Do Better Better #4: How to Pass A Test

Are you ready to be tested?

To put it all on the line?

Are you confident in the choices you’ve made?

Since the beginning of time, policy experts the world over -- and armchair generalists like me -- have fought back and forth about economical, political, medical, and fiscal policies, often enacting them in one administration, only to see them completely reversed in the next, and just a few years later.

Politicians, business leaders, and their advisers make decisions and then act on them, as we all do for ourselves, our families, and our own businesses.

We read reviews, look at charts, go for test drives, make investments, rent instead of buy. The results of some of those policies, sometimes but not always grounded in math, are clear right away.

But a lot of times, they aren’t.

In the past, that’s often been because they didn’t affect enough people, or they affected some people differently, or we didn’t give them enough time, or because the people who enacted them tried to twist the outcome.

But this virus, by its sudden onset, its novelty, and its universality, has been a litmus test against a single moment in time, a measuring stick, a report card for not only our beliefs and values, but most vitally, the macro and micro practical choices we’ve made and that were current in early 2020.

It has been a once in a generation chance to ask and find out exactly and immediately the answer to: “What does X policy do?” It was the ultimate collective nose swab.

You’ve undoubtedly experienced similar non-COVID moments, from fender benders that test your insurance, to PR fiascos that rewrite entire careers, a child’s injury, or a basement flood. These moments often bring an immediate lucidness, they assess our plans and choices in ways nothing else can.

I want to be crystal clear, because this is something that is somehow still poorly understood: these tests, our global COVID test, and the one you got from your doctor or at Dodger Stadium, do not tell you whether you have the virus right now, as you’re reading this.

They are a measure of whether you had the virus at the moment you took the test. They cannot indicate anything further into the future, but are, in fact, a measure of the past, of the choices you made in every moment leading up to the nurse unwrapping the swab, or you spitting into a bag.

On a much larger scale, the policies in question (and the math behind them) when COVID hit varied enormously across two hundred-ish countries, but eight months in, all considered, many have had the same result: Preventable deaths. (This is where I would use a “we didn’t wear seat belts” analogy, but in fact the more accurate correlation would be “we only gave seat belts to the white people in the car.”)

The policies most obvious to include (but are certainly not limited to) are:

• Air pollution that has, by design, disproportionately affected Black and Brown lives in America, and the poor here and everywhere else, and resulted in some of those pre-existing conditions above

• The widespread disdain for science and experts

• Health care systems that reward gains, and thus emphasize treatment over prevention

• In America, health insurance tied to employment, the increasing prevalence of low-wage jobs without benefits, and a health insurance marketplace neutered from the start and sabotaged ever since

• The decades-long, simultaneous unaffordability of healthy plant foods and sweeping abundance of affordable processed food

These are incredibly complicated issues, but if we take a big step back, one thing unites them: their results were inevitable.

Look at it this way: this virus of ours operates on the surface level with some pretty basic math. As far as we can tell, nobody had immunity. Nobody. Maybe that changes a little bit as we dig into a trillion gallons of bloodwork and antibodies from existing coronaviruses, but for now let’s round down and just say it seems like we were all starting from — at least — zero.

Who’s susceptible? Everybody. Pretty straightforward.

On the flip side, our single weapon to fight the virus was just as simple. Stay home, and stay away from one another. We didn’t have a vaccine, or a treatment. We had one move, and that move could have been, and proved to be (in the select cases where it was employed), devastatingly effective.

Why?

Because a virus isn’t really a living thing (by most accounts), which means it needs a host to survive. That’s you.

So — to summarize, again, in the most basic explanation of all-time for a pandemic: humanity faced a brand new virus that everyone on the planet was vulnerable to, but since a virus requires a host, if we all stayed home, it would have nowhere to go.

Control what you can control. Forget all of our other policies and values. Just stay inside.

Got it.

Let’s move on. Because it’s time to factor in our first policy, official or otherwise, which is that many people couldn’t stay home, because of work or other necessary obligations. Of course there were and are others that simply chose not to stay home, but you can read about those morons in On Purpose #3: On Exceptionalism.

So now our virus had its choice of new hosts, and it spread quickly, because:

1) it's airborne

2) it loves enclosed spaces

3) half-ish of those infected with our new virus had no idea they were infected, thus spread it unknowingly (This was the point where everyone who got to and chose to stay at home started watching YouTube videos about exponential math.)

And then our societal and economic choices really came into play on test day: large segments of the new hosts lived in multi-generational enclosed spaces, and -- not only did they not have immunity like the rest of us -- they were in fact in a vastly more precarious position: they had pre-existing health conditions that made the subsequent disease more dangerous, and for many, fatal.

Those conditions have most often been obesity, cancer, kidney disease, something respiratory or cardiopulmonary, diabetes, and asthma, among others. Our policies created these conditions.

Because of the diversity and volume of humans with one of those pre-existing conditions (and often a combination of them), our virus, once incubated, has tormented and killed in some truly surprising and expansive ways, from heads to toes.

And virtually all of these deaths are the direct result of choices we’ve made as a society. Even the best prepared countries have suffered and were going to suffer (again, no one had immunity), but I don’t think I need to go into comparisons here.

We chose to put particular people into office, to regulate some industries and not others, to buy certain products, and to implement certain policies. And then those choices were tested, and we failed.

We have been exposed. As Ed Yong so eloquently put it:

The virus showed up, we didn’t stay home, and so all of our other choices were made bare and exploited.X + Y = almost a million deaths, equals millions with second and third-order new conditions for the rest of their lives.

And recall: these were the starting conditions, the choices that increased our vulnerability to the new virus. Half a year later, things haven’t gotten better: all these resulting conditions are very much still here, but large groups of people won't stay home, and much less wear masks.

In a world where half the hosts don’t even know they’re hosts, this is equivalent to not using a shark cage in cloudy waters, when no one’s even making you go in the water, and when you can afford a cage. Just because you can’t see the shark or don’t believe in sharks doesn’t mean a shark will not eat you.

We’re not out of the woods yet, but it’s time to move on from what verifiably didn’t work, to identify what’s baked in, what’s linked, and how we can plan and execute better.

To be clear, these weren’t just failed Trump policies. Humans have been at this game for a very long time. We’ve made so many strides (use a spear to hunt!), and ignored so much else (too much sugar kills you!).

It’s 2020. A white guy from San Francisco can sequence his genome for $200, but broccoli is prohibitively priced for a Black mom everywhere.

The climate crisis is here, and we caused it, and it will get considerably worse for every second we don't radically rebuild our world.

How will we design our policies going forward to incorporate everything we have learned, 200,000 years in?

And not just in preparation for our next test -- be it climate change or the antibiotics drama -- but in facing the current test that we are presently and resoundingly failing.

We have made so many incredible strides as a species, as a society — poverty is so much less than it’s ever been, hunger and disease are the same. But for all of the progress, and all of the time and collective effort required to get us there, that was just the low-hanging fruit of history.

This year has tested you personally and professionally. Your relationships and bottom lines have been tested. Everything was tested. What didn’t work?

How can you build more robust, more transparent, more transferable and responsive policies and systems starting now? How will you plan for your next basement flood, your child’s return to school, your next annual review?

You can’t prevent every fender bender, but you can research the best insurance and not text and drive. You have more data than you’ve ever had before. We are all starting from square one -- at best. Use math you understand, but do a full evaluation of what you’re exposed to. Don’t protect a pawn only to leave your queen vulnerable later.

Ask better questions, dig deeper, review your results more often, and don’t be surprised the next time life asks: are you ready to be tested? Because ready or not, the tests will keep right on coming.

-- Quinn