17. Was national health even able to be isolated as a priority? If so, why was an internet-based infrastructure for collating health files nationally not already in the works? The founding of a Coronavirus Emergency Task Force was a feat of public relations, as we focussed on the repatriation of passengers from cruise liners in Japan, turning in late February from the success in Afghanistan to “a topic that has become very, very important to everybody” and the “wonderful woman” who died the previous night as “medically high risk,” noting twenty-eight infected by a virus from which Trump assured the nation “healthy individuals should be able to recover,”–as if this left the United States government off the hook, as these folks at medically high risk (an increasing share of our populations) was on their own!
The eleven million estimated to be at highest risk for COVID-19 live not in the states later adopting Shelter-in-Place directives–not, of course, yet in place–in a block of states Trump has long cultivated strong ties, and where he sought to link the best defense against the virus to completion of his signature domestic accomplishment, the Border Wall.
Indeed, the border wall is unable to prevent the increased vulnerability of many regions both of older populations, those most remote from health care, and insurance exchanges, but also high-risk in other ways. Why has this not been better mapped, as it is imperative in the face of a national emergency? The disparities in southern states are of course more particularly pronounced–if many other populations, often those who work in service economies, less able to be accommodated by sheltering in place, or in concentrated areas of poverty without access to health care, from Alabama, to Louisiana, to Mississippi, to Michigan–spaces that are often less with far less easy access to open spaces:
There are a range of multiple fault-lines of unequal access to health care and an obscuring of huge gaps vulnerability to health risks across the country, rooted not only in age and co-morbidity–important as these are in discriminating sensitivity to exposure of viral loads–but deep inequalities to access to testing, to ventilators, and that extent to policies of social distancing and proper policies of sanitation that are so important to curtail the spread of disease by sheltering in place. Those without shelter are of course most at risk. And the distribution of individuals with close access to a hospital–or to emergency care, often needed if COVID-19 is not quickly recognized, suggests a deeper distancing of a good share of at-risk populations from health care.
Based on the possibly equivalent metric of flu mortality, among those over fifty might provide a metric for mapping vulnerabilty of the rural populations, or at least a likely biostatistical starting place–the very people that are often associated with “Trump’s base” and the very ‘heartland’ that the Coronavirus leave exposed as wholes in national security, as much as vulnerability to airborne viral diseases.
The utter irresponsibility of such overlapping images of globalization was critically acute in delaying response to the novel coronavirus as a national threat. Even the interruption of a global supply chain obscured preparing for future transmission of COVID-19 as a virus, whose tie to a recession was linked only to supply chain delays, by late February, as the dependence of Apple, Microsoft, and others on Hubei province was viewed as more significant than the degree of the virus’ future spread, as the “slowing of the supply chain following Chinese New Year” in Q3FY20; Goldman Sachs worried coronavirus would mean no economic growth, before incorporating the virus’ spread–even as CDC authorities insistence that whether the virus would spread was less of question than when, as public health saw dangers in extracting positive consequences from infectious outbreaks. Few travel restrictions were introduced as the virus spread, and the global growth by April had led to 10.000 infections in the US, allowing different families of the virus to enter the nation.