Sunday, June 28: Spirals

It’s going to be a grievous summer for the remainder of the remnant of the United States. Those of us who have closely followed the daily ups and downs of New York State’s statewide and local COVID responses over the last three months, are having a queasy feeling of deja vu as we watch what’s happening — or, sadly, failing to happen — in the “hot states” of Texas, Florida, Arizona, and more to come. We’ve now joined the international club of onlookers — Singapore, South Korea, Italy — who have walked over these same hot coals, who tried to warn and advise. Voices who were ignored by many Northeasterners, with the same flounce of exceptional petticoats that we have seen from the red states this past spring.

It’s a sad club to be in, and the price of admission was devastatingly high. But here we are, watching it unfold all over again:

The overall New York State story, aside from the hideous death toll that struck New York City and nursing homes (and that scandal must not be allowed to drop), was somewhat better than it had a right to be. The lack of real connection between upstate and downstate helped spare much of the state from being overwhelmed, yet everyone heard the same messages from Albany. Unfortunately, national and even statewide media coverage barely picked up on either the troubling regional failures (the situation in WNY is still distinctly different from the rest of upstate north of the Catskills) or successes.

I may be biased, but I think Onondaga County and CNY was one of those regional successes. I’ve previously noted the term “virtuous spiral” as an opposite of a “vicious spiral” — a pattern where good decisions lay the groundwork for future good decisions. While the jury is still out on the efficacy of the local economic response, certainly the public health response to COVID in CNY has been in a virtuous spiral. This has been a coordinated effort between elected officials, hospital and educational leaders, and of course, the public. However, this spiral did not begin in March. There were other local roots of the spiral — such as city and county governments that have learned to cooperate in recent years; newly elected leaders with energy and ambition; and, it has to be said, a toughened, mentally hardy population that has been winnowed down to either those who are really committed to being here, or those who have no place else to go. (That part took decades of economic pain to create.)

But Onondaga County’s testing situation, back in March, looked a good deal like the Florida example above — one drive-through center operating at full tilt (for symptomatic patients only) and a hodgepodge of hospital and private clinics running tests. Delays in results were 7-10 days, not the 24-48 hours we enjoy now. The threat of data pollution was constant. Confusion about mask-wearing, if not exactly outright resistance, was widespread. (And that was before all of the nursing home shock and reopening phase drama started…)

It’s not as if a “virtuous spiral” means smooth sailing. It just means that you are more likely to make optimal choices at critical decision points — and sometimes those critical decision points aren’t clear.

Right now, in the “hot states,” there are stories we’re not hearing about. There are many, many citizens in these states who are doing their best to find out about and follow what was learned in Singapore, South Korea, and New York State. Unfortunately for them, their virtuous spirals are likely confined to their own households or — if they’re lucky — their municipalities or counties. They might have sensible governors, or they might not. There is probably innovation and smart decision-making at these local levels that would benefit everyone else in a second wave (including us here in New York). But I’m afraid we won’t hear very much about them. It is doubtful that the national media will end their obsession with the idea of covering “the national response” (there is no national response, and, where meeting this crisis and perhaps future ones are concerned, there is no nation).

Onondaga County recovered from these early challenges with testing availability — much of the daily briefings in March and April were taken up with the nitty gritty of how to develop a network of labs and how to keep rogue labs from poisoning the data well. In May, the fight was to establish a mobile testing practice to combat institutional spread, for those lessons could later be applied during expected reopening phases. The daily county briefings did much to make the public understand the entire process of setting up a COVID-fighting infrastructure (in itself, a vital part of the virtuous spiral enabling the all-important public buy-in for future initiatives).

At some point, however, we will probably begin to see whether or not — or where else in the U.S. — virtuous spirals will begin to form, and where vicious spirals will become apparent. Some states and localities may surprise us. (Who expected New York City’s response to be so inept, who expected Buffalo to lag so far behind, and who expected the North Country to not, in fact, go into fullscale riots over masks?) In some of these states, the current challenges over testing will find quick solutions. Others will just spin their wheels even deeper into the mud of political polarization while the refrigerated trucks line up.

What happens this summer will determine more than ever the separate fates of the United States. A virtuous spiral, wherever it may be happening, is definitely one curve that we don’t want to flatten.