The records of other countries make this clear. South Korea, Taiwan, Denmark, Finland, Germany, Iceland, New Zealand, and Norway have all had commendable success in protecting their people. Could it be by chance that seven out of eight of the most successful nations in combating the Covid-19 pandemic are headed by women? Tsai Ing-wen of Taiwan, Mette Frederiksen of Denmark, Sanni Marin of Finland, Angela Merkel of Germany, Katrin Jakobsdottir of Iceland, Jacinda Ardern of New Zealand, and Erna Solberg of Norway have all been described in similar terms: as calm, confident, and compassionate leaders. All of them have been commended for thorough preparations, quick decisive action, and clear, empathic communication. Erna Solberg has even been hailed as the "landetsmor," the mother of her country.
Perhaps in such disturbing times as these we feel some primal yearning for a capable, comforting mother, but we need not resort to such psychological speculation. The fortunate countries turn out to be those with the fairness and foresight to have welcomed women into government decades ago.
What seems anachronistic in this critical time is the presence in leadership posts of so many self-aggrandizing, sociopathic male autocrats: Jair Bolsinaro of Brazil, Recep Tayyip Erdogan of Turkey, Alexander Lukashenko of Belarus, Viktor Orban of Hungary, Vladimir Putin of Russia, Donald Trump of the United States, and more. Faced with the pandemic, none of these "powerful" men had a clue. They encountered an invader that could not be bullied, bribed, banished, or bombed. And for their ignorance and vanity, the people pay (and pay and pay).
Lessons in Leadership
I know something about the difference good leadership makes because I've been locked down now in two different countries. One kept me safe, the other nearly killed me. I happened to be in Norway when the virus arrived and saw firsthand what a well-run government can actually do. (Yes, I know Norway seems small indeed when compared to the United States, but both of the governments that locked me down, Norway and the Commonwealth of Massachusetts, where I now reside, represent roughly 5.5-6.5 million people, and Norway's capital, Oslo, is only slightly more populous than Boston. So some comparisons may be revelatory.)
More to the point, with any population, the difference between success and failure is preparation, swift action, and the techniques applied to overcome the pandemic. On February 26th, the Norwegian Institute of Public Health announced the first case of Covid-19: a woman who had returned a week earlier from China. The next day, it reported two cases in travelers returning from Italy and another from Iran. After that came two skiers also back from Italy. One of them, an employee of Oslo's largest hospital, went right back to work, where tracers would soon witness just how fast the unseen virus could move.
And here's the key that escapes political leaders in America: in Norway, testers and tracers were on the job from the start. As February rolled into March, they were already testing and tracking some 500 Norwegian skiers returning from the Austrian Alps and northern Italy. Some had frequented convivial apres-ski taverns there and, once back home, were quick to catch up with friends. One Norwegian tracer labeled such skiers "very sociable people."
Systematically, Norway would test all its returning travelers (every one of them!), then track down all the contacts of those who had tested positive and test them and their contacts as well, and so on down the line. Working with remarkable speed, the tracers used immediate test results -- a tool apparently available in the U.S. only to the rich and famous -- to track the trajectories of the virus as it spread. When cases began to multiply without known contacts, the tracers knew that the virus had begun to hitchhike through an unwitting community and were quick to surround it and shut it down.
In response to the pandemic, the government gradually closed down the capital and other centers of contagion. In Oslo, places of assembly went first: theaters, cinemas, concert halls. Norwegians were even asked to stay away from the World Cup Ski Championships being held at Holmenkollen, on the edge of Oslo.
Universities and schools moved online, while offices of all sorts soon followed suit. Restaurants and bars shut their doors. By March 12th, only two weeks after the first reported case, the capital and much of the country had closed down. On that day, in fact, officials reported the death of an elderly man, the first Norwegian casualty of Covid-19.
By mid-April, some five weeks after the shutdown went into effect, the government began to open up public life again, proceeding carefully step by step. Toddlers were the first to return to their preschools on April 20th, with grade schoolers to follow. By April 30th, Norway had administered 172,586 tests and recorded 7,667 positive cases of the coranavirus, 2,221 of them in Oslo. The dead numbered 207, suggesting a per capita mortality rate lower than that of any other European country and far from America's tragic loss of life. But how to explain this Norwegian record?
Experts attribute it to the government's early and deep preparations, enabling it to respond immediately to the very first case to appear in the country and, after that, to its quick, unrelenting testing and tracing of the contagion. This painstaking effort, backed by Norway's universal health care system, enabled the state to get ahead of the virus, save lives, and stop the pandemic short.
The country's remarkably effective welfare system has bolstered its population throughout the shutdown. Furloughed workers drew full pay from the government for 20 days, and about 62% of their full salaries after that. They'll return to their jobs ready for work in factories, shops, and businesses as the quarantine is lifted. The government's effective and well-targeted expenditures are ensuring smooth transitions; a quick return to production; and, best of all in this troubled time, some peace of mind for employers, workers, and families. The shutdown is bound to be costly, perhaps the worst blow to the economy since World War II, but such thoroughgoing, bottom-up arrangements are less expensive -- in both financial and human terms -- than America's striking neglect of marginal (aka "essential") workers, thrown under the bus of crony capitalism with nothing but lectures on the overrated American freedom to fend for yourself.
In Norway, the invasion of Covid-19 was seen from the outset as a national problem and part of a global emergency. It was never politicized. Norway's conservative prime minister, Erna Solberg, is now receiving high marks indeed, even from opposition parties, for her calm leadership. Children like her too. During the crisis, she gave two nationwide "press conferences" to children to answer questions they submitted about the pandemic. ("Can I have a birthday party?" "How long does it take to make a vaccine?") From the outset, she told them it was okay to be scared. And then she set an example of what a smart, hard-working leader and a collaborative, many-partied parliament can do for all the people, even in scary times.
Remarkably, Norway very quickly achieved the lowest rate of contagion in Europe. From the start, it aimed to stifle the virus to the point where one infected person might infect only one more. In scientific terms, it aimed for an R-0 rate (a rate of reproduction) of 1.0. By the time Solberg announced that goal on March 24th, however, the magic number had already fallen to 0.71. Today, with only 81 Covid-19 patients hospitalized and their contacts already traced and tested, Norwegians can begin to return with considerable confidence to something that edges ever closer to normal life.
Amateur Night
The United States has become an example for the world of just the opposite: a corrupt government unprepared for and even in denial of warnings from within and without. Years ago, President Obama created within the National Security Council a directorate for global health security and bio-defense to prepare for the pandemics sure to come. That directorate even briefed the incoming Trump team on the urgency of pandemic preparations before the president's inauguration. But on taking office, Trump eliminated the threat by eliminating the directorate.
As president, he was also informed of a viral outbreak in Wuhan, China, in early January of this year, but he ignored the message. As has been widely reported, he wasted at least two months in self-serving fantasies, claiming the pandemic would disappear of its own accord, or was Fake News, or a "new hoax" of Democrats plotting his downfall. By March, his conduct had become increasingly erratic, obtuse, combative, and often just flat-out nasty. In April, he abandoned altogether his most pressing presidential duty, first claiming "total power" as president and then shifting the job of testing and protecting the people from an unrestrained pandemic onto state governors already struggling to find basic medical supplies for front-line health care personnel in their own states.
Worse, he roused his most militant followers, some heavily armed, to defy the emergency directives of several states led by Democratic governors. In short, he first unloaded the responsibilities of his office onto state governors, then made it his mission to undermine and threaten some of them. For good measure, he cut off U.S. funding for the World Health Organization, the single U.N. agency best equipped to deal with global health emergencies. Trump already had a proud record of getting away with highly offensive, even criminal, acts in plain sight. Now, through egotism, bravado, and just plain ignorance he's made an epidemic great again (MEGA!), for Covid-19 cases and fatalities in the United States have by now far outstripped those anywhere else on Earth.
Welcome to America
On March 11th, as Oslo was shutting down, President Trump issued an order to take effect in 72 hours: no one flying from Europe would be allowed to enter the United States. It sounded crazy, but -- worried about worse to come -- I changed my flight home to meet the deadline. The next day, the American embassy clarified the president's ultimatum: the travel ban did not apply to U.S. citizens. By that time, of course, it was impossible for me to change my ticket back.
So I left Oslo on March 14th, after assuring friends that I would be okay because Massachusetts, home of Elizabeth Warren, is a progressive state.
Hah!
Changing planes in London, I found myself in a different world: packed into the tail section of that flight among a crowd of American students summoned home from European universities by their anxious parents. Some were in transit from northern Italy, already the heartland of the European Covid-19 outbreak. From the seats behind me came insistent sounds of boys coughing. The flight attendants wore rubber gloves and made themselves scarce. I wrapped a long scarf round and round my face, feeling as if somehow I'd been suckered into a trap.
Seven hours later, we stumbled into Boston's Logan Airport, destined to spend a few more all-too-intimate hours together. I crept along a zigzag trail, amid those coughing boys, with no way of putting distance between us, to the passport inspectors and then beyond. Finally, one by one, we were ushered into a curtained area to experience that airport's first night of official "screening."
I was pleased to think that we were all, at least, to be tested for the virus. But no such luck. When my turn came, the official screener voiced no greetings, asked no questions, offered nothing but a single order: "Go home and take your temperature." Had I been held all that time among those coughing boys for this? Later that week, a local paper reported approvingly that the new airport screening, the first line of defense against the foreign plague, took "less than a minute."
I was angry to have been forced onto that dangerous flight by the president's arbitrary edict and doubly angry that he had terminated travel from Europe without consulting any of his European counterparts. By the look of things that evening, no one from his administration had even informed key American airports receiving flights from Europe until the last minute. I saw a bunch of those coughing boys board a Silver Line bus into Boston and others grabbing taxis. And so we all went off into the night, apparently leaving behind no trace of the state of our health or where we were headed. Some days later, I was not merely angry but very ill.
Ten days after that, in a hospital parking garage, a masked nurse worked a giant Q-tip up my nose. A doctor told me to quarantine myself at home (as I had been doing anyway) until I got the test results in about 5 days. But why should it take so long? Wasn't the whole point of a test to learn what was going on as quickly as possible? The speed of the test result had been the very point in Norway. Combined with the immediate work of the tracers, it enabled the National Health Service to stay ahead of the pandemic and, in the end, essentially, to shut it down.
I went home and got worse. Five days passed with no word. On the 12th day, I felt well enough to call my doctor, who tracked down the result of my test ("just in"). It was positive, but almost two weeks old. So, over the telephone, the doctor gave me the all-clear to put on my mask (a souvenir of my trip to the ER) and go forth to shop. Knowing no Norwegian doctor would turn me loose so soon without another test, I asked for one. Sorry, short supply, only one to a customer. I've kept myself in quarantine at home ever since.
Covid-19 Hitches a Ride in America
On April 10th, came news of the death of 59-year-old Vitalina Williams, an immigrant from Guatemala, who worked a full-time job at a Walmart in Lynn, Massachusetts, as well as a part-time job at a supermarket in Salem. Like the nurse and doctor in the ER, this cashier was an "essential worker," the first grocery store employee in Massachusetts to work herself to death. Here's an immense difference between Massachusetts and Norway. In that country, one job would have paid her a good wage and also given her paid leave to see her own doctor in the National Health Service when she first felt ill. She would have been taken in, diagnosed, cared for, and very likely saved. That is simply how a national health care system works in a social democracy.
So what was my Covid-19 test for? What useful information did it give anyone? I had walked home from the ER in the dark (so as not to endanger others by taking a bus) and gone to bed. Nobody checked up on me because nobody knew my test was positive -- something I, of course, didn't know either. And throughout those nearly two weeks of waiting for the test results, no tracer called to learn if I lived with other people who might be endangered and available for testing. (There were, in fact, no tracers then.) No one asked me a single question about my family, friends, or others I might have contacted since that "screening" at the airport. And had I died in my bed, no one would or could have traced that bright red line between me, those coughing boys, and Donald Trump's compulsory flight to a state caught totally off guard in a country both dysfunctional and unprepared.
On April 20th, five weeks after I returned to Boston, Massachusetts was designated a Covid-19 "hot spot." With 38,077 cases and 1,706 deaths at that time, the state stood in third place behind New York and New Jersey. This was not an honor, but it may be what prompted Governor Charlie Baker to turn to testing -- and belatedly to tracing.
The number of new cases in this state was rising every day, as it has from the first reported case in February. The governor, who also holds a press conference every day, explained that we are now "right in the middle of an expected surge," apparently unaware that a "surge" is what you get when you have missed the moment for preventative testing and tracing. (This is also what you get when, as in the nation's capital, politicians rather than scientists run the show.)
Belatedly, Massachusetts started testing people at the rate of about 9,000 per day, while private agencies funded by the state are in the process of hiring perhaps 1,000 tracers to conduct phone interviews with the contacts of all Massachusetts residents who have already tested positive. Today, May 6th, we official "positives" number 70,271, though 4,212 of us are already dead.
In the first few days of May, the number of positive patients hospitalized fell slightly and state officials adopted an attitude of "cautious optimism." Presumably, something of importance will be learned from those belated tests. As Norway recognized, however, if you don't jump on this virus fast, it rapidly disperses beyond simple person-to-person contacts. It spreads out sociably like so many Norwegian skiers -- or American students. It rides the chairlift and the bus. It gets on the plane. It hangs out at the airport. It hitches a ride with someone stopping at the grocery store. To tally its contacts may become simply a matter of counting the dead.
Tracers in Norway have already moved on to other tests to find asymptomatic carriers who may be contagious or perhaps have developed antibodies. Anyone in that country with even the mildest symptoms may ask for a test. These precautionary studies are essential in case the virus should find new life as the quarantine is lifted. What scientists might learn from such studies, like the new tracing one in Massachusetts, remains to be seen, but surely one inescapable conclusion is that this virus is smarter, more agile, and faster on its feet than any of its associates we've met before or, for that matter, than most of our public officials, from a failed president on down. And for any readers who believe in politics more than science, let me just say that without science you won't even know what hit you.
