Coronavirus advice from your future
France is ten days behind Italy, and ten days ahead of America
If you’re in America, you may be wondering what awaits you in the days ahead. Just ask us here in Western Europe. We know.
The United States is about ten days behind France, which is about ten days behind Italy. The virus has spread to every state in the union. Some are ahead of others. But no matter where you are, look at Europe. The lessons are here to learn—if you want to learn them.
First, if you aren’t already on lockdown: Go home and stay home. These scenes are horrifying:
All of that will end in the next few days. Those feckless young men and women will sit down and read the seminal Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand and be sobered by it. Chastened and frightened, they will repair to their homes.
Actually, they won’t.
But it will end in the next few days. One of two things will happen. Americans will either put themselves in lockdown because they’ve read that paper, run the numbers, and concluded that 2.2 million dead Americans isn’t an acceptable alternative. Or someone else will read that paper, run those numbers, and force them to stay home. This University of Southampton study found that if China had imposed a lockdown three weeks earlier, the number of deaths would have been reduced by 95 percent. The cost of waiting is intolerable. Every day counts.
Public authorities everywhere—no matter how dim they are or determined to cling to the belief that none of this is happening—will soon have no choice but to grasp what “exponential” means. But during this liminal period, large parts of the public will remain in denial—or they’ll understand, but fail to grasp how severe the change in their behavior has to be if it’s to do any good. For a few more days, people who want to believe it’s all a hoax will be able to comfort themselves. Unfortunately, that will include some number of government officials. This period doesn’t last long, but it’s deadly.
Those officials will get around to reading Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand—and if they still can’t quite get their heads around it, they’ll see what’s happening in the emergency rooms. But here’s the problem: Those frolicking cretins on the beach still won’t get it. The lockdown will have to be declared well before a large part of the public fully understands why.
In fact, even ten days from now, a smaller—but still significant—part of the public still won’t understand why. They won’t understand no matter how many frolicking cretins die. This is a huge problem, because unlike China, we just don’t have much experience of locking up millions of people who’ve done nothing wrong and don’t see why they should be locked up. Generally speaking, that’s a gladdening thing. But it’s a real liability during a pandemic.
Officials who are still debating whether or not to declare a lockdown are wasting time and lives. At this point, every minute in which people are in denial and out of their homes is unforgivable. Actually, it’s all unforgivable—none of this should have happened—but it’s too late.
I’ve now seen this all play out across Europe. First, officials think, “We’ve got this under control.” They ignore what the epidemiologists are telling them because it’s unthinkable—and so are all of the implications.
Then they will fantasize that can bring things under control without force. At first, they’ll tell people to wash their hands and stay home if they’re sick. Like the public at large, they comfort themselves with the thought that bad things only happen in authoritarian countries and to people who eat the heads off bats.
Then cases start to mount. They begin to freak out—but they still think everyone will cooperate, responsibly, as soon as they explain things. They begin to hint. They recommend “social distancing.” They refrain from telling the public everything that’s really coming, though, because people must be “kept from panicking.” I suspect that when they say this it means they’re trying to prevent themselves from panicking. I’ve seen no evidence that people panic, beyond the odd toilet-paper purchasing spree. To the contrary: They just can’t be persuaded to take it seriously.
Then they recommend staying at home—in ever-more urgent tones. Some part of the public will get very uneasy, as they should.
Then they tell people they only need masks if they’re healthcare workers, or sick. This is not true. Of course everyone needs masks. Asymptomatic carriers are the primary vector of transmission—what does that tell you? Do you have two firing neurons? But there aren’t enough masks. This lie is your clue that consciously or not, the officials have already begun the grim process of triage. A health care worker’s life, in this new world, is worth more than yours.
Should they have told you the truth? I don’t know. The healthcare workers’ lives are worth more than yours. We can’t replace them, and no one else has a clue how to keep us alive.
Officials will still hope that people will voluntarily do what’s necessary to stop the infection. But they won’t. An astonishing number of people—perhaps 40 percent of the population—will remain convinced they’re just making all of this up so better to control them, or that Big Pharma has ginned up another scam to make another buck, or even that elected officials are such vile and corrupt fucking snakes that they’d see a global pandemic as a splendid opportunity for insider trading, so why listen to a thing they say? The public’s inability to sort truth from fantasy will be matched by the government’s. Governments are made up of people, after all.
An alarming number of people will take perverse pride in not changing a thing about the way they live. They are Galileos, they think to themselves, whose vision and independence of mind allow them to see further and farther than the dull masses. They spit on the stifling orthodoxy of the germ theory of disease.
This stage lasts for about a week.
Then politicians start coming down with it.
Two days later, more or less, the emergency rooms start overflowing. The less mathematically-minded public officials—the base-raters, as Tyler Cohen calls them—realize the growthers were right. That white-as-a-sheet peckerhead epidemiologist who kept yammering on about ‘exponential functions’ wasn’t just another pointy-headed wanker.
Then comes the lockdown order.
Then comes the realization that people aren’t doing this right. Many responded to the order by fleeing the cities. They’ve spread the virus everywhere. Officials realize, too late, that they should have stopped the trains and blocked the roads before giving the order.
Then comes the realization that a stubborn minority just will not stay locked down. Eppur si muove!
Then comes the more drastic lockdown order, with more specific rules. No, you idiot, you can’t go out because “you always go out on this street and you’ve never got sick before.” There are heavier punishments for those who don’t comply. People will wheedle and whine and send tweets to officials saying that all of this is so unreasonable because that if they can’t go outside, they’ll get depressed, and don’t they realize that depression, too, is a serious health problem?
You’ll either be one of them, or you’ll realize at this point that many of your fellow citizens suffer from terrifying cognitive limitations.
Then the health care workers start dropping like flies.
People start to realize how badly the authorities have fucked things up and how many lies they’ve told. Public fury mounts.
I don’t know what happens next, because I’m only ten days ahead. I’ll tell you as soon as I know. At this stage, I assume, China just began shooting people. Doctors in Wuhan are now telling doctors in Europe that their lockdown-lite—wherein people can still go out to get groceries and let the dog take a whiz—won’t work. They tried that in Wuhan, too. It didn’t work. In the end, no one was let out for any reason. Officials went door-to-door, dropped off some food, and sent anyone suspect to a quarantine center. Parents were yanked away from their kids. Kids starved to death in their apartments.
Emergency room doctors here are already begging the government to implement “Chinese-style” measures.
So don’t dither and put off the lockdown, because it’s going to happen, anyway. All you’re doing by delaying is making the eventual lockdown worse, and the number of lives you waste doubles every day you argue about it. (Well, strictly speaking, it doesn’t double—half-hearted social distancing does work. It just doesn’t work well enough.)
Your public officials should start thinking about this problem: A stubborn portion of the population won’t comply. You might have to shoot them. Now’s the time to figure out if there’s a better way, because this will be a problem. The French government simply has no idea what to do, short of shooting them. Putting them in prison would clearly be counterproductive; they’d just turn into a big petri dish.
They’ve tried raising the fine for being out without a permit. They’re begging people, lecturing them, scolding them, sending them text messages. Interior Minister Castaner has gone from “Mes chers compatriotes … ” to “idiots.”
It’s been been eye-opening to see how many adults in France—and elsewhere—are frozen in their emotional development. A large minority cannot understand that government officials aren’t their parents. They’ve not been told to stay home because the government just doesn’t want them to have any fun. Now it’s a vicious circle, because the more irresponsibly they behave, the more appalled the government becomes. They’ve begun to lecture the public like frustrated parents talking to surly teenagers, which arouses the suppressed adolescent among even the responsible ones. The ministers are sounding more and more like parents at the end of their tether. “You’re grounded. No ifs, ands, or buts. Go to your room and stay there. Because I said so!”
You will be appalled when you realize how stupid and irresponsible people really are. Many of you suspected this when Trump was elected. But be prepared: This is a different cohort of stupid and irresponsible people. They do not necessarily overlap with people who thought it would be a superb idea to put the author of this Tweet in the Oval Office:
Across the globe, large segments of the human population suffer from the same cognitive deficits. They can’t understand something as tiny as a virus. They can’t think in terms statistics and exponents. They can’t accept that the virus isn’t a person and you cannot bargain with it. They can’t believe this is happening. They can’t believe that human touch is the problem, not the solution. They can’t believe that even though they feel perfectly well, they are now loaded weapons aimed at their neighbors. They can’t understand something as mean-spirited as life itself. These are difficult things for people to grasp. They aren’t just difficult for Donald Trump, or for Americans who voted him—the whole world is having trouble reckoning with them.
Nothing is intuitive about epidemic disease. The measures you must take to combat it are not natural. When people are frightened, they want to huddle together, to comfort themselves by touching each other. They want to rush toward, not away from, their families. They want to fight or flee, not stay in place and wait. These are instincts, not learned behaviors. But they’re in total opposition to sanitary imperatives.
Take a moment to read that carefully. It’s written to be accessible to laymen. It’s the only policy response that makes any sense. All of this is true and rational:
Our healthcare system is already collapsing.
Countries have two options: either they fight it hard now, or they will suffer a massive epidemic.
If they choose the epidemic, hundreds of thousands will die. In some countries, millions.
And that might not even eliminate further waves of infections.
If we fight hard now, we will curb the deaths.
We will relieve our healthcare system.
We will prepare better.
We will learn.
The world has never learned as fast about anything, ever.
And we need it, because we know so little about this virus.
All of this will achieve something critical: Buy Us Time.
But can people do it? Will they understand this fast enough?
Italy is still having a devil of a time getting people to just stop behaving in ways that spread this thing. They’re still taking advantage of the trip they’re allowed to the grocery stores to stop and gossip and socialize—even now, even though whole Italian villages have been decimated, and this in the old, Roman sense of the word. They have just called in the military to try to enforce the quarantine. What will the military do? I cannot imagine they’ll have the heart to shoot elderly Italians for gabbing in the streets.
Last night, a physician in France shared this email from his Italian colleague:
Dear friend. Thank you for your message. As for me and my family, we’re okay. Here, it is Dante’s hell. I never thought I’d live through such a thing. Dozens of deaths a day. Bilateral pneumonia, even among the young. Our colleagues are infected. Lombardy’s health system has been brought to its knees. Unfortunately, I think, the same thing is coming to France. I hope what’s happened to us will be useful for you, and I’m confident France has a much lower population density compared to ours.
Everyone must stay in their homes. That is the only tool we have at our disposal.
I just don’t know if people are capable of doing it.