Social Distance Is a Social Justice Issue

The headlines have not been bringing good news. The infection and death rate of COVID-19 (known colloquially as coronavirus) is steadily rising, with the CDC estimating a worst-case scenario of between 160 and 214 million infected people in the United States alone, with the potential for more than a million deaths. To avoid this nightmare scenario, many companies have asked their employees to work from home, live television talk shows have pivoted to skeleton crews and empty audiences, and major sporting events—from NBA games to the Masters to March Madness—have been postponed or canceled. The stock market plunged, suffering the worst single day since 1987. Some places across the country have been deemed official containment zones, requiring the aid of the National Guard. The WHO officially named the virus a pandemic. And finally, President Trump, after much hand-wringing and buck passing, declared a national state of emergency. That was just last week.

The key message to emerge from this chaotic news cycle is simple: COVID-19 is something all of us should be taking seriously. Health professionals are warning about a crisis of care that could result in a breakdown of our medical system. And the news has created what can only be described as mild pandemonium: Americans all over the country are emptying the shelves of grocery stores; there has been a near complete sell-out of hand sanitizer and face masks; travel has already been restricted from Europe; the wealthy are retreating to their vacation homes to wait out the worst of what’s to come.

And yet, photos still percolated on social media of St. Patrick’s Day celebrations at bars, of Friday night dinners in packed restaurants, of group selfies in public places. All of this comes as even more data reveals that COVID-19 is insidiously, highly contagious even in people who are showing little to no symptoms.

Young people are extremely unlikely to die from COVID-19. But we, the carriers of this economy-crumbling, society-stopping disease are also the ones arrogant enough to continue on with life as usual, flaunting our invincibility, infecting spaces, surfaces, and other people with our own contamination. In doing so, we are willingly contributing to the spread of a pandemic, and to the eventual deaths of people far more vulnerable to this disease than we are.

If you haven’t yet, heed this call: Social isolation is not a plea from your paranoid friends, it is not a precaution we suggest you take, it is not an ineffective method to contain this virus. Social isolation is a social justice issue—and it is absolutely urgent.

An Avoidable Pandemic

Initially, you could be forgiven for not grasping the gravity of this situation. If you’ve been watching Fox News, for example, you might have thought all of this was no big deal. And, sure, in our “globalized society,” COVID-19 could probably never be contained just to Wuhan. Still, experts have decried the United States’ slow-going efforts to contain, treat, and test for the virus, revealing that there’s little reason a country of our enormous wealth and stature ever needed to get to this specific stage of crisis.

“The U.S. is behind the eight ball in many ways,” says Ofole Mgbako, MD, an infectious-diseases fellow at Columbia University, pointing to efforts by China to buttress their health-care system, and South Korea’s numbers of confirmed cases of COVID-19. “The ability of our scientific establishment to catch up has been delayed by bureaucratic issues and testing not being available on time, as well as a lack of preparedness of health systems.”

In essence, COVID-19 has been used as a political tool by the president, who has stemmed resources and information in an attempt to convince the American public that everything is going to be just fine. Trump seemed to be trying to create a perception that COVID-19 was not spreading, and thus business could proceed as usual. And until recently the CDC was bottlenecking testing procedures, mandating that all tests be evaluated through their headquarters in Atlanta. The catastrophic result of the lack of testing is only now beginning to reveal itself—the virus was contaminating airports, hospitals, public venues, classrooms, and nursing homes. It will take weeks to fully evaluate the consequences of this epic informational delay, but we are bound to see rates of new infections spike dramatically.

The Real Illness at Hand

Meanwhile, COVID-19 is spreading—fast—and we still don’t have enough tests in the United States to properly assess just how many of us are carrying it. That’s why doctors have urged social isolation: If we stay home for the foreseeable future, we can “flatten the curve,” which means reducing the overall exposure to the virus, therefore lowering its reach and eventual death rate by keeping the medical system from becoming overwhelmed. By avoiding public spaces and staying inside, we make the choice to protect not just ourselves, but also our neighbors from potential infection. Nobody wants to be like the patient in South Korea who went to church and a buffet lunch, only to become the eventual source of over 1,000 infections in their community.

There’s an arrogance about resisting social distancing, perhaps especially among the young and male. We won’t be the ones who die of it, so goes the logic. It will be the elderly! I don’t have to worry about dying, so therefore, I’m going to go and celebrate Saint Patrick’s Day as I always do.

But, and I know this may be the first time you’ve ever heard this in your life, so let’s say it succinctly: This isn’t about you. You are not the center of the universe—but you very well may become the center of an infectious disease spreading throughout your community.

“This is about how the virus will affect other people who are susceptible, whose immune systems are down or are compromised, who are older, and who can't fend for themselves against a virus like this the same way someone who is young and healthy can,” Dr. Mgbako explains. “We are being challenged to shift our mental framework away from sheer survivalist panic—to go from ‘Let me buy all the Purell I can to be safe,’ to ‘How can I be a good steward in my community and have us all get through this together?’”

That, Dr. Mgbako says, “is what public health is all about—everyone working within the same model to save as many lives as possible.”

The worst nightmare of public health officials like Dr. Mgbako is watching emergency rooms fill up with people who exist on the margins of society, whose long-term side-effects or deaths from COVID-19 were almost entirely avoidable. This will not be something confronted by the rich people who escaped to the Hamptons, or the upper-middle class people who stockpiled at Whole Foods and Trader Joe’s. It will be another trauma added to the list of the chronically ill, the uninsured, the undocumented, the disabled, the poor.

“We need to think about the community at large and get away from our American individualism,” urges Nelini Stamp, the Director of Strategy for the Working Families Party. “We have to practice basic ethical principles of not doing harm to others and provide justice for people in need.”

To her point, WFP (as they’re known for short), has created a list of demands for lawmakers to consider during this pandemic, each of which are critical to providing care of all kinds during this crisis. Among them are “a mortgage and rent bail-out or freeze so that people don't have to worry about their roofs over their heads; an eviction freeze; emergency paid leave programs including sick time and family leave; and the release of all the people who are in jail for pre-trial detention.”

Even though these don’t fall under our immediate category of “health care,” they make sense for containing a pandemic: If more people are displaced or homeless during this crisis, they will not have a place to contain themselves and therefore, may spread the virus to more people. Workers—especially those whose jobs rely on tips, like those in the food service industry—need paid leave if their businesses go on a temporary hiatus. And those awaiting trial are being kept in close and often inhumane quarters, which are effectively a breeding ground for the virus, thus jeopardizing their health and safety, as well as that of prison workers.

“Our system operates based on haves and have nots, to say the least,” Stamp says. “We come from a place where we have seen this country for many, many years, not invest in programs like single-payer healthcare so that every single person in this country can be insured, and that every single person in this country can be seen, regardless of that financial status.”

The real crisis is not that COVID-19 exists or that it arrived in the United States. The real crisis first lied in our government’s slow-acting response to protect our people. But now, it lies in our own selfish impulses to refuse to be inconvenienced by the hypotheticals right in front of our faces. And soon, the next crisis will hit our healthcare system—and it will take months before we can recover.

The Crisis Yet to Come

As Stamp pointed out, a lot of the aforementioned roadblocks to care—to paid sick leave, a freeze on deportations and evictions, universal healthcare, a decarceral justice system, and so forth—are only going to make the virus more inescapable, especially in condensed communities. Even though those of us in our 20s and 30s are unlikely to die of the disease, it is possible we too will seek medical treatment for symptom management, particularly if COVID-19 results in pneumonia. But should the disease continue to ravage our elderly and our chronically ill, we could be facing a monstrous problem for which it is far too late to brace ourselves. Hospitals all over the country are currently preparing for the worst-case scenario.

“When health care providers themselves get sick or need to be quarantined or stay home, that then pulls other providers into the environment,” Dr. Mgbako says. “And then, more people are coming to the emergency room with symptoms, which results in more exposures. The ratio of patients to providers, then, suddenly gets a lot larger.”

Once this happens, it triggers a scenario that emergency medicine doctors dread: the “rationing of care,” a philosophy typically reserved for wartime medicine. Effectively, it is asking doctors to play God: If a young mother comes in with pneumonia at the same time as a grandmother who can’t breathe, the doctor will have to decide who accesses one of the few remaining respirators. People may die due to a sheer shortage of care.

Not to mention that overwhelmed ERs make other inevitable medical emergencies (heart attacks, gunshot wounds, seizures, strokes, car accidents) more difficult to treat and minimize urgently, which means otherwise non-critical conditions could result in unnecessary fatality.

“In Italy, they're deciding who should be on a respirator and who shouldn't due to a lack of providers and capacity,” says Dr. Mgbako. “Health systems are all thinking about that potential and how can we best avoid that.” In the US, Hospitals are reporting a shortage of surgical masks, gloves, and hand sanitizer for their workers—potentially endangering their employees, who are the most crucial workers needed in this moment.

Even when a cure or vaccine for COVID-19 hypothetically becomes available, Jason Rosenberg, an organizer with ACT UP New York, cautions us to not get our hopes up. He points out that pharmaceutical giant Gilead Sciences is angling to identify a treatment for the virus. “Our pharmaceutical companies carry some of the large scientific advancements of HIV and a lot of other chronic illnesses, but we also see them price gouge life-saving medication,” he says. One of Gilead’s most pioneering drugs is Truvada, which substantially decreases the transmission risk of HIV—Rosenberg says it costs up to $2,000 out of pocket for a month’s supply. COVID-19’s eventual medical savior could very likely, then, be available only to those who can afford it.

The Most At Risk

This somewhat impending healthcare crisis is particularly troubling for our elderly population, many of whom are either in assisted living facilities or are out on their own. The virus is particularly menacing to older people, with a 21.9% death rate among confirmed cases for people 80 and older.

That’s why this news is a little more than concerning for Herbert, a 91-year-old New York City resident I recently spoke to by phone. Herbert has congestive heart failure, and he’s also had some trouble getting around due to more recent surgeries. “But I’m surviving,” he tells me. “I am quite worried because I was due to go in this weekend to get a CAT scan on my brain, but they’re telling people over 70 to stay inside.”

“Now the thing is, if I go for this X-Ray on Saturday, am I opening up Pandora’s Box?”

Herbert is one of an estimated 8,600 individuals who receive services from God’s Love We Deliver, an organization that provides free, home-delivered meals to anyone living in the NYC-metropolitan area who is too sick to shop or cook for themself. God’s Love has 17,000 volunteers, some of whom help to prepare the meal kits, and others who drive for deliveries. In the past three weeks, they’ve seen an increase in demand for services, but a decrease in available volunteers. They are estimating that additional need due to COVID-19 will cost them an unbudgeted $250,000, for which they’ve only raised $30,000.

But their services are urgent in the midst of this pandemic, when most of their clients either cannot fight over groceries at their local Trader Joe’s, or can’t get out of bed. Luckily, Herbert doesn’t have to worry about that for now. During our conversation, he waxes poetic about the “A-1 quality” soup he’s brought, and the particularly delightful jar of Ensure vanilla pudding that came with his last delivery. He is also delighted by visits from a volunteer named Eddy, a “concerned” but “very polite man” who checks on him during his deliveries.

The work of God’s Love—and many charities like it, including homeless shelters, shelters for survivors of domestic violence, food banks, et cetera—is only bound to become more crucial in the coming weeks. It is not a question of if, but rather a question of when things in America will reach the point of more drastic measures. With Spain issuing their official lockdown and Italy’s citizens still weathering theirs, our days appear numbered. The irony being clear: the more we disavow our guidelines and act irresponsibly, the more the disease spreads and thus, the longer we will have to isolate ourselves.

Herbert, though, is happy to do his part and follow doctor’s orders. Even in his own containment due to his own chronic illness, and falling within the age group that is the most at risk for death due to COVID-19, Herbert is thinking of the people who are less fortunate than him. “People have their houses blown apart by tornadoes and hurricanes, and they lose everything. They have no place to go. What do they do?” he asks. “You’ve got to thank your blessings that you have a place to stay, that you’re not in the streets, ok?”

“I think I’ve been blessed by God,” he says.

Perhaps the next time you’re tempted to gather your friends at a local bar, or hop on a plane to capitalize on low travel prices, or convince your pals to join you at the club since you’re all young and supposedly impervious to this disease, you can do all of us a favor by thinking of folks like Herbert, who need us to do the right thing. And, as the saying goes, the right thing to do is rarely the easiest.

But our reality has become this: An inconvenience for you means life or death for somebody else. So please, don’t be an asshole—stay inside.

Originally Appeared on GQ