Tough choices loom for all of us as states ease public-health restrictions

Do I, or don’t I? Do we, or don’t we?

As the stringent public health measures designed to bend the curve with the Covid-19 pandemic begin to lift or ease — including in Maryland and Virginia — hundreds of millions of Americans will make difficult individual decisions about their lives and livelihoods.

Fears are high that going back too soon may result in a deadly second wave of infections and deaths. Dr. Anthony Fauci, a preeminent expert on epidemics and a leader at the National Institutes of Health, warned senators of serious consequences from a premature restarting of activities.

News organizations have begun to put forth informative articles to assist their audiences. These include:

• The terrific Dr. Atul Gawande writing in the New Yorker
• The Wall Street Journal’s “Safety Advice”
• The Washington Post’s consulting with public health officials
• Advisories from McDonald’s to its franchisees
• What HR experts are cautioning retailers about
• The New York Times reporting on topics like going back to the gym, or the worries about riding in elevators.

The federal Centers for Disease Control and Prevention, which some time ago planned to issue guidance, got its leash tugged hard by the White House, instead. The agency has since put out more limited checklists, slices of its expert counsel — material that once would have carried considerable sway due to the nonpartisan respect with which the deep medical science at the CDC was regarded.

But a decade of corrosive argument over health care, notably the role of government in providing the safeguard of health insurance via the Affordable Care Act, aka Obamacare, has led too many partisan politicians and members of the public to become dismissive of rigorous medical science.

Instead, the nation’s top leaders, particularly in the pandemic response, have relied on rumor, hunch, political or personal connection, and other evidence-free approaches with crucial decision-making about Americans’ health — and now their wealth, too.

The extreme assault on fact-based governance and policy-making also has been characterized by an almost-theological belief that government should have little or no role in health care and that individuals should sink or swim on their own. If health insurance relies on the fundamental idea of shared risk so individuals do not suffer devastating individual or single-family financial consequences and diminished care when ill or injured, the pandemic has pounded home the idea that battling contagions is, at root, about not only individuals’ well-being but also the public, collective health.

When confronting an indiscriminate, microscopic parasite with a prime mission only of replicating itself, humans protect themselves not singularly but also as families, communities, cities, counties, states, and nations. We’re a herd wanting to avoid sickness and death with a greater, collective immunity.

The federal response to the novel coronavirus has been shambolic, with one of medicine’s leading journals writing in a stinging, unusual, and unsigned editorial about President Trump and the CDC:

 “The Administration is obsessed with magic bullets — vaccines, new medicines, or a hope that the virus will simply disappear. But only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency. the CDC needs a director who can provide leadership without the threat of being silenced and who has the technical capacity to lead today’s complicated effort. The Trump administration’s further erosion of the CDC will harm global cooperation in science and public health, as it is trying to do by defunding WHO. A strong CDC is needed to respond to public health threats, both domestic and international, and to help prevent the next inevitable pandemic.”

There’s a chance, of course, that the nation’s leaders might transform and take responsibility and provide the nonpartisan, reasoned, and reasonable leadership demanded to deal with a disease that has infected more than 1 million Americans and may already have killed 100,000 — more dead in a few weeks than fell in both the protracted wars in Korea and Vietnam, or almost as many who died in the years of World War I, the great global combat that wise men said would end all such strife.

Covid-19’s economic devastation is inarguable, with a pokey and uneven lockdown — a necessary and shocking measure that aimed to slow the disease’s spread and to avert the overwhelming of the health care system — leading to joblessness and business shutdowns of staggering consequence.

Most Americans, in overwhelming fashion, support the steps taken to safeguard the nation. But the “inconsistent and incoherent” Trump Administration (as the Lancet describes it), not only has put financial considerations first — along with reelection worries — it has politicized health measures like face coverings, testing, and stay at home orders, while also courting those of extreme views. A coronavirus vaccine will be a challenge to develop in record time, but will the evidence-free arguments of the anti-vax crowd undercut the vaccination’s maximum effectiveness even before it gets jabbed in a single arm?

Experts are providing guidance about reopening businesses based on the best available information. Their ideas to require people to sustain crucial, common sense practices that data show to be working now. People need to keep washing their hands, covering their faces, and maintaining physical distance from each other. They should up their hygiene game, sanitizing surfaces with they come in contact and avoiding touching their faces, noses, and eyes.

They may need to be blunt with themselves about their health, especially with underlying conditions like diabetes, high blood pressure, high blood cholesterol, and chronic respiratory issues including asthma. These all heighten their Covid-19 risk, as does their age, and, sadly, their gender and race. With finances pressing and cabin fever stirring, Americans may need to consider with care every aspect of their lives and livelihoods — how they get to work, the safety of their work spaces, where and how they eat, and their exercise and recreation, whether it involves dining out, socializing, or personal care.

Testing, contact tracing, and isolation will loom larger than they may have before, and members of the public may need to think hard before venturing freely out and about what their situation may be if they do get infected.

Do they have sick leave if they develop worrisome symptoms? Is the medical care near them overwhelmed already? How will their loved ones fare if they must isolate? What should parents be thinking about in the days ahead for their children and teens, as Covid-19 restrictions ease? And what should adults be considering for themselves, in their 30s, 40s, and 50s, much less for their older and even elderly loved ones?

Covid-19 isn’t going away. We’ve got a lot of tough work and hard choices ahead of us, individually and collectively.