Photo by Anastasiia Chepinska on Unsplash

As belt tightening lockdown gets going again here in CA, I keep wondering where to land psychologically. Should I be a freedom fighter, or a mask shaming ER doc? Choice B is easier, expected, and gets more “likes”. But as usual I’m pulled to the middle. Of course I’m a fan of indoor masks and physical distancing, but blocking folks from their livelihoods without covering the tab is certainly destroying lives as well.

Rabies has been treated with induced coma, and similarly, if we could make the planet fall asleep for 8 months, it seems many would advocate for that approach today. I might sign up with my family as well. Wake me when Trump gets banned from Twitter. Unfortunately, for many people, they’d also wake up to 8 months of back rent, frostbitten toes and empty freezers.

The spectrum from winners to losers this year is just so extreme. It ranges from newly minted tech billionaires to dead people. But I’d argue there are many fates worse than death. Surrounding that tragically dead core are millions of unemployed, lonely, angry, terrified, bankrupt, sad, drunk and suicidal people too.

Where I land within that spectrum… aside from my empathetic sadness and baseline work anxiety… has been remarkably neutral. I have a job, and my kids are among a thin sliver who can still attend in person preschool. In fact, all the mask wearing has protected me from other illnesses as well. I used to catch a quarterly cold and sometimes pass it along to my family. But those days are gone. Even if the vaccine succeeds, I suspect I’ll be viewing my ER mask as an article of clothing for the rest of my days. To top it all off, we got a check early on signed by the president himself! Go figure.

For me, I feel like one of those lucky few on 9/11 stuck in an elevator shaft listening to floors pancaking all around. Pain and struggle seem to be everywhere. Death stats get most of the attention. But local parks in SLO are teaming with the homeless now. I picture crying faces behind every vacant storefront in the downtown. Kids glued to Zoom for learning seems broadly horrendous as well. The virus gets the blame, but unfortunately, a fair fraction of our predicament feels self inflicted.

When this all began I was hoping COVID19 would become a mechanism that might bring out the best in humanity, like an earthquake or Martian attack. Instead our policies seem to be causing generally good folks to turn against each other. Incredibly, masks themselves have been politically weaponized. Elsewhere, in Venezuela (Vanessa’s birthplace and home to her family) the virus has become yet another tool of further suppression.

I also get the sense we’re thinking about COVID19 like a one time enemy. Let’s just hold our breaths until we’re rescued by “Operation Warp Speed” and then get back to shopping as usual. When the vaccine wins, we’ll have a parade and party like it’s 2019. However, I think COVID19, with a kill rate of ~1%, is just a warmup… a practice pandemic. We’ve had microbial scares every few years for as long as I can remember. So I’m afraid patterns formed this round will shape our approaches for decades. When something like Ebola lands, we won’t stand a chance.

As for this particular California lockdown, the wheels have already seized, so I don’t expect to rescue Christmas. But for COVID22, 24 and 26, here are some thoughts:

For starters, I really wish we could develop a more “granular” response plan that empowers individuals to make decisions that help to optimize their own circumstances, while keeping those around them safe as well. Lockdown is such a big pile of sticks and no carrots. Is there a way to incentivize masks and distancing without destroying lives in the process? Could the basic income checks paid out go only to people who feel at risk, or who are nervous about going back to work? No resistance for those who apply. Those who need or want to keep working like me then forego payment for the good of those in need, and are asked to behave responsibly. Punishment reserved for the social media shame factory. (BTW, our relief check went to Venezuela if you must know.)

On the ICU beds topic, dividing California into 5 regions based on ICU capacity, and triggering lockdowns using those numbers just seems remarkably flawed. We have a warped medical system anyways. Using ICU bed capacity as a severity gauge feels like using the engine temperature in a car to measure speed. Incidentally, I work in a hospital that has an empty ICU that was closed for financial reasons months preCOVID. Another rural hospital where I used to work was closed entirely 3 years ago. It had a brand new OR that never saw an operation. So ICU bed count isn’t just a reflection of critically ill people to physical beds and rooms. It reflects staffing, hospital finances, systemic functionality and nimbleness … which we lack. I just met a new nursing grad as well who hasn’t been able to find work since June as well. Other nurses have told me the same. Why, I’ve no clue.

COVID has laid bare our system. For a side journey, have a read here by a friend who moved to New Zealand: USA to New Zealand: A Journey into Socialized Healthcare

And on to the concept of “essential” worker. It’s absurd. I would argue every human is essential mainly to their friends and families… and completely inessential otherwise. My personal trail of plastic and split hydrocarbons is miles long. The planet won’t miss me. I also wonder if defining essential workers is an amplifier of illness. There seems to be so much shaming of irresponsible behavior. I wonder if the psychology of locked up “inessential people” is basically: “Eff all you all.”

When confused, it’s helpful for me to list things I know.

• I know I don’t need government relief checks. Also, that many, many people do.
• I know trillion dollar blanket relief victimizes future generations as well.
• I know exercise, play and social connections are critical for health, for all ages.
• I know work is livelihood as well as therapy for many.
• I know COVID is killing many, but I’d wager that our approach has killed more.
• I know loneliness is deadly too.
• I know there are fates worse than death; and that suffering is my enemy. Less so death.

Happy holidays. Stay safe. Stay essential.