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A Letter to the West Point Class of 2020

I am a graduate of the United States Military Academy at West Point, Class of 1969.  A group of my fellow graduates published the following letter on June 11, 2020.  It is intended for the 2020 graduating class at West Point, but the sentiments expressed are relevant to all Americans, particularly those who have been shocked and ashamed at the behavior of our president and his loyal supporters in response to the murder of George Floyd in Minneapolis and the threatened and actual use of the American military against peaceful protesters in the weeks following Floyd’s death.

West Point cadets marching
West Point graduates swear an oath to defend the Constitution

When we graduated from West Point and were commissioned in the United States Army or one of its fellow services, we took an oath to defend the nation and the Constitution.  The vast majority of our fellow graduates adhere to that oath, even after we have left the service and after a number of us have retired.  But Michael Flynn and Mike Pompeo are disgraceful examples of West Point graduates who have violated that oath and given their loyalty to a president who lacks common decency, lies habitually, and views himself as a dictator who can use the American Army against American citizens.  I join my fellow graduates who wrote the letter below in condemning those who prize loyalty over fidelity to the Constitution and in praying that these new graduates will remain faithful to the oath they are taking.

Fortunately, some senior past and present military leaders are finally expressing their outrage and concern over Donald Trump’s behavior and his abject failure of moral and ethical leadership. Four-Star Generals Colin Powell, James Mattis, John Kelly, Richard Myers, Martin Dempsey, and John Allen, along with Admirals Mike Mullen, William McRaven, and James Stavridis, among others, have recently spoken out against Trump.  Mattis called him a threat to the Constitution.  The latest military leader to speak up is the currently serving Chairman of the Joint Chiefs of Staff, General Mark Milley.

General Mark Milley said today that he regrets joining Trump in his walk to St. John’s Church, where Trump cynically held up a Bible in an appeal to his base, and in which hundreds of peaceful protesters were routed with teargas and rubble bullets so Trump and his entourage could walk to the church.  General Milley said, “As senior leaders, everything you do will be closely watched.  And I am not immune.  As many of you saw, the result of the photograph of me at Lafayette Square last week.  That sparked a national debate about the role of the military in civil society.  I should not have been there.  My presence in that moment and in that environment created a perception of the military involved in domestic politics.  As a commissioned uniformed officer, it was a mistake that I have learned from, and I sincerely hope we all can learn from it.”

National Guard troops at a protest
Using our military against American civilians is contrary to the oath West Pointers have sworn to uphold

I encourage you to read the letter below.  It embodies the true spirit of service to the nation and fidelity to the United States Constitution.  This is real patriotism, not the loud,  flag waving, MAGA-hat wearing charade on display at Trump rallies.  We should all be grateful that senior military leaders, as well as graduates of the United States Military Academy, are finding the courage to speak out.  This is a moment in our history when speaking out is essential.

 

A Letter to the West Point Class of 2020, from fellow members of the Long Gray Line

 

You are beginning your careers at a tumultuous time. More than 110,000 Americans have died of COVID-19, more than 40 million are unemployed, and our nation is hurting from racial, social and human injustice. Desperation, fear, anxiety, anger, and helplessness are the daily existence for too many Americans. These are difficult times, but we are confident you will rise to the challenge and do your part as leaders in our Army.

Like the classes before you, the Class of 2020 comes with varied life experiences from across America and beyond. You represent the country’s diversity of race, ethnicity, identity and beliefs. Your West Point journey has led you to this moment when, with right hands raised, you take an oath “to support and defend the Constitution of the United States against all enemies, foreign and domestic.” This oath has no expiration date. The burden of responsibility and accountability will both weigh on and inspire you for your entire life. Oaths are solemn, public promises with significant meaning and moral gravity. When they are broken, the nation suffers.

The oath taken by those who choose to serve in America’s military is aspirational. We pledge service to no monarch; no government; no political party; no tyrant. Your oath is to a set of principles and an ideal expressed in the Constitution and its amendments. Our Constitution establishes freedom of the press, of assembly, of religion, of equal protection under the law regardless of race, color, or creed — we cannot take for granted these freedoms that are but dreams in too many nations around the world.

By accepting your commission, you incur a moral purpose and obligation to provide for the common defense. In doing so you enable the nation to fulfill the full range of its aspirations. Today, our Constitutional aspirations remain unfulfilled.

The abhorrent murder of George Floyd has inspired millions to protest police brutality and the persistence of racism. Sadly, the government has threatened to use the Army in which you serve as a weapon against fellow Americans engaging in these legitimate protests. Worse, military leaders, who took the same oath you take today, have participated in politically charged events. The principle of civilian control is central to the military profession. But that principle does not imply blind obedience. Politicization of the Armed Forces puts at risk the bond of trust between the American military and American society. Should this trust be ruptured, the damage to the nation would be incalculable. America needs your leadership.

Postage stamp depicting West Point
This 1937 U.S. postage stamp bears the motto of the U.S. Military Academy: Duty, Honor, Country

Your commitment to your oath will be tested throughout your career. Your loyalty will be questioned, and some will attempt to use it against you. Loyalty is the most abused attribute of leadership. Weak or self-serving leaders will emphasize loyalty over duty under the guise of “good order and discipline.” Unfortunately, some will make a Faustian bargain and endeavor to please their commanders and advance their own careers rather than take care of soldiers, sailors, airmen, and Marines in combat — which is not just a problem, it is a disgrace. America needs your leadership.

We, a diverse group of West Point graduates, are concerned. We are concerned that fellow graduates serving in senior-level, public positions are failing to uphold their oath of office and their commitment to Duty, Honor, Country. Their actions threaten the credibility of an apolitical military. We ask you to join us in working to right the wrongs and to hold each other accountable to the ideals instilled by our alma mater and affirmed by each of us at graduation.

Your West Point education is both a profound gift and a sacred obligation. Our Nation has invested in you and entrusts you with demonstrating the values we expect of our leaders. They rightfully expect some return on that investment. You have the support of the entire nation as well as the heartfelt bonds of our alma mater.

It is imperative that West Point graduates work daily to serve as “leaders of character.” When leaders betray public faith through deceitful rhetoric, quibbling, or the appearance of unethical behavior, it erodes public trust. When fellow graduates acquiesce to bullying, and fail to defend honorable subordinates, it harms the nation and the Long Gray Line. When fellow graduates fail to respect the checks and balances of government, promote individual power above country, or prize loyalty to individuals over the ideals expressed in the Constitution, it is a travesty to their oath of office.

On the eve of your graduation and joining the Long Gray Line and the Army officer corps, we, the undersigned, are resolute in our efforts to hold ourselves accountable to the principles of Duty, Honor, Country in selfless service to the Nation. We will not tolerate those who “lie, cheat or steal.” We pledge to stand for the sacred democratic principle that all are treated equally, and each person has the right to life, liberty, and the pursuit of happiness. This is not about party; it is about principle. Our lifetime commitment is to the enduring responsibility expressed in the Cadet Prayer: “to choose the harder right instead of the easier wrong, and never to be content with a half-truth when the whole can be won.”

Members of the Class of 2020, welcome to the Long Gray Line. We believe in you. We support you. As your lifetime journey of service begins, we pray that your class motto, “With Vision We Lead,” will prove prophetic. America needs your leadership.

Grip Hands,

Concerned Members of the Long Gray Line, a coalition of several hundred West Point alumni from six decades of graduating classes who collectively served across ten presidential administrations.

 

Photo credits:  Cadets in formation at West Point:  Joseph Sohm, Shutterstock; Soldiers at a peaceful protest in California:  Black Pebble, Shutterstock; U.S. postage stamp depicting the United States Military Academy:  neftali, Shuttestock; photo of the United States Military Academy:  ID 16015534 © Nancy Kennedy | Dreamstime.com

 

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Covid-19 Bulletin #5

Covid-19

By now, the coronavirus pandemic is firmly embedded in our national consciousness.  The pandemic has infected well over 150,000 people globally, including–at last count–3,000 Americans and around 60 deaths.  The numbers keep climbing dramatically, and no one knows how many people are actually infected because our country lacks adequate testing.  Trump and his administration have tried to blame the lack of testing on Obama, but we all know this is not true.  Trump’s failure as a leader is entirely to blame.  Nonetheless, here we are with a dramatically changed life.  Most sporting events have been cancelled, along with concerts, museums, Broadway, cinemas, conferences, Disneyland, and other large gatherings of any kind.  Schools have been closed in many states, including NYC, the country’s largest school system.  Universities and colleges are moving from classrooms to online education.  France has closed restaurants, bars, cafes, and clubs across the entire country.  Italy is on lock down, and Spain has ordered its citizens to stay home.  Many companies in the U.S. have told their employees to work virtually.  Most cruise lines have shut down, and airlines have cancelled flights or restricted them to certain locations.  The lines at Costco and WalMart stretch around the block, and many store shelves are empty.  It’s nearly impossible to find hand sanitizer, toilet paper, paper towels, and cleaning products like Lysol and Clorox.  In one of the grocery stores in my hometown, men were seen stuffing grocery carts with nothing but bags of potato chips.  It seems the world has gone mad–and we aren’t anywhere near the peak of this pandemic yet.  

 

This is Covid 19 Bulletin #5 from Dr. Sheila Sund.  The news about Covid-19 has been so ubiquitous that the content of Dr. Sund’s bulletins has now become glaringly familiar to anyone who is paying attention.  However, it is to her credit that Dr. Sund began sounding the alarm weeks before the general public became aware of the potential severity of this outbreak.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

 

Chinook CERT Plus – COVID-19 Bulletin #5, March 9, 2020

 

Don’t focus on numbers

“Marion County confirms first case of COVID-19.” “Cases in Oregon double in one day.” When we see this, it triggers an acute feeling of alarm. But these numbers tell us nothing new—they reflect increased testing, not increased disease spread. That doesn’t mean the risk isn’t real. It’s just confirmation of what we should have already known—COVID-19 is “here.”

So far, we have no way of knowing where we are on the growth curve – day 5, 15 or 30. Our best clue will be increasing cases identified in Marion County hospitals. In the meantime, your best action remains hand washing, disinfecting, and minimizing time spent in large groups, particularly if you are older or have underlying medical problems.

Most importantly, if you feel sick, STAY HOME, even if you suspect it’s just a cold or the flu! If possible, isolate yourself even from family members until symptom free for 24 hours.

 

We’re all going to get it, so let’s just get it over with. FALSE!

I’m hearing this sentiment more and more, but it is incorrect. It’s true that most people will get through this pandemic with just a week or two of illness. But in the meantime, COVID-19 could decimate the population over age 70.

Age US population Fatality rate Potential deaths
70-79 23 million 8% 1.8 million
80 and above 13 million 15% 1.9 million

(Based on current COVID-19 estimates)

For comparison, annual seasonal flu deaths in the US 2010-2019 ranged from 12,000 – 61,000.

Most deaths occur after 1 or more weeks in the hospital. So even if you feel callous about this specific demographic group, their use of medical resources will affect everyone. The more we can slow the spread of coronavirus, the better off everyone will be.

 

Mitigation Instead of Containment

The goal of mitigation is to decrease the expected number of new cases infected by one current case (the reproductive number). If it drops to less than one, the pandemic fades away. In practical terms, mitigation is anything that decreases interpersonal contact in the community, including cancellation of group gatherings, work and school closures, isolation of known cases, and even limitation of travel or quarantine of entire communities.

Yet we can’t really enforce mitigation in this country. Ultimately, it comes down to individuals choosing to put the good of the community over their personal interests, despite economic or social hardship.

If someone is exposed to a confirmed case, they may be instructed to implement one of the following measures immediately. Prepare yourself and your family now!

Exposed, but no “close contact” AND no symptoms:

  • Social isolation – no group gatherings, maintain 6 feet boundary from others. Shopping allowed.
  • Self-monitoring – watch for any signs of illness, possible required temperature checks
  • Active monitoring – public health assumes responsibility for conditions of your isolation and monitoring

Exposed with close contact, but no symptoms:

  • Quarantine, usually at home, for 14 days. No contact with family members or pets. Use separate bedroom and bathroom. Wear mask whenever other people are present. If symptoms develop, 14-day clock resets.

Close contact: being within 6 feet of an identified case for “prolonged” time OR having direct exposure to their respiratory secretions (e.g. coughed or sneezed on).

Exposed and symptomatic, or become symptomatic during self-isolation or quarantine:

  • Isolation, usually at home, for 14 days minimum, under same criteria as quarantine.

 

Other Preparedness Tips

There is no need for a run on the grocery stores or Costco, but if there are things you need or chores you should be doing, it’s time to stop procrastinating. Do them now. The more “caught up” on life you are, the better prepared you will be for any sudden changes.

Manage COVID-19 anxiety!

  • Limit time spent reading about and planning for COVID -19
  • Use reliable sources and avoid social media discussions
  • Continue to follow normal routines as much as possible
  • Take time for reality checks:  What is happening in your life now, not what may happen in the future
  • Do deep breathing or meditation

Perform meaningful actions:

  • Prepare guest bedrooms
  • Organize emergency supplies
  • Think of enjoyable things to do even if social isolation imposed
    • Catch up on book reading
    • Time for home projects, crafts, or gardening
    • Family time
    • Time in nature
  • Address COVID-19 anxiety in kids and teens -what are they reading or hearing in school?
  • Share NPR’s “Just For Kids: A Comic Exploring The New Coronavirus

 

Photo credit:  ID 175225651 © Photovs | Dreamstime.com

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Covid-19 Bulletin #4

This is Covid-19 Bulletin #4 from Dr. Sheila Sund.  Covid-19, which is the proper name for the coronavirus that is currently spreading around the world, is a far more dangerous virus than the flu (twenty times more lethal than the flu), and it is likely that the rate of infection is much greater than what is known and being reported by the media–because no one knows how widespread the infection actually is.  As of today (March 3, 2020), more than 130 Americans have been diagnosed with Covid-19, and ten have died.  The numbers are growing daily.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

 

Chinook CERT Plus – COVID-19 Bulletin #4, March 6, 2020

COVID-19 vs Seasonal Flu

Without a doubt, seasonal flu is a huge health problem. United States experts estimate 32 million cases and 18 thousand deaths from flu – just this year!

But as a virus, flu is “nicer” than COVID-19. A flu patient on average infects only 1.3 other people vs COVID-19’s 2.3 people. Functional time lost from flu averages about 3.5 days, whereas patients with COVID-19 may be sick for 7-14 days. The hospitalization rate for flu in the United States sits around 1% and the death rate rarely exceeds 0.1 %, whereas worldwide estimates for COVID-19 currently stand at 15% hospitalized and 3.4% dying.

Although these numbers are definitely overestimated because of testing patterns, they are still much higher than flu. And while both illnesses are disproportionately bad for older, sicker people, COVID-19 also seems to sicken and kill younger people at higher rates than seasonal flu.

Most importantly, as a society, we’re “used” to flu. Healthcare systems are prepared for it and there’s a reasonably effective vaccine. >55% of the population is fully immune in any given year. Ultimately, most healthy people consider flu an annoyance, not a problem. But we are not used to COVID-19, it is spreading rapidly, and we are definitely not prepared.

Medical Surge from COVID-19

Many parts of the United States healthcare system are overburdened at baseline. They are not capable of handling a rapid increase in very sick patients from COVID-19.

Using Marion County, Oregon, as an example:

  • Licensed hospital beds:  ~550  (~500 at Salem Hospital, one of the four largest hospitals in Oregon).
  • Average occupancy Salem Hospital (2018):   80%  (During flu season, this number can reach 100%).
  • Average “available extra beds” for COVID-19:  ~110.

If we assume 10% of patients require hospitalization, our “extra” beds could be filled by the time we have 1000 local cases (the current estimated number in Seattle).  Although that’s about 45 days from the first local infection, it’s potentially only 10-15 days from the time a local outbreak is first recognized. Care may also be limited by limited critical care beds, ventilators, sick hospital staff, and shortages of supplies and medications.

Meanwhile, at the clinic level, staffing drops from illness, quarantine—and parents staying home with kids when schools closed. At some point, healthcare for all patients could deteriorate, even if they don’t have COVID-19. And that’s one big reason why I personally am far more concerned about COVID-19 than seasonal flu!

Community Spread of COVID-19 – What should you do?

We will not know when COVID-19 arrives here. In fact, it might be here already, given the major outbreak a few hours north. Once in the community, it will spread. Most of the time, you will not know who is sick. It just becomes a game of odds—and your personal approach to risk!

Example: Marion County, Oregon – population ~ 350,000

 

Days into cluster

~Number of cases

~% of county infected

Day 0 (1st patient)

1

Day 30

100

0.03%

Day 45

1000

0.3%

Day 60

8000

2.3%

Day 75 65000

19%

 

No hospitalized patients have been identified in Marion County yet, so we are probably earlier than day 30 which means your odds of picking it up in the community are extremely low. Once it is identified, there may be another 30 days before community risk starts to climb significantly.

Risk will always be higher from what you’ve touched than who you are with—an object carries the risk of everyone who touched it since the last time it was disinfected.

 

COVID-19 Caution Spectrum – it’s your choice where you fall on it

  • Gambler:  Go about your business normally. The odds are in your favor.
  • A Little Cautious:  Follow recommended hand washing and avoid hand contact with others.
  • More Cautious:  Add cleaning and disinfecting routines.  (Particularly objects and settings where things are touched by many people.)
  • Getting Anxious:  Add avoidance of settings with multiple people within 6 feet for >15 minutes.  The greater the number of people together, the greater the risk
  • Quite Anxious:  Add gloves in stores, no group gatherings, work from home
  • Paranoid:  Minimize contact with people

For significant underlying medical conditions or over age 80, move up the caution spectrum!

AT ANY CAUTION LEVEL:  IF YOU FEEL SICK, STAY AWAY FROM PEOPLE UNTIL ASYMPTOMATIC FOR 24 HOURS!!!!

            Do not work. Do not go to school. Minimize contact with family members.

            Wear a mask around others if available (keeps you from spewing germs).

Many cases of COVID-19 will be mild and symptomatically similar to flu and other viral illnesses, yet much more contagious. You can’t tell if you have COVID-19 or a different infection, but you could be spreading it if you go out in public.

If everyone with mild symptoms stays home until better, community spread will slow.

 

Photo credit:  ID 174295771 © Buddhilakshan4 | Dreamstime.com

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Covid-19 Bulletin #3

This is Covid-19 Bulletin #3 from Dr. Sheila Sund.  Covid-19, which is the proper name for the coronavirus that is currently spreading around the world, is a far more dangerous virus than the flu (twenty times more lethal than the flu), and it is likely that the rate of infection is much greater than what is known and being reported by the media–because no one knows how widespread the infection actually is.  As of today (March 3, 2020), more than 130 Americans have been diagnosed with Covid-19, and ten have died.  The numbers are growing daily.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

 

Chinook CERT Plus – COVID-19 Bulletin #3, March 3, 2020

COVID-19 in Oregon and Washington and my concerns about testing

As of today, Oregon has identified three cases of COVID-19, with twenty-seven in Washington. Many are thought to be community acquired. But if you look closer, descriptions of the identified cases are all either:

1) hospitalized with severe illness (including death) or

2) known contacts of other cases.

Despite the risk of community spread, the actual number of tests for coronavirus is quite low—only 25 in Oregon since the first community case was identified on February 28. It is not a problem with testing availability. Oregon can now run 80 tests a day and Washington up to 500.

Instead, state health officials are still following CDC criteria for testing:

    1.  known contacts with fever and signs of lower respiratory illness
    2.  travel from affected areas plus fever, signs of lower respiratory illness, and hospital
    3.  no known contact but fever and severe lower respiratory illness (ie critical care)

 

My opinion:

When testing is limited to these criteria, it is impossible to determine if COVID-19 is spreading in the community:

1) If each patient only infects two others (current estimates), the likelihood of finding both those “two cases” by testing a limited number of contacts is low.

2) Limiting testing to critically ill patients will miss 95% of cases who never get that sick.

Even worse is the danger of “losing” healthcare workers with this approach to testing.

Critically ill patients average 3-7 days in the hospital before testing is performed—yet are infectious the entire time! Dozens of hospital staff from Kaiser Westside in Hillsboro are now quarantined at home after the initial Oregon case was identified in their facility. Similar quarantines are being implemented at other hospitals around the country.

An additional 10% of infections will be hospitalized but never tested by current criteria—thus never identified as contagious.

Besides being unfair, the loss of healthcare workers can seriously impede our ability to respond to outbreaks of COVID-19. In turn, this could lead to a higher overall fatality rate from COVID-19, as well as affecting availability of healthcare for everyone, infected or not.

(Sorry for the rant, but this has caused me more alarm than anything else about COVID-19 so far!)

 

Preparations for community spread of COVID-19

At work:

  • Desktops, tabletops, and counter tops.  Clean and disinfectant (wipes or spray) daily when sitting down
  • Repeat daily – more often if used by more than one person.  Disinfectant should stay wet for several minutes
  • Door handles, phones, keyboards, other objects used jointly:  disinfect daily
  • Avoid handshakes, hugs, and other physical contact with coworkers
  • In meetings, position yourself at least 6 feet away from others when possible.  If not possible, orient yourself away from other people’s faces.   Corner or wall locations can decrease shared “face space.”
  • Go to restroom every hour and wash hands – set an alarm!
  • Also wash hands immediately before eating.

DO NOT TOUCH YOUR FACE

            DO NOT WORK IF YOU FEEL SICK

            DO NOT LET OTHER EMPLOYEES WORK IF THEY FEEL OR ACT SICK

At home:

  • Consider establishing a “dirty area” at the entrance of your house.  Anything from outside the house stops here!
  • Shoes, purses, backpacks, grocery bags (unpack bags from dirty area)
  • Avoid setting anything from outside on counter tops.
  • Groceries and supplies go immediately into cupboards.
  • Thorough hand washing:

As soon as you enter and set down “dirty” things

After putting away purchases

After cooking (and touching “dirty” things) and before you ea’

  • Clean and disinfect tables and counters once or twice a day.  Only if they come in contact with dirty hands or dirty things
  • House door handles, car door handles, steering wheel, other “touchable” car areas:  disinfect once a day (or after outings)

BE PREPARED FOR QUARANTINE!!

If your coworker, friend, schoolmate, or housemate gets coronavirus, congratulations! You may win an immediate fourteen day (or more) forced home vacation, possibly with your family!

You’ll be expected to phone in your temperature and symptoms twice daily. Other than that, don’t expect much help. Better make that grocery run now for fourteen days of supplies. Quarantine could happen tomorrow!

 

Photo credit:  ID 173074233 © Akesin | Dreamstime.com

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Covid-19 Bulletin #2

This is Covid-19 Bulletin #2 from Dr. Sheila Sund.  Covid-19, which is the proper name for the coronavirus that is currently spreading around the world, is a far more dangerous virus than the flu (twenty times more lethal than the flu), and it is likely that the rate of infection is much greater than what is known and being reported by the media–because no one knows how widespread the infection actually is.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

 

Chinook CERT Plus – COVID-19 Bulletin #2, March 1, 2020

 

Community Spread

Once a case of coronavirus is identified, it often appears that the infection rate starts climbing rapidly within a few days. But it’s important to realize these numbers don’t mean rapid spread of infection. The infection was already there. It’s only the testing that has rapidly increased—and therefore your awareness

Based on current data, a reasonable guess is that each infected person infects two others, and it takes about 5 days for each “generation” of the illness. With that, you can estimate local spread.

Day 0               1 person infected

Day 5               3 people infected

Day 10             7 people infected

Day 30             127 people infected

Day 60             8190 people infected

(Day 90 would be 524,160 cases—but the model breaks down before then!)

Unfortunately, it may take 60-120 infected patients in an area before one is sick enough to trigger suspicion and testing (hospitalized with serious illness). Once confirmed, public health starts testing all contacts (and eventually contacts of contacts) with even low-grade symptoms—and the positives roll in. Throughout this time, cases continue to double roughly every five days

My note: I find it comforting that Seattle has reported only one death so far. Given the likelihood that Covid-19 has been spreading there for weeks, this seems remarkably low. If real, perhaps the serious illness and death rate will be much lower in the United States than reported elsewhere.

 

Social distancing

“Social distancing” is the main way pandemics are controlled. If human contact decreases enough to allow less than one new infection for each current case, the pandemic will gradually fade away.

Local and state governments choose which social distancing requirements to implement (which means it could vary a lot from community to community).  The first step is usually quarantine of groups with known exposure to the virus. Closure of schools and cancellation of events and gatherings are common next steps. The level of quarantine seen in China would be unusual in the United States, but this is uncharted territory and it’s hard to predict how people will respond.

 

My Pandemic Preparedness Supplies

  • Liquid hand soap – lots of it.  Does not need to be “antibacterial.”  Bar soap not recommended – “germs” live on bar surfaces and cracks.
  • Paper towels.  For hand drying and for surface cleaning/disinfection.  Single sheets work better than rolls, but are not essential
  • Bottle of bleach

            Unopened bleach bottles should be used within the year, or they lose potency

            Freshly mixed bleach solutions must be used within 24 hours

            Good ventilation decreases chlorine smell

  • Good surface cleanser with detergent.  Doesn’t really matter what you use as long as it cleans both grease and dirt.
  • Oral digital thermometer.  Forehead and ear are not as accurate
  • Hand lotion – your hands will thank you!
  • Facial tissues for coughs, sneezes, and anytime you need to touch your face.
  • Spray bottles for bleach solution

Nice, but not essential

  • Disinfectant spray and wipes.  Sprays work best, but not practical for objects like phones, door handles, etc.  Ethanol or bleach based are most effective..  Homemade bleach solutions actually work better. They’re just inconvenient.
  • No touch trash cans
  • Hand sanitizer.  Not needed if washing hands frequently.
  • Ibuprofen for fever and symptom control
  • Cough drops
  • Disposable gloves for cleaning.  Can also wear in high-contamination environments like grocery stores

Disinfecting instructions

  1. WASH SURFACE FIRST. Disinfection does not work on dirty surfaces!
  2. Spray disinfectant enough to visibly wet all surfaces. Let air dry.

The longer the surface remains wet, the better!  Up to four minutes

Homemade bleach or commercial spray

  1. If spray disinfectant cannot be used, use a fresh wet disinfectant wipe.  Let air dry.

            Do not reuse disinfectant wipes

            Use new wipe if current one no longer thoroughly wets surface.

            Homemade bleach solution – use within 24 hours.  Common household bleach is 5-6% – mix 2 tablespoons with 2 cups water

 

Thanks to Dr. Sheila Sund for permission to reprint her work.

Photo credit:  ID 174166208 © | Dreamstime.com

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Covid 19 (Coronoavirus) Bulletin #1

Photo of a coronavirus

This is Covid 19 Bulletin #1 from Dr. Sheila Sund.  Covid 19, which is the proper name for the coronavirus that is currently spreading around the world, is a far more dangerous virus than the flu.  Despite what Donald Trump said on television several days ago, Covid 19 is twenty times more lethal than the flu, and it is likely that the rate of infection is much greater than what is known and being reported by the media–because no one knows how widespread the infection actually is.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

On February 28, Dr. Sund published the following bulletin on Covid 19, and she has graciously allowed me to reprint it on this blog.  As she publishes future bulletins on Covid 19, I will reprint them here as well.  Stay tuned.

 

Chinook CERT Plus – COVID-19 Bulletin #1, February 28, 2020

How bad is Covid-19?

Based on evaluation of 72,000 cases in China:

“Mild” symptoms (not hospitalized): ~81%.   Mild cases can still be sick for up to 14 days

Serious illness (hospitalization): ~14%

Critically ill (intensive care): ~5%

Fatality rate ~2% overall.   < 1% if young and healthy, 14.8% if age 80 or above

My note: serious illness does not usually occur until the second week of the illness

Covid-19 is already a pandemic by the traditional epidemiology definition:

Uncontrolled spread of an infectious agent on at least two continents

My note: there are strong social/political/economic reasons why official organizations and governments avoid labeling something as a pandemic – even when it is!

Official case counts are misleading, both in the United States and internationally.  Patients are counted only if they have a positive test, yet:

  1. The availability of testing is limited in many places
  2. Testing is limited to the sickest patients or those with known case contact

Before Feb 27, a sick patient could only be tested in the United States if they had visited China or had contact with a known case.  On Feb 27, criteria were expanded to travel from six countries, but otherwise, patients without known exposure can still only be tested if they are not just hospitalized, but critically ill.

My note: Given the rapid spread of cases around the world, it seems highly likely there are already clusters of infection with community spread within the United States. However, with current testing limits, these will not be identified until someone within the cluster becomes critically ill (such a patient was identified just today in Lake Oswego). Given the typical time course of the illness, these patients will already have been infectious for at least seven days.

 

Personally, I am taking this illness very seriously. I implemented my family’s infection control plan this week, which affects four households (including one in Lake Oswego!). I’m working on putting it all in writing, and then will share with you. But in the meantime, here is the most important tip of all – WASH YOUR HANDS! (Read on.)

 

YOUR COVID-19 PREVENTION TIP OF THE DAY

WASH YOUR HANDS, WASH YOUR HANDS, WASH YOUR HANDS.

 

Hand washing instructions (yes, there is a correct way!)

1) Wet hands with clean, running water (warm or cold), turn off tap, and apply soap.

2) Lather hands and rub front and back to wrists, between fingers, and under nails

3) Scrub hands for at least 20 second (hum “Happy Birthday” twice)

4) Turn faucet back on and rinse your hands well under clean, running water.

  5) Dry hands using a paper towel

 

Hand washing at home

Pump liquid soap at every sink

Does not need to be antibacterial

Use paper towels even at home during times of increased infection risk

Damp hand towels can harbor germs

Dispose of paper towels in non-touch trash can – foot pedal, magic hand wave.  Not inside cabinet

Use hand cream frequently

 

Hand washing in public

Gather paper towels before washing hands

Use one paper towel as barrier from counter – set other towels on it

          Wash hands as above, drying completely with paper towels

Avoid touching public surfaces after hand washing

Use paper towels to turn off sink, open trash cans, and open doors

Option: Ziplock bag with hand soap, paper towels, and hand sanitizer for public use.  Keep plastic bag “clean” – store inside purse/bag

No touch public surfaces – set on paper towel

 

When to wash hands in pandemic

Every 1-2 hours when out of home in public

Before leaving public location – avoid contaminating your car

          As soon as you enter house (touch as few things as possible first)

Before touching any food, including packaged snacks or restaurant food

After contact with potentially contaminated things in home (groceries and supplies, outside door knobs, shoes, backpacks/purses)

Toilet, etc – just like always

 

Hand sanitizer

Use only if you can’t wash your hands!  Why? You can’t disinfect something that is dirty!

Germs hide in oils and grime…and hands get dirty very quickly.

Sanitizers work best if hands are clean

Sanitizers must be at least 60% alcohol

          Rub gel over all surfaces of hands and fingers until dry (~20 seconds)

 

Photo credit:  Coronavirus (ID 171082256 © Dgmate | Dreamstime.com)

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Our Man in Hong Kong-the Coronavirus Threat

Workers encased in plastic

Our Man in Hong Kong is Tim Wiseman, an American, a professional man who works for a multinational company.  Two years ago, after happily living and working in Colorado Springs for years, he accepted an overseas assignment with his firm in Asia.  A self-described Bumpkin, he began writing an email journal of his experiences, exploits, trials, and triumphs (surely there were some) as a stranger in a strange land.  In this series of posts, he describes what it’s like to be living in Hong Kong while the Coronavirus is spreading throughout Asia and parts of the rest of the world.  His accounts are humorous, as well as sobering, and he ends with an important message.

The Bumpkin Report — Living with a Potential Pandemic

January 28, 2020

When I moved to HK, one of my goals was to embrace more of an adventure lifestyle. To learn, travel, bumble (bumpkin-style) and generally explore and embrace this big ol’ world.  WOW.  I could not have predicted this type of adventure!!  First, I got to experience a full-on political revolution (Vive la revolution!!!) of the HK protests. Now, I get to experience living next to ground zero of a potential pandemic.

Zombie Apocalypse
First of all, I am extremely knowledgeable about infectious disease scenarios because I have seen every zombie movie, read every zombie book, and watched every episode of The Walking Dead.  All those exhaustive hours have not gone to waste.  Anyone who follows zombie scenarios knows THE most important consideration is…..are they SLOW zombies or FAST zombies? Can I get an AMEN!?  (Geoff, Caleb, Sam, Mikey – back me up here!)

Fortunately, Hong Kong has slow Coronavirus zombies. Slow zombies mean armor up (masks and hand sanitizer) and wait it out (stay in your apartment).

For those that don’t follow zombie movie . . . here is the situation on the ground.

Post SARS
In 2003, the SARS outbreak infected thousands and thousands and killed almost 300 hundred in Hong Kong, SARS is STILL spoken with a bit of fear and respect, therefore people here take the current situation very seriously.

Chinese New Year – Jan 24 to 29
Nearly 2 billion individual trips will be made during this 7-day Chinese New Year (CNY) holiday. It is THE holiday for China.  Think Thanksgiving, Christmas, and New Year rolled into one. This is terrible timing for a virus outbreak. Hundreds of thousands of Hong Kongers go back to mainland China to visit family. Then they will pour back over the border. This has everyone on high alert.

An interesting aside – there is a strict “family visiting formula” for CNY.  Day one of the holiday is designated to visit the husband’s family.  Day 2 is set aside to visit the wife’s family.  Day 3+ is reserved for extended family and then friends.

Airport
I was in the airport this weekend and 99% of people were wearing masks.  Hand sanitizer stations were set up everywhere and the temperature check station was in full operation. This is a good thing.

Masks
You’ve probably heard about the special masks that one should wear and that the global stocks are sold out. Fortunately, I had a nearly full box of masks left over from my cold last year so I didn’t have to do battle in the stores to get my supply.

However, get this! We are being told that when we throw away our disposable face masks in public that we need to tear or shred them because people will dig them out of the public trash cans, fold them, iron them and then repackage them to resell on the street.  I have no idea if this is a real thing or more of an urban myth.  Either way…ewww, gross!

Nearly empty shelves in stores
No hand sanitizer or face masks here–and sadly no limes for Gin and Tonic

Hand Sanitizer
I’ve been a one-man lecture series telling everyone that clean hands and antibacterial wipes are more important than the face masks. You rarely will be next to someone who coughs or sneezes on you, but you will definitely touch the train/bus/trolly/escalator/stair rail/elevator button that has been touched by 1,000 other people every hour.  This clean hand concept isn’t quite as well adopted as the masks, nonetheless all the hand sanitizer is sold out in stores as well. Fortunately, I had some prior stock from my cold last year and I did pick up some extra before the rush on the stores so I feel pretty well supplied. I also stocked up on bleach and cleaning supplies.

Empty Streets but not empty stores
Between the CNY holiday (everyone traveling) and the virus, the streets of Hong Kong are very quiet.  Even the traffic is diminished.  This is a good thing to prevent virus spreading. Walking around, you see 80%-90% of people are wearing masks.

I’ve also seen pictures of empty grocery stores making their way around social media.  This is 100% not true.  Masks and hand sanitizer, yes, but everything else is fine. Okay, my local store was out of limes for my gin and tonic and that was pretty tragic.

Work from home policy
The partners have been emailing back and forth the past few days and we decided on a work from home policy the rest of this week. This will give us a few more days to determine if things are going to get more serious or not. We are also documenting any travel (business or professional) for everyone as well as any visiting clients.

Elevators:
The button panels in every elevator that I’ve seen have been covered with sheets of plastic with a little sign.

Men playing poker using face masks as chips
Playing poker with masks as the chips

Schools:
Many of the universities and schools have decided to keep closed until February 17.  As is well known, schools are giant germ factories. So this is a good thing as well.

And yet life goes on:
I’m still going out to dinner with friends, enjoying the city, and even went bowling with a bunch of friends the other day…and one of them was pregnant and she wasn’t too worried.  I’m even still hosting my poker night this weekend – but I will require mandatory hand washing!

In general, everyone is being diligent about prevention, but nobody I’ve come across is scared or panicked. I feel the same way- I’m paying close attention, but still living life (semi) normally.

SO TAKE THAT, YOU ZOMBIES!

 

February 24, 2020

Hello Bumpkin readers. I’m still alive and kicking!

But wow, I have dropped into the most amazing social experiment about human behavior!

Overall, things are moving along as normal as possible here.  We all wear our masks and carry hand sanitizer. I really appreciate how diligent the city has been and how serious everyone is taking it.  While the actual number of people infected is quite small, the transmission rate can be very high in such a densely populated place like HK.

As things have stabilized, life is sloooowly coming back into the city. The past month has been quite boring.  Most all social and public gathering have been cancelled. However, I was out every night last week with colleagues or friends and you could tell that places are getting busier.

Here is a random list of observations.

Dashboards:
If you are interested in the local and global infection rate is…here are the nerdy data dashboards that we are all watching and have become the topic of conversation at every business and social gathering.

Schools Still Closed:
All schools, including University level, are still closed until mid-March.  I would not be surprised if that gets extended another few weeks just out of extra caution.  All schools are using virtual teaching techniques.  My friends with kids say that they meet with the teacher online, then do some homework and then connect again to discuss.  My friend who has a 6-year-old daughter said it’s not easy to get a bunch of 6-year-old’s to stay focused online for very long!

Business is Suffering:
Business overall is slowing down.  Many companies are reducing spending and cutting costs, and most all are impacted in some way from the virus.  Hotels, airlines, and restaurants are suffering the most.  Hong Kong restaurants are ALWAYS packed during lunch and dinner.  But today you may be one of only 3 or 4 tables and the rest are empty. In some ways it’s quite nice to just walk into any restaurant and get an open table without a reservation. But the food and beverage industry is taking a beating and places are cutting staff and even shutting down.  Airlines have cancelled dozens of flights every day.  The airport is very quiet.

Movie Theaters:
They were closed for a couple of weeks, but now you can go if you get your temperature checked and you wear your mask.  The theaters will seat every other row to keep space between patrons.

Workers encased in plastic
Workers encased in plastic (this is a joke but it’s not far from the truth)

Claustrophobic at work:
Our office has a MANDATORY policy of wearing a mask all day long at the office.  It’s quite claustrophobic.  You can’t breathe like normal.  Your glasses keep getting fogged up. Then when you put on your phone headset for calls and it can make you feel a bit smothered.  Gaaahhhh – can’t breathe!  Photo of office under plastic – this isn’t a real office – it was just for fun.

Panic Buying:
YES.  There is panic buying of toilet paper!  Can we be pragmatic for a moment?  One can technically get by without toilet paper.  That’s like number 74 on the list of survival supplies.  And for some reason it’s these little old Hong Kong ladies that are leading the panic buying charge.  They are slightly hunched over dragging 4-5 bags of toilet paper (each bag here is always 10-12 rolls). When the shipment comes in, they all race down to the store and clean it out.  So bizarre.  As for me, I accidentally walked into my local store the other day just as they stocked up and I now have enough TP to last a month!  I feel so wealthy! ?

Toilet Paper Theft:
Not kidding.  Here is an article from the Post about a knife point robbery of toilet paper.  Here is the extra funny part.  Halfway down the article there is a photo of someone’s apartment window stacked full of toilet paper.  I texted my neighbor to confirm my suspicions….and yes it’s MY BUILDING!  I have a genuine Toilet Paper crime syndicate in my building.  So many jokes in my mind that I can’t even process them!  See the photo below of window stacked with TP at my apartment building.

Article: https://www.scmp.com/news/hong-kong/law-and-crime/article/3050907/armed-gang-steals-hk1000-toiletvvv-paper-coronavirus

Other Bizarre Panic Buys:
Yes masks and hand sanitizer and even pump soap are impossible to find.  Rice and noodles get bought out regularly, but there have been some weird panic buys

  • Vinegar – based on the theory that it is a natural disinfectant
  • Spices – NO idea why

    Hoarding of toilet paper in apartments in Hong Kong
    Many people in Hong Kong are hoarding toilet paper in their apartments

I’ve stocked up on oatmeal, rice and quinoa.  And my freezer is stuffed with pizza rolls. Not really, but it’s full of food.  And, of course, Gin and Tonic for medicinal reasons!

Masks – Part I
If you don’t have a “connection” or source, and IF you can find them, the current street price is between $2US and $5US PER paper mask.  And even that will lead to a line out the door.  I was in Japan two weeks ago and every drug store I went to was sold out as well.  They said the Chinese are coming over and buying everything.

Masks – Part II – Resupply Shipments
I, along with all my local friends, are requesting shipments of masks and hand sanitizer from contacts all over the world.  And they are sold out EVERYWHERE. Africa, South America, Europe.  Everywhere. Special thank you to Steve, Carol, Ash, Winnie, and Bruce that were able to track down some supplies and send them my way.  If I get enough, I might open up my own black-market operation and make a little extra money on the side! ?

Masks – Part III – Gweilo’s think they are invincible:
This is an interesting cultural observation.  In general, when you see someone NOT wearing a mask, it’s a bit alarming and everyone stares.  However, when people are outside walking around for recreation on trails or at the beach, more often than not, it’s a Gweilo / western person.  Not always, but more than 50%.   I’ve discussed this with several locals to get their perspective.  The reactions are somewhere between “Gweilo’s just don’t understand how serious this is.” And “Those Gweilo are so #!$!$ arrogant.”  Overall, the local’s are a slightly resentful of the Gweilo attitude.

Masks Part IV – Volume buying on the grey market
One of my friends here is the general manager of a gold processing facility.  They refine gold for jewelers, technology companies, investors, etc.  He said that his workers will not come to work unless he provides the masks.  He needs 200 masks every day.  He told me he is part of a “grey market” network that buys and sells large volume masks.  He just made a purchase of 9000 paper masks for….get ready…$36,000.  He had to get special permission from his headquarters for the unusual type of expenditure.

Temperature Checks:
They are everywhere.  My office building.  My office at the reception desk.  Some residence buildings. Some shopping malls. Movie theatres. Even some banks.  But the most humorous experience was from this weekend.  I went with a friend to a beach on an island located only 100 yards from shore. But you must take a very small 6-person boat for the 90 second trip.  Yes, you guessed it, we had our temperature checked on the little boat.

 

Man in Hong Kong selling masks on the street
A street vendor selling face masks in Hong Kong–just the right gift for Valentine’s Day in a pandemic zone.

If you want to nerd-out, there is a lot of global chatter about how completely useless temperature checks are, especially at airports.  The benefit is mostly psychological.

In summary:
All irony and amusement aside, this has been fascinating to watch unfold and it confirms two long-held beliefs.  1) Individual people are rational – but when we get together in groups, we become idiots. 2) DO NOT rely on the government – self-reliance is still the only way to go.

Lastly – my advice in these circumstances is to pay attention and get your supplies early. It’s always a good idea to have some ‘emergency’ supplies on hand.  And if something does go wrong (hurricane, snow storm, lengthy power outage, Covid-19 virus) then GET your supplies FIRST.

 

All photos courtesy of Tim Wiseman.  Used with permission.

 

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On the Inevitability of Social Liberalism

Conservative Commentator Rush Limbaugh
Conservative Commentator Rush Limbaugh

The progress toward social liberalism may have been impeded since Trump took office, but it is inevitable, despite those who oppose it.  Had Rush Limbaugh had been on the radio in 1918, we can imagine him loudly denouncing the women’s suffrage movement.  “Women should not be allowed to vote,” he might have argued, “because their role is in the home.  The fairer sex is concerned with children and local issues.  They don’t understand the loftier matters of state, government, war, or politics, nor should we ask them to.”  He would have been joined in his opposition by Sean Hannity, Tucker Carlson, Steve Bannon, Laura Ingraham, and other firebrand conservatives who would use their media platforms to impede social progress.

Denying women the right to vote would be incomprehensible in 21st century America, but until 1920, when the Nineteenth Amendment to the U.S. Constitution was ratified, women’s suffrage was a hot social issue in this country, and many conservatives—some waving their Bibles and quoting scripture—vehemently opposed giving women the right to vote.  Prior to 1920, the opposition to women’s suffrage was as strident and vocal as Donald Trump ranting about immigrants at one of his rallies.  The Anti’s, as opponents of women’s suffrage were known, offered these kinds of arguments:

  • Only a minority of women want the vote. The majority are happy not having it.
  • Doubling the number of voters would lead to more corrupt voting practices.
  • Women have been making advances without having the vote; therefore, they don’t need it.
  • Women should focus on what suits them: education, reform, and charity.
  • Women already have important roles in society. Giving them the vote would force them to sacrifice their higher interests, namely the family.
  • Because women are excused from public service requiring the use of force (e.g., police, military), they would be irresponsible voters.

Despite these lame arguments, the Nineteenth Amendment passed.  Women have now had the vote in this country for nearly a century, yet as recently as 2015 conservative extremist Ann Coulter said on the radio program “Free Speech” with fellow conservative Gavin McInnes that women should not have the right to vote.  Coulter argues that if women were not able to vote, “We’d never have to worry about another Democrat president.”  In Coulter’s opinion, women, especially single women, “are voting stupidly.”  In taking away their right to vote, these women “would finally be silenced.”

American society, like all societies, will always have people who oppose social change.  It upsets the status quo.  It challenges conservatives’ value system and threatens their identity.  It enables debate that may threaten the legitimacy of their ideology.  It frightens them because they don’t want to lose or share the privileges or special status they and their kind have enjoyed.  Allowing any social change may open the door to even more social changes, and they worry that the world they are comfortable with will end.  In the worst of cases, they are not just concerned with protecting their own social status, they actively seek to deny others the opportunity to enjoy equal status.

Some opponents of social change find moral justification for their opposition in the Bible, the Koran, or another religious text.  They invoke God because no one can envision a higher authority.  If the Creator of the Universe opposes women’s suffrage, or racial equality, or gay marriage, their reasoning goes, then who are we to challenge God’s will?  These arguments are spurious and illogical on numerous grounds, but when you have no better arguments to make, invoking the name of God may be if not your best option then your option of last choice.

Turn-of-the-Century Nurses as Suffragettes
Women fighting for suffrage

Social changes do not come easily.  Many people advocated women’s suffrage well before the mid-nineteenth century, but the movement’s formal origin can be traced to the Seneca Falls Convention in 1848.  However, the movement did not achieve its objective until 1920—seventy-two years later.  The struggle for racial equality has lasted even longer, and many would argue that it still has not been achieved.  Unquestionably, racial prejudice remains to a greater or lesser degree in some American’s hearts and minds, but even in the relatively short span of my lifetime, I have seen considerable change in how African Americans are perceived in this country and treated by those in mainstream society.  The full extent of Martin Luther King’s dream may not yet have been achieved, but considerable progress has been made since the 1960s, and today it would be as unthinkable to return to segregation and Jim Crow laws as it would be to return to slavery.

The women’s suffrage movement and the struggle for racial equality illustrate my principal thesis:   that social liberalism is inevitable, although not without struggle, sacrifice, and fierce, highly opinionated resistance.  Social change does not come easily—but it comes.  Social conservatives initially resist change—and some will furiously, even violently resist it—but social progress is inevitable.  Like the arrow of time, it only has forward direction if we view progress from the scale of decades and centuries rather than years.  Reversals will occur, as they are occurring now under the Trump administration, and societies may backslide now and then, but as a macro view of human history shows, in the long run the arrow of social progress does not reverse.  Rights and freedoms gained can be taken away—but when that happens, as it did in Cambodia under Pol Pot, the setback lasts for a relatively brief period in the longer scale of human history before rights and freedoms are restored and social progress continues.  The pace of progress varies by culture, and one might argue that progress will never occur in North Korea and other repressive countries, but I would counter that we have to view progress on a macro scale.  Social progress will come to North Korea and Syria and countries like them but not perhaps in our lifetimes.

LGBT Rights and Gay Marriage

In Trump’s America, the battle lines between social conservatism and social liberalism are currently drawn around LGBT rights and gay marriage.  Our society is somewhere in mid-struggle with these issues but progress continues.  The acceptance of gay and lesbian relationships has been steadily increasing in the past 25 years.  In 1991, for instance, more than two-thirds of Americans said that sexual relations between two adults of the same sex was always wrong.  By 2008, just over one-half of Americans had the same opinion.  In a 2013 PEW survey, 60 percent of Americans believed that homosexuality should be accepted, and that number has since risen to 63 percent.  Attitudes about homosexuality began changing around 1970 and acceptance has trended upward since.

Attitudes about LGBT vary considerably from culture to culture.  Acceptance is greater in more affluent and less religious societies.  Acceptance also varies by generation.  Millennials are more accepting of homosexuality than baby boomers, and the generation following millennials is likely to be even more tolerant.  Younger people are more exposed to diversity, particularly in school and through social media, television, and films, where favorable depictions of gays are now more commonplace.  Despite Trump’s on-again, off-again support for LGBT people serving in the military and the reactionary attitudes of his followers, acceptance of homosexuality has become more mainstream.  It’s difficult to envision social forces that could reverse that trend.

Two women holding LGBT rainbow flags
The LGBT struggle for equal rights continues

Likewise, attitudes toward gay marriage have evolved considerably since 2001 when 57 percent of Americans opposed it.  By 2017, only 32 percent opposed it while 62 percent were supportive.  Support for gay marriage is highest among people unaffiliated with a religion and slightly less so by white Protestants and Catholics.  It is lowest among white evangelical Protestants.  As expected, more than seventy percent of Democrats and independents favor gay marriage, while only forty percent of Republicans are supportive (although that number continues to rise).

In 2015, the Supreme Court ruled in a 5-4 decision that gay marriage was legal in all fifty states.  When that ruling was made, thirty-seven states and the District of Columbia had already legalized gay marriage, but the issue remained contentious, and several Republican contenders for the 2016 presidential election—Ted Cruz of Texas and Scott Walker of Wisconsin—favored a constitutional amendment banning gay marriage.  It is conceivable that an upswell of conservatism could result in a reversal of this Supreme Court ruling now that we have a more conservative court, but public support for gay marriage is strongest among younger generations, and all those young voters are likely to continue supporting this socially progressive development.  Despite conservative religious opposition, this social advance seems likely to have passed the point of no return, and if a more conservative Supreme Court reverses the 2015 ruling, the rising tide of support for gay marriage will eventually restore this right.

Interracial Marriage

Less contentious today is the idea of interracial marriage, but half a century ago it was not only frowned upon but illegal in some states.  In the mid-sixties, Richard Loving, a white man, and Mildred Jeter, who was part black and part Native American, were sentenced to one year in prison for marrying.  Their marriage violated the State of Virginia’s anti-miscegenation statutes and the Racial Purity Act of 1924, which forbade marriage between whites and people of color.  In a landmark ruling that year, the Supreme Court declared that raced-based restrictions on marriage were unconstitutional.

Interracial married couple Mildred and Richard Loving
Mildred and Richard Loving

In 1967, only three percent of married couples consisted of spouses from different races.  By 2015, that number had jumped to seventeen percent.  In 2017, 29 percent of Asian newlyweds (born outside the U.S.) and 27 percent of Latino newlyweds (born outside the U.S.) were married to spouses of another race.  For Asians and Latinos who were born in the U.S., the rates of interracial marriage were even higher:  46 percent of Asians and 39 percent of Hispanics.  Today, eighteen percent of black newlyweds and eleven percent of white newlyweds are marrying spouses from other races.

In a PEW Research study of attitudes toward interracial couples, non-black respondents were asked if they would oppose having a close relative marry someone who is black.  In 1990, 63 percent said they would oppose it; in 2016, that number had shrunk to 14 percent—a remarkable attitudinal shift in just twenty-six years.  We can see evidence for this shift on television, where a number of current ads depict interracial couples.  What was once taboo is becoming more commonplace.  Even the majority of Republicans today say interracial marriage does not matter.  By 2014, there were more than five million interracial married couples in the United States, a number that will continue to rise, as will the number of children with biracial heritage.  At some point in the future, our country will have more people with mixed-race heritage than people born from parents of the same race.

Women in the Workplace and the Military

We have to take a longer view to appreciate the strides women have made in the workplace and the military.  In the 19th century, women had few workplace choices and were largely confined to the homestead raising children.  The Civil War gave many the opportunity to work as nurses, just as the Crimean War had given that opportunity to British women.  During this era, women who worked outside the home were primarily teachers, dressmakers, and domestic servants.  In the twentieth century more opportunities opened up, but it wasn’t until World War II that the dam really burst.  With so many men off to war, women filled many jobs previously open only to men, including jobs in industry.  My mother and her older sister worked in an airplane plant in California during the war, part of the Rosie the Riveter generation.  The situation regressed a bit in the “Father Knows Best” era in the 1950s when men, returning from war, took back their old jobs and women were expected to tie their aprons back on and keep house and raise children.

Young American woman in full military combat uniform
Women are now able to serve in front-line combat roles

Today, while women still earn less for doing the same jobs as men, the gap is slowing narrowing, and women make up an increasing percentage of the workforce.  In 2013, more women entering the workforce had at least a four-year college degree than men, and the gap between men and women is still growing.  Forbes reported in 2008 that more than 11 million women were enrolled in college, compared to just over 8 million men.  A PEW Research study found that in 2012, 71 percent of recent female high school graduates had enrolled in college, compared to just 61 percent of men.  Today, women make up nearly half of the nation’s workforce, and about forty percent of them are in management, leadership, or professional roles.  With more women earning college degrees than  men, they will eventually surpass the number of men in jobs requiring  a higher education.

American women have always served in the military, a few in combat roles disguised as men in the Revolutionary and Civil Wars.  But women were prohibited from officially serving in combat roles until 1994, although they made up nearly 14 percent of service members in all branches.  Even after 1994, women’s roles in combat were restricted.  However, in 2015, the Pentagon announced that women would now be allowed to serve in front-line ground combat roles.  Progress in women’s equality has been steady, albeit with grudging social acceptance.

However, that acceptance demonstrates a fundamental shift in societal attitudes, and it’s difficult to image the circumstances that would compel our society to move in retrograde—to prohibit women from combat, to restrict the types of jobs women can hold, to reverse decades of progress, and, despite Ann Coulter, to take away women’s right to vote.

The Inevitability of Social Liberalism

In 2018, we are witnessing a resurgence of conservatism and with it a resurgence of white power hate groups, racism, and xenophobia—energized and condoned by Donald Trump and Steve Bannon (under the guise of nativists and nationalists) and their media trumpets, particularly the crews at Breitbart, Fox News, and other ultra-conservative media operations.

Three columns in ruins at Ephesus symbolizing the crumbling of reactionary edifice
Like these ruins in Ephesus, the bastions of the Old Order are slowly crumbling

They are funded by a few radially conservative billionaires and their families, like the Mercers and the Hunts, who are pouring hundreds of millions of dollars into socially regressive causes and political campaigns.  But no matter how loud and powerful they are, the sheer numbers of mainstream Americans who make choices about who and what they’ll accept and how they’ll live, and what they’ll support form a rising tide of social change that can be retarded but not denied.

It is possible to deny people rights they once had.  We saw it in Russia during the Bolshevik Revolution and in Nazi Germany in the 1930s, and like Russia and Germany it usually occurs during periods of extraordinary national upheaval when a minority that assumes power seeks to retain power by controlling and restricting the masses.  But social attitudes and values, once planted, can be suppressed for only so long.  Eventually, societies evolve beyond the temporary denials of rights once held—a process that may also require extraordinary upheaval.  Human progress moves inexorably forward, though it may span more than a few lifetimes.

Social regressionists like Trump, Bannon, Limbaugh, Hannity, Carlson, Coulter, and Ingraham may work hard to reverse social progress.  They may achieve some successes along the way, but ultimately they are like pimples on the ass of progress because, as I have shown in this discussion of women’s progress, racial equity, and LGBT rights, social liberalism is inevitable.  It occurs as successive generations become more accepting of diversity and more willing to extend equal rights to all people, regardless of gender, race, religious preference, or sexual orientation.  It occurs when the bastions of the Old Order crumble as the hatred and privilege that support them are exposed and eroded.  It occurs as the edifice of intolerance is crushed by the weight of tectonic demographic shifts that the powerful are powerless to resist.

 

Sources:  U.S. Department of Labor, PEW Research Center, NORC at the University of Chicago, The Williams Institute, Madamenoire, and Forbes magazine.

Photo credits:  Rush Limbaugh:  victorfosterono @ flickr; suffrage women:  Everett Collection Inc. @ Dreamstime.com; LGBT couple:  Rawpixelimages @ Dreamstime.com; Mr. & Mrs. Richard Loving:  Tullio Saba @ Flickr; woman soldier:  Roman Kanin @ Dreamstime.com; ruins in Ephesus:  Bin Wang  @ Dreamstime.com