I study public health and I have no idea how long this crisis will last, how many people will die or what our world will look like after this. I didn’t know when I started my MPH a year and a half ago that I would be graduating into a pandemic and recession. But I do know that we have choices.
Epidemiological models can’t predict how we will respond to adverse conditions; they can only make assumptions and give us outcomes. All that remains, apparently, is a stark choice; either a police state emboldened by new emergency powers, where healthcare continues to be a restricted commodity, or a rejection of the long-believed lies of neoliberal economics in favor of a new vision, a new world that values human life enough to put human needs first by redistributing wealth and providing healthcare for all people.
This crisis has laid bare the duct tape and fantasy that holds the country together. Grocery store workers and delivery workers have become a frontline defence for society, who receive thank yous from government officials instead of $20/hour and a union. In New York City, death and infection rates are coming to mirror existing inequalities, as if the cure for coronavirus were simply money. The pandemic is not the great equalizer that Governor Cuomo claims it to be; in Michigan and Illinois, black people are disproportionately facing higher rates of COVID-19 infection and death. A landlord hoards an entire empty hospital in Philadelphia. The virus is raging through the prison at Riker’s Island.
I fell into public health rather haphazardly. I applied to three master’s programs: one in communications, one in narrative medicine and one in public health, with eventual goal of going to medical school. I didn’t really have much of an idea of what public health entailed—a pretty lackadaisical way of applying to graduate school, in retrospect. But I knew that I wanted to study and contribute to the public’s understanding of oppressive systems like incarceration, the deportation machine and the drug war. I began to study and write about opioid-related overdose and harm reduction, a subject deeply concerned with death statistics. This crisis has touched every city and town in America, with Black people in Baltimore and white people in West Virginia sharing the same grief. Even as a researcher one is in touch with heartache; being in the world of overdose prevention one learns a lot about death in a society that does not seem to care that in 2017 nearly 70,000 people died from drug overdoses. There hasn’t been a flattening of the curve of these deaths. There have been dips, but the deaths are still in their thousands, many every day.
I’ve also seen that frontline workers and people who use drugs, despite the dire state of things, continue to organize to protect each other. Frontline workers save lives every day in needle exchanges and supervised consumption sites, and unions for people who use drugs have been fighting to open these sites across the country, in a nationwide move toward a less carceral, more health-centered approach. These people are saving lives in the present, even though no one knows when the overdose crisis will end exactly. There are no curves or projections or timelines, but every life matters.
On rainy days, I’m confined to the house, which seems to amplify the doom and gloom coming from the newsfeed. But otherwise, every morning after my coffee I take one of my two daily walks alongside the Seekonk River, which separates Providence from East Providence. I usually go just after 10 or 11 in the morning, and then in the late afternoon, between 4:30 and 5. At this time of year the river is still devoid of the geese and ducks we will see in the summer time. There are a few people walking on the path at any given time, far enough apart for it to not pose any real risk. The stillness of the river, the presence of the abandoned train drawbridge, its tracks stuck pointed to the sky to allow for boat traffic below, are reassuring constants at a time when all the statistics—the death rates, the projections, the models—are in flux.
I am starting to get tired of discussions about predictions and models. Everyone has become an epidemiologist, interpreting early studies or coming up with models of their own. No model is completely predictive and some models are full of horseshit, but it seems they’ve all been interpreted for one primary purpose: to determine how bad the crisis will get simply in order to predict the earliest date we can “go back” to our lives. This is an understandable reaction, we have all lost a lot, and very suddenly—but it’s a bit callous. How soon? How many dead, how many infected, before we can put this “behind us”? Modelling can serve a purpose, to get us to understand how serious things are now, and how bad they can potentially get; but for now there’s more focus on the light at the end of the tunnel than on those who will die before we get there. I get that it is terrifying; I’m graduating into a very precarious and uncertain job market. But we have to accept that we are in this for the long haul; not only will this mean a few months of social distancing, it will mean that our lives will not be the same. Are we prepared to take care of each other, through this crisis and beyond?