rates in the world, South Dakota’s leaders preached “personal responsibility” and refused to require masks, much less stricter measures. Ian Fury, a spokesperson for Gov. Kristi Noem (R), told me his boss gave citizens “up-to-date science, facts, and data, and then trusted them to make the best decisions for themselves and their loved ones.”  

 It’s true that individuals have an important role in fighting Covid-19. Everyone should wear a mask, and, unfortunately, everyone should reconsider big family gatherings this holiday season. But relying on individual action to fight a deadly virus — an approach that the US has leveraged for problems ranging from the opioid crisis to global warming — simply hasn’t worked.

Today, America is among the worst performers at fighting Covid-19. Despite recent surges in Europe and Israel, the US remains within the top 20 percent for most coronavirus deaths per person among developed nations, with more than twice the death rate as the median developed country. If the US managed the same Covid-19 death rate as Canada, more than 190,000 Americans would likely be alive today.” 

“But it’s not just Trump and friends. Every state in the country, Democratic or Republican, has at some point reopened restaurants or bars, allowing people to congregate in indoor areas that experts widely agree are breeding grounds for Covid-19. While resisting shutting down such places, local and state officials have argued that it’s on people to wear masks, cancel private gatherings for the holidays, and avoid nonessential activities — while leaving room for people to not follow at least some of those guidelines. Every state in the country has also, subsequently, seen surges in the coronavirus this fall.”

“Meanwhile, much less attention has gone to addressing Covid-19 from a truly structural perspective. The coronavirus has revealed America’s pathetic public health infrastructure — there’s still no national testing-and-tracing program, and no state has an adequate contact tracing program, if they have such a program at all. Businesses and workers have been left to fend for themselves, as Congress failed to pass an economic relief bill before the last one started to expire. For all the talk about outdoor activities being safer during the coronavirus pandemic, there’s been next to no action in most of the country on getting people outside — at times, governments have even eliminated outdoor venues by closing parks or beaches.”

“It’s easy to yell at people over their Covid-19 failures — simply log on to Twitter and blast away. It’s costless for a governor to tell people that it’s on them to stop the spread of the coronavirus by voluntarily giving up things they love, especially if the same governor doesn’t even plan on following his own advice.

So rather than do anything about it, Americans are stuck blaming each other for Covid-19. But until we truly realize this is a collective failure, not an individual one, the problems will linger.”

“Since the start of America’s epidemic, experts have warned that indoor dining and bars are among the worst places for the spread of Covid-19: People are in poorly ventilated indoor areas where the virus spreads more easily sit close for possibly hours, can’t wear masks as they eat or drink, and spew germs at each other as they shout, sing, and laugh.

So many experts have called on governments to close bars and restaurants. Acknowledging the economic toll of this, economists and public health experts have also asked for a bailout of the industry to make employers and their workers whole until the pandemic resides.

None of that happened. Instead, America started to reopen before Covid-19 cases were under control — at the US’s best point in the spring and summer, it still had more than 60 times the daily new cases of Australia, New Zealand, and South Korea — with bars and restaurants reopening in every state by the fall. Public officials acknowledged the risks but merely moved to limit capacity and called on everyone to be responsible by physical distancing, wearing a mask, and limiting contact with people from other households.

This has not gone well. Coronavirus cases have shot up across much of the country, with the US in the middle of its third and biggest surge of Covid-19 yet. At the same time, we’ve gotten more data showing how dangerous bars and restaurants can be for the spread of Covid-19: A study published in the Journal of Korean Medical Science found that a person in South Korea may have been infected with Covid-19 in a restaurant in as little as five minutes. Another study in Nature found, “Reopening full-service restaurants was associated with a particularly high risk.

Despite that, officials across the country have by and large resisted shutting down again. Many of them, instead, have cited another culprit for Covid-19 spread: private gatherings. New York, for example, put out a PSA to stop “living room spread,” and the state published data suggesting households and private gatherings are driving 74 percent of coronavirus spread.

It’s true private gatherings and households are driving some transmission. Most experts agree Thanksgiving dinners likely led to a surge on top of a surge, and similar Christmas and New Year’s events likely will too.

But that’s why at least some experts believe there’s a need for more focus on systemic action, not the individualistic approach. “People, in general, are horrendous risk assessors — we’re awful at assessing risk,” Daniel Goldberg, a medical historian and public health ethicist at the University of Colorado, told me. “I hate to say people can’t be trusted, but.”

There are other problems with this framing. For one, the New York data doesn’t separate within-household transmissions from social gatherings — so the 74 percent figure includes someone spreading Covid-19 to the husband he lives with (not as avoidable) and someone spreading the virus to someone he invited over for drinks one night (very avoidable). This also only includes the cases that New York could actually contact trace, and it’s much easier to trace transmission between family and friends in a household than strangers in a bar.”  

“there’s nothing unusual about Covid-19 spreading among people who live together. It’s typical for the bulk, even the majority, of the transmission of any disease to happen within households. If you’re infected, the people you live with or come into close contact with at home are simply likely to get it too. That’s how pathogens work. What matters most, though, is where that virus originated from in the first place.

To put it another way: People couldn’t infect others in their homes if they hadn’t picked up the coronavirus in bars, restaurants, or other public spaces. So if these places weren’t open, individual choices to gather — including over Thanksgiving and Christmas — would be of far less concern. There would simply be much less virus out there jumping from person to person.”

“If officials want people to wear masks, they can mandate masks and actually enforce those mandates. If they want more adults to stay home, they can replace any income individuals might lose by not going into work, or take steps to make work-from-home life more bearable, like deeming schools “essential” or subsidizing day care. If they want people to stay outdoors and not indoors, they can do things that can encourage people to go outside instead of congregating inside — like offering free outdoor activities like ice skating or art installations, or even just places to eat (with some heating during the winter) — rather than shutting down parks.”

“Otherwise, we’re going to be stuck with relying on people to make decisions — almost always against their own social, cultural, and economic interests — to do the right thing. So far, that just isn’t working.”

“The alternative to not taking collective action is more death. The countries that have done the best against Covid-19 — including Australia, New Zealand, South Korea, and, to a now lesser degree, Germany — all approached the issue collectively, leveraging government aid and public health systems to let people stay home without losing as much income or health insurance, to test and trace infections, and, when necessary, to close down to stop the spread.”

https://www.vox.com/future-perfect/22179222/covid-19-coronavirus-pandemic-individualism-collectivism

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