October 14, 2020

I finished shooting my bits for the Fine Arts Center of Kershaw County’s online Zoom theater production of Oscar Wilde’s ‘The Importance of Being Earnest’ this evening.  It was the second project this week for which I was able to get my tailcoat out of its garment bag and give it a little fresh air.  The other was some filming for an online video from the Politically Incorrect Cabaret.  I took a moment afterwards to take down my jury-rigged green screen until it will next be needed, put my props away and turn my dining room back into some semblance of order.  Next up is another online classic, Moliere’s Tartuffe in which I am essaying Orgon. 

We may be all in some form of quarantine/separation these days and gathering together in a playhouse is going to be one of the last things to come back from coronavirus restrictions, but theater people are going to theater one way or another.  One bright spot for me as been being asked to be part of projects originating with my dear friend Frank Thompson and his merry crew in Columbia South Carolina and getting to work with them on a piece after having known them casually through social media and the occasional theater party for many years now. Online theater does allow you to pull together a cast from all over and the technical requirements are minimal – a laptop with a camera, a Zoom hookup and a green screen for a virtual background and there you are.  I am considering driving back and forth to Seattle for my November vacation and, if I do, I will likely be hanging green Party City plastic and emoting Moliere in a selection of the country’s finest Hampton Inns.  I’ll just need to remember to pack some electric work lights as the lighting in most hotel rooms is suboptimal for filming.

One of the reasons I’m thinking about driving, other than giving myself some very long stretches to let my brain decompress and think about plenty of nothing while making my way across Kansas or Wyoming, is to get a sense of how the country is really reacting to Covid-19.  Most of the reporting on community issues is tainted by a certain amount of political agenda. Given a crisis where we should all be pulling together, politicians and the media have banded together to do their darndest to push us into one of two camps – the red and the blue for want of a better shorthand.  One group for political advantage and the other group for ratings and the money those translate into over time. One wonders what would have happened if, after Pearl Harbor and FDR’s call for entry into World War II, half of the population had enlisted and gone to work manufacturing armaments while the other half had paraded in the streets waving Nazi and Rising Sun flags and calling those that were preparing for war all sorts of unpleasant epithets and the press had covered it all with both sidesism and egged domestic disturbance on.  The ultimate outcome of the conflict might have been just a little bit different.

Now that we have more or less managed to create two very different approaches and attitudes towards a single universal problem, what do we do?  The red side’s denial of the seriousness of the problem angers me personally as I watch more and more of my patient population fall ill and hear of more and more young healthy people who have succumbed.  To me, those are lives wasted, not acceptable collateral damage.  Rates per unit population are surging in less populated conservative states but, as their populations are low, absolute numbers are low so there is a feeling in these communities that Covid-19 isn’t a problem other than for certain at-risk classes of individuals.  The trouble is that somewhere between 25 and 40% of the population falls into those at-risk classes and it is not possible to isolate those individuals.  Take the elderly.  Only about 10% of older Americans live in some sort of congregate facility.  The vast majority are in the community trying to live their lives day to day just as the rest of us are.  Even those in congregate living cannot be completely isolates.  Staff, caregivers, delivery people, and all the rest that keep a housing facility running cannot be isolated with them.  They are going to come and go in the community and many of them will return home to school age children who seem to be among the primary vectors.

Urban blue populations have adapted relatively well to new ways of living.  Most city dwellers mask up, gauge six or so feet appropriately, don’t crowd into small spaces, and have figured out how to protect themselves and their families through a thousand and one little changes and risk stratifications. They look down on red populations and their unwillingness to adapt with scorn.  The trouble is scorn and shame aren’t going to make anyone do things any differently.  People respond very negatively to it and a huge piece of our current divide comes from forty years or so of urban populations in service and tech economies looking down on rural populations in resource utilization economies.  Something I learned very early on when working with the mine workers programs in Appalachia that I medical directed for many years was that if I, a doctor at a medical school in an urban center, were to call a doctor in a rural community to suggest a different treatment plan for a patient, I would be frozen out and unheeded.  No one likes an outsider butting in and telling them how to do their job.  The strategy we hit on was to make sure we hired nurses of and from these small rural Appalachian communities and I would teach them modern approaches to geriatric medicine and how to think through problems.  These nurses could then go to the local doctors, their friends and neighbors for decades and present things and would be listened to as they were of that world. 

We need something similar at the moment to bring red and blue American together in better public health planning.  I don’t think it can happen under the current administration which has basically withdrawn the federal public health system including the CDC and the FDA from the battlefield but, if there is a change in administration, there can be strategies adopted that then flow to the states and then counties.  If untrusting populations see trustworthy information coming from local sources, they may begin to change their behaviors and we may start to make some inroads on bringing things under better control.  If we don’t, I feel we’re going to be in for a very long time of it with deaths approaching, if not over 7 figures.

In the meantime, do what you can do:  Wash your hands, wear your mask, stay out of crowds as much as possible.  It’s not that difficult.

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