On this episode of Social Distance, staff writer Ed Yong joins Katherine Wells and James Hamblin to discuss his most recent article, “Our Pandemic Summer.”
Listen to the episode here:
What follows is an edited and condensed transcript of their conversation.
Katherine Wells: My birthday is July 23. I was hoping you might be able to walk me through what that day might look like.
Ed Yong: We’re not going to be in this severe state of lockdown in perpetuity. It will start lifting at some point. But every health expert I spoke to is very clear: This is going to be a lingering problem. Your birthday is an interesting timeframe because that is probably going to be past the point when this first wave has peaked and starts to abate, so some of the restrictions we’re seeing now are going to lift. We can expect some elements of our once-familiar life to resume, but not all of them.
Wells: So on my birthday, I wake up and walk to the place down the street to get myself an iced coffee. So far, so good?
Yong: Small businesses that don't have massive crowds are an obvious place to think about opening first. It doesn’t lead to the large crowds that will still continue to be problematic. It’s easy to imagine how you could keep many of these same precautions that we are using right now, even in that situation. You could have markers on the ground to tell people how far away to stand from each other. You could have servers wearing face masks.
Wells: So I get up, I go to my coffee shop. Am I wearing a mask?
Yong: Let’s be very clear about the masks. First, health-care workers need them above everyone else. The supply for health-care workers first needs to be stabilized, and I think there’s still a question mark about how long that will take.
Wells: It could be longer than July?
Yong: I really don’t think we should be overly optimistic about what supply chains are going to be capable of doing. People have this sort of innate sense that this being America, a powerful and rich nation, having identified the problem, we can fix it. But one of the experts I spoke to told me that this isn'’t a problem about dollars and cents; this is a problem of physics. How much of a thing can you make and where can you get it to? Come July, we might have gotten past the first wave of the pandemic, but other countries might be getting into their first peak or getting into a second. The demand on these resources is already stretched.
The other thing is that the masks are not for protecting you; the masks are for protecting other people from you. Everything depends on whether people can get used to that idea and see the masks as this sort of communal good. If they don’t and if they still think of the masks as a way of protecting themselves, they’re probably also going to be less likely to wear masks.
Wells: Got it. So I’m at the coffee shop. I’m probably wearing a mask. Do I know if I have had the coronavirus yet?
Yong: There has been lots of talk of immunity testing—looking for antibodies that people would typically build up in response to an infection to see whether you have been previously infected and therefore might be immune and able to just go about your business freely without worrying about either getting infected or infecting other people. There are many problems with this idea. First, we don’t know if people with antibodies who test positive are capable of transmitting the virus to other people.
Wells: You could be immune and contagious?
Yong: That’s a possibility. Even if you have antibodies against the new coronavirus, we don’t know whether those antibodies do you any good or not. Antibodies can stick to different parts of the virus, and vary greatly in their effectiveness depending on where they stick. So do you have the right kind of antibodies? We don’t know, and the tests that people are talking about can’t tell you.
Let’s say you have the right antibodies. Do you have enough? Even for diseases we’ve studied for more than a century, it’s still not clear what level of antibody in your body would provide sufficient protection. But let’s say we work all of those things out. It would take a mammoth and probably unlikely effort by your birthday. But let’s assume that miracles happen and we know those things.
The big problem that remains is called the base-rate problem, which is that even tests that seem accurate can be wildly misleading if they’re testing for something that is still rare in the general population. By July, only a minority of Americans will have experienced this virus. Even if your antibody test has a small false-positive rate—a small chance of telling someone that they have antibodies when they actually don’t—the fact that so few people are infected means that the number of false positives is going to massively outweigh the number of true positives.
To put it another way, come July, if you get a test result that says you have antibodies to the coronavirus, the likelihood that you actually have those antibodies is quite small. I admit that this is ridiculous and counterintuitive, but it’s a problem for screening for something that is actually quite rare among a large population of people.
Wells: Got it. So I go to the coffee shop. I get the iced coffee. I stand six feet away. I have a mask on. The barista has a mask on. I walk outside. I want to go to the beach, and I want to take the subway to get there. All good?
Yong: I struggle to imagine how a city like New York would work without the subway. That is a scenario specifically that a few public-health experts basically threw their hands up at me about. That is essentially the equivalent of a mass gathering. A typical New York subway car is densely packed with people. Even if they’re all wearing masks, it’s still a potential risk.
But let’s say it works and that it’s normal; you get to the beach. It’s interesting to me that a couple of people I spoke to specifically mentioned a beach as a hypothetical example of an outdoor space where you could have a fair number of people, but probably not packed together in the density that you might expect on a normal summer day. Maybe there’ll be restrictions on that. Maybe there’ll be specific rules about you must be six feet away from people.
Wells: I go to the beach, and then maybe I bring one friend, and we’re far away from each other and we’re far away from all other groups. And then I get on the subway. But we’re waiting in a socially distanced line to get on the subway because they’re only letting 10 people per car at once. It takes me a long time to get back home, and when I get back home, I accidentally injure myself in a really minor way, like I step on something sharp. Can I hop over to the urgent care or to a doctor’s office to get bandaged up?
Yong: I would expect that medical care would still continue.
Wells: Are they wearing PPE [personal protective equipment]?
Yong God, I hope so. Maybe they’ll have enough PPE by that point. Maybe they won’t. Maybe they’ll also stop running out of important drugs. We’re already starting to see drug shortages of lots of important critical-care medications because there weren’t enough in the first place. A lot of important drugs rely on long international supply chains that were already stretched thin. Many of those chains are now running perilously dry because during a pandemic, the entire world is depending on the same drugs. A lot of those supply trains run through places like Italy, China, and India, which has halted exports for a while. These supply-chain issues are not going to resolve themselves super quickly. My advice would be: Part of being a responsible citizen is also being good stewards of our own health, to the extent where that’s possible.
Wells Okay. My last question is: I would normally go to a restaurant and then a bar with my friends. Do I get to do that?
Yong: I would expect that going to a restaurant is probably fine. A lot of restaurants are going to be in trouble anyway, but assuming your favorite restaurant still exists, like the coffee shop, it has some restrictions in place like the coffee shop did. Maybe the tables are not packed as tightly as they would normally be. But will you be able to go out and have a nice meal with a small group of friends? I have a hard time imagining that that wouldn’t be possible.
Are you going to be able to go to a crowded bar afterwards? There’s a distinction to be made between what would be advisable from a public-health standpoint and what will be allowed from a political standpoint and what people will actually do. One thing that ties all of these predictions together is: We will have to get used to the idea of smaller groups, more sparsely populated public spaces, and just slightly more flexible plans than we used to have.
We all should also recognize that this new normal is still way beyond what a lot of people get to do. A lot of people with disabilities don’t get to go to the beach. A lot of people don’t have money to go for a nice meal in the evening with all their friends. I’m hoping that what comes out of this is that we all feel grateful for the small little bits of joy we have, and that we become more aware of the disparities in what normal looks like to different people.
Wells: In your piece, you talk about a story from the Vietnam War where Vice Admiral James Stockdale spent seven years being tortured in a Hanoi prison. Stockdale’s strategy, you write, was to meld hope with realism. This is the quote from him: “The need for absolute unwavering faith that you can prevail, with the discipline to begin by confronting the brutal facts wherever they are.”
Yong: Stockdale talked about how there were a lot of optimists who were imprisoned with him. They would say, We'll be out by Christmas, and then Christmas would come and they wouldn’t be out. Then they would say, We'll be out by Easter ,and then Easter would come and they wouldn’t be out. He says that a lot of them just died of a broken heart. We’re experiencing similar dynamics now. People want to believe that things will be okay. But there is a difference between thinking things are going to be okay without really grappling with why they’re not, and fully internalizing what is happening and nonetheless retaining hope for the future. Striking that balance is what we all need to do now, because otherwise we’re just going to keep on getting broken again and again. If we go into the future clear-eyed and hopeful but realistic, we’ll ultimately end up being more resilient.