There is a lot to grieve in the age of the coronavirus. But, it seems perpetual. This is leaving people stuck along the stages of grief, which has resulted in a re-opening of society that, sadly, will likely lead to more grieving.
Perpetual grieving
Above is a graphic detailing the five stages of grief commonly described in various psychological and sociological texts. As we’ve learned with the forecasting models for the pandemic, models are not precise. However, I think it’s fair to say that we were all in denial early on when confronted with the pandemic.
This denial led to a delayed response to take mitigation efforts with epidemiologists writing at the end of April that as high as 90% of the casualties to that point could have been avoided if lockdown had been put in place just two weeks earlier.
But, as the weeks go on, it seems there is something new to grieve.
Certainly for the increasing number of deaths, those families and loved ones are grieving.
The frontline workers face death and confront their own risk of death daily. Both of my brothers are healthcare providers and many of my clients are emergency responders. I’ve found for many on the frontlines, they must have a certain amount of denial in order to push through and continue to risk infection daily just by doing their jobs.
But, for the rest of us, we mourn the life we used to live and the life that up until now, we could’ve expected to live.
For those with children reaching a culmination of their various stages of education–from finishing elementary school, to graduating high school, to receiving their baccalaureate degrees–they’ve had to settle for yard signs and drive-by “parades”. Not to mention all the associated ritualistic events these students have missed, proms, formals, heck, even “senioritis”–how do you have that feeling when school’s closed?
For me, initially it was losing what has become my favorite activity with my kids: visiting national park sites. According to trips I’ve since had to cancel, we would’ve visited likely 40 sites between now and when even the slightest chance of risking going back will happen. I went through the stages of denial, believing we could still take our Spring Break trip through Georgia and Florida, then anger as I cancelled all the reservations, then bargaining to try to schedule even local overnight trips to area state parks before their campgrounds were closed, to depression at losing it all, to accepting it and realizing we’re just going to have to wait.
But, yesterday, was a breaking point for me.
As most readers know, I live in Louisville, Kentucky. Last week was Derby week and yesterday was supposed to have been the 146th running of the Kentucky Derby. But, like all major sporting events and large-crowd activities, it has been postponed until Labor Day weekend, and even then it might be run with no one in the stands.
The Kentucky Derby is the one time each year my hometown gets a 2:00 minute slice of the national and international spotlight. Whether it’s dressing up to go to the track and mingle in the grandstand, or dressing down to survive the Bacchanalia that is the Third Turn of the infield, or attending a Derby party, or even just enjoying a mint julep as the race begins after spending the day planting your annuals (another Derby tradition around here), it’s a day most Louisvillians look forward to all year.
And, this year, yesterday, it. was. gone.
This video attempts to end on a hopeful tone, the singing of “My Old Kentucky Home” in an empty Churchill Downs. Contrary to the lyrics of “weep no more,” it has caused the exact opposite reaction.
Angry re-opening
For many, what they have lost and are losing is their very livelihood. Small business owners, particularly bar and restaurant owners, are running out of savings and unlikely to survive just on take-out and delivery orders. For others, their manufacturing jobs sit idle and for those who are in certain jobs, like the meat processing plants, they’re being devastated with the virus running rampant through them.
All of this is feeding a very real sense of not just anger, but rage.
The nightly news televise scenes from the increasing protests demanding that the lockdown measures be lifted so people can get back to their jobs and make some income. This picture from the Michigan rally has already become iconic of the anger of these protesters:
For various reasons–a plateauing of new cases of the virus, a decline in the number of daily deaths (though daily, there are still deaths), testing coming on-line (though not at levels public health officials say is sufficient to open up), state unemployment funds running out of money such that people will have no income if they don’t return to work, and the political effect of a not insignificant percentage of the citizenry demanding elected officials relax restrictions–almost all states have begun re-opening businesses in phases.
I think we all hope the re-opening is successful. We hope that the speculation that warm weather may suppress the spread of the virus works in tandem with the re-opening so more people are not infected as they return to work and engage in commerce. For many, they are hopeful they will get to attend their houses of worship and experience the fellowship that provides comfort and healing during this horrendous time.
We all hope that it gets better.
But, that would defy the logic, the models, and actual experience.
More grieving to come
What one of the incredibly frustrating things is about this damn pandemic is how much we still remain in the dark about it, including, worse, those who are supposed to be the ones to lead us out of the darkness.
In January, relying on false information from Chinese officials, the World Health Organization (WHO) issued statements that the virus could not be transmitted person-to-person, even as it was burning through Wuhan province doing just that.
At the outset of this disease, the Centers for Disease Control (CDC)–the very organization whose name says it’s supposed to be controlling diseases–issued faulty tests for the disease and said masking was not recommended, only to reverse course and now recommend masking when in public.
The WHO was misled and the CDC has learned, but the incompetence from the outset undermines their credibility going forward, even as they remain the two bodies whose recommendations guide all actions.
But all that said, the logic of the spread of the disease has not changed:
- The COVID-19 virus is a respiratory disease.
- As such, it is spread by exhaled droplets infected with the virus being inhaled by others.
- Most dangerous of all, it is spread by people showing no signs of infection.
And, so, this is how an airborne, respiratory disease has ravaged the globe. People who seem completely fine, having no reason to believe they shouldn’t be at the grocery store, or getting physical therapy performed on them, or attending choir practice at church, or working at their jobs, end up spreading it to others. And for many of those, they, too, will not show symptoms as they return to their homes to care for a child with asthma or visit an elderly parent in a nursing home, or drop off groceries for a shut-in doing a good deed.
It is only because of the lockdown measures that the number of cases are plateauing. But with the measures being phased out, the models have now changed their projections. Whereas at the beginning of April a total of 60,000 deaths were projected due to the mitigation efforts, we ended the month surpassing that projection. With the re-opening being factored in, now the projected number of deaths is a high as 130,666–essentially a doubling of the number of deaths already.
While the models can be criticized for the factors considered and not considered, we now have real life examples of what happens when lockdown measures are in place and when they are not.
For much of the Scandinavian countries, they followed similar lockdown measures as the United States. Sweden, on the other hand, decided not to. For those demanding society re-open, many have become fans of the Swedes. But, they’re not considering what’s happened in Sweden.
First, as a commentator noted, it’s easier to expect certain behaviors of people when they’re Swedes. Meaning, a fairly homogeneous population that is well-educated typically exercises good judgment. But, even still, their death rate far surpasses their neighboring lockdown countries:
- Norway: 211 deaths; 4 per 100,000.
- Finland: 230 deaths; 4 per 100,000.
- Denmark: 484 deaths; 8 per 100,000.
- Sweden: 2,679 deaths; 26 per 100,000.
In an interview I listened to, one analysis drew the comparison between Sweden and Israel. Both countries have relatively the same size population. However, Israel has a much higher population density, which, as New York City has shown, causes the virus to spread faster. Israel has implemented lockdown measures whereas Sweden has not. The results:
- Sweden: 22,317 cases; 219 per 100,000; 2,679 deaths; 26 per 100,000.
- Israel: 16,193 cases; 182 per 100,000; 230 deaths; 3 per 100,000.
The other thing is that while demands for re-opening are premised on restoring people’s livelihood’s and the economy, that is not what is happening in Sweden. Just because restaurants and bars have never closed, being relatively well-educated people who exercise good judgment, the Swedes are not patronizing them in sufficient numbers to restore the economy. So, Sweden took a gamble, more people died, and it’s economy is still cratering.
Why should we expect anything different here. Particularly given that you cannot compare our citizenry with that of the Swedes. The photo above from the protest shows how poor judgment we sometimes exercise.
Sad
As the re-opening happens, there is expected to be more cases and more deaths. Many people have started seeing themselves as relevant pollsters for determining their risk of exposure. Who else has had someone say to them, “I mean, I don’t even know someone who has it” as a justification for why they believe the fear of infection is overhyped.
I do happen to know someone who had it and he barely survived. Jody Demling is a local sports reporter. I met Jody when he was our local celebrity for Down Syndrome of Louisville’s golf outing about a decade ago. Louisville being Louisville, a big small town, we would run into each other throughout the years.
Jody got the virus in March. He doesn’t know where or how. He ended up on a ventilator for six days. Here’s a glimpse of his experience from a local report:
“The doctor met with me, and I could tell by the look on her face that it was bad,” Demling said. “She said, ‘We’re going to be preventative and do this now, and hopefully it will help down the road. She said, ‘We’re going to put you on a ventilator.’ So, I got a chance to call my wife, to talk to her, to talk to the kids a little bit. I called them twice and I don’t remember the second time. And that’s when things for me start getting a little blurry.
Fortunately, things worked out for Jody, but consider what he went through:
“It’s scary,” he said. “I am a real live product of this happening to me. I’m lucky and fortunate to still be here. And we didn’t do anything out of the ordinary or go anywhere wild and crazy. I didn’t even know I had it. That’s the scary part about it to me still. … It’s just one of those things where you just don’t know, and that’s the hard part for me now watching all this stuff, seeing both sides. Seeing people that say, let’s not wear a mask or do this, it just makes me mad and upset. If you really want to go through this, you don’t. Trust me. It’s been a terrible month.”
Risk/reward calculation is a tricky thing that we humans are often very bad at. If we think the reward is fantastic, we’re willing to accept more risk than we reasonably should–just consider all the millions spent on lottery tickets. If we think the reward/consequence is very bad–as it most certainly is with the coronavirus–we underestimate our risk for it because we use denial to convince us it isn’t as bad as we think so we can push forward.
The disease progression from this virus is terrifying. Something I hope never to go through and even more, something I hope my 75-year old mother and my children never have to go through. I hope you don’t get it. I wish no one else would get it.
But, as we re-open, the logic, models, and experience all tell us we’re going to have more cases. And, with more cases, more death.
There will continue to be more grieving. And, I find it incredibly difficult not to remain at the stage I felt yesterday.
Sad.
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