As COVID-19, the disease caused by the coronavirus, spreads in the United States, it is becoming clear that America’s individualistic framework is deeply unsuited to coping with an infectious pandemic. Right now, one of the most important things Americans can do is deploy measures like social distancing and self-quarantining, even if they do not feel sick and are not at risk of the worst effects of the disease, in order to “flatten the curve” (epidemiologists’ term for slowing down the natural progression of an outbreak). This requires a radical shift in Americans’ thinking from an individual-first to a communitarian ethos—and it is not a shift that is coming easily to most, especially in the absence of clear federal guidelines.
This month, along with about 8,000 other writers, I was supposed to fly to San Antonio for an annual conference sponsored by the Association of Writers & Writing Programs. I had decided early on not to go, mainly because I had already been in touch with many virologists and epidemiologists (I’m writing a book about chronic illness in the United States) who’d been calling for proactive social distancing since February. I watched on social media as colleagues weighed their decision, and was struck by the fact that so many were discussing whether to go based on how they perceived risk to themselves; some even pointed out that the danger was “only” to the elderly or people with preexisting conditions. Others subtly shamed those who were expressing concern. They joked about “freak-outs” and “germaphobes.”
As the crisis deepens, behavior is changing, but some public figures, and some in the media, continue to frame reasonable levels of anxiety and the necessary, pragmatic steps of preparation more as “panic” than prudence. (There will always be people who panic, but most of what I’ve seen is a justifiable concern about how to prepare for a disease the true scope of which we don’t understand.) Until this week, many institutions were unwilling to take proactive steps to limit community spread of the coronavirus. Schools near me in New Haven, Connecticut, continued to have students shake hands with teachers every morning until the city told schools to stop such practices.
Why this unwillingness to change behavior, this lingering suspicion that somehow it is weak or a form of “panic” to adopt practical measures? Some of this is sheer denial; Americans today are not used to the notion that an infectious disease we have no treatment for might sweep through the nation. It startles the mind that our high-tech, modern medical system, which routinely wrests sick people from the arms of death, could actually be overwhelmed by a challenging but not remarkably deadly virus. One hundred or so years ago, most deaths in the U.S. were caused by infectious disease. Today, most are caused by chronic conditions. This is new to us.
But we also live in a country stubbornly hung up on a damaging idea of self-reliance, a nation pathologically invested in the idea that we should all “just do it”—an attitude that challenges us to muscle through it—whatever it might be. We have no shared discourse for the idea that the hard thing to do, the truly challenging thing to do, might be to do less in order to help another. Or: to do nothing at all. To stay home. We are so addicted to the concept of individual responsibility that we have a fragmented health-care system, a weak social safety net, and a culture of averting our eyes from other people’s physical vulnerability. This manifests in dangerous policy: Many Americans don’t have paid sick days and lack good child-care options. They are therefore likely to continue to show up to work or school even when sick—or risk losing their jobs.
When you’re sick with an illness that doesn’t resolve easily, as I was from 2012 to 2014, you realize quickly how strange our obsession with individualism really is. The experience of being ill is one that underscores our interconnectedness. Most of us will struggle with some kind of sickness one day. So I emerged from my own illness with a new sense of compassion—and, frankly, a fresh horror at my privileged indifference to others in the years before I’d gotten ill.
As the social scientist Arthur Frank reminds us in The Wounded Storyteller, the body in illness is not a “monad”—meaning a unit of one—although our entire health-care system is built on this notion: the individual hospital beds, the sense of isolation. Rather, it is inherently “dyadic,” because the body is never not in relation to others, especially in cases of contagious illness. The sick body is always in dialogue with the medical system, with spouses, and so on. Research showing that diabetic patients with empathetic doctors have better outcomes than those with brusque doctors, for example, highlights the material and corporeal reality of Frank’s point: The body is a social encounter, not just a vessel for our hyper-individualism.
You have probably read or heard the poet John Donne’s famous formulation “No man is an island” many times. He wrote this line after almost dying from spotted fever in 1623. Donne was 51 and the dean of St. Paul’s Cathedral when he fell gravely ill. His daughter was engaged to be married when he got sick; he urged her to wed while he was in the hospital, so he would know she was taken care of. From his bed, he listened to the church bells toll the news of weddings and of deaths from the epidemic around him.
Physically, Donne felt largely alone. “Variable, and therfore miserable condition of Man; this minute I was well, and am ill, this minute,” he wrote. “As sicknes is the greatest misery, so the greatest misry of sicknes, is solitude.” And yet the very loneliness of lying in bed was what led him to his most famous insight about the human experience.
No man is an island, entire of itself; every man is a piece of the continent, a part of the main … any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bells tolls; it tolls for thee.
One doesn’t have to be Christian to see that he was entirely right when he wrote “No man is an island”: It is a fact as much as a way of living. Today, perhaps the best way to acknowledge this reality, to live as “part of the main,” is to embrace solitude. In other words, with COVID-19, the best way to be community focused is to be physically isolated—to avoid large groups, to “reduce your touch points,” as Alana Levine, a rheumatologist affiliated with the Hospital for Special Surgery and New York Presbyterian-Cornell, told me. Unfortunately, there is no prescription for the “right” thing to do, no answer to the question of whether to have the playdate or fly to Florida right now. But there is an ethos to cling to: If you are privileged enough to skip an event or work from home, you may save a life—even though the life you save may not be your own. It might be the life of your cousin with cancer, or your colleague’s brother, who has diabetes.
Americans have allowed ourselves to believe that the self, rather than the community, must do all the healing. COVID-19 is a stark reminder that the community, rather than the self, may be the first line of protection. To be ill is to know our interconnectedness, but to be ill in America today is to be brought up against the pathology of a culture that denies this fact.
COVID-19 gives us an opportunity to frame our fears not in the context of panic or overwhelming anxiety, but as care. Our interconnectedness is part of the very meaning of life. That more and more Americans sense this is evident from what many of the 2020 Democratic presidential candidates offer in their platforms. No person is an island; the nation that believes in individuals more than it values community risks its own survival. Accepting and embracing this might be the tougher path than muscling through, each by each, whatever comes.