Yesterday the US surpassed China as the country with the most diagnosed cases of coronavirus. It’s a macabre accomplishment and not at all surprising, given our government’s early missteps and the incompetence with which it has handled the crisis over the past few months. In India, 1.3 billion citizens are on lockdown, ordered not to leave their homes for the next 21 days. In prisons, refugee camps, and detention centers, people are starting to test positive, raising the specter of outbreaks among vulnerable populations that lack consistent access to running water and basic hygienic supplies. Health care workers are dying, their colleagues battling fear and fatigue as they continue to care for the sick. Here in New York State, nearly 45,000 people have tested positive, a number that will almost certainly reach 50,000 by the end of today.
Amidst our confinement at home, I struggle against uncertainty. We’re hearing that the lockdown in New York could last another month or more. That’s 4-6 more weeks in which everything we knew is upended and what was once comforting—a touch, a conversation with a stranger—has become fraught with danger. The gloominess of the prognosis contrasts jarringly with the weather outside, which feels bright and hopeful. What will become of our families and communities? Will we recover and rebuild in ways that emphasize compassion and justice, or will the inequalities and chasms that this pandemic has exposed become further entrenched in our societies?
The countries that have been most successful at containing the coronavirus—Singapore, South Korea, Hong Kong, Taiwan—share a number of approaches, gleaned from hard-won experience battling SARS in 2003. In each case, the government acted quickly to shut down travel from China and to identify and isolate the sick. Each country has a system of universal health care, the importance of which cannot be overstated; it allowed residents to seek care without worrying about the cost, and it centralized the medical response among providers. What’s more, each country has a robust public health apparatus in place. In Singapore and South Korea, in particular, trained workers focused on extensive tracing of those with whom infected patients had been in close contact, using CCTV footage and GPS data from cellphones. This level of surveillance might be unpalatable to those in Western countries who fear, with good reason, the repercussions of giving the government more access to personal data. But the tradeoff other countries made between increased surveillance and decreased privacy enabled them to weather the pandemic without widespread closings of schools and workplaces.
Public health always involves a tension between civil liberties on the one hand and the public good on the other. The starkest example is a government-ordered quarantine of someone who is ill and forbidden from leaving a containment area. It’s way too late in the US to adopt the approach of Singapore or South Korea, as it’s clear that community transmission has been occurring across the country for some time. But in our current moment, in which entire cities and states have essentially been shuttered, it’s worth grappling with uncomfortable questions about how much of our privacy we’d be willing to give up in a public health emergency, and what safeguards we’d want to see in place first.