The Invisible Plague
Images matter.
I am a data person.
I gravitate towards aggregated measurements. I use words like ‘gravitate’ and ‘aggregated’ when I do it.
I am delighted when these measurements explain something useful. I complain when they are incorrect.
Sometimes the complaining has been loud, and then someone writes about me in the newspapers (well, these days, mainly my collaborators — but I am there, somewhere, in the background, and that matters more to me).
My personal plague management plan has been entirely derived from raw data. I have traveled, frequently and somewhat unwillingly, for the last ~15 months. This travel has been between US states where my rigidity around human contact and hygiene is yoked to my risk of exposure.
For bad times, the ‘self-care’ was quite rigid:
- take flights as early as possible, before the airport terminal (a much higher risk than the plane itself, in my estimation) fills up with slack-jawed divs who chew with their mouths open
- double masking well before it was cool (primarily to ensure that an N95 mask does not require adjustment over time)
- learning to fit an N95 properly… they are not at all comfortable
- the ‘drop and flee’ maneuver — checking bags, then waiting outside the airport before passing through security and moving to the gate only when necessary
- never eating or drinking anything in an airport or a plane, ever
- skipping breakfast, and more crucially for me, coffee, in order to never use an airplane bathroom
- going to a closed airport terminal to use the bathroom rather than use a busy one the single time I got caught out
- if all else fails, drive
Even as the paranoia of my own personal plague journey ran down over time (right after the second Pfizer jab, for some reason), I think my record stands up well — 30 flights, 13 PCR tests for work, 6 PCR tests for fulfilling Massachusetts travel guidelines, one scary 2am trip to a hospital, a variety of scenarios that I would avoid given the opportunity, some second-hand exposures, and zero infections.
All of it, informed by data. The JHU COVID tracking website. The state and city numbers. The effectiveness of HEPA filters. The air volume of a 737–800. The analyses of particle-borne and aerosolized viruses. The analyses of superspreading sites. The amount of quarantine time necessary between an exposure and the PCR detection window. The interlocking titration between all of the above. And the humility to know when I did not truly know.
I don’t want to argue with anyone about the supportability of any of this. It felt rational at the time, as some of it was definitely appropriate for risk assessment, and it delivered a sense of agency.
It was also exhausting.
And throughout the entirety of it, I never saw a single person cough.
They’ve started coughing again, recently. I’m sure it’s normally just a tickle in a throat, or piece of dry pretzel. But I promise you, because I actually kept track of it, I didn’t hear a single public cough from the start of the Plague through the next calendar year.
But: I swear I haven’t even seen a video of a person with COVID cough. Not one good solid tussis, anywhere. No visible forehead sweat, no pallid cheeks, no pale and wan bodies.
And no dead people. Six hundred and eighty thousand dead people have passed me by invisibly and in silence.
I know they are there, because the numbers make pictures in my head. Traincars, lorryloads, conical heaps, of very real very dead people. Forests of corpses. I hear their whispers in the testimony of others — scientists keep big networks, and many people lost collaborators. Unfortunately, also, there were deaths within my extended family.
These deaths, second and third hand, were text messages and Twitter DMs and phonecalls and emails, and always sanitary. While these human costs were very real, I never saw them either.
Because we’ve seen, and I cannot overstress this, fuck all.
There have been a lot of contenders for what we’ve fucked up most during the Plague. Between the CDC, the WHO, national policies, state policies, local policies, a parade of scientists who have utterly disgraced themselves and will remain on my personal shit-list until the heat death of the universe, vacuous twats who discovered R in a corridor last week and decided they were infectious disease modelers, anti-vax weirdoes, herd immunity creeps, ‘natural cure’ loons, the Vitamin D dupes, the unmitigated fuckhammers behind the GBD, the hydroxychloroquine zealots, the 5G dafties, the zinc kooks, the ivermectin clowns, the actual no-shit plague deniers, the rogue MDs who should not be struck off the medical register as much as just struck, and every other half-pint two-bit dimwit dipshit groinhandle with an opinion louder than their shirt, there is a lot to be ashamed of as a species.
Yeats has run through my head a lot: “The best lack all conviction, while the worst are full of passionate intensity. Surely some revelation is at hand, surely the Second Coming is at hand.”
The only problem for old Willy B is that this is how the responsible dissemination of evidence works. The best have plenty of conviction, and have to run it in parallel with the generation of a knowledge base according to best practices. The best are titrating their public statements and opinions according to observations gathered naked on the seashore during a ruinstorm. Almost as if they expected to be judged by their commitment to responsibly telling people how to live their lives.
The worst, on the other hand, couldn’t give a hot buttered fuck and experience nothing beyond a blinding and selfish commitment to their own ridiculous convictions, and neither the willingness, intelligence, or imagination to ever question them. At their worst, they consider mass death as yet another good opportunity to put their hand in your pocket. Digitally-enabled graverobbers, thickjobs, worthless miserable bastards every rat Jack of them. Plague Quislings. These people would do a TikTok dance on your grave for clicks. Not content with the myth of the Jikininki, we took blind narcissism and digital space, and invented them again.
And yes, I think there is a better contender for the worst mistake.
And it is that there was no concerted effort to let us see COVID.
Every newspaper article, Twitter thread, anecdote, from some poor benighted attending or RN who will need counselling from now until they’re mercifully old enough to forget everything else as well starts:
I wish you could see what I see.
It will contain a harrowing depiction of what an ICU at 100% capacity looks like, feels like, how it makes you act. But — for obvious reasons — no photos, no video. And while the reality is presented, it is abstract.
It’s an idea I encountered well over a year ago, in this excellent essay from Sarah Lewis. I’ve thought about it about once a week since I read it.
Few things have resonated with me more than this:
Yet as we see cities shuttered and roads empty, I will remain focused on the absence of something else — a representative, visual archive of the staggering human toll of the crisis from which might emerge, in time, our emblematic pictures. For society to respond in ways commensurate with the importance of this pandemic, we have to see it. For us to be transformed by it, it has to penetrate our hearts as well as our minds.
That was May, 2020. The issue did not go away. It’s either six weeks later or about ten years, by now. My internal clock is bollocksed.
This much longer piece details the mechanics of how photojournalists lost (or never got) access to images of death and dying, and how this particular suppression was managed. Briefly: a combination of new guidelines around the dissemination of personal health information, and — far more importantly that the guidelines themselves — the general response to them by hospitals.
I strongly advise you read these two articles. This will still be here when you’re done.
So.
The consequences.
Science and Policy
If you get wrecked on barleywine and drive a combine harvester through a daycare center, you will never see daylight again. They’ll bury you under the prison when you die in it.
If you make a poor policy decision that kills 5000 people, well, nothing happens. Unless, by some miracle, people remember and vote for someone else.
The reason is that those deaths are projected, modeled, or as otherwise calculated after the fact. There are no crime scene photos of a bloody combine harvester clogged up with tiny shoes. They are not the proximal deaths of a bloody claw hammer, they are distal deaths, removed from the decisions that produced them to such a degree that it is trivially easy to avoid their stain.
If someone accused me of occasioning mass death, and I was acting in bad faith, I would simply:
(a) produce a competing model that says 5000 deaths was actually 5
(b) find a mitigating or competing factor the model did not account for, and yell loudly about that… if an empirical response is provoked questioning this logic, pick another and repeat ad nauseum until you are not in trouble
(c) pick a real or perceived bias of your accusers, and beat them around the head with it
(d) claim your own moral high ground, assert the fact that given (a) through (c), it is disgusting to produce rampant speculation and play the ‘blame game’ regarding something so serious, especially if it is still going on
Easy. Mischief managed.
These sorts of disputes are usually hard to interrogate. That process requires specialized skills, combined with aggressive skepticism, boldness, and time. They also require you to play a disconnected game containing an unstated and sometimes unknowable amount of sophistry, where you deal with competing abstractions.
This disconnection can be extreme. Take something like the Great Barrington Declaration. It is a serious policy proposal to kill millions of people. I saw precisely zero serious public health experts accept it, and about one hundred get incandescently angry at it. At this point, it’s a titular example but also just one proposal amongst many which builds a house of evidence on very thin foundations.
But the point here is not this ghoulish deathmarch dressed in the finery of tenure and respectability: it is that we can all ballyrag and annoy each other about it, in the absence of having to see images of the consequences. This all happens with no context, no urgency borne of tragedy, no weight.
<- No. They don’t.
BUT ALSO: they may also have never have seen one by any other means.
Denialism
You might think it was a challenge for the more furious denizens of Samtown to deny or dismiss 680,000 deaths, that it requires a special kind of Class IV tribalism, or a peculiar point in history where unconstrained digital connection enables that tribalism.
Or maybe some kind of head injury. Pick your poison.
I don’t want to get into the weeds on this one. I would simply assert that the raw audiovisual material containing the dirge and shambles of the last eighteen months might have done a better job than we all did, with our facts and other such impertinences, to out-compete false digital realities.
Often those realities were desperately thin — out of context images with Impact text about some perceived conspiracy or slight thrown over the top. The conspiracy memes don’t even agree with each other: COVID is simultaneously a hoax, but also real but not dangerous, but also dangerous and only combated by vaporware drugs.
As per typical, the only laudable thing about these is that they make great source material for twelve-year olds making much funnier counter-memes.
These days, the collective frustration at this unending metastatic stupidity often spills over into true ugliness. For instance, you can often find your local Professionally Sensitive person competing to make the best “fuck around and find out” joke about bleak situations like this:
There’s a whole subreddit about this, the Herman Cain Award.
I warn you: this isn’t just dark, it’s pitch black.
I do not have the same read as the author, but the facts are true.
So are the bodies, that none of these Herman Cain Award winners never saw.
Conclusion
I don’t know. I don’t know how to finish this.
I’ve been in internecine wars about numbers and abstractions for the last 15 months, and now I feel — very acutely, really painfully — the absence of the images than they represented.
All I know is images change you. That they hack context. I remember places I’ve never been to and times I’ve never lived through because of the acuity of some brave soul’s representation of how they look. The unremitting plastic ugliness of an early hospital death from metastatic cancer. The vastness of space, the My Lai massacre. The Somme, Passchendale, Iwo Jima, Okinawa. Documentaries from North Korea.
And those having nowhere near the significance of the images I saw live — the fall of the Berlin Wall and 9/11 come immediately to mind.
We did a better job at capturing the collapse of the Arecibo Observatory than the entire health care systems of the world around it.
And I can’t shake the thought that this is our biggest failing of all, never truly attempting to make it real. Piss, blood, vomit, and shit real. Grim real. Genocide real.