At this writing, 290,000 Americans have died of COVID-19 in just eight months, making it the worst pandemic to hit the United States in over a century. Thousands of people are now dying every day. We do have vaccines on the way, but they will take time to manufacture and distribute—and many parts of the public say they won’t take one. We’ll almost certainly be living with the disease for at least another year.
Public-health measures that restrict our ability to gather, move freely, or even make a living are triggering intense social conflict among Americans, to the point where public officials have been targeted by armed mobs. This politicized response is unique among nations. In most industrialized countries, citizens accepted mask-wearing and lockdowns as necessary. As a result, most of them enjoy far lower rates of infection and death, and a greater trust in their governments. The United States has 4% of the world’s population—but almost a quarter of fatalities from COVID-19, as of this week.
Given these facts, why do so many people resist simple, non-pharmaceutical health measures like wearing masks, social distancing, and staying home when local governments ask them to, in order to maintain hospital capacity?
Studies and Pew surveys point to a stew of conspiracy theories that have circulated through social media, combined with a deep distrust of mainstream institutions. President Trump and other GOP leaders have explicitly promoted conspiracy theories that COVID-19 was exaggerated for political purposes, invented in a Chinese lab, or developed by “Big Pharma” to sell vaccines, among other notions. There is a great deal of junk science circulating on social media pushing ideas like “masks don’t work” or “COVID is just a flu.” With so many people (including law enforcement) refusing to cooperate with simple measures like wearing masks or contact tracing, states have been forced to adopt more extreme measures like stay-at-home orders or business closures.
Those have profound, negative economic fallout. So far, many more people have lost jobs than died of COVID-19. One study of the impact of California’s first shelter-in-place estimated that for every life saved, 400 jobs disappeared, at least temporarily. Aside from unemployment payments and $1,200 “stimulus” checks, people who lost their jobs were not helped by government—in stark contrast with many other nations. Canada, for example, replaced 75% of income lost due to the virus.
This unwillingness to help those hit by layoffs has created tremendous hardship, which might feel much more immediate than a disease that has most strongly threatened retired people. When lockdowns come with mass unemployment, with little help available, it’s not surprising that people would resist them. Thanks in part to so much economic uncertainty, lockdowns have also triggered depression and anxiety in many Americans, especially young people, as Greater Good has reported. School closures have been very hard on working parents, not to mention children themselves.
Turning the tide on COVID-19 requires widespread adoption of public-health measures—which means that we each need to make personal and collective sacrifices in order to protect each other’s health. Here are three reasons why we should support the steps that many states are taking as we approach the end of 2020, many of which mean that we will not be able to celebrate the holidays and New Year’s as we have in the past. While nothing in this article can make your life easier, it might help you to see that your sacrifices matter.
COVID-19 is serious
From the beginning of the pandemic, many people have tried to minimize its impact, often for political purposes. Their arguments rely on faulty math, incomplete information, or wishful thinking.
It’s not true that COVID-19 is “just the flu,” as some claim. Despite worldwide mobilizations to stop it, COVID-19 has infected more people more quickly than the flu, its mortality rate is significantly higher, and the long-term effects appear to be much more debilitating. Because of the intensity of infection, there is a real danger that hospitals can be overwhelmed, which puts nurses and doctors at risk and makes patient survival less likely. Indeed, almost 700 American health care workers have been killed by the virus.
There are those who claim that COVID-19 has not triggered “excess mortality”—more deaths than we would expect in a given period. This notion is based on a serious misreading of death statistics.
For example, memes circulating on social media have used raw mortality data available on the Centers for Disease Control and Prevention (CDC) website to suggest that fewer people have died in 2020 than previous years. This is wrong, because it fails to account for how provisional and incomplete those numbers are. In fact, recent assessments of excess mortality indicate that the toll from COVID-19 might be much worse than raw data suggest.
Finally, some argue that mortality for COVID-19 is much lower than many previous pandemics. This is absolutely true. For example, before transmission and treatments were understood, bubonic plague routinely killed up to a quarter of the population in infected communities. Diseases that Europeans brought to the Americas created apocalyptic conditions and wiped out entire cultures. When it first appeared, AIDS was a death sentence.
This is the point at which we leave the cold numbers behind and must ask ourselves how much each human life is worth. If simple behavioral changes can save the lives of people in our families and communities, shouldn’t we take them?
Adhering to public health guidelines saves lives
When worn by all parties, masks work in preventing disease transmission, as does maintaining a distance of at least six feet away from other people. How do we know this? Because we have hundreds of studies—and a body of real-world experience—that confirm these tactics save lives and slow the spread of disease.
“Masks may not completely prevent getting infected, but they do reduce transmission, and there is even a thought that masks may reduce the dose of virus you inhale so that even if you do get COVID it will be a milder course,” says Geetha Tamaroon, a doctor at Highland Hospital in Oakland, California. “Even if we could take care of all the patients, we don’t have enough hospital beds and critical care staff to manage a huge surge of patients. So, preventive measures like masks matter.”
Dr. Geetha Tamaroon at Highland Hospital in Oakland, California.
The United States needed almost all of its citizens to wear masks in order to make COVID-19 manageable. Unfortunately, only about half consistently and correctly wore masks, which created our current national emergency. Shelter-in-place orders, like the new one issued this week in California, are met with even more resistance, because of their negative economic and social impact. However, while there have been many drawbacks and missteps in implementation, researchers almost universally agree that they do work to slow COVID-19.
For instance, a new study published last month by the CDC found that stay-at-home orders and public mask mandates “contributed to an 82% reduction in COVID-19 incidence, 88% reduction in hospitalizations, and 100% reduction in mortality in Delaware during late April–June.” A major study of COVID-19 responses in 131 countries, published in the flagship medical journal The Lancet, found that “school closure, workplace closure, public events ban, ban on gatherings of more than ten people, requirements to stay at home, and internal movement limits” did indeed dramatically reduce infections and deaths. In isolated places like New Zealand, lockdowns virtually eliminated COVID-19.
Anecdotally, Tamaroon, as well as other doctors and nurses interviewed for this article, agree that California’s first shelter-in-place order had a positive effect within weeks. They went from being dangerously slammed with cases and running out of personal protection equipment to experiencing the slowest shifts of their entire careers. This gave their hospitals time to resupply, develop new protocols, and learn more about cases and treatment.
“If there is a nursing or bed shortage, it affects everyone,” says Tamaroon. “Sheltering-in-place makes my job manageable, as fewer patients come into the hospital with COVID-19 infections, which allows me to better attend to the health needs of the community.”
Fighting the pandemic can bring out the best in you and in the people around you
We fight the pandemic by wearing masks, staying home when cases rise above a certain level, voting for competent leadership, trying to help each other when hardship looms. And this fight doesn’t just reflect our desire to keep ourselves and our loved ones safe; it represents deeply rooted care for our fellow humans.
You might think, when confronted by a threat, that most people will act mainly to protect themselves instead of others. That’s not true. We are all influenced by optimism bias—that is, our tendency to underestimate personal risk—that leads us to wear masks on our chins or go to concerts. However, though we can neglect our personal safety, we are very highly motivated to protect other people.
When political scientists Clifton van der Linden and Justin Savoie surveyed Canadians in April of this year, they found that respondents were significantly more motivated to wear masks if they read about how masks protect other people than they were by a statement that stressed protecting oneself. In another recent study from Sweden, researchers found that people who were more generous in an economics game were more likely to learn about the virus, wear masks, and socially distance.
In March, researchers in the United States tested four different messages about COVID prevention: one that emphasized protecting others from COVID-19, one that focused on protecting yourself, a combination of those first two messages, and a fourth message that didn’t emphasize any victims. Consistent with other studies, they found that people were most motivated by the message focused on protecting others.
“There’s a lot of research suggesting that while people do care a great deal about themselves and are self-interested, people also care a lot about other people and those social motivations are a big part of our behavior,” lead author Jillian Jordan told my GGSC colleague Jill Suttie.
Taken together, these studies show that facing a collective threat like the pandemic can bring out the best in us. Following public-health measures may truly be a sacrifice, cutting us off from favorite activities, family, and sources of income, but it also gives us the chance to show compassion, care, and love. We do need to keep hearing “prosocial” messages that remind us that other people need our help. That’s why good leadership and accurate public-health education is so crucial.
That said, there are many ways to mess up these measures. While studies agree that lockdowns save lives, a substantial number of experts argue that they should be an absolute last resort, after other possibilities have been exhausted. In other words, it might be OK to keep businesses and schools open, but only if masking is strictly enforced, accurate testing is readily available, and contact tracing is widespread. That has simply not been the case in much of the United States, to say the least.
In this respect, frequent lockdowns reflect larger public-health failures. In California, many experts have criticized restrictions for being far too broad. Do playgrounds really need to close? Do elementary schools? Is it reasonable to ban relatively safe activities like small outdoor gatherings? Can the guidelines be realistically applied to nontraditional families—or to singles? Those are open, debatable questions of implementation; with little hard data to go on, the answers often come down to judgment calls that are hard to make and easy to second-guess.
In addition, the impact of lockdowns reflects racial and economic inequalities. One study of the effect of the first shelter-in-place order in San Francisco’s predominantly Latino Mission District found that low-income people will not stay home if they’re not paid to be there. Latino delivery drivers, cashiers, and construction workers were vastly more likely to be infected than European-American office workers who could easily stay home without losing income.
Do these problems mean that lockdowns—an umbrella term that covers a range of actions, from targeted closure of businesses to travel limits to stay-at-home orders—should never happen? When asked if lockdowns are overkill, John Swartzberg, a clinical professor emeritus with the UC Berkeley/UCSF Joint Medical Program, had a terse reply over email: “Ask the families of the 290,000-plus in the U.S. alone who are dead. Ask the people who are suffering from the post-COVID syndrome. Ask the 100,000 people currently hospitalized.”
Are these worthwhile tradeoffs? Is the depression and anxiety that comes from isolation and uncertainty worth saving the lives of people we don’t know? Is one life worth hundreds of jobs? Can we balance missed school years against lives that ended before they could enjoy retirement?
Those are existential and moral questions that can’t be answered with data. Here’s one way to look at the problem: Jobs come back, but lives do not; depression passes, but death is permanent. If we must make sacrifices, we can take heart in knowing that our sacrifices matter—if we’re able to persevere for just a little longer.
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