Coronavirus: Grassroots public health

There have been two recent images in the New York Times that capture a crucial aspect of what is going on in the US as we struggle to respond to the novel coronavirus, COVID19.  In the first, health care executive Bruce Greenstein replies with an elbow to Donald Trump's offer of a handshake.  Trump has been shaking hands with lots of people, including some who have been found to be infected.  Greenstein demonstrated in that moment, caught in this dazzling photo, enormous self-possession -- exactly what it takes to enact social distancing when it has not been endorsed by the hierarchy.

That's where we all were a week ago, feeling slightly awkward about refraining from a handshake.  But a week has passed and something has happened in society. In the second image, a Times' graphic listed events canceled and places closed.  These include: the NBA season, SouthxSouthwest and the Metropolitan Museum of Art.

In the terrifying absence of sane national leadership, a grassroots public health response has surged. If social distance was what could help flatten the curve, and dampen the epidemic, every organization had the possibility of enacting that: WE COULD CANCEL EVERYTHING.  By Friday, major colleges and universities had sent their students home for the duration, large gatherings (however, you define that) had been called off, and Zoom chic had become the new black (cute top, cool headset, modeled here by my goddaughter, Gahlia Eden).

I know a lot about grassroots public health because I started my research career in San Francisco in 1986, looking at AIDS in black and Hispanic communities.  The activism of the gay community created the essential push on the government to get an epidemic response moving.  I am not surprised to see veterans of that era in the forefront of response to this pandemic, Gregg Gonsalves among them.  Many others are stepping up as well.  In my own email has come news from the presidents of UU congregations in my district about going online for services, foundations' reassurances to grantees, public health leaders' communications of reliable information and demands for care for the vulnerable.  Most important of all, in my view, has been the updates from the Poor People's Campaign, mobilizing efforts to ensure a response to the epidemic that includes all the people.

Here is what has been surprising to me: It is evident that this grassroots public health comes from LOVE, in the way Rev Dr. Martin Luther King taught us. There is profound concern for neighbors and strangers.  While we see videos of people, in their fear, fighting over the last pack of toilet paper, what is happening in this broad mass enactment of public health is LOVE.  It is a powerful motivator in this moment when we are left to our own devices to make the best of what we have.

The many expressions of this LOVE have been touching.  Here is one message from a friend.

Coronavirus: "Caring across social distance"

I couldn't make this morning's Grant Club meeting because I woke up with a terrible sore throat.  I am in the C/F/C--cold/flu/coronavirus--netherland.  The only things I know for sure are: I hope it's a cold and it's lonely.  I shouldn't say it's that lonely -- I was talking on a webinar to 100 people and other calls have been coming in all day.  But it has a shell of loneliness because I shouldn't go out and others shouldn't come in, as least not until this thing declares itself.  I've never wished so hard for a runny nose and sneezes.

Anyway, in this state, I was glad to see a google doc shared by our UofO leader, Molly Rose Kaufman, called "Caring across social distance."  By way of context, Molly is my youngest child. When she was a baby, she would sit in the kitchen nook and have breakfast with every member of the family as they floated through.  Social distance is not her thing.  Some of the items on the "Caring across social distance" list included: headsets for the UofO team (so we could optimize our Zoom calls); "digital campus" that included a baking show led by Holly Barszcz and me (which has long been a dream of mine); and telephone call trees.  While much of what is going on is dreadful (meaning full of dread), it is also a time when we have to invent a new way life.  It's like camping, or breathing during an inversion.

An email to faculty from the university where I teach (The New School) had the subject line:

Moving your face-to-face courses 

online in a hurry

It was very supportive of the challenges we face and suggested that we take control of that which is within our control.  At this moment, it is within my control to plan my first contribution to the baking show, "Making David's Brownies."  Link to follow!

The new stage of coronavirus: cancel everything

We have reached a new stage in the coronavirus COVID19, in which the call is to cancel in-person gatherings to the extent we can.  Medical historians have pointed out that, during the 1918 flu epidemic, cities that canceled events and closed schools had many fewer deaths than those that did not.  This supports the draconian steps that China, South Korea and Italy are taking to contain the epidemic.  It takes us from the "wash your hands" period to whole new phase, in which such major events as SouthxSouthwest are getting canceled and Harvard University is sending its students home with the instruction to stay there until the coast is clear.  And when that will be is anybody's guess.

Here are the major points I've identified in the articles I've read today:

1)    The situation is evolving quickly.  Just because we don’t see it around us, doesn’t mean COVID19 is not here.  In China the number of cases went from a few hundred to tens of thousands in a couple weeks.
2)    It is not “just like the flu.”  We don’t know what this virus can do, but it seems to be very deadly and especially for our older people and those with other illnesses – this describes many in our congregations and our communities.
3)    We have to contain germs – getting people to wash their hands, cough into their elbow, and refrain from shaking hands are key interventions at this point.
4)    We have to use “social distance” – that means, avoiding in-person gatherings.  At this point authorities are talking about “large” gatherings, but even small gatherings have the potential to unleash a chain of infection that can sweep a community.  Religious communities, because we gather with each other so much, are particularly vulnerable.  (See Dr. Kubersky's letter to the editor on the epidemic sweeping New Rochelle.)
5)    We have to get government to act to implement the social distancing as much as possible, as soon as possible.
6)    We have to get government to care for the vulnerable, those who will be unable to work, don’t have health insurance, and lack paid sick leave.  The strategy of social distance can only work if we find the way to include everyone. How can we ensure the safety of the homeless, the illegal immigrants, the people without health insurance or paid sick leave?

Here are two readings I found that sum up the situation and what we’re facing:

David Troy offering some explanations about the epidemic
Yascha Mounk, on why we should CANCEL EVERYTHING

We are in for a long, rough time, and we will need to find new ways to be in solidarity.  Not to mention, at some point we have to start talking about the ecological damage that is creating the conditions for new illnesses to emerge, what Dr. Robert Wallace calls "farming pathogens"!

Coronavirus and Main Street

There has been lots written about the new coronavirus, COVID19, which causes respiratory illness, and there will be lots more.  And lots about Wall Street, where stocks tumbled in fears of what a possible pandemic would do to the economy.  But, as Gary Nesta Pine sings, "Mr. Wall Street, do you care about the Main Street?"

The Atlantic published the first article on the topic that I've read.  It lays out the situation that will be faced by many of us Main Streeters.  In fact, a huge proportion of the American working people lack the three things you need to be easy in this epidemic: sick days, an understanding employer (even maybe the ability to work from home), and health insurance.

A blog post by British economist Simon Wren-Lewis about the economic effects of pandemics notes:

But economics can also influence health outcomes, and not just in terms of NHS resources. For a minority of self employed workers there will be no sick-pay and those without a financial cushion will be put under stress. One of the concerns as far as the spread of the pandemic is concerned is that workers will not be able to afford to self-isolate if they have the disease. So if I was in government I would be thinking of setting up something like a sick-leave fund that such workers could apply to if they get coronavirus symptoms. 

The government also needs to think about keeping public services and utilities running when workers in those services start falling ill. In fact there are a whole host of things the government should now be doing to prepare for a pandemic. It is at times like these that we really need governments to act fast and think ahead. Do we in the UK, and US citizens, have confidence that the government will do what is required? One lesson of coronavirus may be never put into power politicians that have a habit of ignoring experts. (emphasis added)

This reminded me of getting breakfast two days ago in the working class diner on Main Street, West Orange.  It was full of people having a nice Sunday brunch with their kids.  My waitress was attentive, but her nose was running the whole time, and she was not washing her hands in between sniffs.  She looked miserable and probably would have liked to be home, watching TV and taking cough medicine.  If the coronavirus hits our area, there will lots of people working and sniffing because they don't have a choice.  

We do have a choice: we can follow Wren-Lewis' advice to "never put into power politicians that have a habit of ignoring experts."  We can follow Reverend William Barber's advice and fight for policies that protect the poor.  And we can follow my advice: Care about Main Street.

Soon to be a book....

I've been visiting Main Streets since 2008, with the intention of understanding the link between these centers of civic, social and commercial life with our collective mental health.  After visiting 178 cities in 14 countries, writing two scientific papers, and posting semi-regularly to this blog, I'm prepared to describe the connection.  This has taken the form of Main Street, a book to be released in October by New Village Press.  The advance comments and book cover will be coming soon! You might ask your local Main Street bookstore to stock it!

Main Street, Squirrel Hill, Pittsburgh

In the aftermath of the horrific massacre at a synagogue in Squirrel Hill, I am flooded with memories of the pleasant neighborhood and its active, bustling Main Street where I've had lunch and dinner many times. I am also flooded with memories of the contrast between the serenity of that neighborhood and the life-and-death struggles that were going on in The Hill, East Liberty and Homewood.  The separateness was, as I remember it, both profound and false. 

One might ask, "Is not the crime that troubled the poor, Black neighborhoods different from virulent anti-Semitism?" 

I had a major encounter with this question in my research career.  I was engaged as a consultant to a study of instances of fatal school violence, being carried out by the National Academy of Science/Institute of Medicine. My team examined two episodes of school shootings in East New York, 1991-1992. Our paper, "What did Ian tell God?" is included as a chapter in the National Academy Press 2003 book, Deadly Lessons, which you can download for free at their website. 

Throughout the process of the study of fatal school shootings, the dominant discourse was this:

that school shootings in "white" schools were the real focus of the study, because these were bizarre, "rampage" shootings, nearly impossible to understand. By contrast, a school shooting in the violent, minority neighborhood of East New York was sad, but not unexpected.  After all, "white" people don't kill each other, but, sadly "Black" people do.  

As a result, and because there could not possibly be any connection between the "white" cases and the "Black" cases, our chapter was placed at the back of the book.  I am, I confess, still angry the story of East New York was marginalized, when its lessons were desperately needed to solve the problem of fatal school shootings. 

It was not until the Parkland shooting in February 2018, that links were acknowledged. The youth leaders who emerged from Marjorie Stoneman Douglas High School were joined by youth leaders from a diverse array of high schools, all of whom had suffered from violence.

We are sorely tempted, in an Apartheid society, to see things as different, and to rate them as "my problem" or "not my problem" depending on factors like our skin color or religion and geography.  And we are equally tempted to be angry when some problems get attention and others are allowed to fester.  And we get upset when people point out links among problems, as "diluting" the "real" issue.  Why, after all, talk about murders in Homewood just now, after the massacre in Squirrel Hill?

But these reactions derive from the logic of Apartheid, which enforces separation in all things.

To return to the question posed early, we may not yet know all the links between black-on-black crime in a poor neighborhood and virulent anti-Semitism attacking a prosperous one.  But we do know enough to know that the disinvestment in massive urban neighborhoods destroyed effective urban functioning, undermined working class solidarity, and tore the social connections that can keep hatred in check.  Indeed, the destruction of minority neighborhoods was an expression of racial hatred, and once unleashed, why would it stop there? What we call "racial" hatred has many targets, including women, sexual minorities, religious minorities and immigrants, to name a few. 

We need to learn the lesson of history, which is that my safety can only be measured in the safety of others. The German pastor Martin Niemöller wrote this teaching poem:

First they came for the communists, and I did not speak out - because I was not a communist;
Then they came for the socialists, and I did not speak out - because I was not a socialist;
Then they came for the trade unionists, and I did not speak out - because I was not a trade unionist;
Then they came for the Jews, and I did not speak out - because I was not a Jew;
Then they came for me - and there was no one left to speak out for me. 

Might we see the violence in Squirrel Hill as the same as sending pipe bombs to liberal politicians, denigrating the caravan of immigrants trying to reach safety, killing students in schools and cutting school lunches?  I believe these are interconnected in their logic and implementation.  We can create a powerful response if we consider those connections and the ways in which we might interrupt them.

Somebody has to make the first move in creating solidarity.  It may be that Squirrel Hill will reach out to its neighbors in East Liberty, who have lived tragedies of violence.  It may be that the people of The Hill, East Liberty and Homewood will go to sit shiva with the people of Squirrel Hill.  However it happens, let us all be prepared to follow suit, linking arms in radical solidarity.

Can God save a city?

Martha Park is a writer and artist who creates illustrated investigates of urban situations.  She looked at the crisis of Cairo, Illinois, in this remarkable piece.  Ben Carson, Secretary of Housing and Urban Development, has abandoned the city -- left its fate in God's hands.  While his act is brutal, in its honesty it reveals the larger approach to cities in our nation -- abandon them and their people when they have ceased to profit centers.  Move somewhere else to make money.  These planned shrinkage policies are a disaster for the local areas and for the nation, as Dr. Rodrick Wallace has so clearly shown us in his studies of the effects of planned shrinkage on the Bronx.  When will we learn?