An epidemic before the pandemic

Lack of trust doomed ability of Americans to save more lives

 The Covid-19 nationwide shut down happened three years ago March 15. But for me, the quarantine began on March 1. That’s when a dear friend and veteran journalist gave me the contact information of a top medical expert at a nationwide health insurance company.  I emailed him questions about that peculiar virus that had cropped up in Wuhan, China. It seemed as though it was spreading. In my email I wrote that I thought a pandemic was likely and asked him for advice.   

At that time, I had only the vaguest ideas about what being in a pandemic meant. I thought that, in the worst-case scenario, we would all have to quarantine for a few months and then, well, it would be over. 

Ha.  

The doctor’s lengthy reply came within a few hours. He said that the U.S. already  was in a pandemic and that I should fasten my seat belt. “Cancel all air travel. Cancel all other travel that puts you in contact with the public. Stop eating in restaurants. Avoid public places. Get a three-month supply of medication and a six-month supply of food. The supply chain will be hit hard. . . .. Stock up on toilet paper, since it will be one of the earliest products hit by supply chain shortages.” He predicted that denial would start to fall apart within two weeks, “amplified by false assurances from the Oval Office and the inevitable blowback for conspicuous incompetence in managing this ‘hoax’ by the Democrats.”  

He turned out to be right on all counts. In the moment, his email scared the bejesus out of me. I ordered a large shipment of food for my daughter’s freezer, raided Costco for our own and later kicked myself for buying just one, not two, 25-pound bags of flour. And yet, at the time, it all sounded so extreme. I wondered whether or not I was overreacting. While I shared the advice with family members, I forwarded the email to just one friend, who stripped off the expert’s identity and posted the text on Facebook. Most people who read the post thought it was an absurd exaggeration and many, no doubt, doubted its authenticity.  

My husband, Pete, and I were fortunate in many ways. I kept my job, which went entirely online.  Our passions served us well: Pete’s for growing a wide variety of vegetables and fruit on the farm he started in retirement, mine for baking bread. He packed our freezer with his harvest and I went through 125 pounds of flour and 20 pounds of oatmeal, making bread of all kinds but especially my go-to recipe, oatmeal bread. But while Pete discovered his inner hermit, serene in the face of isolation, the lack of human contact drove me wild. I channeled my frustration by walking miles every day and writing a memoir about my childhood and my sister’s struggle with illness, “Saving Ellen.” 

Like so many, we didn’t get through unscathed, even though we never got Covid. Pete lost his brother to the virus. I pined for my granddaughter, who was on the verge of walking when I saw her in March of 2020 and was almost a grown-up 2-year-old a year later, when we were all finally able to visit.  I know she will never remember that year of my absence, but I will. The awful mental health consequences of the pandemic continue to unfold, especially for the young, who are at sea in their own epidemic of depression and anxiety.  

Yet our infection rates and death toll from the pandemic were both stunning and predictable. Stunning, because this staggering failure wasn’t supposed to happen; just a few months before the pandemic, in October of 2019, Johns Hopkins released a survey of pandemic preparedness and said that the United States was the most prepared country in the world to battle a global disease. The self-congratulation was premature.  

When the real emergency showed up, all those elaborate systems which looked so good on paper were worthless.

More than 1 million of us died. Our infection rates were among the highest of any developed nation, and higher than most undeveloped ones. Tucked in the report was a clue, as a column from Ezra Klein later pointed out: the United States had the lowest possible score on trust in government. Granted, the miserable performance of the government during the crisis certainly seemed to justify American disgust, and yet the lack of trust all but predicted the conspiracy theorists, the anti-vaxxer protests and the refusal on the part of many, even in Congress, to wear masks. None of it helped.   

The situation reminded me of a brilliant book published in 2007 which I read long before the pandemic. "The Ghost Map: The Story of London’s Most Terrifying Epidemic,” by Steven Johnson, tells the story of London’s 1854 cholera epidemic. It details how scientist-sleuth John Snow figured out that the true source of the disease was contaminated water, and not “miasma,” or bad air, as was commonly believed. Yet there was another hero in the story that history has all but forgotten.  Few in the infected neighborhoods were inclined to trust Snow. They were already mourning their dead. They didn’t know this brilliant, inquisitive man. Why should they listen to his theory, or give him any of the details of the plague that had taken their loved ones?

It was Rev. Henry Whitehead, whom everyone in those neighborhoods did trust, who coaxed the cooperation that Snow needed. Without Whitehead, residents wouldn’t have talked to Snow, and he wouldn’t have solved the puzzle - or be credited with founding the field of public health.  

And without trust in the modern day, it was sadly predictable that America would suffer unnecessary losses during the worst pandemic in 100 years.   We managed to create vaccines to fight Covid within nine months, a tremendous scientific achievement for which I and millions of others are grateful. But there is no quick way to restore public trust. Its lack will continue to threaten our public health and democracy itself.