To publish this blog this week may seem counter-intuitive as Covid cases rise around the country and the world, but please bear with me.   I believe, even if you disagree with what I argue here, there is no harm in looking at our present situation through this social-science-based lens, especially as our Covid Response isolates and negatively impacts so many children.  “The life of the average American child today is difficult because of our national Covid response,” a director of a national agency told me this last week, “but the life of the average under-resourced American child is desperate.”

This director did not wish to be named publicly, a black woman who keeps vigilant not to contract Covid 19, but worries about tens of millions of children unreasonably affected by our national and local Covid Response.  To her mind, our present response is decimating school life—and, thus, the lives of millions of children and families, especially in communities of color and lower income communities.  Another national director told me last week:  “Online schooling is leaving most children behind, and it’s especially crushing our boys.  Some kids do fine, but with kindergartens and early grades online, we are talking about a disaster for learning and development.”

A 62-year-old who has been quite sick from various illnesses over his lifetime, I had just finished watching the Oklahoma-Texas football game when I spoke to my colleague by phone.  The game went to 4 overtimes with Oklahoma ultimately winning.  On my TV screen, I saw thousands of Americans who lived bravely on that field and in those stands, many of them wearing masks, some not, but all of them living life.   Watching that courage, I returned to a set of questions I’ve tried to articulate publicly for eight months.

Why does America choose to live in so much fear?  

Is living this way what we should be doing as a nation? 

How can we not see what this is doing to our children?

My GI team and I now train and consult with teachers, parents, and professionals mostly via online modalities like Zoom and Google Meets and will continue to do so as needed. We will also continue to follow local laws and regulations, including wearing masks.  Meanwhile, in our work, we find a huge amount of fear everywhere that shuts people into their houses, keeps children from attachment with friends, family, and peers, keeps teens from crucial social emotional development, and shutters school buildings.

This latter forces children into online education formats in which most kids do not learn as well as they would in in-person schooling, in general, and in which the consequences of 6 to 8 hours on screens per day are ultimately dire for young, growing brains.  Meanwhile, the one of the educational “disasters” my colleague referred to lies in the 25% or more of our nation’s children without an education at all because of lack of resources and lack of available, actionable online modalities.

My social science research over the decades has focused on education and child development, but certainly we can all now see beyond our own specialties to the public numbers.  The death toll from Covid 19 (SARS-CoV-2)  in the U.S. stands at 225,000 as I write this.  This is very painful for all of us, but pales, I believe, in comparison to the carnage we cause one another with the abject fear at the center of our Covid Response.  In the spring, we were supposed to shut down for a few weeks to give our hospitals a break.  Most of our hospitals were never overwhelmed in the first place–only hot spots were overwhelmed–but we did what we were told to do.

Now, what are we doing?  Is it possible that our present Covid Response is inhumane?

 

Non-Political Science

 

Because I am a social scientist not a politician or epidemiologist, nothing I say in this blog is meant to support any candidate in this election cycle, nor to persuade you against any party, candidate, or against your own right to handle Covid as you believe it should be handled.   An Independent who has voted for both Democratic and Republican candidates over the years, I believe the politicization of Covid has been detrimental, no matter which party we belong to.  The position I will present is science-based from the viewpoint of expanded science–by which I mean, not based mainly or solely based on a single thread of epidemiology, but from across the social and medical science spectrum.

In 1968, during a tumultuous time in our country, the Hong Kong flu inflicted casualties in the U.S. of around 100,000 dead, but we did not yet possess the media and social media to  scare America into an economic and educational state of being that includes significant paralysis and under service.   Were the Hong Kong flu present in 2020, its U.S. death numbers would be around 200,000 because of 1) population growth (we now far more Americans than we did then), 2) we have far more elderly persons now, and 3) we have far more obesity now.   We did not shut down our economy and schools in 1968, and we were involved in civil rights battles and wars overseas in that era just as we are now.

Covid 19 is more contagious than the Hong Kong flu so we can say contagion is one reason we have had a different response to a virus in 2020, and I would certainly agree with that–back in March.  But now?  Speaking only for the U.S., I feel like I have to say:  we were Americans then, and we are Americans now, but it feels like our American ontology has changed.

 

Ontological Questions

 

Ontology is the study of Being, of existence and reality, and it is the study of our relationship to Being itself.   During my undergraduate years at Gonzaga University in the 1970s, my philosophy professors challenged us to connect concepts of ontology and Being with meaning.  Being, reality, and the way we live our lives lead to our sense of meaning as a people, both personally and collectively.  In this context, I hope you will ask two ontological questions about fear and cost today, as our nation did less publicly with the HK in 1968.

What is best for most, or nearly all, Americans?

What is best for most, or nearly all, of America’s children?

No matter whether you agree or disagree with the direction of this blog, I hope you know that my focus is on the well being of children.   While our present Covid Response ontology focuses on number of deaths and number of positive cases now, I hope I can help people and leaders to shift our present focus to the present and future wellness of our children. To explore this with you, I need to look at the number of Covid deaths with you in some depth.

There is no denying the seriousness of Covid 19–225,000 deaths is a serious matter.  According to the CDC, people 65 and over account for 78% of these Covid deaths, with 31% of Covid deaths occurring among people 85 and older.  Each of these lost lives hits us in the heart.  Equally clear, though, now–and much clearer than in March: our most vulnerable elderly can be protected with targeted measures.  Approximately one half of Covid deaths have been nursing home and related mortality.  Elder facilities and the fragile elders can be protected via self-quarantine and protocols that are now built into their elder settings–they were not built into these facilities back in March.  New therapeutics also provide help in Fall 2020 that we could only imagine in March.  And younger people who are vulnerable–e.g. have cancer, kidney disease, diabetes, or other conditions–can self-quarantine and isolate as needed now.

Meanwhile, looking at the existing death numbers for Covid, including all vulnerable groups, and using numbers from the CDC and Johns Hopkins databases, the chance of an American dying from Covid 19 is approximately .06%.  This number is based on cumulative death numbers (February through October); our actual death numbers now are even lower on a month-by-month basis, because of better therapeutics now.  The chance of a child dying from Covid 19 is even lower than .06%–it is infinitesimal.  This latter point is crucial–Covid 19 is even safer for children than the Hong Kong flu was, operating differently on children’s systems.

Again:  whether death of an elder, vulnerable person, or child, any death must be valued and counted because its loss of life will be grieved, but every year, approximately 2.9 million Americans pass away of various causes.  Approximately 600,000 Americans die of cancer every year, and even more of heart disease.  Hundreds of thousands die of Alzheimers/Dementia.  Covid death numbers will not equal the number of cancer or heart disease deaths, or even, if counted without overlap, Alzheimers/dementia and natural cause deaths in 2020.  Somewhat morbidly, I know, I am returning to a crucial point:  do the numbers of Covid 19 deaths justify shifting our ontology of childhood and education into fear as we have?

The word “overlap” is important.  A colleague asked me during a recent Zoom meeting:   “Could it be that even our present Covid death numbers are not exactly real?”  This statistical question affects ontological questions because our sense of being and our fear of death are affected by statistics.  Because of the overlap between Covid 19 and other causes of death, the actual Covid death numbers are difficult to track.  A recent case in my neighborhood illustrates the overlap:  a man in his 70s was dying of liver cancer, contracted Covid, and a few weeks later, he passed away.   His death was actually a cancer death, but reported as a Covid death.  Accuracy of mortality numbers is important to a people’s ontology, so it, too, is worth looking at in some depth.

In a new study just out in JAMA, “Excess Deaths from Covid-19” (October 12, 2020), researchers found that between March and August of this year, there were 1,336,561 deaths in the United States as a whole, which is a 20% increase over what would normally be expected.  Some of these deaths were actual Covid 19 deaths, the researchers found, but around 30% were “disruption-in-care deaths”–deaths of people with “acute emergencies, chronic diseases like diabetes that were not properly care for, or emotional crises that led to overdoses or suicides.”  As people were afraid to go to doctors or felt they could not go because of Covid Responses, they died from their illnesses; but these are counted as Covid deaths in statistics we see in the media, not as disruption deaths.  Similarly, the researchers found that suicide and overdose deaths because of Covid Response not Covid 19 itself accounted for tens of thousands of “excess deaths.”

The recent JAMA study follows an earlier study on our nation’s 100,000 Alzheimers/Dementia deaths between February and May.  These deaths exceeded last year’s death rate for that quarter by 18%.  Initially, the researchers assumed the 18% jump reflected actual Covid-19 deaths; after more careful study, they discovered that many of these excess deaths were overlap deaths and “quality of care” deaths–because of fear built into our national Covid Response, family members who used to go see loved ones to make sure they were getting care could not go see them or take them to doctors; even nursing home staff members were isolating from the elders, leaving fragile elders un-cared for after they fell or experienced other emergencies that hastened their deaths.

In reading this analysis you might say, “Okay, maybe death rates are not as high as I thought, but what about serious illness rates from Covid, and what about hospitalizations?”  Serious illness rates from Covid 19 are actually quite low, especially with the new therapeutics available.   The CDC showed severe illness from Covid 19 at approximately 7% of Covid 19 patients (“severe” is defined as requiring hospitalization).  That number constitutes around 10 in 100,000 Americans total becoming seriously ill from Covid 19.  That does not mean the disease is not painful or, in some cases, a lingering illness.  In my own community, a 28-year-old got Covid 19 and was sick for 1 month.  He had “the worst headache and fatigue I’ve ever had, and for a couple days, I felt like I couldn’t breathe.”  Like death, serious illness from Covid 19 is real, but the actual numbers of people who are severely affected or experience long-lingering effects is low.  Similarly, only the hospitals in hot spots have become overwhelmed with Covid 19 patients.

Looking at death and illness rates is a difficult task, but it is important for an ontological discussion:  life, death, illness and hospitalization sit at the heart of human ontology.   My worry for children now is that we have expanded the death, illness, and hospitalization data in our minds to such a fever that we are living now in a new American ontology of fear.  This is an American and somewhat worldwide ontology different, in many ways, from our previous ontology (for example, in 1968), in which we balanced the scales toward policy and practices that were more fearless, and more targeted.  Yes, the Hong Kong flu and Covid 19 are different; yes, Covid 19 is more dangerous, but still, we felt less abject fear in 1968, we feel more fear now to such an extent that the fear, not the disease, is controlling a lot of our Covid Response.

My job is not to change your mind about how you handle Covid 19; my job is to raise questions for you at deep levels, questions on which child development and health depend, I believe.   If you have seen the ontology of fear rule decisions in your own school districts, now is the time to ask (even despite rising cases):  do we still want to paralyze our schools and economy with the fear?  I think everyone of us benefits from asking ourselves and our community this question, but especially people with children in school have a stake in begging our communities to take on a more child-friendly approach to our ontological dilemma.

In this context, the United Nations, the World Health Organization, and thousands of public health experts from around the world have signed the Great Barrington Declaration.  It implores governments and communities to protect our most vulnerable people with new therapeutics, mask wearing, and other strategies including rapid development of vaccines, but meanwhile, only to use school closure for very brief periods in local hot spots, not as a national or statewide strategy.  The authors of the Declaration base their new logic on the “social and economic disruptions” that are so severe now, the “cure” inherent in our fear-based Covid Response has become worse than the virus itself.

For your community and school district meetings, here are specific questions to ask leaders:

Do the death, serious illness, and hospitalization numbers really justify what we are doing as a nation, or as a city or town? 

Are we sure our school district should be as afraid of Covid 19 as it is? 

Should we deny 50 million school children a normal life, good schooling, sports, grace, connection, and a happy and successful life?

Should we condemn the economically disadvantaged in our population (approximately 30 – 40% of America as a whole) to unemployment, underemployment, and familial, traumatic stress?

Especially given the fact that Covid 19 will be with us for years, isn’t it time to look at other less options than our present Covid Response?

 

Ontology, Trauma, and Mental Health

 

An ontology of fear affects a national and local mind in part because of death and disease, but also, in part, because of a promised cure.  “We know what we are doing to our kids is bad,” we might say or think, “and also it’s bad for the lower half of our socio-economic system, but we’ll keep living this way until January when we get a vaccine.”  A vaccine will no doubt be welcome, but flu vaccines are only about 50% effective.  A Covid vaccine will not constitute a panacea.  People will still contract and die of Covid 19 and then of other future viruses.  Unless we grapple with the ontology of fear now, we will live in at least partial self-destruct mode through this January, then April, June, September…and onward.

As we struggle over ontological questions, it is important to note:  the U.S. Covid death and serious illness rates are higher than in other nations’ in large part because Japan’s, China’s, Taiwan’s, Korea’s average BMI are under 10 points–America’s is around 35.  The Covid 19 virus statistically favors obesity-weakened genetic, immune and physiologic systems.  We as a nation must look at what we eat and many of our other habits so that we can become healthier.

But still, even accounting for American vulnerability, 99% of Americans will not be harmed by this disease, while many more will be harmed mentally, emotionally, and even physically by our present Covid Response.  To dig deeper into these latter harm numbers, we need to look at under-resourced families and communities first, including the disabled, people of color, men, women, children in whose homes and communities the devastation created by our ontology of fear now includes these trauma responses:

• Severely Increased Unemployment (real unemployment in the U.S. is hovering at or near 25%)
• Increased Suicide
• Significant Educational Distress and Failure
• Hidden Child and Domestic Abuse
• Increased Poverty
• Increased Crime
• Hidden Sexual Abuse
• Substance Abuse Increases
• Alcohol Abuse Increases
• More Deaths of Despair (from isolation, both among the elderly who cannot see loved ones and among the general population, as well)
• Significant Increases in Anxiety and Depression (especially among children and teens).

The Wellness Trust, a non-profit in the suicide prevention sphere, recently published its study of Covid and Covid Response, noting that by year end we will likely have around 75,000 American suicides.  Last year the number was just under 40,000.

By the time Covid 19 virus has moved through the earth sometime in the next few years and mutated as flu viruses do, it will have killed hundreds of thousands of people, even perhaps millions worldwide.  Even with a vaccine, there will be Covid 19 deaths; and also, deaths from cancer, heart disease, Alzheimer’s, suicides, overdoses, car accidents, gun violence, crime, war, and many other causes of death.   Even with a vaccine in place, at the level of Being, of meaning, of national ontology, what should we do?   We are forced now to weigh Covid 19 deaths against Covid Response destruction, a terrible place to be in, but it is where we are.

 

Toward a New Ontology of Covid

 

When we look at protecting three categories of Americans–the elderly/physically vulnerable, our 30 – 40% of socio-economically disadvantaged, and our children–all at once, I believe a new ontology can come into view, one that will focus on living bravely.   Our compassion and empathy for those who suffer from Covid 19 and other illnesses will come from ontological power–resilience and strength, not reactive fear at case or mortality numbers.  I recently lost a friend to Covid and it hurt, and I grieve, but I also work to keep that death in perspective so that his death was not in vain.

A new ontology will face the threshold we are at now:  of needing to weigh the well being of children and families against the saving of a number of lives.  More starkly put:  we have come to a point in our history when we need to decide on a middle ground that protects children and families first and foremost, while also doing whatever possible to save the lives of our vulnerable elders.   We can do and have both, but interestingly, in my own interviews this last six months with vulnerable elders, I have asked “If we had to choose a sacrifice, which should come first in our country, the well being of children and families or saving a set number of lives?”  In nearly every case, the elder has said, “The well being of children and families.”  It is primal in us to focus on what is best for children.   Even my own father, 91, who has COPD (thus, for whom Covid would likely be a death sentence) agrees with the idea that the lives of children and families come first.  “Our children and grandchildren are the reason we are alive,” he said recently.  “Their needs should always come first.

To bolster this more fearless and more nuanced national ontology of Covid, we might look to other countries like Sweden, which kept restaurants, gyms, and churches open this last spring when America shut everything down.  People in Sweden used common sense, practiced some social distancing, did not gather in huge groups, but in-person schools for kids under 16 stayed open.  Sweden has had 6,000 Covid deaths out of a population of 11 million–6,000 deaths too many we can say, but still a relatively small number per population, and around the same mortality we have had in the U.S after and through our shutdowns, lock downs, and online schooling.

In a new national ontology, we can use good common sense on social distancing, mask wearing, washing hands, but end shuttered schools, 25% restaurant capacity, low airline travel, threats of future lock downs, and end “phasing back” business activity when case counts in the state go above 5%.   We can move our new ontology forward with appreciation for Drs. Fauci and Birks and others like them, including politicians in both parties who have done their best, while we look carefully now, as citizen scientists, at what these recent heroes got right and also got wrong.

Meanwhile, we can understand that the present CDC and some political leaders are working out of an ontology of fear that is well-meant but includes only a single thread epidemiological model–the idea that everyone’s activities must be curtailed in order to save certain lives.  When even the World Health Organization asks countries to reconsider fear-based Covid Responses that lead to “negative social, psychological, and emotional outcomes,” and our own American Pediatric Association calls for schools to go back to in-person learning, it is time for a different ontology now than we had in March.

 

Strategies for a New Covid Ontology

 

This new ontology expands existing science to include more mental health and social science, which leads to strategies and practices like these:

• Re-open schools for in person education except in a community hot spot.  Schools and school districts that do not have the funds to accommodate the present CDC public health guidelines (e.g. guidelines such as “only 10 students in a room, sitting 6 feet apart”) should still reopen without compliance, using common sense; meanwhile, mask wearing for young children is generally not necessary and creates an enforcement dilemma teachers and students do not need.
• If disease-vulnerable teachers choose not to work in the open school environment, substitute teachers must be trained, and the school system empowered to decide how to handle teachers’ leaves-of-absence at local levels.  No matter who wins our elections, funding for schools and teachers will need to be increased at the federal level on behalf of all children, and especially in states that have lost significant education-directed tax revenue from our eight-month Covid Response.
• Move from a vision of national or state-wide control of Covid 19-spread to a local one in which hot spots–indicated by significantly overwhelmed hospitals–enforce data-driven responses locally; these responses might be shut downs for two weeks or use of curfews in businesses/areas that data show are spreading the virus quickly in that hot spot, but shut downs should remain minimal.
• Pass legislation that protects school districts and businesses from law suits related to Covid 19 spread.
• Build and re-build America’s health care infrastructure so that every person in America has health care available.  This is especially crucial now with so many bread winners newly unemployed–we need a national health care system in which both public and private options are available, such as Germany has, so that people who have assets and want health care through businesses can get it, but people who want it through government can get it there.
• If you are involved in nursing homes and similar facilities, continue to follow protocols that allow a single visitor per resident (a tested family member who can check on patient care), and until the vaccine is available, remain protective of nursing home residents in ways similar to those practiced now.
• Across the country, allow anyone who is vulnerable–e.g. people with cancer, the elderly, people who are obese–to self-quarantine as they feel they need to, which assures them freedom of choice on how to live their lives personally, and ontologically.
• Test everyone at various intervals even after a vaccine is devised, especially if the Covid 19 version of the virus mutates.  As testing occurs, remember that some tests lead to false positives and false negatives—yet, still, testing, contract tracing, and self-quarantine of the infected are crucial steps in moving beyond our fear-responses into a more broadly life-, education-, and economy-sustaining ontology.
• Lobby media and others to stop publishing infection rates as top stories but instead to report on local hospitals if these hospitals get significantly overwhelmed with cases–this is a key factor in understanding where hot spots exist; the total number of cases is mainly just a fear-inducer and not necessary for accurate national response to Covid 19.
• As needed in hot spots, deploy the military and other assets to build field hospitals, extra beds, an extra wing for Covid patients, and to otherwise aid heroic hospital and health workers with adjunct health personnel until the localized crisis is over.
• Deploy all useful therapeutics, and when a vaccine is proven effective and safe, deploy it everywhere possible, but also assume that it will take time (some experts believe it will take around a year) for the American people to fully trust a vaccine; this is normal, and not a reason for national divisiveness or violence against others.
• Push back on public health officials who have set a “less than 5% infection state wide or city wide rate” or similarly low rates for reopening and upward-phasing; discuss in your communities that these rates are too low for the reality of this virus’ contagiousness, and largely negate our ability to tend to the ontological needs of our community’s children.
• Masks help slow the spread of the virus, so until a vaccine is available, please wear a mask if you are sick or have been around anyone who has or had Covid 19 recently; some national re-education will be needed and should be funded so that people completely understand how masks do and do not help us; if in doubt, wear a mask in small spaces (e.g. grocery stores) in which you do not know the people around you, at least until there is a vaccine in place.
• Let social distancing be a personal practice and avoid as much as possible the shut down of any school, sports team, or workplace because of the existence of Covid cases; self-quarantine and other methods can be used and the operations continued courageously and with common sense–this vision targets hot spots for significant virus-spread-control, but allows everything else to keep functioning as best it can for the sake of everyone.

These strategies do not remove common sense safety protocols, but also acknowledge, as one community leader told me recently, “We can’t eradicate the virus, so we have to learn to dance with it.”

These are also strategies–and a new ontology–that will be useful not just for this Covid 19 virus, but for other viruses that emerge and mutate over the next decades as climate change releases viruses throughout the globe.

 

Forward with Courage

 

If we do not develop a new ontology–if we continue as a nation the way we are going–our national debt will far eclipse our GDP which will have dire consequences especially for our lower income people and our children.  We will continue to neglect building state and local tax revenue streams that are essential for taking care of our citizens.  Our schools will continue to be understaffed and our students underachieving.  We will likely continue social distancing and even partial shutdowns for months or years, keeping small businesses shuttered, and our poor will get poorer for decades.

Some of us remember the Y2K panic which unnecessarily sucked away precious national dollars that could have been spent on more important things.  After 9/11, we were so afraid of the existential threat of Al Qaeda, we succumbed to people in power who pushed agendas that, in some ways, attacked our democracy at its core.  Now we are battling a virus and the same thing is happening–we are self-destructing.  Covid 19 can be dangerous, just as Al Qaeda was, but the ontological question we face again now is similar to what it has been in every past battle or panic–what do we want American life to be?

Can America continue to thrive when its people have been trained to fear a monster that is not a monster to 99% of Americans?

I hope you will put the monster where it belongs–into a significant place in our national consciousness where diseases go, but not a place that destroys children’s lives.

Let’s give back to our children and families the world, the education, the socialization, and the mental health they deserve.

 

–Michael Gurian