Tuesday, November 17, 2020

The Perfect Virus

 

If the Chinese had indeed attempted to design a virus that would disrupt American society as much as possible, they could not have designed a more perfect pathogen than the novel coronavirus that is causing the United States all manner of difficulties—physical and mental breakdowns in health, economic shrinkage, and increasing hunger, to name a few. It is a unique combination of easy transmission, relatively low virulence, and surprisingly diverse symptoms that makes this virus so damaging to human society.

If the virus were slightly more difficult to transmit, we wouldn’t have to worry about wearing masks. The disease, COVID-19, would be self-limiting. Hospitals would not have to face waves of gravely ill patients who overwhelm the capacity of our emergency rooms and ICUs. But it does spread very easily, through the air and, to a lesser degree, on surfaces.

If the virus were more virulent, no one would be protesting the wearing of masks or the closing of businesses. Fear would be openly justified, and most Americans would do their best to both avoid the virus and to restrict its spread. But it is not very lethal. It is not Ebola or Marburg. The mortality rate is low and is decreasing as medical science develops better treatments. But when you combine easy transmission with even a low mortality rate, the afflicted overwhelm the health-care system and the deaths keep piling up.

The virus also produces a variety of symptoms, some of which linger and are perhaps permanent. For most people who are infected, the symptoms are either mild or even nonexistent (although there is some evidence that the heart, lungs, kidneys, and other organs may experience damage even in the absence of obvious symptoms). But for others, the symptoms are severe. One of our neighbors, who experienced moderate symptoms, is now suffering from asthma, which makes it difficult for her to walk even slowly uphill. The doctors think this will eventually disappear, but this is not a certainty. This multiplicity of manifestations is another unique aspect of this disease. If it were just like the common cold or influenza, it would be much easier to treat. But it isn’t.

Unfortunately, the easy transmission and relatively low lethality of this virus create a perfect formula for the politicizing of this illness. The reason for this is that the only way to contain the spread of the disease is to ask humans to do things that are difficult. Practicing physical distancing, shuttering businesses that rely on high social interaction, and wearing masks are not things we want to do. The obvious short-term consequences of doing what we need to do to stop the spread of the coronavirus include increasing unemployment, a shrinking economy, and a disruption in such public goods as in-person education. In the hands of a leader who measures his success by economic growth, low unemployment, and a robust stock market, who has never been able to see long-term benefits from short-term sacrifices, this pandemic presented a perfect situation to create the worst of all worlds, which is exactly what we have in the United States.

Of course, it doesn’t have to be this way. Jacinda Ardern, the former-Mormon prime minister of New Zealand, pushed for very strict measures. Consequently, this country of almost 5 million citizens has experienced a total death toll of 25. Yes, 25. Utah, by contrast, has a population of 3.2 million and has experienced 732 deaths as of today. In the past week, 60 Utahns have died. That is 2.4 times as many as New Zealand has experienced during the entire pandemic. And Ardern was recently reelected in a landslide, showing that Trump’s priorities were exactly backward. In order to preserve economic health and, it can be argued, political popularity, you have to control the virus first. Of course, Trump has never learned anything from either his own failures or the successes of others.

And New Zealand isn’t even the best case. Taiwan, with a population of nearly 24 million, has had a total of 7 deaths. Yes, 7. A couple of weeks ago, I read a news report that Taiwan had gone 200 days without a local case. They don’t even need to wear masks, but they probably do.

In the very early days of the pandemic, before things shut down, we had a student computer programmer at BYU Studies who was from Taiwan. He was wearing a mask to work, at a time when the U.S. was not yet encouraging this practice. Obviously, he was listening to his government’s health experts, not ours. The Taiwanese were ten steps ahead of both us and the virus.

Many Americans still have massive confusion about the concept of freedom. Freedom has become a conservative rallying cry. But it seems whenever the government requires something that will eventually bring us more freedom in the long run, these benighted souls somehow get offended and claim that the government is overstepping its bounds and is taking their freedoms. But I ask you who has more freedom right nowthe people of New Zealand and Taiwan or the people of America? This is a stupid question, but most Republicans probably can’t answer it, because they have been so indoctrinated in hatred of government that they don’t understand that there is freedom to do things and freedom from things, and often abusing the freedom to do things deprives you of the freedom from things, like widespread illness and economic ruin. These protesters of government overreach would, of course, never protest the 20-mile-per-hour speed limit in school zones. But what is the difference between that and a mask mandate?

Republicans have failed in a similar way with health care in general. They keep perpetuating myths and ignoring widespread evidence. Of the top 100 nations on earth, only one does not have universal health care. Guess who? And guess why? Because the Republicans misunderstand their favorite principle: freedom. They think government providing or guaranteeing health care for all citizens takes away our freedom. But my friends in Germany have much greater freedom in their health-care choices than I do. And they pay half as much as I do for high-quality care. Who really has freedom?

Returning to the topic I started with, the novel coronavirus was perfectly created to expose the idiocy of those who put economics above public health. By contrast, it has revealed the brilliance of those who put public health first. I say “created,” but it was not concocted in a Chinese laboratory. It was designed in the laboratory of Mother Nature. And she has more surprises than this in the wings. Global warming is probably the next crisis we will face, and sadly, the Republicans are facing it with the same combination of inverted priorities, willful ignorance, and stubborn denial that they have exhibited in making America number 1 in coronavirus deaths.

Tuesday, November 10, 2020

The Human Brain and Rational Thought

 

Lately, I have been living a dual existence. By day, I am the editorial director at BYU Studies, where I deal largely with rational-thinking experts in various fields. These are mostly professors who have been trained to think clearly, to present logical arguments, and to rely on verifiable or at least reputable evidence. On the editorial end of the publishing process, we source check everything, invite peer reviews, and carefully consider the arguments presented to determine whether everything “adds up.” Sometimes it doesn’t, and so we send articles back to their authors for revision. I’ve been doing this for over sixteen years now, so I feel very comfortable in this world of rational thought and careful reasoning. I believe it has given me a pretty good eye for reliable information and reputable sources.

At home, I spend a lot of time with my wife, who is a self-employed math tutor, so rational thinking is also the norm in our conversations. For the past few months of the pandemic, we have also had our oldest son living with us. He works as a research analyst in New York City for the Economist, so if you want accurate data about all sorts of topics, he’s a great source. During the pandemic, the Economist’s office is closed and he has to work remotely, so he figured he could work just as easily from our house in Utah as from a New York apartment (and get better food), and he’s moved in with us until the New York office opens back up. In essence, for a good part of my waking hours, I live in a very rational world.

Then there’s the rest of my life. At the end of May, my ninety-five-year-old dad fell and broke his hip. He was starting to fail both physically and mentally before the accident; his balance wasn’t very good, and his memory was deteriorating. He was still living alone up until the broken hip, but we were worried about him because he had fallen several times over the winter and spring. Even though his memory had been getting worse over the past few years, he was still lucid and able to carry out his daily routine, including driving around North Ogden to run errands (I used to tease him that he drove better than he walked) and taking care of the house and yard, with a little hired help to assist him. Despite his strength and balance issues, he was in good enough shape physically that after he broke his hip the orthopedist recommended surgery to stabilize the femur and reduce the pain. After a month in rehab, where he made slow but steady progress, my dad was discharged, and I brought him to an assisted living facility in Provo, where he could continue receiving care and, we hoped, perhaps get well enough to move back home.

But the shock to his system caused by this major trauma was apparently too severe. As the hip healed, his general physical health and his mental health began to decline. It soon became obvious that he would never return home. It has been a roller-coaster ride since then, but the overall trend has been downhill. The short-term memory issues he has had for a few years suddenly blossomed into almost total memory loss. Some days are better than others, but most days if I call him shortly after lunch, he can’t remember if he has eaten or not. And he has been experiencing disorientation in waves that last several days, followed by several days when he at least knows where he is. When he gets disoriented, he sometimes hallucinates, or at least inhabits a different reality than the one most people inhabit. He told me one day, for instance, that he was down by the lake, and there were ten streams there. He counted them for me. I knew he was in his room, however, because he was talking to me on the phone, and it is a land line. Another day, he told my sister that he had just returned from Ohio. This break with reality seems to ebb and flow. For a few days, he’ll be present in his surroundings, albeit still with little memory. But then he becomes detached and talks about things that aren’t real.

The brain is a complex organ. We really don’t understand it well. Even those who research it or counsel those who deal with mental illnesses don’t really have a clue about how brain chemistry works, what causes thought processes to sometimes derail and depart from the rational world, or why some medications seem to ease the symptoms. When the brain gets old, something often seems to break, sort of like a computer with corrupted software. My dad is experiencing this. So, quite often his reality is not the same as mine. But that doesn’t mean it isn’t very real to him. I have no doubt that he actually saw in his mind the lake and the ten streams.

There are similarities between my dad’s atrophying brain and the brain of one of my sons, who is dealing with a serious mental illness. Out of respect for his privacy, I won’t give any details, other than to say that his reality is very different from mine. A mental health professional gave me some advice one day. She said that it isn’t possible to carry on a rational conversation with a mentally ill person when the illness is manifesting. This advice has actually come in handy when I’m talking with my dad. His brain is broken, and I am unable to experience his reality in the bad stretches. I can try to ask him questions and gently nudge him toward my reality, but his brain is experiencing something different than mine is, so communication is impaired.

And this brings me to another major part of my life that has been frustrating for at least the past four years. I’ve found that I also cannot carry on a rational conversation with Trump supporters. They inhabit a completely different reality, if we can even call it that. The parallels here between dementia and mental illness and a tribalistic Trumpian world view are both obvious and disturbing. Trying to convince a Trump supporter that the president is lying (all the time), or that he has grossly mismanaged the government response to the pandemic, or that he is overtly racist, or that Joe Biden is not a socialist, or that socialism itself is not really a danger (which part of Germany’s economy is it, exactly, that scares you?), or that there has been no significant fraud in the recent election is an exercise in futility. They are convinced that their “reality” is right, and no amount of rational evidence can dissuade them. I’m not sure how to classify this. Brainwashing? Tribalism? Mental illness? What do you call it when someone cannot see the danger and disaster of their own thought processes? How do you convince someone that almost all conspiracy theories are crazy? You can’t give them facts, because they have their “alternative facts,” no matter how inconsistent they are.

So my life right now is a collision of two very different worlds. There is the rational world of evidence and logical reasoning and common sense. In this world, two plus two equals four. And then there is the world of dementia, mental illness, and Trumpian irrationality. In this world, two plus two can equal anything. I want to be able to carry on a sensible conversation with all three of these forms of irrationality, but it may be impossible. For dementia and mental illness, science has not found any cures, even though certain medications can ease the symptoms to a degree. For the irreality inhabited by Trump’s supporters, even a failure on the scale of America’s enormously catastrophic response to the coronavirus can be explained away by his followers. They truly believe that he has done a superb job, just like he says. And they are convinced that there was massive voter fraud, just like he says, despite the lack of any evidence at all. It’s all a big conspiracy to steal the presidency from him. What do you do when millions of people, including your next-door neighbors inhabit a “reality” that is wildly irrational . . . and very dangerous?