Category: Health

Walking Down Main Street, USA

I was at Disney World recently. I’ve been to Disney world many, many times over the last decade and a half. Not that long in the scheme of things, I grant you, but long enough to have an impression and an opinion on how things ought to be. Enough to recognize the difference between when Disney lives up to their advertising, and when it falls short. This last trip, it seemed to fall short.

Unlike other times where some catastrophe has wrecked part of my trip, there wasn’t a singular issue. Rather, it was the collective effect of many little issues. Things like “Bell Services was slow” or “the app was buggy” or “there weren’t enough servers working the kiosks.” Little annoyances that, individually excusable, collectively undermine the experience. For another vacation, I might not even mention them. After all, these things happen. But Disney advertises itself as being a cut above the rest precisely because it supposedly smooths these issues over through its trademark pixie dust and monopolistic panopticon of an area the size of Manhattan. 

The blame, according to people who follow Disney religiously, lies with the new executives. In trying to squeeze more profit from the parks, they have stripped things down to the bare bones. Cast members are overworked, overstretched, and underpaid, and the result is burnout and absenteeism. Thus, the usual layer of pixie dust becomes a bit spottier. It’s a compelling story, which is part of why I doubt it. It’s a little too quaint, a little too storybook, with a simple villain making bad choices, to explain systemic breakdowns.

Of course, that doesn’t make the story untrue. Disney has been cutting costs. Like any large institution, there is a measure of redundancy within the organization, at which the new executives seem to be taking aim. The new thinking seems to be that theme parks can still sell merchandise without needing a gift shop at every ride, so a lot of shops are being closed and the workers reassigned. But what happens when you keep cutting? The rides still function, but the lines are longer. The cast members, who are covering more people, are just a little less bubbly. Luggage takes a little longer to arrive. Food is just a little less fresh. The shelves aren’t restocked as quickly. 

But if the answer is Disney’s CEOs, why is the same true everywhere across the country? If the reason for so many shops at Disney’s Hollywood Studios being closed is Disney corporate strategy, why are shops closing in my hometown? Why are the ingredients at my local grocery store less fresh, and the mail running late, and the store shelves restocking so slowly? You could say something like “supply chain issues” or “worker shortages” but really this only pushes the problem back a step. Why is the supply chain struggling now? Where have all the workers gone? 

What seems more remarkable is that no one wants to mention the obvious answer. We’re in the midst of a pandemic that killed more than a million Americans before many states just stopped counting. Millions more have been sickened, and are unable to work to the same capacity. Others are restricted from working in order to support people in the former group. And this is only the disruption to the United States, not even touching the dislocation caused by disruption to global supply chains and migration. 

The idea that society- any society -can shrug off upwards of a million excess deaths and millions more disabled, without any kind of social or economic disruption, is a fantasy far beyond anything at Disney World. The idea that workers will be just as eager to compete for the same wages, despite the increased danger of infectious disease, coupled with the pressure of having to cover for sickened or dead colleagues, likewise ignores the basic tenets of supply and demand. When this happened during the bubonic plague, it was the beginning of the end of feudalism, as high-demand workers gained more leverage and began to upend traditional hierarchies. The decades after the 1918 Influenza Pandemic were a high point of labor unrest and economic turmoil in the United States, which only began to dissipate after the New Deal fundamentally restructured the American economy. 

Disney continues, as it long has, to be a microcosm of American society at large. Price hikes, staff shortages, shorter business hours, longer lines, are all making themselves known. And likewise, some of the early attempts to grapple with the issue are on display. In response to a more competitive labor market, in addition to tightening time off policies, Disney has been forced to look to new demographics, expanding and accelerating its college recruitment program. At the same time, since it cannot afford to lose the talent it has, the company has been compelled to become more inclusive in its rhetoric. 

Which, if you consider the ongoing spat between the right wing Florida state government and Disney, is hilarious. It is the head-in-the-sand public health policies, coupled with xenophobic protectionist immigration controls that have pushed Disney to embrace a more liberal political stance to attract talent. If this pattern ripples out to the wider American economy, and without aggressive government intervention in the labor market and public health, it almost certainly will, it will be a reversal of fortunes worthy of the Disney storytelling tradition.

Real Men Aren’t Scared of Needles

Since most of my readers access this site from countries where the COVID-19 vaccine is now available, I’m here to remind you to get vaccinated when it’s your turn. If you’re over twelve in the United States, you are eligible now. While there are many things in life that can be safely postponed or procrastinated, this isn’t one of them. Getting as many people vaccinated as quickly as possible is humanity’s last best chance to quash this virus before it becomes endemic, which would make it impossible to go back to normal. 

You’ve probably already heard this argument from better qualified sources than me. And let’s be real, if you haven’t listened to epidemiological statistics or long term morbidity case studies coming from the CDC, you have no reason to listen to them coming from me. So instead, I’m going to present an argument that you probably won’t see on a prime time TV spot any time soon. 

You should get the vaccine because getting the virus will ruin your sex life. 
I mean, you should also get it because the virus might kill you, or kill other people, or leave you unable to climb stairs, and so on. But if those stories haven’t convinced you already, clearly you have a different set of priorities. So if you need a better reason than your own survival: you should get vaccinated because more and more COVID-19 survivors are developing sexual dysfunction, in particular male erectile dysfunction. Not just from running out of breath or getting tired, either, but from the virus itself being present long after acute infection phase. Tissue samples confirm the presence of COVID-19 spike proteins obstructing normal arousal mechanisms.

Don’t take my word for it. The pilot study is open access, and not that long to read by the standards of  journal articles. Yes, there is some medical jargon, and there’s the usual amount of carefully worded and qualified statements saying that more study is needed, but the data speaks for itself. It’s incredibly obvious, isn’t it? A novel virus is introduced into our precious bodily fluids without the knowledge of the individual, certainly without any choice. Luckily our scientists are able to interpret the resulting loss of essence correctly. 

There are obviously public health implications in these findings that viral particles are lingering in certain tissues and obstructing function after the acute infectious period. But the American public has demonstrated in its actions that it doesn’t really follow the nuance of public health, or scientific studies, or systemic issues in general. The only people who care about things like disability adjusted life expectancy or long term national stability are over-educated bleeding-heart know-it-alls. On the other hand, protecting one’s manhood from the virus’s attempt to sap and impurity our precious bodily fluids is as American as apple pie. 

On Social Distancing Vis a Vis Communism

I wish to try and address some of the concerns raised by protests against measures taken to protect public health in the wake of the ongoing COVID-19 pandemic. Cards on the table: I think people who are going out to protest these measures are, at best, foolhardy and shortsighted. It’s hard for me to muster sympathy for their cause. Still, calling someone names doesn’t often win hearts and minds. So I’m going to try and do that thing that people tell me I’m good at; I’m going to write about the situation from where I stand, and try to understand where these people are coming from, in the hopes that I can, if not change behaviors, at least help people understand who may be equally mystified and apoplectic at my position as I am at theirs. 

I’m not going to address any conspiracy theories, including the conspiracy theory that these measures are part of some ill-defined plan of a shadowy elite to seize control. Mostly because, from where I stand, it’s a moot point. Even taking all of the claims about evil motivations at face value, even if we assume that everyone in government secretly wants to live in a totalitarian dictatorship and they see this as their chance, that doesn’t really affect the reality. The contents of my governor’s soul is between him and God [1]. He says he wants to save lives, and he’s put in place policies to mitigate the spread of disease. People are dying from COVID-19; maybe slightly more or fewer people than the numbers being reported, but definitely people [2], including people I know. 

For context, since the beginning of this episode, I have had friends and acquaintances die, and other friends and acquaintances friends go from being student athletes, to being so sick that they can’t sit up to type on a laptop. My university campus- the places where I learn, interact with others, and often write these posts -is split between being field hospitals, quarantine lodgings for hospital workers, and morgues. Because there aren’t enough staff, undergraduate students, even freshmen like me, who have any experience in nursing or medicine, are called on to volunteer as emergency workers, and facing the same conditions, often without proper equipment, that have claimed so many lives. Every night, from my own bedroom, I hear the sirens of ambulances rushing back and forth from the retirement village to the hospital. We’re not even the epicenter, and things are that bad here. 

So the virus is very real. The toll is very real. The danger is real. We can quibble over who bears responsibility for what later. There will be plenty of time for anger, grief, and blame; plenty of time to soberly assess who overreacted, who under-reacted, who did a good job, and who ought to be voted out. I’m counting on it. In the now, we know that the virus spreads by close and indoor contact [2][3]. We know that there are only so many hospital beds, and we have no way to protect people or cure them [4][5]. It stands to reason that if we want to save lives, we need to be keeping people apart. And if we believe that a function of government is looking out for and protecting lives, which even most libertarians I know agree on, then it stands to reason that it’s the government’s job to take action to save as many lives as possible. Yes, this will require new and different exercise of powers which might in another context be called government overreach. But we live in new and different times. 

Not everyone is able to comfortably come to terms with change. I get it. And if I’m really honest, I’m not happy with it either. A lot of people who argue for shutdowns try to spin it as a positive thing, like a children’s television episode trying to convince kids that, hey, cleaning up your room is actually fun, and vegetables are delicious. Look at the clear skies, and the dolphins in the Hudson River. Staying at home makes you a hero; don’t you want to feel like a hero? And yeah, there are silver linings, and reasons why you can look on the bright side. For some people looking for that bright side is a coping mechanism. But truth be told, mostly it sucks. Not being able to hug your friends, or eat out at a restaurant, or just hang out in public, sucks. You’re not going to get around that. And a lot of people are angry. People feel deprived and cheated.
And you know what? That’s fine. You’re allowed to feel angry, and cheated. Being upset doesn’t make you a bad person. Your experiences and feelings are valid, and you’re allowed to pout and stomp and scream and shout.

That’s fine. Let it out, if you think it’ll make you feel better. You’re right, it’s not fair. Life isn’t fair, good people are suffering, and that’s infuriating. Unfortunately (and I do mean this sincerely), it won’t change anything. The virus has made it abundantly clear that it doesn’t care about our feelings, only our behavior. However we feel, if we want to save people, we need to stay apart. If we support the idea that governments should look out for people, we should insist that they lend their power to these measures. We can still hate being cooped up. But we need to understand that this is the lesser of the evils. Whether it takes a week, a month, or even a year, the alternative of massive death needs to be ruled out.

Some people have raised the argument that, even though we care about human lives, Americans need to work. The implication that Americans need to work, as opposed to, say, just kinda wanting to work, implies a kind of right. Maybe not as absolute as free speech, or as technical as the right to a trial by a jury of peers, but maybe something akin to a right to privacy; a vague but agreed upon notion that we have a general right to strive for something. Of course, no right is truly absolute. Even free speech, the one that we put first in our bill of rights, and generally treat as being the most inviolable, has its limits. As a society we recognize that times of war, rebellion, or public danger, our rights are not absolute. The police don’t have to mirandize you to ask where the bomb is, or stop chasing an armed suspect because they ran into a private home [6]. 

Hopefully, even if we may, as a matter of politics, quibble on where the exact lines are, we can all concede that rights are not absolute, and having exceptions for a larger purpose is not advocating tyranny. This same line of reasoning would apply to any previously undefined right to work as well. And I think it’s pretty clear the basis for why the current pandemic constitutes such an exception. We can have respectful disagreements about what measures are useful in what areas, but when the overarching point is that we need to minimize human contact for public safety, it seems like that covers most things in dispute. Again, you don’t have to like it. You’re welcome to write a response. But do so from your own home. If you’re feel compelled to protest something specific, then protest safely, but don’t sabotage the efforts of people trying to make this go away.

Maybe you’re thinking: Okay, that sounds nice, but I actually need to work. As in, the bills don’t stop coming, and this stimulus check isn’t going to cut it for longer. Life doesn’t stop for illness. Even in localities that have frozen certain bills and have good food banks, there are still expenses. In many places, not enough has been done to allow people who want to do the right thing to be able to do so. Not everyone can work from home, and in a tragic irony, people who live paycheck to paycheck are less likely to be able to work from home, if their jobs even exist in a telecommuting economy. For what it’s worth, I’m with the people who say this is an unfair burden. Unfortunately, as we know, life isn’t fair, and there’s not a way to reconcile saving lives and letting everyone work freely. As an aside, though I don’t think anyone genuinely believes in sacrificing lives for GDP, I’ll point out that more people getting sick and dying actually costs jobs in the long run [7][8]. Economists agree that the best way to get everyone back to work is to devote as much of our resources as possible to fighting this virus.

People say we can’t let the cure be worse than the disease, and although I disagree with the agenda for which this is a talking point, I actually agree with the idiom. Making this a choice between working class families starving, and dying of disease is a no-win scenario, and we do need to weigh the effects of cutting people off. That doesn’t make the virus the lesser of the evils, by any stretch of the imagination. Remember, we haven’t actually ruled out the “Millions of American Deaths” scenario if we go back to regular contact patterns, we’ve just put it off for now. That’s what flattening the curve means; it’s an ongoing process, not a one and done effort [9]. Saving lives is a present tense endeavor, and will be for some time. Still, a cost-benefit analysis requires that we understand the costs. People are losing jobs, and suffering for it, and government policy should take that into account. 

Here’s where I diverge from others: keeping things shut down does not necessarily have to mean that people go hungry. Rather than ease lockdown restrictions, this is where I would say governments, both state and federal, need to be doing more while they’re telling people to stay home. It’s not fair to mandate people stay at home while their livelihoods depend on getting out and working; agreed, but there’s more than one way to neutralize that statement. The government could scale up the stimulus checks, giving every American an emergency basic income. Congress could suspend the debt limit and authorize special bonds akin to war bonds to give unemployment and the Payroll Protection Program as much funding as they need, removing the bottleneck for businesses. Or, you could attack the problem from the opposite end; mandate a halt on payments for things like rent, mortgages, utilities, and so on, and activate emergency nutrition programs drawn up by the pentagon to keep Americans fed during a nuclear winter. Common carriers such as utilities, telecoms, delivery companies, and other essential services could be placed under temporary government control through existing emergency powers if necessary. 

Such a mass mobilization wouldn’t be unprecedented in American history. The world wars the the New Deal show that it can be done while maintaining democratic governance. The measures wouldn’t need to be permanent, just for the duration of the crisis created by the pandemic. There’s a good historical case that a strong response would benefit our economic recovery once this passes [8]. You wouldn’t necessarily need to do all of the things I mentioned; you could tailor it to fit demands in specific areas. The point is, people don’t need to starve. The trade off only exists in the system we’ve constructed for ourselves. That system is malleable, even if we don’t often view it as such, because we so rarely get to a point like this. The lockdown is easier to see as malleable, because it’s recent, and we can remember a time before it, but there’s a much stronger scientific basis for why we need to keep it in place, at least for now.

I’ll address one more point, and that is the argument that, material need or no, people have a deeper need, and by implication a right, to get out and try to make a living in the world. This is subtly different than the idea that people have a default legal right to do as they will, as covered earlier. By contrast this strikes at a deeper, philosophical argument that people have a need to contribute positively. The idea that people simply go stir crazy, and television and video games lack that certain element of, as Aristotle put it, Eudaimonia, the joy achieved by striving for a life well lived [10]. I think this is what people are getting at, at least, the people who have really sat down and thought about it, when they decry increasing government dependence while life is under quarantine. They probably understand that people need to eat, and don’t want anyone to die, but deeper than any legal right, are concerned that if this state of affairs drags out, that people will stop striving, and lose that spark that drives the human spirit. People need to be able to make their own lives, to give them meaning. 

Expressed in philosophical terms, I’m more sympathetic to this argument than my politics might suggest. I agree that people need meaning in their lives. I even agree that handouts don’t provide that meaning the same way that a successful career does. It is human nature is to yearn to contribute, not just survive, and for a lot of people, how they earn money outside the home is what they see as their contribution; the value they add and the proof of their worth. Losing that is more than just tragic, it’s existentially terrifying. I remember the upheaval I went through when it became clear I wasn’t going to be able to graduate on time with my disability, and probably wouldn’t get into the college on which I had pinned my hopes and dreams as a result. I had put a lot of my value on my being a perfect student, and having that taken away from me was traumatic in its way. I questioned what my value was if society didn’t acknowledge me for being smart; how could I be a worthwhile person if society rejected the things I put my work into. Through that prism, I can almost understand how some people might be more terrified of the consequences of a shutdown than of the virus.

The idea that work gives human life meaning isn’t new. Since the industrial revolution created the modern concept of the career, people have been talking about how it relates to our philosophical worth. But let’s tug on that threat a little longer. Before any conservative pundits were using the human value of work to attack government handouts, there was a German philosopher writing about the consequences of a society which ignored the dislocation and alienation which occurred when the ruling class prevented people from meaningful work. He used a German term, Entfremdung der Gattungswesen, to describe the deprivation of the human soul which occurs when artificial systems interfere in human drives. He argued that such measures were oppressive, and based on his understanding of history would eventually end in revolution. 

That philosopher was Karl Marx. He suggested that industrial capitalism, by separating the worker from the means of producing their livelihood, the product of their labor, the profits thereof, and the agency to work on their own terms, the bourgeoisie deny the proletariat something essential to human existence [11]. So I guess that protester with the sign that “social distancing = communism” might be less off the wall that we all thought. Not that social distancing is really communist in the philosophical sense, rather the contrary; social distancing underlines Marxist critiques of capitalism. True to Marxist theory, the protester has achieved consciousness of the class iniquities perpetuated by the binding of exploitative wage labor to the necessities of life, and is rallying against the dislocation artificially created by capitalism. I suspect they probably wouldn’t describe themselves as communist, but their actions fit the profile. 

Here’s the point where I diverge from orthodox Marxism. Because, again, I think there’s more than one way to neutralize this issue. I think that work for meaning doesn’t necessarily need to be work for wages. Suppose you decoupled the drive of material needs from the drives for self improvement and worth, either by something like a universal basic income, or the nationalization and dramatic expansion of food banks, rent controls, and utility discount programs, such that a person was able to survive without working. Not comfortably, mind you, but such that starving is off the table. According to Marx this is most assuredly not communism; it doesn’t involve the worker ownership of the means of production. People still go to work and sell their labor, and market mechanisms dictate prices and reward arbitrage. 

What this does, instead, is address the critique of our current system raised by both Marx, and our protester. In addition to ensuring that no one goes hungry, it also gives the opportunity, indeed, an incentive, for individuals to find socially useful and philosophically meaningful work beyond the market. Feeling useless sitting at home? Go get on video chat and tutor some kids in something you’re good at. Go mow lawns for emergency workers in your area. Take an online class, now that lots of them are free. Make some art; join the trend of celebrities posting videos of themselves singing online. If you have any doubts that there is plenty of unpaid but necessary and useful work around the house, ask a housewife. Rather than protest the lack of a particular task, we should take this opportunity to discover what useful and meaningful work we can accomplish from home. 

The dichotomy between opening and starving is a false fabrication, as is the dichotomy between deference to scientific and philosophical principles. Those who protest one or the other appear either to represent a fringe extreme, or misunderstand the subtleties of the problem and the multitude of measures which we may take to address it. Our individual freedoms reflect a collective responsibility and commitment to self moderation and governance, which we must now demonstrate, by showing the imagination, foresight, and willingness to sacrifice for a greater cause which has defined our human struggle. In this moment, the responsibilities to our fellow human beings outweigh some of the rights we have come to take for granted. This exigency demands a departure from our norms. We must be prepared to suspend our assumptions, and focus on what really matters. Now is the time to find meaning in things that matter to us. To demand better from our government than platitudes and guidelines. To help ourselves and our fellow human being without prejudice. 

Works Consulted

[1] Matthew 7:1, KJV

[2] “Coronavirus Disease 2019 (COVID-19).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2020, www.cdc.gov/coronavirus/2019-ncov/index.html.

[3] “Coronavirus.” World Health Organization, World Health Organization, www.who.int/emergencies/diseases/novel-coronavirus-2019.

[4] “ Over the past several weeks, a mind-boggling array of possible therapies have been considered. None have yet been proven to be effective in rigorously controlled trials”“Pursuing Safe and Effective Anti-Viral Drugs for COVID-19.” National Institutes of Health, U.S. Department of Health and Human Services, 17 Apr. 2020, directorsblog.nih.gov/2020/04/17/pursuing-safe-effective-anti-viral-drugs-for-covid-19/.

[5] “ There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19. Current clinical management includes infection prevention and control measures and supportive care”“Therapeutic Options for COVID-19 Patients.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Mar. 2020, www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html.

[6] Burney, Nathan. “The Illustrated Guide to Law.” The Illustrated Guide to Law, 17 Apr. 2020, lawcomic.net/.

[7] Pueyo, Tomas. “Coronavirus: Out of Many, One.” Medium, Medium, 20 Apr. 2020, medium.com/@tomaspueyo/coronavirus-out-of-many-one-36b886af37e9.

[8] Carlsson-Szlezak, Philipp, et al. “What Coronavirus Could Mean for the Global Economy.” Harvard Business Review, 16 Apr. 2020, hbr.org/2020/03/what-coronavirus-could-mean-for-the-global-economy.

[9] Ferguson, Neil M, et al. “ Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand.” Imperial College of London, 16 Mar. 2020, https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-03-16-COVID19-Report-9.pdf

[10] Aristotle. “Nicomachean Ethics.” The Internet Classics Archive, classics.mit.edu/Aristotle/nicomachaen.1.i.html.

[11] Marx, Karl. “The Economic and Philosophic Manuscripts of 1844.” Marxists Internet Archive, www.marxists.org/archive/marx/works/1844/manuscripts/preface.htm.

World Health Day

The following message is part of a campaign to raise public awareness and resources in light of the global threat posed by COVID-19 on World Health Day. If you have the resources, please consider contributing in any of the ways listed at the end of this post. Remember to adhere to current local health guidelines wherever you are, which may differ from those referenced in this post. 

Now that the world has woken up to the danger that we face in the Covid-19 pandemic, and world leaders have begun to grapple with the problem in policy terms, many individuals have justifiably wondered how long this crisis will last. The answer is, we don’t know. I’m going to repeat this several times, because it’s important to come to terms with this. For all meaningful purposes, we are living through an event that has never happened before. Yes, there have been pandemics this bad in the long ago, and yes, there have been various outbreaks in recent memory, but there has not been a pandemic which is as deadly, and as contagious, which we have failed to contain so spectacularly, recently enough to use it is a clear point of reference. This means that every prediction is not just speculation, but speculation born of an imperfect mosaic. 

Nevertheless, it seems clear that unless we are willing to accept tens of millions of deaths in every country, humanity will need to settle in for a long war. With the language of the US President and Queen Elizabeth, the metaphor is apt. Whether “long” may mean a few months, or into next year will depend on several factors, among them whether a culture which has for many decades been inculcated with the notion of personal whimsy and convenience is able to adapt to collective sacrifice. The longer we take to accept the gravity of the threat, the weaker our response will be, and the longer it will take us to recover. Right now all of humanity face a collective choice. Either we will stubbornly ignore reality, and pay the price with human tragedy of hitherto-fore unimaginable proportions, and repercussions for decades to come, or we will listen to experts and hunker down, give support to those who need it, and help each other through the storm. 

For those who look upon empty streets and bare shelves and proclaim the apocalypse, I have this to say: it is only the apocalypse if we make it such. Granted, it is conceivable that if we lose sight of our goals and our capabilities, either by blind panic or stubborn ignorance, we may find the structures of our society overwhelmed, and the world we know may collapse. This is indeed a possibility, but a possibility which it is entirely within our collective capacity to avoid. The data clearly shows that by taking care of ourselves at home, and avoiding contact with other people or surfaces, we can slow the spread of the virus. With the full mobilization of communities, we can starve the infection of new victims entirely. But even a partial slowing of cases buys us time. With that most valuable of currencies, we can expand hospital capacity, retool our production, and focus our tremendous scientific effort towards forging new weapons in this fight. 

Under wartime pressure, the global scientific community is making terrific strides. Every day, we are learning more about our enemy, and discovering new ways to give ourselves the advantage. Drugs which prove useful are being deployed as fast as they can be produced. With proper coordination from world leaders, production of these drugs can be expanded to give every person the best fighting chance should they become sick. The great challenges now are staying the course, winning the battle for production, and developing humanity’s super weapon.

Staying the course is fairly simple. For the average individual not working essential jobs, it means staying home, avoiding contact as much as possible, and taking care to stay healthy. For communities and organizations, it means encouraging people to stay at home by making this as easy as possible. Those working essential jobs should be given whatever resources they need to carry on safely. Those staying at home need to have the means to do so, both logistically and psychologically. Logistically, many governments are already instituting emergency financial aid to ensure the many people out of work are able to afford staying home, and many communities have used volunteers or emergency workers such as national guard troops to support deliveries of essentials, in order to keep as many people as possible at home. Psychologically, many groups are offering online activities, and many public figures have taken to providing various forms of entertainment and diversion.

Winning the battle for production is harder, but still within reach. Hospitals are very resource intensive at the best of times. Safety in a healthcare setting means the use of large amounts of single-use disposable materials, in terms of drugs and delivery mechanisms, but also personal protective equipment such as masks, gowns, and gloves. If COVID-19 is a war, ventilators are akin to tanks, but PPE are akin to ammunition. Just as it is counterproductive and harmful to ration how many bullets or grenades a soldier may need to use to win a battle, so too is it counterproductive and harmful to insist that our frontline healthcare workers make do with a limited amount of PPE. 

The size and scope of the present crisis, taken with the amount of time we have to act, demands a global industrial mobilization unprecedented during peacetime, and unseen in living memory. It demands either that individuals exhibit self discipline and a regard for the common good, or central authorities control the distribution of scarce necessities. It demands that we examine new ways of meeting production needs while minimizing the number of people who must be kept out at essential jobs. For the individual, this mobilization may require further sacrifice; during the mobilization of WWII, certain commodities such as automobiles, toys, and textiles were unavailable or out of reach. This is the price we paid to beat back the enemy at the gates, and today we find ourselves in a similar boat. All of these measures are more effective if taken calmly in advance by central government, but if they are not they will undoubtedly be taken desperately by local authorities. 

Lastly, there is the challenge of developing a tool which will put an end to the threat of millions of deaths. In terms of research, there are several avenues which may yield fruit. Many hopes are pinned on a vaccine, which would grant immunity to uninfected, and allow us to contain the spread without mass quarantine. Other researchers are looking for a drug, perhaps an antiviral or immunomodulator which might make COVID-19 treatable at home with a pill, much like Tamiflu blunted the worst of H1N1. Still others are searching for antibodies which could be synthesized en masse, to be infused to the blood of vulnerable patients. Each of these leads requires a different approach. However, they all face the common challenge of not only proving safety and effectiveness against COVID-19, but giving us an understandable mechanism of action.

Identifying the “how and why” is not merely of great academic interest, but a pressing medical concern. Coronaviruses are notoriously unstable and prone to mutation; indeed there are those who speculate that COVID-19 may be more than one strain. Finding a treatment or vaccine without understanding our enemy exposes us to the risk of other strains emerging, undoing our hard work and invalidating our collective sacrifices. Cracking the COVID-19 code is a task of great complexity, requiring a combination of human insight and brilliance, bold experimentation, luck, and enormous computational resources. And like the allied efforts against the German enigma, today’s computer scientists have given us a groundwork to build off.

Unraveling the secrets of COVID-19 requires modeling how viral proteins fold and interact with other molecules and proteins. Although protein folding follows fairly simple rules, the computational power required to actually simulate them is enormous. For this, scientists have developed the Folding@Home distributed computing project. Rather than constructing a new supercomputer which would exceed all past attempts, this project aims to harness the power of unused personal computers in a decentralized network. Since the beginning of March, Folding@Home has focused its priorities on COVID-19 related modeling, and has been inundated with people donating computing power, to the point that they had to get help from other web services companies because simulations being completed faster than their web servers could assign them.

At the beginning of March, the computing power of the entire project clocked in at around 700 petaflops, FLOPS being a unit of computing power, meaning Floating Point Operations Per Second. During the Apollo moonshot, a NASA supercomputer would average somewhere around 100,000 FLOPS. Two weeks ago, they announced a new record in the history of computing: more than an exaflop of constant distributed computing power, or 10^18 FLOPS. With the help of Oracle and Microsoft, by the end of March, Folding@Home exceeded 1.5 Exaflops. These historic and unprecedented feats are a testament to the ability of humanity to respond to a challenge. Every day this capacity is maintained or exceeded brings us closer to breaking the viral code and ending the scourge. 

Humanity’s great strength has always lay in our ability to learn, and to take collective action based on reason. Beating back COVID-19 will entail a global effort, in which every person has an important role to play. Not all of us can work in a hospital or a ventilator factory, but there’s still a way each of us can help. If you can afford to donate money, the World Health Organization’s Solidarity Fund is coordinating humanity’s response to the pandemic. Folding@Home is using the power of your personal computers to crack the COVID-19 code. And if nothing else, every person who stays healthy by staying home, washing hands, wearing homemade masks and keeping social distance is one less person to treat in the ICU. 

What is a Coronavirus, anyway?

I had about come to the conclusion not to write anything on the current crisis. This was because I am not an expert. There are plenty of experts, and you should listen to them over me, and I didn’t want to detract from what they’re saying by adding my own take and spin. I also didn’t want to write something because, in five attempts so far, every time I’ve sat down to write something out, double checking my sources and cross referencing my information, the situation has changed so as to render what I was about to say outdated and irrelevant, which is incredibly frustrating. The last thing I want to do is give advice contrary to what’s being said. 

But it looks like we might be heading towards a situation where the advice is stabilizing, if only because when the advice is “shut down everything”, you can’t really escalate that. And the data suggests that we are moving towards a long war here. It’s hard to say, but I’ve seen reports with numbers ranging from a few weeks, to eighteen months. And whether we manage to skate by lightly after a few weeks at home, or whether the first two years of the 2020s go down in history akin to the time of the Bubonic Plague, we need to start understanding the problems with which we find ourselves dealing in a long term context. Before I delve into what’s going on, and what seems likely to happen, I’m going to spend a post reviewing terminology.

I wasn’t going to die on this hill, but since we’ve got time, I’ll mention it anyway. Despite begrudgingly ceding to the convention myself, I don’t like calling this “Coronavirus”. That’s not accurate; Coronavirus is not the name of a virus. The term refers to a family of viruses, so named for protein chains which resemble the outermost layer of the surface of the sun. You know, the spiky, wavy bit that you would add to the picture after coloring in the circle. There are a lot of viruses that fit this description, to the point that the emoji for virus (ie: 🦠 ) could be said to be a generic Coronavirus. In addition to a number of severe respiratory illnesses, such as SARS, and now COVID-19, Coronaviruses also cause the common cold. 

They’re so common, we usually don’t bother naming them unless there’s something unusual about them. The World Health Organization was a bit slow to come out with its name for this one; and in the interim the media ran with the word they had. Despite my instinct, I’m not going to tell you you need to get up and change everything you’re saying and remove posts where you said Coronavirus, just be aware of the distinction. We’ve gotten to a point in social discourse where the distinction is academic, the same way everyone understands that “rodent problem” refers to rats or mice rather than beavers. But do be aware that if you’re reading scientific journals, if it doesn’t specify, it’s as likely that that they’re referring to the common cold as COVID-19. 

The term COVID-19 is designated by the World Health Organization, short for COronaVIrus Disease, 2019. WHO guidelines are explicitly crafted to design names which are short, pronounceable, and sufficiently generic so as to not “incite undue fear”. These guidelines specifically prohibit using occupational or geographic names, for both ethical and practical reasons. Ethically, calling a disease specific to an area or people-group, even when it doesn’t imply blame, can still create stigma. Suppose a highly infectious epidemic was called “Teacher’s Disease”, for instance. Suppose for the sake of this that teachers are as likely to be carriers as everyone else, but the first confirmed case was a teacher, so everyone just rolls with that. 

Even if everyone who uses and hears this term holds teachers completely blameless (not that they will; human psychology being what it is, but let’s suppose), people are still going to change their behaviors around teachers. If you heard on the news that Teacher’s Disease was spreading and killing people around the world, would you feel comfortable sending your kids to school? What about inviting your teacher friend over while your grandmother is staying with you? Would you feel completely comfortable sitting with them on the bus? Maybe you would, because you’re an uber-mind capable of avoiding all biases, but do you think everyone else will feel the same way? Will teachers be treated fairly in this timeline, by other people and society? And perhaps more crucially, do you think teachers are likely to single themselves out for treatment knowing that they’ll have this label applied to them?

There are other practical reasons why using geographic or occupational names are counterproductive. Even if you have no concern for stigma against people, these kinds of biases impact behavior in other ways. For instance, if something is called Teacher’s Disease, I might imagine that I, as a student, am immune. I might ignore my risk factors, and go out and catch the virus, or worse still, I might ignore symptoms and spread the virus to other people. I mean, really, you expect me, a healthy young person, to cancel my spring break beach bash because of something from somewhere else, which the news says only kills old timers? 

You don’t have to take my word for it either, or even the word of The World Health Organization. You can see this play out through history. Take the Flu Pandemic of 1918. Today, we know that the virus responsible was H1N1, and based on after the fact epidemiology, appeared first in large numbers in North America. Except, it wasn’t reported due to wartime censorship. Instead, it wouldn’t hit the press until it spread to Europe, to neutral Spain, where it was called Spanish Flu. And when the press called it that, the takeaway for most major governments was that this was a Spanish problem, and they had bigger issues than some foreign virus. The resulting pandemic was the worst in human history. 

I am not going to tell you what words you can or can’t use. Ours is a free society, and I have no special expertise that makes me uniquely qualified to lecture others. But I can say, from experience, that words have power. The language you use has an impact, and not always the impact you might intend. At times like this we all need to be mindful of the impact each of us has on each other. 

Do your part to help combat stigma and misinformation, which hurt our efforts to fight disease. For more information on COVID-19, visit the Centers for Disease Control and Prevention webpage. To view the specific guidelines on disease naming, go to the World Health Organization.

This Was A Triumph

Today I am happy to announce a new milestone. As of today I have received from my manufacturer the authorization code to initiate semi-closed loop mode on my life support devices. This means that for the first time, my life support devices are capable of keeping me alive for short periods without immediate direct human intervention. For the first time in more than a decade, it is now safe for me to be distracted by such luxuries as homework, and sleep. At least, for short periods, assuming everything works within normal parameters. 

Okay, yes, this is a very qualified statement. Compared to the kind of developments which are daily promised by fundraising groups and starry eyed researchers, this is severely underwhelming. Even compared solely to technologies which have already proven themselves in other fields and small scale testing, the product which is now being rolled out is rather pathetic. There are many reasons for this, from the risk-aversiveness of industry movers, to the glacial pace of regulatory shakers, to a general shortage of imagination among decision makers. It is easy to find reasons to be angry and feel betrayed that the US healthcare system has once again failed to live up to its promise of delivering breakneck innovation and improvement.

Even though this is disappointing compared to the technological relief we were marketed, I am still excited about this development. First of all, because it is a step in the right direction, even if a small one, and any improvement is worth celebrating. Secondly, and chiefly, because I believe that even if this particular new product is only an incremental improvement over the status quo, and pales in comparison to what had been promised for the past several decades, the particular changes represent the beginning of a larger shift. After all, this is the first iteration of this kind of life support device which uses machine learning, not merely to enable a fail-safe to prevent medication overdoses, but which actually intends to make proactive treatment decisions without human oversight.

True, the parameters for this decision making are remarkably conservative, some argue to the point of uselessness. The software will not deploy under anything short of perfect circumstances, its treatment targets are short of most clinical targets, let alone best practices, the modeling is not self-correcting, and the software can not interpret human intervention and is therefore mutually exclusive with aggressive treatment by a human.

Crucially, however, it is making decisions instead of a human. We are over the hill on this development. Critiques of its decision-making skill can be addressed down the line, and I expect once the data is in, it will be a far easier approval and rollout process than the initial version. But unless some new hurdle appears, as of now we are on the path towards full automation.

Unchosen Battles

Sometimes, you get to pick your battles. On items that don’t directly affect me, I can choose whether or not to have an opinion, and whether or not to do the research to be informed. Sure, being a good, well-informed person with a consistent ethical framework dictates that I try to have empathy even for issues that don’t impact me, and that I ought apply my principles in a consistent way, such that I tend to have opinions anyway. But I get to decide, for instance, to what degree I care about same sex marriage, or what’s happening in Yemen, or the regulations governing labor unions. None of these things has a noticeable effect on my day to day life, and as such I have the privilege of being able to ignore them without consequence. 

Of course, this isn’t always the case. There are lots of policies that do directly affect me. The price of tuition, for instance, is of great concern, since I am presently engaged in acquiring a degree which I hope will allow me to get a job that will let me pay my bills, ideally without having to take out a small fortune in loans to cover it. Transport policy affects because I am an adult with places to be who cannot drive, and current American transport policy borders on actively hostile to people in my position. 

And then there’s healthcare. I’m not a single issue voter, far from it, but healthcare is a make or break issue for me, since it dictates whether I, and many people I care about dearly, live or die. The policies of the US government in this area determine access to the tools of my life support, whether my insurance company is allowed to discriminate against me, and what price I have to pay to stay alive. These policies are life and death, but that turn of phrase is overused, so let me put it another way: 

With the policy as it is now, I can scrape by. Others can’t, which is tragic, but I’m lucky enough to have money to burn. If the policy changes to make my medication affordable the same way it is in Mexico, I will in one stroke save enough money each year to cover my tuition forever. If policy changes to remove existing protections, then nothing else in the world will matter, because I will go bankrupt and die in short order. It won’t even be a question of choosing between medication and food or rent; without my medication I don’t live long enough to starve to death, and the money I’d save by starving is trivial anyway. I don’t have the privilege of choosing whether to care, or even which side I fall on. I would love to have other priorities; to say that Climate Change is the greatest threat, or immigration is a moral imperative, or whatever other hill I might elect to die on. But for the time being, as long as I want to continue breathing, I have my political opinions chosen for me. 

That’s the way it’s been for as long as I have had political opinions of which to speak. But recently, there’s been a shift. Suddenly, after years of having to beg minor officials to listen, with the presidential election gearing up, people have begun to take notice. Talking points which I and the people I work with have been honing and repeating for seemingly eons are being repeated by primary front runners. With no apparent proximal trigger, our efforts have gained attention, and though we remain far from a solution that will stand the test of repeated partisan attempts to dismantle it, a potential endgame is in sight. 

But this itself brings new challenges. Where before we could be looked upon as a charity case worthy of pity, now we have become partisan. Our core aims- to make survival affordable in this country -have not changed, but now that one side has aligned themselves publicly with us, the other feels obliged to attack us. Items which I previously had to explain only to friends, I now find myself having to defend to a hostile audience. Where once the most I had to overcome was idle misinformation, now there is partisan hatred. 

This is going to be a long campaign. I do not expect I shall enjoy it, regardless of how it turns out. But my work to etch out a means of survival continues. 

My Camera

I have a bit of a strange relationship with photographs. I love to have them, and look at and reminisce about them, but I hate taking them. Maybe that’s not so strange, but most people I know who have a relationship with photographs tend to have the reverse: they love taking them, but don’t know what to do with them after the fact. 
Come to think of it, hate might be a strong word. For instance, I don’t loathe taking pictures with the same revulsion I have towards people who deny the school shootings that have affected my community every happened, nor even the sense of deep seated antipathy with which I reject improper use of the word “literally”. Insofar as the act of taking pictures is concerned, I do not actively dislike it, so much as it seems to bring with it a bitter taste. 
Why? Well, first there is the simple matter of distraction. A while ago I decided that it was important that I pay more attention to my experiences than my stuff. Before that, I was obsessed with souvenirs and gift shops, and making sure that I had the perfect memories of the event, that I often lost focus of the thing itself. Part of this, I think, is just being a kid, wanting to have the best and coolest stuff. But it became a distraction from the things I wanted to do. Some people say that for them, taking pictures of an event actually makes them appreciate the experience more. And to that I say, more power to those people. But in my case, trying to get the perfect shot has almost always made me enjoy it less. 
Incidentally, I do find this appreciation when I sit down to draw something by hand. Trying to capture the same impression as the thing in front of me forces me to concentrate on all the little details that make up the whole, and inspires reflection on how the subject came to be; what human or natural effort went into its creation, and the stories of how I ended up sketching it. Compared to taking photographs, sketching can be a multi-hour endeavor. So perhaps the degradation of attention is a consequence of execution rather than lineage. 
I also get some small solace from deliberately avoiding taking pictures where others presumably would take them to post to social media. When I avoid taking pictures, I get to tell myself that I am not in thrall to the system, and that I take pictures only of my own will. I then remind myself that my experience is mine alone, that it is defined by me, and no one else, and that the value of my experience is totally uncorrelated with whether it is documented online, or the amount of likes it has. It is a small mental ritual that has helped me keep my sanity and sense of self mostly intact in the digital age. 
But while these reasons might be sufficient explanation as to why I don’t take pictures in the moment, they don’t explain why I maintain an aversion to my own exercise of photography. And the reason for that is a little deeper. 
With the exception of vacations, which usually generate a great many pictures of scenic locales in a short time, the most-photographed period of my life is undoubtedly from late 2006 through 2007. Taking pictures, and later videos, was the latest in a long line of childhood pet projects that became my temporary raison d’être while I worked on it. I didn’t fully understand why I was moved to document everything on camera. I think even then I understood, on some level, that I wasn’t seriously chasing the fame and glory of Hollywood, nor the evolving space of vlogs and webshows, else I would have gone about my efforts in a radically different way. 
From 2006 through 2007, the photographs and videos rapidly multiply in number, while simultaneously decreasing in quality. The disks in my collection gloss over the second half of 2006, then are split into seasons, then individual months, then weeks. The bar for photographic record drops from a handful of remarkably interesting shots, to everyday scenes, to essentially anything it occurred to me to point a camera at. Aside from the subject matter, the picture quality becomes markedly worse.
We never imagined it, but in retrospect it was obvious. My hands had started shaking, and over time it had gone from imperceptible, to making my shots unrecognizable even with the camera’s built in stabilization. At the same time, my mind had degraded to the point of being unable to concentrate. Everything that captured my attention for that instant became the most important thing in the universe, and had to be captured and preserved. These quests became so important that I began bringing in tripods and special equipment to school to assist. 
I felt compelled to document everything. My brain was having trouble with memories, so I relied on my camera to tell me who I had spoken to, where, and when. I took voice memos to remind myself of conversations, most of which I would delete after a while to make space for new ones, since I kept running out of space on my memory cards. I kept records for as long as I could, preserving the ones I thought might come up again. I took pictures of the friends I interacted with, the games we played, and myself getting paler and skinner in every picture, despite my all-devouring appetite and steady sunlight exposure. I was the palest boy in all of Australia. 
Not all of the adults in my life believed me when I started describing how I felt. Even my parents occasionally sought to cross-examine me, telling me that if I was faking it, they wouldn’t be mad so long as I came clean. I remember a conversation with my PE teacher during those days, when I told her that I felt bad and would be sitting out on exercises again. She asked me if I was really, truly, honestly too sick to even participate. I answered as honestly as I could, that I didn’t know what was wrong with me, but something sure was, because I felt god-awful. 
I was sick. I knew this. I saw that I was losing more and more of myself every day, even if I didn’t recognize all of the symptoms on a conscious level, and recognized that something was deeply wrong. I didn’t know why I was sick, nor did any of the doctors we saw. So I did what I could to keep going, keeping records every day with my camera. I shared some of them. I became a photojournalist for the school newsletter, on account of the fact that I had been taking so many pictures already. But the overwhelming majority I kept for myself, to remind myself that what I was feeling, the deteriorating life I was living, wasn’t just all in my head. 

My camera was a tool of desperation. A last ditch stopgap to preserve some measure of my life as I felt it rapidly deteriorating. I have used it since for various projects, but it has always felt slightly stained by the memory. 

Early to Rise

I am not a morning person. This has been the case for as long as I’ve been old enough to have sleeping patterns to speak of, and unless my metabolism does a total reversal with age, I don’t foresee this changing. I am a person who wakes up late and goes to bed accordingly. 

This isn’t because I hate sunrises or morning talk shows; on the contrary, I enjoy both. My problem is that trying to drag myself out of bed in the morning is immensely painful. It often feels like someone is using a metal claw to unceremoniously yank my spinal cord out through a hole in my back, dragging the rest of my body with it by the nerves and sinews. I won’t say it’s the worst pain I’ve every experienced, but it’s up there. I also don’t wake up quickly, either. My brain takes time to boot up in the morning, and during this time I am unable to so much as walk a straight line. The earlier I am woken up, the longer this process takes- if I am dragged out of bed early it can take an hour before I’m conscious enough to make decisions, and leaves me for the rest of the day with an overwhelming exhaustion that borders on clinical narcolepsy.

I am aware that this goes somewhat beyond the normal scope. It’s almost certainly an underlying neurological problem- one of several. Since my brain already has some issues switching gears, it stands to reason that we’re looking at a different symptom of the same cause. But since meds only seem to blunt the symptoms and draw out over a longer period, I am stuck with it. I try to avoid mornings wherever humanly possible, and suck it up when I can’t. 

Of course, the problem, as one may suspect, isn’t actually with mornings. The problem is with my brain making the switch from being asleep to fully awake. In particular I have more trouble than most waking up when my brain is at an inopportune point in the sleep cycle.

Theoretically, this could be addressed on the other end- getting to bed earlier in order to make sure I get the right number of hours of sleep to wake up naturally at, say, 8:30 (which I know isn’t early by most definitions, but compared to my current routine, may as well be pre-dawn). Here we run headfirst into my other problem: severe and chronic insomnia, exacerbated by metabolic disorders that make it not only difficult, but actually dangerous to fall asleep at a reasonable hour most nights.

The situation of being a college student doesn’t help. In many ways the stereotype that college students are bad at time management is self reinforcing. Campus events start and run late, and emails containing essential information and even assignments are sent out hours before midnight. Facilities open from 10-1am. The scheduling of exams and final projects mere days after the material is covered makes long term planning impossible, and reinforces crunch time and cramming- even more so since it is all during the same few weeks. Last minute scrambling is not merely routine, it is impossible to avoid.

For as often as Americans ridicule the collectivist workaholism of Japan, China, and Germany, we suffer from the same kind of cultural fetish, or at least our young people do. Hauling oneself up by one’s bootstraps is used to encourage behaviors that are anti-productivity; destroying sleep schedules and health in order to make deadlines so that one can continue to repeat the same cycle next year. I could, and probably will eventually, write a whole post on these attitudes and their fallout, but for the time being, suffice it to say that being a college student makes already difficult problems much harder. 

But I digress. The point is, my sleep schedule has become unsustainable, and I need to make some changes. Getting to bed earlier, though a good idea, will not work on its own, since every time I have tried this I have wound up laying in bed awake for hours, making me feel less rested in the morning. What I need to do, and what I’ve dreaded doing, is force myself to get up earlier and get going, so that I will be tired enough to actually fall asleep at a (more) reasonable hour. In essence, I am performing a hard reset on my sleep schedule.

As schemes go, this one is fairly straightforward, but that doesn’t make it any easier. The fact that it is necessary does not make it easier either. But it is necessary. Not only do future plans depend on it, but being able to recognize, plan, and execute these smaller points of self improvement is critical to any future I hope to have. I am rising early to great the dawn not only in a literal sense, but in a metaphorical sense as well. 
At least, that is what I shall be telling myself while dragging my sorry behind out of bed.