August 12, 2020
Two things I know for sure about the coronavirus pandemic:
1. Face masks properly used are the simplest and most effective method of controlling the spread of the virus which has already affected more than 120,000 Tennesseans and killed more than 1,200 of them. For the person wearing a mask, it filters out some if not all of the incoming droplets containing the virus; and more importantly, it holds in many of the viral droplets that may be exhaled. So according to one analysis, if 95% of the population in a given area wear cloth (not surgical) masks when around other people, each person who may be infected will go on to infect 30% fewer people than would otherwise be the case. Over 35 days, then, 100 infected people will translate into 889 virus cases if no masks are worn—but to only 332 cases if 95% are wearing masks, and this degradation would continue (National Public Radio “Shots”).
That may not seem like much, but in fact, as Centers for Disease Control director Robert Redfield has written, “the more individuals wear cloth face coverings in public places where they may be close together, the more the entire community is protected.” Also, Redfield has said, “If we could get everybody to wear a mask right now, I really think in the next four, six, eight weeks, we could bring this epidemic under control” (STAT News).
2. Unfortunately, for far too many people in Cheatham County, the State of Tennessee, and many other states, even the thought of that brief and painless inconvenience is evvidently too much to contemplate. (Serious illness or death from the COVID-19, apparently not so much.) A nation-wide analysis of mask-wearing by the New York Times in late July concluded that full use of such protection was more prevalent in Tennessee’s large cities than in rural areas—as low as 4% in some places and no more than 50 to 65% even in Nashville and Memphis (The Tennessean). That is, in other words, nowhere close to the “universal” or “near-universal” compliance that scientists say would make a difference.
Data or no data, as many of us travel around Kingston Springs or Ashland City or other places in Cheatham County– or read the paper or watch TV or scroll through the Internet– we have seen with our own eyes that our fellow citizens go in and out, up and down, in groups or otherwise without a care or a face mask or even a thought to social
distancing or other safety measures. In some quarters of our divided country, moreover, to mask or not to mask has become a partisan political issue, which should generate many scholarly dissertations if anyone is still around to write them.
Dr. Deborah Birx of the White House coronavirus task force visited with Gov. Bill Lee at the end of July, in any event, to deliver a personal warning that Tennessee—where new cases are already at record levels—was about to join other southern states like Florida, Texas, and Georgia in what she called a “full logarithmic spread” that would be much harder to reverse (Nashville Post). She suggested, according to The Tennessean, that “the virus has spread among asymptomatic young people into rural areas, and it now threatens to reach new levels of infection.”
As of July 24, the state health department reported that there were 412 confirmed cases of the virus in Cheatham County, with four deaths–probably not considered high for a population of some 41,000. But, said Birx, “the virus is there. You may not see it today because it may still be in younger people. But it is spreading, and it will hit your nursing homes and it will hit those that have serious consequences from this virus” (The Tennessean). One week later, there were 104 more confirmed cases in Cheatham County, and one additional death, and the week after that the total cases jumped to 573, with seven deaths.
Dr. William Schaffner of Vanderbilt University agreed with Birx as to the jeopardy facing rural areas like Cheatham County if necessary action is not taken. “Because this virus is moving through the state, and progressively into rural counties, there are plenty of people to infect,” Schaffner said. “I think those mayors and doctors and … leaders of rural communities are going to be surprised over the next several weeks as more and more of their citizens, the people who live in these rural areas, actually become sick” (The Tennessean).
A study released by Vanderbilt’s Department of Health Policy in early August concluded, “Coronavirus is now infecting and hospitalizing more rural Tennesseans as the fastest-growing outbreaks shift from Nashville and Memphis into mid-sized cities and less-populated areas.” Last May, the study said, only about 20% of new infections and hospitalizations were reported from counties outside the Nashville and Memphis areas, but by late July, the percentage in smaller population areas had increased to 47% (The Tennessean). For people in Cheatham County and similar areas, in other words, that means the brunt of the pandemic is coming our way.
So where do we stand? As July came to an end, the U.S. reached and passed the 150,000 milestone for deaths on account of COVID-19, having already roared past the 4 million mark in total cases. (It hit 5 million in early August.) “The three most populous states– California, Texas, and Florida– were among several that set seven-day records for virus deaths this week. Others set records for new cases,” USA Today reported. “Tennessee and Arkansas set records for both.”
Tennessee, being smaller and perhaps in an earlier stage, could not match the terrible toll occurring in Florida—257 reported deaths in one day, the fourth record in a row in this department, and 9,007 new cases that same day for a total of more than 470,000 (Reuters). But our state recorded its all-time record for new cases in a day, with 3,314 on July 13, followed by 3,140 two weeks later amid a long succession of very high numbers. Another 2,553 new infections brought the total of still-active cases in Tennessee to a record high of 38,272 on July 27, before it actually fell back slightly the next few days (Nashville Post)– and then shot back up again at the end of the month. (More recently it has exceeded 40,000.) During this period, availability of intensive care beds across the state dropped to 14% of total ICU beds, and at the end of the month, only 12% of ICU beds and 16% of all inpatient care beds were still available in Nashville and surrounding counties (Nashville Post). Bed availability has improved but is still low.
Which is exactly what the White House task force’s Dr. Brix was talking about when she tried to persuade Gov. Lee that Tennessee is at an “inflection point” where measures like mandated face masks and closing of bars needed to be implemented in order to change the trajectory of the pandemic. (Lee’s basic response to almost everything, in a word, was “Nope.”) Just as Brix said, Kara Hartnett wrote in the Nashville Post, “Rural counties throughout the state have started to experience an influx in new cases of COVID-19 as outbreaks in Metro areas began to stabilize and stretch outwards into bordering counties. … Davidson’s 15 neighboring counties have seen big jumps in new cases, causing more people to get sick and require hospitalization.”
And to ice the cake, if that were needed, guidelines issued by Harvard University’s Global Health Institute and Safra Center for Ethics in late July said it may be too late for the mask mandates, bar closings, and similar measures advocated by Birx and her colleagues (and already considered unthinkable by Gov. Lee and other Tennesseans). According to the Harvard experts, our state and a dozen others are already at the “tipping point” for uncontrolled spread of the coronavirus, so that only lockdown or stay-at-home orders will be sufficient to mitigate the effects (Yahoo News). Lee has already decreed that “I’m not at any point considering closing the economy back down” (The Tennessean), but he may find he has no choice.
It should be noted that in early August, the daily number of new cases in Tennessee has been considerably lower and the total number of active cases has remained “relatively flat,” e.g., 38,331 on August 11. No one has explained the seemingly positive change, other than noting that 30% fewer tests per week have been reported during this period (Nashville Post). The online Vox news site reported in an extensive analysis on August 12 that only six states have met four or all five of “the basic criteria to reopen and stay safe,” while Tennessee complies with only two.
Who is responsible for the fix that we are in? It would take a book, or several of them, to itemize all the things that President Trump has done to make the effects of this pandemic more severe and long-lasting than they ever had to be. Trump ignored the early warnings of impending danger (if in fact he ever saw them), and once the cases and deaths started adding up, he sought to minimize or obscure the threat, describing it as the “sniffles” and later saying it was “going to just disappear” (NBC News). In the spring, when much of the country had put itself on “lockdown” status (or tried to), he began agitating against his own administration’s guidelines—bulllying hard-pressed governors to “liberate” their states and not very subtly instigating “open them up” protests, some of them armed, to get bars, businesses, and sports events back on line prematurely. “His supporters have followed his example,” Diane Ravitch wrote for the New York Review of Books, “and they have demonstrated at state capitols in opposition to mask-wearing mandates and any other restrictions on their normal activity.”
This deliberate strategy of laying responsibility and blame on the states while continuing to ignore the evidence of escalating infection and death led to “consequences that continue to plague the country today as the virus surges anew” (New York Times). All along, Trump has withheld his support, if not to say ridiculed, the need for and benefits of wearing face-masks– spurring Republicans everywhere to adopt “a similar tone of skepticism and defiance. …[I]t is undeniable that Trump politicized masks and set a lethal example” (Jeremy Peters and Maureen Dowd in the Times).
In mid-July, for reasons best known to himself, the president actually admitted on television that the pandemic would get worse in the U.S. before it got better and asked, but did not mandate, that people wear masks “when you’re not able to socially distance.” But a few days later, he was back in his old form, re-tweeting a video advocating the use of a discredited and dangerous malaria medication for treatment of the virus and discouraging the use of face masks. He also resumed bashing the nation’s foremost expert on infectious diseases, Dr. Anthony Fauci, and again pushing for re-opening of the economy despite signs of the virus’ going out of control, especially in our part of the country (HuffPost, MSN). He and his unspeakable education secretary, Betsy DeVos, also continued to threaten to reduce funding for school districts that refuse to re-open their schools on time, with students physically in the classroom, regardless of local conditions.
Trump’s last chance to accomplish anything lies in his headlong drive to secure production of a safe and effective coronavirus vaccine, which is the only hope at present of arresting the virus’ advance. The administration has poured billions of dollars into several development and testing projects, with the goal of producing the vaccine by the end of the year, or more likely by the November elections. Everyone must hope that the frantic pace of Operation Warp Speed will not result in disastrous mistakes or side-effects.
With the president abdicating a leadership role, one might expect the next line of defense for Tennessee to be its governor, but while that has been the case in some states, it certainly hasn’t here. Almost from the beginning, Gov. Lee has maintained a detached and unsympathetic attitude toward the plight of the virus’ present and prospective victims. When there was a dramatic 40% rise in infections and hospitalizations in May and June, as Tennesseans were released (or released themselves) from an early stay-at-home order, Lee took the news with frightening nonchalance. His administration was monitoring the “uptick” in the number of casualties, he said, and besides, “[the new deaths were] not unexpected given that folks are out and about much more, moving around our state” (The Tennessean). The governor was not about to admit that the restrictions on residents and businesses had been abandoned much too soon, and he was not about to slow down the “re-opening” process or to mandate use of face masks, the practice of social distancing, or any other such preventive measures. He still hasn’t.
Finally, in early July, Lee issued an executive order allowing– but not ordering–the county mayors of 89 counties (including Cheatham) without health departments of their own to issue “orders or measures requiring or recommending the wearing of face coverings within their jurisdictions.” For himself, the governor avoided mandating anything in this regard, saying only that “[p]ersons are urged to wear face coverings in public places” and thus laying the blame or opposition on the county mayors who had to make the actual decision. He said the next day that local officials around the state were calling his office and trying to determine what authority they actually had, and then explained in fluent (Casey) Stengelese: “We’re exploring the most effective way to make this possible, to check the authority of implementing mask requirements in those communities with the highest level of cases. We’ll have a resolution on that question hopefully very soon.”
Lee chose his meeting with White House advisor Deborah Brix– who came to warn Tennesseans at the risk of Donald Trump’s displeasure– to display just how stubborn and indeed rude he can be about almost any definitive measure to help control the on- rushing virus. As recounted in The Tennessean, Brix suggested that closing bars and limiting indoor restaurant dining state-wide would have the desired effect– to which Lee quickly replied that he had no plans to do either, or even to give county mayors the authority to do so. “Beyond the regions that currently have restrictions, that’s not a plan for us now,” he said, finessing the fact that he lacks any real state plan to combat the pandemic. “I’ve said from the very beginning of this pandemic that there’s nothing off the table. I’ve also said that we are not going to close the economy back down, and we are not going to.” (So isn’t that off the table?)
Lee and Brix sparred inconclusively about a mandate for the use of face masks, with Brix saying there should be one whether it came from the governor or the county mayors and the governor continuing his refusal to ensure state-wide compliance. “People wear masks because they believe there is a reason to do so,” he said tautologically, “And I believe they will increasingly understand that as their local officials, for example, advocate for that.” Unfortunately, there is just no evidence to support this belief.
The Tennessean later reported that the states of Arizona and Tennessee, as Brix had said, were very similar in terms of how they experienced the coronavirus. But Arizona followed Brix’ advice– as Lee had not—and so it is one of the few states where the virus is actually receding. In Tennessee, Nashville stands out as an exception in that it followed the path of mandated face-masking, bar closings, and the like, and is now on the way to recovery (though still battling with tourists and over-age millennials who have insisted on riding around downtown mask-less and stuffed into open mobile saloons).
Meanwhile, it turns out the governor also has strong beliefs about how the state’s schools should respond to the threat posed by the coronavirus. His plan for re-opening the schools, which have been closed since last spring, was widely taken (and intended) to mean they should be opened without further delay and with students attending in person in virtuallly all cases. “Make no mistake, extended time away from the classroom is harmful for children,” he said upon issuing the plan at the end of July. “We fully support re-opening our schools with in-person learning as the best option. Planned delays should be reserved for the most extreme situations” (The Tennessean).
In mid-July, even before the plan was announced, more than 2,000 medical professionals in an organization called PlanMyCare criticized rapid re-opening of schools with in-person classes as being “[i]nsane and irresponsible” (Nashville Post). Among many other things, the group said students and teachers should not return to school buildings until the virus in Tennessee is brought under some kind of control, such as reducing the transmission rate from the then-current rate of 36.5 new cases per 100,000 people a day to 10 new cases per 100,000 and maintaining than rate for two consecutive weeks. “Rushing to re-open the state” before had led to “rising transmission rates, rising daily case counts, and rising hospitalizations,” said a spokesperson for the medical practitioners. “Rushing to re-open schools will have similar consequences, and lead to suffering and possible death.”
And it seemed in the first week of August that the PlanMyCare (and others’) predictions might be coming true. The Tennessean reported that nearly 50 school districts had opened their schools by August 5, most of them on an in-person basis, and that at least 14 school-related COVID-19 cases had already been confirmed. Two school districts in East Tennessee already had to close schools or change their schedules. It also appeared that despite the governor’s not-too-gentle urging, about 25% of the state’s public school students would start the year taking their classes online (The Tennessean). Cheatham County planned to begin full operation on August 17 with a combination of in-school, online, and “hybrid” attendance options (Cheatham County Exchange).
But if Lee’s plan for re-opening schools could be described as “insane,” it was hard to know what to call the governor’s executive order a few days later allowing high-school boys’ football and girls’ soccer teams to begin practicing with full contact and leaving the first games scheduled for August 21 and 17 respectively (Cheatham County Exchange). It seemed that Lee was throwing the bomb, so to speak, in his effort to convince us (and maybe himself) that the pandemic is merely a minor convenience. (Metro Nashville schools, however, quickly agreed not to hold any inter-scholastic games until after Labor Day. But the entire Cheatham County Central football team was reported to be in quarantine on August 10 after two cases of the virus were confirmed (Fox News 17).
Most coaches and administrators, it seemed, were surprised but pleased by the governor’s revival of fall sports, but the president of the Tennessee Football Coaches Association, at least, was somewhat less than ecstatic. “I’m glad for the kids. But I just think there are a lot of hoops to jump through,” he told The Tennessean. “I just think when you look at the numbers and what is happening with Major League Baseball [numerous positive COVID-19 tests for the Miami Marlins and St. Louis Cardinals after very few games were played], I’m kind of scratching my head right now.”
Indeed, there should be a lot of head-scratching going on at the idea of even allowing a boys’ football season this year, certainly at this stage. When you think of high-school boys running the risks of a normal teen-ager’s life, probably sitting in a classroom much of the day with other students who have had another set of contacts, practicing football at least a few times a week, and then playing games against players from another place altogether with sweating, spitting, slobbering, and close bodily contact on every play, you have to wonder how many new cases of coronavirus can fail to be generated from every contest and the contacts made thereafter by the participants. These players are not ensconced in any “bubbles” either, as in professional hockey and basketball, and it certainly looks as though screaming, hugging, and high-fiving fans will be allowed to attend their games, which is not the case in most pro sports. In the National Football League, where the players are older and stronger and the games have not yet begun, at least 66 players have already opted out for the season rather than risk infection or worse of themselves, families, and others (Associated Press). Do these athletes know something that has eluded the rest of us?
Other than football, one thing that does seem vitally important to Governor Lee is the bill he was unable to get through the regular session of the state legislature, granting broad civil immunity to “businesses, schools, and other entities against COVID-19-related lawsuits” (as The Tennessean described it). So great is the governor’s concern for friends in the business world that he has called a special legislative session to deal with this bill again, along with two others—one authorizing “telehealth” medical services and urging insurers to cover it, and another increasing penalties for protesters said to be camping illegally at the Capitol.
It is fairly clear that this session is all about Lee’s desire to immunize Tennessee businesses and schools from, perhaps, damage suits for failing to observe required protections against the virus or otherwise creating dangerous conditions or ignoring safety needs. The telehealth proposal is pretty much window-dressing to make the package look more respectable, and the increasing penalties for camping, vandalism, etc. at the Capitol seem like red meat to entice wavering legislators to swallow the whole kit-and-kaboodle. A lot of people think that intervening causation by the coronavirus can be raised as a legal defense without any help from the legislature (and that the bill is bad policy anyway), and several legislators have expressed concern over language that would make the immunity bill retroactive to the date of the virus’ arrival last March.
If the governor wants to convene a special session of the legislature, there are so many items more pressing to the average Tennessean that could be considered instead: adding legal standards enabling the Tennessee Occupation Health and Safety Administration to enforce COVID-19 workplace safety measures against recalcitrant employers (e.g., identifying possible sources of contagion, observing social distancing, providing personal protective equipment); addressing the unconscionable delays and inefficiencies in the state’s unemployment compensation program; keeping the Department of Human Services from letting $60 million in federal money go down the drain when it is intended to provide meals for children from low-income families (if not the many similar flaws in other food-security programs); clarifying and simplifying Tennessee’s procedures for absentee ballots so that, among other things, voters do not have to fear serious or fatal viral infection from going to the polls; and of course, expanding the state’s TennCare/Medicaid program to cover the 300,000 or more additional low-income individuals who cannot afford decent medical care. This expansion can be accomplished with 90% federal reimbursement and would produce well over $1.4 billion per year, which will be sorely needed to meet the soaring cost of treating coronavirus infection and of medical care in general. But in Bill Lee’s world, unfortunately, so far it’s (his) first things first.
For Cheatham County, at least, County Mayor Kerry McCarver has the authority to mitigate or resolve many of the foregoing issues and to help prevent a looming future of unnecessary suffering–but he doesn’t want to. Rather, he has staked out a position of encouraging but refusing to mandate the use of face masks in Cheatham County, and on the basis of flimsy concerns about the form of Gov. Lee’s delegation order and the pervasive misapplication of quasi-legal concepts like freedom and personal liberty, he has doggedly refused to reconsider.
First, the mayor argues that the governor “has not outlined who would enforce his executive mandates and what the penalties would be,” and that the order authorizing him to act “did not direct state funding for the local county to cover costs involved with enforcement” (Cheatham County Exchange, Ashland City Times). Yet somehow or other, many counties in our general area–including Wilson, Sumner, Rutherford, Williamson, Montgomery, Robertson, and Davidson (which is able to act more independently)–have managed to figure out the bureaucratic details and to mandate mask-wearing at some point without the world’s coming to an end. There is no authority or reason for requiring a gubernatorial executive order to spell out all these nuts and bolts.
Next, McCarver has said he has relied on “good old Cheatham County sense” to let the residents determine “our own personal responsibility to ourselves and each other” in the context of a dangerous and largely uncontained pandemic” (Ashland City Times). This kind of statement is really akin to pandering, since good sense in our county or elsewhere clearly requires the use of face-coverings, and a casual trip around the county over a weekend (at least Ashland City and southward) is likely to find almost no one wearing a mask indoors or outdoors or giving any apparent thought to social distancing either.
The mayor may not choose to notice what is happening, but as state health commissioner Dr. Lisa Percey said last month, “We have a growing problem in Tennessee, including rural areas. Now, at least half of cases are from an unknown source, or community transmission, meaning from people who are out and about trying to get back to normal. …This is not the time to get back to normal. We are all experiencing what we call quarantine fatigue , but I guarantee you this virus is not getting tired. We must double down on our efforts to flatten the curve [of rising cases].” (Cheatham County Exchange).
Such declarations of emergency by government officials–that they are responding to a public health crisis and “are actively shaping their response to changing facts on the ground”–have led the courts to view restrictions on social activites as a “dynamic and fact-intensive matter” and to entrust their regulation to the politically accountable officials of the state, who should not be subject to second-guessing (Opinion of the state Attorney General, July 24, 2020). The existence of such an emergency means that even minor defects or disagreements should not invalidate measures enacted in response unless they are found arbitrary or unreasonable.
Finally, McCarver seeks refuge in the oft-invoked claim that the governmental action involved in requiring the use of face masks violates the rights of those who object: “We also have to decide what level of government do we need and [be] willing to tolerate or accept to live truly free and independent (Ashland City Times).” This argument is often heard coming from persons who venture into stores or businesses or other crowded areas without bothering to employ even the simplest protections of themselves, their families and friends, and others in their lives. An experienced government official should know, however, that “quarantine laws” and “health laws of every description” were held to be within the police power of the state almost 200 years ago (Gibbons v. Austin, U.S. Supreme Court, 1824), and that the decision of the Supreme Court in Jacobson v. Massachusetts (1915) involving required smallpox vaccination held that “in every well-ordered society charged with the duty of conserving the health of its members[,] the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint… .”
In light of these cases, which still apply, measures such as stay-at-home orders, closure of non-essential businesses, and others designed to limit contact with others are especially likely to be permitted now because of the lack of a vaccine to prevent the spread of the COVID-19 virus. This sort of regulation would likely not be considered to be arbitrary, unusual, or unreasonable, “because health boards across the United States, and across the world, have recommended such regulations to protect the public health and safety” (Alabama Lawyer). And a mere mask-wearing requirement, being less intrusive than any of these restrictions, and much less than a smallpox restriction, would be even more likely to be upheld. One may have a right to kill oneself (or not), but that right would not extend to endangering family members, friends, or members of the community. The recent opinion of state Attorney General Herbert Slatery III fully subscribes to the principles of Gibbons and Jacobson, and county mayors should consider themselves bound as well.
As this article indicates, we have been ill-served at all levels of government in terms of combating the coronavirus or making use of simple but effective counter-measures such as wearing a face mask or practicing social distancing, thus leaving the pandemic in most places just as dangerous as ever. But if you think about it, there is one person we can still depend on–ourselves. We have seen, heard, and read enough about the situation to know what needs to be done, and we are capable of doing it without having someone tell us to, or force us via governmental action. Unfortunately, it seems that many of our fellow citizens are not so inclined, so that all we can do is try to appeal to their self-interest in the absence of any concern for the welfare of anyone else. Or if we are confronted in our homes, our work, our children’s classrooms, or anywhere else with an intolerably dangerous situation, we can report it to the authorities and keep raising h**l until somebody does something to fix it. Obviously, this approach may not be enough to do more than delay the inevitable.
Last July, the New York Times quoted Dr. Scott Gottlieb, former head of the federal Food and Drug Administration, as to “the potentially devastating consequences of failing to rein in the virus, noting spikes in cases in states like California, Texas, Arizona, and Florida. He warned that other states, like Georgia, Tennessee, and Kentucky, could follow similar patterns.” And so they have. “We’re seeing record numbers of cases, rising hsopitalizations and really a shifting of the center of the epidemic potentiallly in the United States,” Gottlieb said (also true). “This just portends more trouble for the fall and winter, that we’re going to be taking a lot of infection into the fall, that we’re never going to really be able to come down.”
In all, the American public, as well as its government, has not given a very good account of itself since the pandemic descended upon our country. Instead of rising to the occasion, we have whined and complained, refused to make even the slightest sacrifice or to suffer the slightest inconvenience, and worst of all, turned even the simplest question or request into a bitter partisan dispute. Look at our House, Senate, and president spend weeks fighting about nothing while millions go without jobs or fair compensation or often anything to eat; look at the endless arguments over just the issue of whether we should wear face masks or not. And our most difficult trials are still ahead of us.
“The current moment is demonstrating just how far away we are from being able to come together to solve a planetary crisis,” wrote Harry Cheadle in July on NewRepublic.com. “The pandemic is a test, and we’re failing it. If the federal government reacts to the greatest public health crisis in a century with half measures, what could possibly convince it to react sufficiently to climate change? If governors won’t demand that their citizens wear masks to save lives, will they be willing to get people to reduce their carbon footprints? If so many authoritarian and authoritarian-adjacent governments react to a pandemic with denial, what can we expect as the climate crisis worsens?” Sadly, the Greatest Generation is all but gone, and all the evidence suggests that America no longer has what it takes.