Medical Examiner

Who Actually Gets to Shrug Off COVID

Yes, some of the divide is geographical. But it’s not as stark or simple as a recent Atlantic article supposes.

A group of maskless young people smiling and toasting at a bar.
jacoblund/iStock/Getty Images Plus

Fine, I’ll take the bait. Yesterday, the Atlantic published a piece called “Where I Live, No One Cares About COVID” by Matthew Walther, an editor and writer who lives in rural southwest Michigan. The piece delivers on the title: No one in his immediate geographical area takes COVID seriously, he says, nor does he. He notes that he has spent a lot of time going to restaurants, going to weddings, and grumbling over headlines about booster shots. The piece is not a mere report of his actions and observations; the thinly veiled subtext is that taking COVID seriously is for dweebs. He diagnoses concern over the virus as a pathology of the “professional and managerial classes in a handful of major metropolitan areas,” who are overrepresented in media.

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It’s a narrative that fits neatly into the culture wars that pit an elite, out-of-touch big-city media against salt-of-the-earth rural America. It almost seems designed to inflame: It sat in the No. 1 most-read spot on the Atlantic’s website and generated a lot of angry tweets.

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But it also strikes me as a faithful dispatch from rural Michigan. And because Walther’s experience is probably representative of that of many in America, it’s worth examining what it gets right and what it conveniently ignores, both in terms of the reality of COVID and the morality of pretending it doesn’t exist.

I’m from a small town in the Midwest, and although I no longer live there, I visit often, including several weeks in central Illinois and rural western Michigan this summer. Walther is correct that many people in these areas are far less concerned about COVID. Case numbers aren’t discussed like the weather forecast. No one outside a hospital seems to know what an N95 is. To be honest, I found it refreshing after the claustrophobic, masked reality of 2020 in New York City. (This feeling was also made possible by the vaccine: I traveled in July, when case rates were low, and delta hadn’t really arrived yet.) It was glorious to stay with family, crowd into restaurants, and otherwise not give a damn about COVID—and not be too worried I was putting anyone else in danger.

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There’s something else I agree with Walther on: Many in the professional class can err on the side of neuroses. Take this piece by Alexis Madrigal, also published in the Atlantic, who detailed a very, very mild encounter with an infectious disease as if it were a moral failing. Madrigal, after much hemming and hawing, attended the wedding of his best friend, which required traveling on a plane and involved some reveling indoors. Upon his return home, he antigen-swabbed his nose many times, tested positive, and then absconded down the street to isolate from his family. Stressful, sure, but Madrigal—who reports a grand total of 20 coughs—ends the essay with the notion that he was plunged into another reality by the virus. Madrigal’s piece was somewhat absurd for the opposite reason Walther’s was: It was a cautionary tale in how not to manage COVID anxiety. It’s a bit much. I get that.

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What Walther gets wrong is that COVID concern is black-and-white, that you’re either obsessing over it like a Madrigal or ignoring it like a Walther. Surveys show most Americans favor some COVID precautions, like reinstating some sort of mask guidelines (52 percent) or increased COVID testing (76 percent). Preferences do vary by geography—a reality that is very noticeable on the ground and shows up in local norms—but that definitely doesn’t mean that everyone in an area has the same attitude. While in Michigan, I spoke to a grocery store clerk who was unnerved by the lack of masks; she was immunocompromised and COVID posed outsize risks to her, and yet she couldn’t quit her job because … bills. People who have had organ transplants live everywhere in America; Walther claims that neither he nor his wife, who gave birth during the pandemic, has had conversations about COVID risk with their doctors. But surely some of his fellow Michiganders have, by dint of their medical conditions. Walther is also wrong that cities are so uniformly uptight about the virus. In New York City, where I live now, large swaths of our population are unvaccinated by choice, and many bars look the other way when it comes to checking vaccine status. One more bone to pick on geography: There are 60 million people in “rural America,” or 20 percent of the population. The other 80 percent live in urban areas—including 26 million people in the top 20 most liberal cities. Both are equally American, and the preferences of conservative rural America—regardless of its elevated position in American mythology—are no more valid than the preferences of liberal metropolitan America.

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The essay is very convincing on the fact that Walther himself really, really does not care about COVID. Nowhere in the piece does he mention the toll of 800,000 people who have died of COVID, a death count that is currently rising by 1,300 each day. He waves away rural Michigan’s surge, noting that hospitalizations “are always high this time of year.” Here is a quote from a recent New York Times piece by an ER doc there: “My colleagues and I know the patients are piling up, but there just are not enough nurses to properly triage everyone. … Patients who need surgery can’t be transferred because nearly every hospital within a two-hour drive is near or at capacity, too.” Most of the people “piling up” in hospitals are unvaccinated; some are vaccinated but high-risk because of their age and health. Health care workers are burnt out, and, apart from his wife’s midwife, Walther pretends like they don’t exist—even though they’ll be ready to care for Walther should he need a hospital bed. Just because Walther can’t see what’s happening in America’s ICUs doesn’t mean it isn’t happening.

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COVID denialism at this point in the pandemic is a luxury, plain and simple. These debates aren’t really about the Walthers or Madrigals in the world. I can’t speak to their age, race, ethnicity, or income specifically, but it is fair to say that writers at the Atlantic—and, yes, the American Conservative, where Walther works—stand in for a class of people who have been least affected by the pandemic. Here’s something worth mulling over: Of the nearly 400,000 COVID deaths in 2020, only about 4,000—1 percent—were among non-Hispanic college-educated white individuals age 25 to 64. As of this fall, 1 in every 240 Indigenous people have died, 1 in 390 Latinos, and 1 in 480 Black Americans; 1 out of 100 people older than age 65 have died. COVID doesn’t prey on the white managerial class in Manhattan or Michigan; it picks off racial and ethnic minorities, the working poor, the medically vulnerable, and the elderly, with prolific precision. Whatever you think of Madrigal’s reaction to a positive test, it was, at least, socially responsible. Walther, on the other hand, seems unconcerned with social responsibility at all. His moral argument, if there is one, boils down to this: A lot of people agree with me.

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That’s one thing that Walther’s article nails: The moment to get on board with precautions for the good of the group is long past for a lot of people. It’s hopelessly naïve to think deep-red counties are going to adopt vaccine mandates or display high rates of double-masking in public places where caseloads are high. That said, a lot of good can be done without buy-in from everyone. Policymakers could still decide to make reliable rapid tests and high-quality masks accessible and cheap for those who want them, and they could work on educating those who just haven’t had time to keep up with every twist and turn of the news. There could be even better efforts to vaccinate the millions of people who still want to be vaccinated (yes, they exist), with a push to make vaccines accessible to low-income and immigrant communities. But our pandemic response will need to continue to account for defiance. Future pandemic preparedness plans will need to bake in the fact that some people will just deny that the virus meaningfully exists.

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