Trump’s diagnosis, a wake-up call for US

The first thing to say is simple: Best wishes to President Trump and the first lady for a speedy recovery from Covid-19. After the announcement that they had tested positive for the coronavirus, I tweeted that I hope we can all remain civil, avoid snark, seek lessons and wish the Trumps a swift recovery. The result was an outpouring of gloating and snark — one person responded that “my thoughts and prayers go out to the virus.”

Let’s think about that. One of my objections to Trump has been the way he has eroded norms that underpin this country — like accepting election outcomes, respecting science and acting in a respectful way to opponents. If we decry such behavior and hope that the election can begin a period of national healing and recovery, then don’t we uphold norms best by modeling them? A second point is also straightforward: Let’s learn from the president’s infection. Let’s make this a wake-up call that leads to mask-wearing and social distancing, saving lives.

The US has lost 208,000 people to the pandemic in part because we as a country didn’t take the virus seriously. We’re seeing a rise in new infections, which now exceed 40,000 a day, roughly twice the level of early June, and many epidemiologists warn that it will most likely get worse. One reason for the uptick in numbers is increased testing, but another is simply that people in the United States and all over the world are suffering pandemic fatigue.

We’re sick of isolation. We crave human contact. We want hugs. We are social animals, and the virus exploits that instinct. I’m now in Oregon, and I sense that we are all becoming more lax, particularly in parts of the country where the virus never hit hard and people didn’t lose friends or see refrigerator trucks parked outside hospitals. That laxity is lethal.

The Institute of Health Metrics and Evaluation predicts that 363,000 Americans will have died of Covid-19 by Jan. 1. That would amount to more Americans dying in nine months from the virus than the total number of combat deaths over four years in World War II.

Yet the institute’s model also suggests that if 95 percent of Americans just wore masks (the level in Singapore), then nearly 100,000 lives could be saved between now and the end of the year. Think about that. As a country, we’re still seared by the nearly 3,000 deaths in the 9/11 attacks. But the institute’s model warns that by the end of December, we’ll be losing that many each day.

Larry Brilliant, an epidemiologist who early in his career helped eradicate smallpox, argues that we can crush this virus as well. We’ve seen the toolbox that other countries employed to do so: universal mask use, social distancing, testing, contact tracing and so on. We as a country have the tools and we have the resources; what we lack is the will. Dan Patrick, the lieutenant governor of Texas, suggested that he and other grandparents would prefer to die rather than take measures against the virus that would disrupt the economy. Uncovered protesters rampage through stores without masks, shouting “Take off your mask,” “It’s all a lie,” and “Take it off.” Store and restaurant employees have been shot by customers angered at requests that they wear masks.

Mask-wearing lags in the United States compared with some other countries, particularly among men. A poll suggests that many American men see mask-wearing as wimpish, “a sign of weakness.” Likewise, some Americans seem to believe that avoiding masks is a measure of freedom. No, it’s a measure of decency, altruism and responsible behavior. But note that one should avoid masks with valves (which are less protective of other people) and use the mask to cover one’s nose as well as one’s mouth. And it’s profoundly unhelpful to remove one’s mask when speaking.

Strangely, many of those who denounce masks are also those who claim to believe in “personal responsibility” yet don’t understand that going without a mask is just like driving while drunk. Sure, most of the time when you go without a mask, you won’t infect anybody, just as most of the time if you drive while tipsy, you won’t crash your car. Every day some 300,000 people drive while intoxicated, and they kill about 10,000 people a year — which pales beside the 100,000 who the modelers believe will die in the next three months because of reckless Americans who won’t wear masks.

Drunken driving, like mask avoidance, is largely male; three times as many men as women are arrested on charges of driving drunk. But we have been able to change norms and stigmatize drunken driving, while also nurturing new norms even about tasks that people find yucky, such as picking up dog poop. Perhaps the shock of Trump’s infection gives the United States an opportunity to build a new national norm about wearing masks.

It’s extraordinary that mask-wearing is even controversial, considering that masks were used more than 100 years ago to mitigate the influenza pandemic of 1918 (although there was resistance then, too). A review of 172 studies in The Lancet found that face masks significantly reduce virus transmission, and one recent study estimated that state mask mandates (covering about half the American population) might have averted 230,000 coronavirus infections.

In one study published this year, researchers placed hamsters with the coronavirus in cages next to those without the virus. When surgical masks were placed between the cages, infections fell by more than half. Asia’s success in combating the virus — in Taiwan, South Korea, Hong Kong, Japan, Vietnam and Thailand — appears to be a result in part of people’s willingness to wear masks. Crowded Hong Kong, for example, has a per capita death rate from Covid-19 only one-45th the rate of the United States, and Dr. Kwok-Yung Yuen, an infectious disease specialist there, told me the reason is straightforward: 97 percent of Hong Kong residents wear masks.

Even without a vaccine, Dr. Yuen said, a country can get the pandemic under control if people simply wear masks consistently for four weeks. One encouraging real-world experiment unfolded in May. In Missouri, two hair stylists were found to have Covid-19, but they and their 140 customers had worn masks — and even though they were in close contact, not one tested positive.

Masks also protect jobs and our national economy. Goldman Sachs estimated that a national mask mandate could substitute for lockdowns that would shrink the economy by 5 per cent. Joshua Lederberg, a renowned geneticist and Nobel Prize laureate, argued that in the struggle against new diseases, “it’s our wits versus their genes.” So far we’ve bungled the fight and lost 208,000 Americans as a result. So as the Trumps battle the virus, let’s learn lessons, sharpen our wits — and commit ourselves to a lifesaving norm of social distancing and wearing masks.