Covid-19 presents some ethical perhaps even philosophical questions, a rational exploration of which is the purpose of this post. We will quickly see that the needs to stop the disease and continue living create an unavoidable paradox, and that’s where we’ll start the post.
Next, we will digress into information to convey at least my understanding of virology to enable discussions of potential methods for control and prevention, and to lay bare my thinking.
We will then return from the digression to a more complete discussion of the paradox, steps we’re taking, and who decides, followed by concluding remarks.
Until effective treatment or preventative measures such as vaccines are available to combat this virus, our response has been necessarily limited to one of attenuated transmission rates through quarantine, distance, sanitization and obstruction of infected airflow. The up to two-week latency in development of symptomatic immune system response as well as the broad spectrum of case severity confound outbreak control by obfuscating specifics, perhaps even modes, of transmission. This lack of direct and obvious even perspicuous cause-effect relationships combined with political sensitivities and fear of inducing panic has, in my opinion, led to inane stances by some and harmful guidance by others. What, exactly, is good guidance, then?
From a societal perspective, one element of good guidance must be the availability of care for the sick. While there are no specific treatments, it is clear that hospital care does indeed improve survivability for those badly afflicted by Covid-19, and that we should endeavor to be in a position to provide that care to everyone who needs it. Therefore, a metric to be closely watched is the number of available hospital beds, the staff, and the equipment to support them. This has direct consequences such as postponement of optional surgeries to increase the number of available beds, however, in some cases this creates an ethical dilemma inasmuch as optional surgeries include those that provide mobility and alleviation of severe pain (such as joint replacement surgeries).
Further complicating our course is the necessary liberty to engage in activities that earn money, educate the young and old, and pursue and find happiness at some reasonable level. I am able to work from home during this pandemic; most people are not. The need to feed one’s self and family, to pay rent, utilities, medical costs, to buy food, and on and on are necessities of life that are not suspended during a lock down or quarantine. Likewise, the people to whom the bills are paid and who produce products of necessity cannot be indefinitely shut down without societal collapse. We must understand that these are much more than economic concerns, they are basic need concerns of shelter, food, medical care and, let’s not deny it, toilet paper. Our response towards these ends has been an abject failure disproportionately impacting, of course, the poor, the person living paycheck to paycheck, and those in significant debt.
Those two elements: limiting disease spread to maintain availability of medical care and liberty to sustain life in the pursuit of happiness create the paradox of apparently contradictory aims now gripping our world.
What, exactly, is a virus anyway?
Since the dawn of human writings on earth, we’ve debated what it means to be alive. That debate continues as we’ve understood the Virus, the Prion and other interesting things on earth that are at the threshold of what it is to be alive.
The term virus is a general description for an organism on the threshold of life that neither has metabolism nor innate reproductive capability, therefore the term organism may not be correct yet is used because the virus does convey and replicate its specific genome. Moreover, viruses do indeed evolve through natural selection which is how a virus can “jump” form one species to another.
A virus is in three parts: (1) The virion which contains the genetic information of the virus (RNA or DNA depending on the virus), as well as other proteins, acids, and substances necessary for the virion to be active. (2) The capsid which is a protein encasement surrounding the virion. Most capsids are very small, ranging from about 0.02 to 0.4 microns (millionths of a meter, corona is on the order of 0.1 to 0.14 microns in diameter). Compare this to bacteria which range in size from 0.3 to 5 microns and human cells which range in size from 2 to 120 microns (the ovum or human egg is 120 microns). (3) The virus itself which only exists after the capsid has attached (akin to docking) to a compatible host cell, facilitating virion content introduction, and the resulting takeover of the cell to metabolize and reproduce the active virus.
The virion is the agent of infection. It is only able to interact with very specific host cells, usually limited by host species and cell type, for which it has the “key” to “dock”. Once docked, the capsid is breached and the contents of the virion enter the host cell through various biologically complex means. The virion then uses the host cell’s internal structures and metabolism “nourishment” to reproduce its own genome, create virions complete with capsid encasements, and repeat the cycle most often until the host cell bursts freeing many more virions into the host cell environment.
First, let’s address some terms because they are confusing, overlapping, and debated so my use needs to be clear. There are two basic strategies involved in dealing with organic threats: Poisoning and Disruption (my term).
- A poison, in my usage, is a substance that causes metabolic malfunction leading to, in most cases, the death of the cell or organism. Antibiotics are a selective poison.
- Disruption, in my usage, is a substance or process that creates irreparable damage to a cell or organism causing the death or inability to reproduce of that cell or organism. Concentrated alcohol disrupts protein structures and cell walls. Bleach disrupts cell walls. Both are also called poisons or poisonous, but in this post I’m after the method of action, not the terminology. High heat, for instance, is very disruptive, that’s why it works. Ultraviolet radiation and other means can also disrupt airborne infectious agents including virions.
In sanitizing anything, we seek to remove or deactivate the infectious organism from the local environment, be that the outside of our bodies, surfaces, food, or the like. There are, as you will have guessed, two strategies: Poison and Disruption, like rat poison and a rat trap (or a gun loaded with rat shot) if you will. As we will see with treatment, the process of sanitization is necessarily limited to strategies that do not destroy the item to be sanitized, or that require the proper disposal of such items in lieu of sanitization. Good old fashioned soap and water does a pretty good job of reducing contact infectious agents including virions, by the way. Friction in vigorous washing also mechanically disrupts species, so even without “sanitizer”. Robust hand washing is helpful, and generally more effective than simply using hand sanitizer. In some cases, warm water aids in disrupting the capsid.
Our virus is not like bacteria and fungi, however. It is not capable of growth (reproduction) without target host cells, so the notion that viruses somehow increase in crumbs and foodstuffs and “dirt” is inaccurate. What is accurate is that a person with a viral infection is more susceptible to bacteria and fungi that do grow in such places and with such content to feed on. Moreover, virions exit a person in various ways, mostly including droplets that are expelled through cough or sneeze. We should note under sanitization that most virions are, over time, disrupted by air from which the droplet protects the virion. Air (notably, Oxygen) compromises the capsid over time, in most cases, through oxidation and other forms of degradation disrupting the virus. How long this takes depends on the capsid and therefore the species.
The primary means of sanitization, aside from hand washing, is the use of chemical agents that disrupt the cell (bacteria, fungus) or the capsid (viruses). These include concentrated alcohol, chlorine containing bleach, in some cases hydrogen peroxide, and many other agents as are recommended by the authorities. Heat is also a very effective disruptive element provided that the correct temperatures are reached; this is impractical for most applications.
Stating the obvious, such agents are disruptive to just about everything, so consumption of those agents in concentrations required to disrupt infectious diseases will disrupt the host cells also. Consumption of such agents is dangerous and deadly, except as tested and advised by the authorities. Chlorinated water, for instance, does disrupt certain organisms in our drinking water (and swimming pools).
The primary treatment for viral infections is the awakening of the human immune system to attack the invader, and keeping the patient’s symptoms under control to facilitate a robust response. This requires attention to all secondary opportunistic bacterial attacks as well as symptoms produced by the immune response that endanger the patient.
The human immune system targets complex protein (and other) signatures identified as invasive. It essentially has a book of mug shots and goes after known bad actors (or pollen if you have allergies). When an attack occurs, it takes some time for the immune system to publish this mug shot. Vaccines work by providing a harmless version of the invader to put the mug shot in the book and accelerate the human immune response to invasion. Likewise, treatments involving blood cells from survivors of a disease essentially put more cops on the beat armed with that mug shot.
Antiviral drugs are also used to treat specific viral genomes or spectra of genomes. The strategy is to impede the life cycle in one of several areas: attachment (“docking”), dissolution of the capsid to allow entry, inhibition of the reproductive take-over mechanisms of the organism, and combinations of all of these.
The first thing to say about the virus, SARS-CoV-2, that causes Covid-19 is that it has no direct relationship to influenza (the flu) viruses, except that it too is RNA virus rather than a retrovirus such as HIV. This disease is not flu-like; its presentation in the ill includes a much broader range of severities and symptoms, the latency between exposure and symptomatic illness is much longer, and emerging data support the notion that this is much more than a respiratory ailment due to impact on liver, kidney, brain, and sensory function as well as formation of blood clots due to the infection. Some of these impacts may be collateral to bodily immune system response rather that direct viral infection damage but they nevertheless occur and, in some cases, leave permanent damage or cause death.
The fatality statistics and demographics of Covid-19 vary widely with fatality ranging from over 10% to about 1%, compared with our usual pandemic flu presentation which is about 0.1% fatal (the annual fatality rate of the flu varies with many things such as the strain itself, the efficacy of the vaccines, and so forth). I find the Covid-19 demographic presentation particularly challenging because the data that I have personally reviewed, which is Texas and CDC based, shows a presentation similar to all causes of death. In other words, fatality by age group is quite similar to what we see outside of Covid-19 perhaps meaning that Covid-19 fatalities are a proportional adder to the existing statistics which by their very nature are heavily biased towards death at old age. Shortly put, whatever the odds are that you will die tomorrow, Covid-19 increases those odds in proportion to what they were without Covid-19. The more likely you were to die without Covid-19, the greater the share of fatalities you get, resulting in a median fatality age in the 80-year-old range. Remember that a median is the half way point, not the average; if you take the age of every fatality, put it in a file, sort it by age, and find the center of that list, that’s the median. This means that the sheer number of fatalities at 80 years old is much higher than other ages for Covid-19, and it is similar to the mortality statistics for that and every age group, best I can tell with the data I reviewed. The flu is not like this; it’s peak fatality demographic is 65 years of age and it does not overlay at all on top of unrelated mortality demographic statistics.
The hospitalization rate is remarkably high for Covid-19. In Texas, 8-11% of cases require hospitalization and one assumes that the care in hospital is lifesaving meaning that lack of proper care will inevitably increase the fatality rate. I have no demographics to review for hospitalization, but it is clear that a lot of people who are not elderly are under hospital care. As the disease spreads and the case load increases, the number of beds occupied by Covid-19 patients also increases, and the number of beds is finite meaning that we may exceed available hospital capacity. If that capacity is exceeded and other accommodations are not made available in a timely manner, the ethical and philosophical questions presented by the need to reject certain persons from care are enormous and could result in civil unrest. This is a situation we do not want to be in, and it is not a simple problem of beds but also of equipment and staff. Hospitalization lasts, on average, about 12 days. Fatalities during hospital care typically occur beyond the 12 day mark.
Binding the Paradox
The ultimate act for the good is to give one’s life so that others may live, to be selfless and courageous. We see this in is iconic cultural and religious presentations such as Sydney Carton’s decision to force his self-destructive solution on Darnay in Dickens’ A Tale of Two Cities, Spock’s decision to force his self-destructive solution on the Enterprise in The Wrath of Kahn, the Crucifixion of Jesus, the Binding of Isaac, and many other examples in literature and in history.
The ultimate act of tyranny is to forcefully deprive people of their lives for no purpose or purposes purporting to benefit the many. We all know or should know the perils of such notions, of eugenics, of genocide, of racism, of homophobia, of the murderous wielding of power. We should also know that, at times of war, the draft may indeed be necessary to defeat an evil foe like Adolf Hitler.
Our paradox may require elements of both extremes, but the first question is whether or not we’ve overacted, whether or not this is something that requires action in the first place. What is the risk in quantified terms?
In considering Covid, there must be a basis of comparison to behave rationally and find the middle road. 2018 CDC Data informs us that 2,839,205 deaths were registered in the US in 2018, a rate of 723.6 per 100,000 or 0.72% of the population. For relative information related to causality, heart disease accounts for 0.16%, cancer 0.15%, Alzheimer’s 0.03%, and the Flu/Pneumonia for 0.01%, but rates are confusing, at least to me.
Combining Flu statistics we overall death statistics, we can say that about 9% of the population got the flu in 2018-2019, and combining that level of infection with a 0.1% mortality rate results in about a 0.01% mortality rate for the flu/pneumonia among the general population. We can also say that of the people who got the flu, about 35.5 Million of us, 490,600 or 1.4% required hospitalization.
Using Covid statistics of a 10% hospitalization rate, a 1.5% mortality rate, and assuming the same infection rate as the flu (9%), we could postulate that 35,500,000 infections would occur per year consuming 3,550,000 hospital beds for 12 days at a time (compared with the flu which the NIH tells us results in 4-6 day stays), resulting in 532,500 deaths per year. Since this would be an addition, the adjusted 2018 fatalities would be 2,839,205+532,500=3,371,705 with Covid being a rate of 135.71 per 100,000 slightly below cancer at 149.1 per 100,000 and almost ten times higher than the flu/pneumonia at 14.9 per 100,000. We of course do not know if 9% is representative of not; it is likely not less than 9% is about all we can say with confidence.
Focused on Hospital resources, we can say that the Flu burdens the hospital system with 490,600 cases x 5 days mean stay = 2,453,000 bed-days. At a 9% infection rate and 10% hospitalization rate with an average stay of 12 days, Covid would add 3,550,000 hospitalized cases x 12 days = 42,600,000 bed-days. That’s a 17 fold increase (1700%) of hospital burden above the flu. Cleary, we are not prepared for this.
If we were to presume that our hospitals have excess capacity to handle the flu/pneumonia plus twice that number of hospital bed-days, about 400,000 Covid cases could be cared for in a year, meaning a total number of annual cases less than 4,000,000 or an infection rate of 9%*4,000,000/35,500,000 = 1%, not 9% as we see in the flu.
There should be no doubt that we are not prepared to deal with Covid as if it were the flu; doing nothing will clearly exceed our ability to cope and result in, to put it mildly, societal unrest.
If we use this rational evaluation to weigh the good thereby balancing the scales between encouraging individual heroism, something we outrageously expect from all of our medical care providers as well as first responders, and tyrannically forcing actions, we can bind the paradox into a reasoned and equitably weighted plan of action that can be measured by facts and figures.
To do this, we have to admit to under and overreactions and get them behind us so that we can stop blaming each other, face reality as it is, and collaboratively create the future we desire.
To start with, we should address the failure of re-opening. Painfully slow re-opening plans were recommended, reliant on testing and re-testing, and contact tracing to identify and enforce quarantines in extremely specific populations or individual persons. Many leaders appear to have weighed the impact of protracted unemployment for people in the latter half of our paradox, and essentially bet and lost on the notion that the summer heat would somehow weaken or at least temporarily eliminate disease spread. The wager is made, the bet is lost, and the paradox is complex.
We must get over this and stop the inane dialogue trying to create shame and the anathematization of people who do not do what we think is appropriate, duly noting that this is occurring from both ends of the paradox spectrum (stop the disease at all costs on one end and do nothing on the other end). We must also make the changes necessary to achieve our 1% goal, and this should be approached as a goal not as a matter of dread. People thrive on competition, let the infection rate be a competition across the board as a goal of the good not as a matter of tyrannical oppression and force except where no alternative exists.
How and Who Decides
We’ve gone a long way together in this post. We’ve discussed the paradox between control of the disease and living life, the nature of viruses, the potential healthcare burden, and finally some tangible goals for limiting the impact of the disease and allowing life to continue. But we have not discussed methods or how decisions are to be made, an important part of any solution.
In my view, the good has three primary measures. In terms of disease response, the good is defined as being able to care for the sick within the bounds of existing infrastructure or reasonable expansions thereto including competent, trained, staff. In terms of the people, as adults, the good is defined as liberty to do as they freely choose within the bounds of impact on the ability of other persons to do the same thing. In terms of governance, the good is to promote and, at times, require, standards of behavior that balance the other goods to maximize the number of people able to freely pursue life without minimizing the needs of any group or person.
If my stated goals and definitions of the good are acceptable, how should they be pursued? Who makes the decisions as to what specific steps are necessary and sufficient for the attainment and in proper balance of the goods?
It is clear that we can neither shut everything down nor open everything up as it previously was. It is also clear that our response did buy time, did wreck many lives, and failed to produce adequate measures to permit reopening during that costly shut-down. That our leadership has been, across the political spectrum, less interested in solutions than in appearances is painfully obvious. All of that said, this is a new disease, we’ve never seen a Corona Virus on this scale, and learning does occur from trial and error. This means that we have some empirical notion of what does work and what does not work in infection control, and that data must be used to provide guidance towards our goal. No solution other than complete and total isolation is perfect; we must gauge efficacy towards the goal, not towards perfection. To do otherwise it so succumb to Zeno’s folly in saying that motion does not occur because the half distance must always precede the whole distance, distances are infinitely divisible, and therefore the end cannot be attained (If you move halfway to your goal every time, you will never reach that goal). We are free to exceed the goal, and the goal can be met.
Our approach should be one of risk mitigation, not of war or conquest. This is a specific process in Business, Engineering, and the Sciences, not some fancy phrase, the notion being that we assess the total risk then assess what is tolerable and plan mitigation activities to decrease the total risk to the tolerable level. You may note that I have used this process in this post, being a risk manager myself.
Our first mitigation steps must be things that we can do now, and our plans must launch the things that we will do later – such as treatments, vaccines, and so forth. Each of these steps needs to be assessed and assigned a target in terms of infection containment and healthcare burden and tracked as best we can to those goals.
What can we do now?
Mitigation Activity Number 1: Communications. As Aristotle wisely teaches us, force is the last resort when rational reason fails. Communications are required for people to make rational decisions.
Our most severe problem at present is a lack of coherent, fact based, communications to the people who must volunteer to undertake these risk reduction measures. I personally think that Dr. Fauci has been very helpful in this regard, in gently guiding and not shaking his finger in rebuke. That said, that shame and force are being broadly used to achieve compliance is both repugnant to a free society and clear evidence that the population does not agree with the basic necessity of these measures. We must improve communications so that people will freely choose to adopt risk reduction measures, and we must admit our mistakes and invite correction and dialogue.
Mitigation Activity Number 2: Distance and wear masks. These measures decrease infection rates but do not eliminate infections. Cloth masks are effective in catching droplets which are a common mode of transmission simply because the virion is mostly expelled from our bodies in droplets, but we need to improve mask efficacy as time goes on to maximize mitigation because of the small size of the Covid-19 (and most) virions which, at 0.1 to 0.14 microns, can escape a HEPA filter (0.3 Microns) and the publicly available cloth masks. Obviously, hand washing and other sanitization methods accompany distancing and wearing masks; I have assumed this without making it a mitigation step.
Note: On distancing, the recommendation is 6 feet to two meters from our CDC. The World Health Organization is guiding various countries to one meter; I have read their recommendations. Apparently, the WHO has taken it upon themselves to assess the risk and accept higher risk than the CDC and other health organizations. We must insist that the WHO and other organizations publish the distance vs infection risk curves along with their recommendations so that we can properly assess risk to our goal and select distances that are suitable for our needs and practical for the good as we’ve defined it.
Mitigation Activity Number 3: Provide more effective masks.We have masks that filter at this level, known as N-95 healthcare provider masks, and they are in short supply for healthcare providers. Industry is currently ramping up production including domestic production which was weak due to dependence on China and low global demand, and we will need to eventually deploy these more effective masks to the public once healthcare provider needs are met.
Mitigation Activity Number 4: Models. The use of models and animated GIFs has weakened the credibility of many communication attempts because what has come to pass is greatly different than what the models predicted. The use of models is common in my industry, and I’ve crafted quite a few myself. Like the weather and indeed the climate, this situation has too many variables and too many required assumptions to make accurate predictions, especially in the near term. And when the variables are understood, they are understood in statistical distributions resulting in model outputs that themselves are statistical distributions, not absolute answers.
We need to refine the data used in and methods used by our models. At present, this is next to impossible given the disparate sources of data and what is reported, therefore we need a program to selectively refine data towards the end of robust modelling. What that hogwash means is that we’ve got to understand which variables under our control have the most impact on infection rates and outcomes and then get a better handle on what those variables look like. We could either call this the sensitivity of infection rates or hospital beds to … distance, mask type, diet, etc., or we could use mathematical terms and say the partial derivative of infection rates with respect to distance etc. What one must do is postulate the most important items, model it, and see if one has erred.
Mitigation Activity Number 5: Treatments. The enormous number of studies underway gives us good hope that treatments will be forthcoming. That said, the initial trials were very disappointing because they were conducted using patients who were near the end of life meaning that any side effect from the treatment itself could be fatal. It may be a better approach to look for treatments early in the disease, such as Tamifu® which is not indicated for late stage flu treatment and can have, I can say from personal experience, some very interesting side effects. Perhaps an ethical dilemma, I’d say we should place primary focus on keeping people out of hospital beds rather than curing them once they are in them albeit both need to be reviewed. We need to estimate the reduction in hospital stays both in quantity and duration in order to weigh contribution of this activity.
Mitigation Activity Number 6: Vaccines. That we will find a vaccine is a foregone conclusion. How effective it will be in preventing infection, reducing fatalities, and reducing hospital bed consumption and duration is the real question before us. Vaccines may be a silver bullet, but our prey is not a werewolf; it is a virus. The nature of all living things evolves, and virion level changes frequently occur changing the nature of the infection – sometimes less sometimes more severe, as well as changing the “mug shot” for our immune system. Also, certain methods produce more durable immune system responses and even recovery from an infection does not ensure immunity in future – surely many of you have had Strep throat more than once! Again, we need to work on the goals in terms of infection rates and hospital bed consumption.
Mitigation Activity Number 7: Repair Collateral Damage. This disease and our response to it has created and continues to create a wide swath of collateral damage across this country and the world. People have been forcefully deprived of their livelihoods, businesses have failed further damaging the most vulnerable among us, and many of the protest and riots in progress today consume additional fuel provided by the frustration and impact of measure taken to control this disease. This needs repair, and not a simple check to every taxpayer. If we fail at this, all other measures are for naught because we cannot require people to do things that are harmful to themselves or their families.
It is here that logic must needs fail and the good be weighed philosophically. Throughout this post, we’ve posited that the good is our goal, and we’ve used tangible definitions of the good in order to metricize and measure attainment. Now we must face the dilemma of whether or not the ends justify the means, whether we have the right to impose our solutions on other people to our advantage and their despair. In other words, the final element of this section is upon us: who decides.
We could answer by saying that the power of the vote decides, but that means that 49% of the population is forced to comply which is, if nothing else, a good way to start a revolution. On the other hand, we could say that we require a mitigation activity for the decisions made to render the impacted people whole by correcting the damage we do. This is added to the means to the end of decreased infections thereby obviating that conundrum and softens the blow of the solutions imposed across the board. Of course, and of necessity, this imposed a burden on the 51% to supply these additional means. In other words, we would seek the equity that Aristotle deems necessary for justice and the pursuit of happiness.
But while we may compel businesses to shut down and prevent people from working under force of law, we certainly cannot compel compassion and love of neighbor. That’s the real problem here; the government is horribly ineffective and providing personal solutions, and loans in this case make no sense whatsoever. As I said, philosophy must come to our aid, and I’ll start with a page from the 1982 film Gandhi. In the film, during violent unrest following independence, a Hindu man who has killed a Muslim child comes to Gandhi and asks what he must do. Gandhi replies that he must adopt a Muslim child orphaned by the violence, and then states that the man must raise that child as a Muslim.
This, then, is my suggestion. We should develop a network of people who care for other people, not by religious affiliation or status or any such thing but, rather, seeking to connect people with needs in as diverse a manner as possible while being geographically convenient. Take, for instance, that old tradition of a community coming together to rebuild a person’s barn or house that has burned down, to enable another’s life to continue at expense of self and with the profit of gaining new friends, new ideas, and being the good personified. The Citizens of these United States are the most charitable individuals in the world. Let’s stop fighting and help each other through this.
Society survived the Spanish Flu in 1918, and it will prevail over Covid-19 as well. However, the political use of this situation and difficulties caused by our response, necessary or not, create an atmosphere likely to foster poor choices in governance and tyranny that could cost many more lives than the pandemic itself. So, while Mel Gibson and Tina Turner can stand down from their Mad Max Beyond Thunderdome roles, well, Rome did fall resulting in the dark ages and we must take care to avoid a repeat as governments and experts become untrusted, as supply chains are interrupted, and as people lack the ability to work and sustain themselves and their families.
Our approach on this, and many matters of late, is one of negative reinforcement which we should all know is a last resort and not a primary means of fostering behavioral change. We need leadership and methods based on collaborative competition to reduce infection rates and healthcare loads, based on visions of the future that include everyone and help people thrive and be happy. In short, we need hope and solutions that people embrace.
Leaders in the ancient world were generally chosen for one year terms. Even when Rome imposed a dictator for a crisis, he was given six months and was expected to resign when the task was complete – that’s one reason why the lifetime dictatorship given to Julius Caesar was repugnant to many. And our ancient forebears had a nasty habit of prosecuting governors, consuls, generals, and other officials after their terms, causing many great leaders to live in exile. There was a cost for failure that we do not impose on our leaders. Indeed, the very assumption made by Aristotle in Nicomachean Ethics that leaders and legislators act for the good is made with that worldview – that there is some accountability for tyranny and failure. We no longer speak softly, and we no longer carry a big stick. Both need to return when it comes to our leaders and elected officials.
What I suggest is that good governance cannot occur if the only penalty for poor performance is losing an election bid, which does not mean losing power and influence. Here we need some stronger legal measures. Our quagmires are quite like those of early Rome, and I’d recommend a good read of Livy’s History of Rome to see that none of our difficulties are new.
Our hope always lies with the people, with their judgement, with whom they elect. But hope lies at the bottom of Pandora’s empty box if the necessary changes lack voice, if the people lack power, and if the young’s dreams are killed by tyrannical oppression.
The resolution that I’ve offered to the paradox between disease control and living life requires us to act out of hope and not dread, to hold ourselves and others to account, and requires us to trust ourselves and others. Exactly how this will be accomplished, I do not know but I do trust that, at some point, it will be.