You Can’t Be Any Poorer Than Dead
Nurses at Kaiser Permanente hospitals and clinics in California could be fired immediately for wearing their own face masks, according to unions representing nurses at the facilities. The news comes after nurses were ordered to reuse disposable protective gear to save supplies in the face of shortages brought on by the coronavirus pandemic.
The California Nurses Association and National Nurses United sent a flyer to members noting that Kaiser had threatened nurses with firing if they wear their own N95 masks, which offer a high level of protection from airborne contaminants, to work. “Kaiser has told nurses that if they’re seen wearing their personal N95 masks, they could be fired ‘on the spot’ for insubordination,” the flyer read. The unions did not immediately respond to a request for comment.
Kaiser spokesperson Marc Brown said firing nurses for using their own N95 gear is not the company’s official policy. Asked if nurses would not be disciplined if they wear their own masks, Brown did not provide an answer. “That is not our policy. We provide the appropriate medical-grade protective equipment for the protocols and level of patient care being provided. We cannot assure the integrity of protective equipment not provided by Kaiser Permanente,” Brown wrote in a statement to The Intercept. “We want them to wear equipment we can be sure is effective.”
As of this afternoon, California had more than 2,200 confirmed cases of coronavirus infection. Of the total cases, 662 (and 11 deaths) have been reported in Los Angeles County.
The disease is spreading, and most likely, the worst is yet to come. Hospitals around the state are bracing for an influx of patients in the very near future.
In L.A. County, five people had been hospitalized at some point with COVID-19 as of March 6. Two weeks later, it was 48. By Monday, it was 90. Those numbers sound low, but the overall trajectory and rate of increase suggest they’re about to get a lot higher. Last week, Gov. Gavin Newsom’s administration forecast needing 20,000 hospital beds in the state to treat coronavirus-infection patients. Now, it has upped that number to 50,000.
The L.A. reader who e-mailed those items to me says:
The nurses in the Bay Area are being asked to intubate people, but they don’t have PPE. Some are threatening to walk out, and there may even be a strike. Things are already getting bad here, and its only been a few days. People think that when they get sick, someone will take care of them. But that isn’t true—there won’t be enough trained people. COVID is running through our nursing homes, and the first minor in the US has died.
The largest transfer of wealth in American history is about to take place, and we don’t even know who is getting what, when, or why. And Trump is telling people to fill the churches on Easter Sunday as a sign of their faith. Some of you will be sacrificed for Wall Street. It’s filthy, and infamous.
He’s referring to some remarks the president made to Fox’s Bill Hemmer after a White House town hall:
Trump on why he picked Easter as the day he wants to end strict social distancing and reopen American businesses: “Easter is a very special day for me … Easter Sunday, and you’ll have packed churches all over our country.” pic.twitter.com/6cXEtW8LmR
— Aaron Rupar (@atrupar) March 24, 2020
Earlier, during the town hall meeting, Trump kept hitting on the theme of how he wanted America to be back to work by Easter Sunday (April 12). Hemmer called the rebirth of commerce an “American Resurrection.” Really.
I think this is madness. Certainly I hope that this can be accomplished. You would have to be insane to want America to enter into an economic depression, which is certainly coming if the economy stays forcibly idled. But watching Trump’s town hall comments (see here for clips), he kept comparing the coronavirus deaths to deaths from automobile accidents — the idea being that we lose tens of thousands of people annually to car crashes, but we don’t ban cars. He said that the damage from the economic shutdown is worse than the deaths that would result from learning to live with the virus.
This is crazy talk. As we know, the problem is not simply the raw number of deaths. The problem is that our hospitals are going to be overwhelmed. As the L.A. reader points out, in the Bay Area, the nurses union says their workers are having to intubate people without protective gear. What if medical personnel go on strike, demanding basic protection, to which they have a right? Or what if too many of our doctors and other medical personnel are felled by the virus, and can’t work? A physician e-mailed me yesterday, saying that he is physically exhausted, and struggling with depression. If the country goes back to work too soon, we’re going to see even more death, and the destruction of our health care system, without getting the economy working. Do you really think we can have a functioning economy with hundreds of thousands of people, perhaps millions, being infected by this runaway virus?
I do not understand the view that the economic hit would be unquestionably worse than death. Let’s be clear: this is not about sacrificing the poor and the working class for the rich. I don’t agree with the L.A. reader that these sacrifices are being proposed for “Wall Street.” Millions of ordinary people will lose their jobs, and be financially ruined, by a depression. We know this. I’m one of them, and most likely, so are you. Every political leader in the world is, or soon will be, facing a tragic choice now, making a gruesome cost-benefit analysis between economic destruction and mass death. I think for most of us tonight, this is still a mostly abstract threat. We haven’t lost anyone close to us to this virus. If we’ve lost our job, the real pain hasn’t hit yet. Soon enough, we will have lost someone dear to us, and we will be suffering real economic pain.
Still, I can’t wrap my mind around the idea that we, as a nation, would believe that it’s better to accept a much higher death rate from this disease if it could save the economy. Besides which, I don’t think people grasp how this would work, or rather, not work. Bill Gates said today:
“There really is no middle ground, and it’s very tough to say to people, ‘Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts,’” Gates said in an interview with TED Tuesday. “It’s very irresponsible for somebody to suggest that we can have the best of both worlds.”
Trump has suggested that this middle ground would indeed be possible — by letting some healthy people return to work, for instance, while keeping more vulnerable workers in their homes. Experts have said that drastic and widespread social distancing is required to keep the pandemic from spreading further. Trump has said he would make a decision at the end of the month but has said that he believes the “cure” could be worse than the “problem itself.”
Asked what he would do if he were president, Gates returned to his concerns about reopening the economy.
“The economic effect of this is really dramatic. Nothing like this has ever happened to the economy in our lifetimes,” Gates said. “But bringing the economy back … that’s more of a reversible thing than bringing people back to life. So we’re going to take the pain in the economic dimension — huge pain — in order to minimize the pain in the diseases-and-death dimension.”
Over at First Things, Rusty Reno discusses the theological aspects of the crisis, calling on Christians to “say no to death’s dominion.” He writes, in part:
At the press conference on Friday announcing the New York shutdown, Governor Andrew Cuomo said, “I want to be able to say to the people of New York—I did everything we could do. And if everything we do saves just one life, I’ll be happy.”
This statement reflects a disastrous sentimentalism. Everything for the sake of physical life? What about justice, beauty, and honor? There are many things more precious than life. And yet we have been whipped into such a frenzy in New York that most family members will forgo visiting sick parents. Clergy won’t visit the sick or console those who mourn. The Eucharist itself is now subordinated to the false god of “saving lives.”
Truth is another casualty of this sentimentalism. The media bombard the public with warnings about the danger posed by the coronavirus, when the truth is that only a small percent of the population of New York is at risk. By an unspoken agreement, leaders, public health officials, and media personalities conspire to heighten the atmosphere of crisis in order to get us to comply with their radical measures.
A number of my friends disagree with me. They support the current measures, insisting that Christians must defend life. But the pro-life cause concerns the battle against killing, not an ill-conceived crusade against human finitude and the dolorous reality of death.
This is what is happening in New York as I write. The media maintain a drumbeat of warnings. And the message is not just that you or I might end up in an overloaded emergency room gasping for air. We are more often reminded that we can communicate the virus to others and cause their deaths.
Just so, the mass shutdown of society to fight the spread of COVID-19 creates a perverse, even demonic atmosphere. Governor Cuomo and other officials insist that death’s power must rule our actions. Religious leaders have accepted this decree, suspending the proclamation of the gospel and the distribution of the Bread of Life. They signal by their actions that they, too, accept death’s dominion.
This is all so bloodless and abstract and pious. Governor Cuomo and other officials — and doctors, nurses, and medical personnel — are dealing with an unprecedented crisis that may crash the city’s health care system. They are also no doubt thinking that if it gets bad enough, with people dying unable even to get into the hospital, the police and National Guard may have to put down civil unrest.
The Hasidic communities in New York City, who have resisted following social distancing rules, have become a hotspot of coronavirus. I guess they have courageously rejected the dominion of death. Now look. Because they didn’t want to change their lives, other people — health care workers — have to bear the burden of trying to save the lives of those who end up in the hospital because of it.
A reader of this blog commented on another post today:
Yesterday was one of my hardest ever as an ER nurse. I had an 89-year-old lady with pneumonia and possibly COVID (test result not back yet) on bipap respirator as well as vasopressor medication to keep her blood pressure up. It was an intense 7 hours and she was really struggling and her BP kept going dangerously low. Then her daughter showed up, her only family, and they made the decision to take her off all support. Daughter said her goodbyes to her mom then left.
I disconnected her from the respirator, from the medication, turned off the heart monitor. Now no more noisy alarms, I dimmed the lights, played some Chopin piano on my phone, and my job shifted to keeping her comfortable with morphine and Ativan until her heart inevitably stopped. Which it did two hours later. The last things she said to me in the hour before she died was “Thanks” “Can I have a sip of water” and “What is your name?”
Going to go in tomorrow and do it all over again.
Every day, this — until we get a vaccine, or somehow build herd immunity, if we don’t crush this virus now. Anyway, that’s what death means. A friend just messaged me from the Upper West Side of Manhattan, saying that the sound of ambulance sirens is a “constant soundtrack.” It is true that Christianity teaches us that death is not to be feared, but that does not mean we should seek it out. Jesus wept at the tomb of Lazarus, after all. There really are some things more important than physical life — Christianity teaches that martyrdom is better than apostasy — but to confine oneself to one’s home during a national emergency, to stop a virus that threatens to crush our hospitals, is not exactly a Joan of Arc move.
Last autumn, I interviewed Father Kirill Kaleda, a Russian Orthodox priest who pastors a church dedicated to the martyrs made under the Bolshevik yoke. His office is on the grounds of a national monument to the 21,000 political prisoners executed by the predecessor of the KGB in that field over a 14-month period. This is a man who lives with death. He told me that we have to be prepared to suffer, even to suffer martyrdom, because that’s what it means to be Christian. But we are under no obligation to seek this out, he said. He said this in an emphatic way, as if to cut off in my mind any romantic idea of Christian suffering and martyrdom.
Reno, who’s a friend of mine, is passing harsh judgment on priests who are not serving mass to congregations today, accusing them of a lack of faith, and of moral courage. This is so, so wrong. Nobody — not those priests, not the faithful — wants to be away from church now. We do it not out of fear, but as a temporary sacrifice to save lives. You really can communicate the virus to others by your presence. Yesterday my son and I drove up to the country to bring some food to my mother, who is old and has COPD. If she gets the virus, it will almost certainly be a death sentence. She is self-quarantined in her house. We delivered her groceries, cleaned them with sanitizing wipes, and talked to her from twelve feet away. All three of us knew that to have given her a hug could have meant passing on the virus — if either my son or I are carrying it, and don’t know it — that would take her life. So we all kept our distance, and hated it. Have we surrendered to death’s dominion? Or is that a sacrifice all of us are prepared to make to keep my elderly mother from drowning to death in a hospital bed from fluid-filled, virus-infected lungs?
This is not an abstraction. The political leaders who have closed down economies in European nations, and in some American states, are fully aware that by doing this, they are choosing to accept a staggering amount of material loss and pain onto the body politic, for the sake of saving lives. Are they also cowards who have “accepted death’s dominion”? Or is it more truthful, and of course more charitable, to say that they recognize that human life is sacred, and that while we cannot save everyone, we ought to be prepared to bear a great sacrifice to save as many as we reasonably can?
I wonder what doctors, nurses, paramedics, and frontline medical personnel would think about the claim that accepting social distancing and lockdowns in this public health emergency is a liturgy serving the “false god of ‘saving lives'”?
Similarly with the push on the political right now to get the economy back on track. I get that. Honestly, I do. Like all of you reading this blog, I have been thinking about what it would mean to lose my job. I have one friend who has already lost his business, and another who is on the verge of it. I wish it were possible to make this all go away, by sheer force of will, and good old American optimism. But the virus does not care about our narrative. It’s not a reality show, where the plot has to resolve itself by Easter Sunday.
When you think about the choice the virus confronts us with between poverty and death, remember the title of a Flannery O’Connor short story: “You can’t be any poorer than dead.”