Sometimes, we’re nowhere. Like millions of Americans, I am on lockdown, lest I spread contagion. I sit in my house in Charlestown and brood over the systemic failures that led to the catastrophe. But when I contemplate life after all of this is over, I find reasons for optimism and even feel a kind of hopefulness I have not experienced in years.
Of course, I’m sick at heart. I lay awake at night, imagining a wave of death that sweeps away the old and the frail. I perseverate about an unprecedented economic collapse of both supply and demand, and worry about what that would mean to my family or to the entrepreneurs I know.
No pandemic was more predictable. Many nations were ready. After a novel coronavirus emerged in Wuhan in December, Chinese authorities and governments in Singapore, Taiwan, Germany, Hong Kong, and South Korea implemented the standard response to pandemics: mass testing and contact tracing of the infectious, followed by a quarantine of those shedding the virus and of vulnerable groups. The Chinese state restricted the movements of 700 million citizens.
Every city and county in the United States had such a “pandemic response plan,” including Seattle and King County, among the first places with community transmissions in the United States. As early as the last week of January, American epidemiologists knew what was coming and what would be required. But all the plans assumed there would be “surveillance” — testing and tracing — and reliable data early in the pandemic. It didn’t happen, because the president fecklessly dismissed the dangers, the federal government irresponsibly hesitated, and the Centers for Disease Control incompetently botched the manufacture of the reagents in the tests sent to public labs.
As I write on March 25, we still don’t know how many Americans are infected with SARS-CoV-2, the virus that causes the COVID-19 disease, although it might be as many as a quarter of a million people. That number will likely double every few days until social distancing has its effect, a hard lesson in exponential functions. We don’t know the final body count, which will depend on our discipline, but it might range from tens of thousands to 2.2 million, according to models in a widely read study from Imperial College London. The United States is on the same mortal trajectory as Italy, the nation worst hit by fatalities in the pandemic. By contrast, South Korea seems to have broken the back of new transmissions without closing down its economy, because it administered 350,000 tests in a nation of 51 million. So far, about 140 South Koreans have died.
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Ending the COVID-19 pandemic will require three things in addition to initial social distancing, according to Larry Brilliant, the epidemiologist who helped eliminate smallpox: widespread testing so that we know who is sick and can quarantine them; some mechanism to identify who is well so that adults can go back to work and children can return to school; and, ultimately, vaccines and antiviral treatments. But the idea that we can indefinitely lock down the human species in its cities until there is a vaccine, as Imperial College proposed, is sociologically implausible and economically impossible. Testing is the cavalry that seizes the field so that other forces can be deployed.
I can’t imagine our current polity implementing such a solution. Nonetheless, that’s what we’ll have to do in the end. When we come through this, we’ll be a different country. The United States of America that defeats the pandemic will possess certain virtues, old-fashioned and newfound. It will value facts and expertise, such as testing data and epidemiology, above party grievance and agitprop. It will fund, research, and develop vaccines and antivirals, and deliver health security to everyone through some kind of universal policy. (Disclosure: Flagship Pioneering, where I work, created and funded Moderna, the biopharmaceutical company that developed mRNA-1273, the first vaccine for COVID-19 to be tested in humans.) This new United States will possess the capacity for coordinated economic stimulus and social welfare and monetary and industrial strategy. Most importantly, its citizens must be willing to act upon their common humanity and fulfill their mutual obligations.
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We are engaged in a sort of war. War “puts nations to the test,” Karl Marx once wrote. “Just as mummies fall to pieces the moment they are exposed to the air, so war pronounces its sentence of death on those social institutions which have become ossified.” If we can pass through this crisis without suffering the trauma of too many deaths or another Great Depression, then many of the institutions that failed us will be replaced with more effective ones. We will be recalled to the better angels of our nature, in the resonant language of another Victorian, at a similar time of doubtfulness and dismay. Kindness and intelligence are contagions, too.
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Jason Pontin is a senior adviser at Flagship Pioneering, a venture firm in Boston focusing on health care and sustainability. From 2004 to 2017, he was the editor-in-chief and publisher of MIT Technology Review. Send comments to magazine@globe.com.