Our Year: Emergency Mode Can’t Last Forever

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S1: One of the images I think will stick with me long after this pandemic is over is this simple visualization that got repeated over and over again, a line graph showing waves of coronavirus infections followed by what felt like a tsunami over the winter. You’d see these graphs when you opened up the newspaper and they’d get blasted out over Twitter and the data many of these charts were based on, it came from one source, the covid tracking project. I wonder if you’ll ever look at a line graph the same way again, because I feel like I close my eyes and I see the sort of waves of coronavirus and that must go double for you. Yeah, it is interesting.

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S2: Like any certain shapes of charts, like I definitely am like, oh, I know that one.

S3: Alexis Madrigal runs the covid Tracking Project with his colleagues over the Atlantic magazine. He’s a journalist there. And last year he was looking for information no one seemed to have, which is how he ended up recruiting a bunch of volunteers to track it down state by state.

S1: He was looking for covid testing and infection numbers, hospitalization rates, death data. And what they found was a bit of a mess. Each state was doing it their own way, feeding dribbles or deluges of information to an unsuspecting public.

S2: It’s funny, I do think that it has changed my relationship to the idea of data a little bit. It has not led me to believe that data is like all knowing or powerful or, you know, something other than, you know, just something categorically different.

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S1: It’s just as flawed as everything else. Yeah. Along the way, the covid tracking project became a primary source both for other journalists and for the government.

S2: Probably the most surreal moment of all of them was actually because our hospitalisation numbers were basically being used as a de facto national hospitalisation numbers in the U.S. before the late fall and winter as the hospitalizations took off and reached new levels. The New York Times was actually like texting me and being like, what’s the number? And at one point, I didn’t know and I didn’t quite realize what was going on, I texted them back the number, the right number, and it showed up as a push alert like five minutes later, like I’m talking like before I even got back to my computer. And that’s when I was sort of like, whoa, we are this central node in this information system right now. And it is really freaky to be in this position, you know, sitting there in my house with my kids around in my sweatpants. And that’s what’s going on, you know, I mean, it was there was some intense moments like that where we realized the weight of responsibility that we really had.

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S1: For me, one of the clearest signs that this one year anniversary of the covid lockdown is meaningful, that something’s changing, is that the Kova tracking project just shut down? Do you feel relaxed right now? Me, yes. Because this giant project you’ve been working on is done.

S2: Well, sort of what I describe it, I feel less tired, but more uneasy that kid like me could go for all of us after this year. Yes, that’s right. Yeah, no kidding.

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S3: Today on the show, as vaccines roll out across the country, the time seems ripe for cautious optimism. But just like at the beginning of the pandemic, the future is anything but certain. I’m Mary Harris. You’re listening to what next? Stick with us.

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S1: Part of the reason the covid tracking project is shutting down is that it was always intended to be a stopgap measure meant to prod the government into action, not replace it. The project is not shutting down because U.S. covid data is now perfect. In the goodbye’s statement on the project’s website, they said, We are both satisfied that the federal government is now producing enough data to replace many of our metrics and eager to turn our attention to the analysis of those areas of the data that remain inadequate. You wrote at one point, President Donald Trump’s incompetence slowed the pandemic response but did not define it. We’ve learned that the country’s systems largely worked as designed, and I thought that was interesting. And I was running, if you could explain that a little bit, because I think there are a lot of people who look at the last year and think it revealed a lot of incompetence on the part of one administration in particular. Mm hmm. Why do you think it revealed something more global?

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S2: Well, I think the easiest answer to that question is, did we have a data system for tracking tests? No. Did we have a data system for tracking hospitalizations? No. Did we have a high speed system for understanding death? No. I think that a lot of public health officials were stunned, as they are, by what has happened, cannot believe that there the system that they had been working on, that there’s all these pandemic preparedness plans stretching back decades, that it wasn’t enough and that, in fact, the things that they had designed, obviously, things like the non pharmaceutical inventions, social distancing, all the things those were pandemic preparedness plans and those work just fine. But the assumption that went into those things would be that there would be data that would be useful for decision making, that would just exist, that would exist, that that it would be there, that we’d know the number of cases, for example. But we didn’t not even close. You know, we knew we knew what we could confirm. But we still to this day have no idea how many people were infected. Maybe 80 million maybe is one hundred million. Maybe it’s one hundred and thirty million. That’s a pretty wide error bars there. And I think that’s really what it comes down to. Trump certainly made things worse. Absolutely. There’s just no doubt about that. But the systems that would have needed to exist before the pandemic just did not. And so the systems that got built, their emergency response systems, not something that pandemic preparedness had actually gotten ready ahead of time.

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S1: Why do you say the system was designed that way versus it was? Some things were overlooked.

S2: I think that if you look at the depth of pandemic preparedness planning, a big chunk of it is function on this kind of model of what we’re just going to tell you what needs to happen. And then you all out there will do it. You’ll listen to these public health officials and they weren’t really planning on the level of data sharing that was really necessary. I mean, that’s the part of the design of the system, was not to provide a lot of this information to the public like that wasn’t really how people thought about what would be needed to give to the public. There’s been a ton of thought about what, you know, we call tactical communication, which is what do I need to tell you to get you to do something and not what information like what data do I need to provide to the public to build trust with them to maintain over this incredibly long period of time, these super painful viral countermeasures? And that’s kind of what I mean. It’s not it’s Trump made that worse by taking the best CDC communicators out of commission. But the playbook, the communications playbook that they were planning to run was going to be tactical. In that way, it would have used the pre-existing CDC data systems, which, again, did not have all of the components that we would have wanted and needed.

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S1: Another data issue is baked right into the country’s DNA. The share of power given to state governments has meant that having sound data at the federal level depends on getting good information from each state.

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S2: Federalism is what it is. You know, the states have a lot of power to decide how things go within their borders. And, you know, not just what the governors do, but even like what data is available is really up to governors. And we know that governors pay very close attention to the dashboards that are out there for their states recovered, and that that allows them to shape the narrative around what’s happening in the state. And that doesn’t necessarily mean that they’re covering stuff up. It just means that they choose what information to communicate at the state level. That is just part of how the American system works. You know, and I think that really shows in the variety of outcomes that different states had, particularly, you know, it’s a little hard to blame the states that got hit really hard in March and April because no one really knew what the hell was going on, you know, and again, we couldn’t test anybody. So we have no idea how many cases or where you really if you can’t count cases, you end up counting bodies in this case. And that’s what happened to a lot of the northeastern states. And but later on, people did know what was going on and still had these, you know, very different approaches to trying to protect people’s health.

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S1: My impression from looking at your reporting is that even the data that the federal government is releasing now or the states is far from perfect. And I wonder if we can tell a story or two that kind of reveal how the data is imperfect and what impact it might have. Like you’ve written, this is a really simple metric that covid deaths are reported by the CDC like sometimes a month after they happen. Mm hmm. And that means that when you’re looking at a chart of covid deaths, like it’s hard to know what it means.

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S2: Yeah, that’s exactly right. So the death accounting seems like it would be simple, right? Like when somebody dies, that’s obviously just like a fact. But the way that it actually turns out, each state does it differently. There’s different components of every death certificate and covid could go in different places. And one thing that we’ve seen happen over and over and over again is that when a place gets hit particularly hard, it’s infrastructure for handling those death certificates gets overwhelmed. So what you see pretty typically now is there’s one peak that is pretty close to the peak for hospitalizations, and that’s like death that for whatever reason, got reported very cleanly and made it into state and federal data, let’s say, within a week. And then there’s a whole other set of death certificates that get backlogged and that end up some set of weeks later, like Virginia did this in a very intense way. Ohio did this in a very intense way. Suddenly, long after the peak has passed, you know, weeks or, you know, a month afterwards, you start getting huge numbers of deaths reported by the state. And the reason that this is actually quite a bad thing is that there’s at least some research that the thing that really changes people’s behaviors in terms of being safer is when they see death reports that death numbers can actually drive behavior change. And so if we knew about those deaths earlier, maybe people would be safer in math and maybe fewer people would die. I think the other thing that just remains a huge problem is testing data. So testing data is important, you know, on its own and in a sense, like the pure raw volume of testing is sort of interesting to know. But a lot of states actually use testing data in conjunction with cases to create a positivity rate, and then they use that positivity rate to, you know, as a gating threshold for various things. The problem is that it’s not clear how accurate it is to use that calculation. And the reason is that some tests get reported in electronically very quickly and other tests take longer. They don’t make it through the normal pipelines.

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S1: And so and this positivity rate data is being used to determine stuff like whether school is open and and other things, right?

S2: Exactly. Exactly.

S1: Hearing these stories, it just makes me feel like we’re in a really precarious place because we’re at this moment where vaccines are becoming more and more available for a lot of the country. The weather is warming up and. It feels like the fog is lifting, right? Mm hmm. But as you’ve said, the one thing that seems able to counter the feeling that people may have that I should be able to get back in to the world and act in a certain way is data. But it sounds like the data is still quite imperfect.

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S2: I mean, it’s it’s interesting, I think at this point, you could put together a data driven packet of information like the go to tracking project gets to do on a weekly basis or daily with tweets that would give people a pretty good sense of the pandemic from from federal data. I think that the problem is that was not something the Biden administration promised a covid-19 dashboard. It seems to have abandoned that. And the truth is, you know, the CDC data visualizations are bad, like just you know, it kind of no two ways about it. And I don’t think they’re interested in changing that. You know, I don’t think it’s seen as like a top priority. And and I don’t know that they really care all that much, to be honest with you. Is that a problem? Yeah, it’s a problem. I mean, that’s kind of what I was saying about, you know, when we talk about the system working as intended, I you know, a lot of the CDC folks, you know, clearly don’t think this is something that they have to work on or there wouldn’t be the kind of problems that we have, particularly on that visualization side where, you know, even just getting like notes on like, you know, weird data points takes like pointing it out on Twitter, you know, I mean, that stuff should just happen automatically. People should just care that the data that’s being presented to the public is well explained and visualized in the absolute best way possible. And actually, I just don’t think that that right now is is where the CDC is.

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S3: When we come back, why Alexis is still hopeful about the pandemic’s trajectory despite the tough trade offs that lie ahead.

S1: Despite the very real issues that still exist with our covid data, Aleksa says he’s seen real improvements since the pandemic started. The federal government has created better channels of communication to get more accurate numbers, especially when it comes to hospitalization. The CDC has also built out an electronic reporting system for covid test results. And for Alexis, that means we’re starting to get a handle on this thing. He’s just hoping all those systems get the care and feeding they need to keep being useful.

S2: I think if we saw the kind of regular tuneup maintenance that’s necessary to keep those data feeds equal, that would be another great sign, a particularly nerdy great sign. But it would be the kind of system that allows, you know, more precise comparisons across states, which are things that people want to do. So to me, it’s that kind of small maintenance and care work around this data that actually would say, OK, there’s now enough capacity in the system that people are taking care of this stuff.

S1: Hmm. Well, as the numbers guy, the person who’s been watching covid sort of ebb and flow, when do you think you’ll know that the pandemic is ending?

S2: I think it’ll be independent when the hospitalizations from covid really, really drop off. And we expecting to see that because so many of the older folks who were so at risk for severe covid are getting vaccinated. I think we’re up over like two thirds of people over 65 have at least one shot. And of course, you know, there’s all these lags built in there because their immune system has to be on two shots and immunity. So, like, we’re when we say that, we’re not like it’s not like right around the corner that, you know, everybody would be. And I’ve heard at least two just on a pure ethnic data kind of way. I’ve heard two stories of people getting infected after their first shot. So I think that, you know, we know that it’s going to take a little while still. And what I’m hoping is I actually think, you know, the Bush administration setting Fourth of July as more or less like freedom and freedom from covid sharing kind of day. That seems pretty realistic to me. And it makes sense. I think hopefully that this won’t all happen. And these like crazy kind of quantum way. We’re like suddenly everybody’s doing everything, you know? I mean, it would be a good idea, given the experience of concern to sort of turn the dial slowly and be willing to hang on for a little bit longer. I mean, that’s that’s what I’m hearing from public health officials. And that really makes sense to me, especially given that there are some places that we’re seeing in the data that are a little worrisome, where we’re we’re seeing plateau’s in cases and hospitalizations before we actually wanted we wanted the numbers to go down a lot more before we saw numbers in the Midwest and the Northeast start to really plateau.

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S1: Yeah. I mean, I guess when when you mentioned July or August, the summer, I just think, why aren’t we worrying more about a fall surge?

S2: I am not. Yeah, I yeah I am. I am worried about that. I could seasonality is a thing that’s real for this virus and it’s real for other coronaviruses and all those kinds of things. And so I what I hope is that by the fall and let’s call it October, that we basically have everybody vaccinated. It certainly seems like it’s going to be possible to do that in terms of supply. And then I hope that there are boosters ready for people if we get some of the these other variants that seem to evade vaccination or natural immune response. So, yeah, I think it’s going to be worrisome. And also, you know, I think there are very real tradeoffs with the public health interventions that have been in place for so long. And if our whole country is vaccinated, you know, we get really vast numbers of people vaccinated. I think we have to say, like, well, we we kind of did the best we could here, you know? And it seems very difficult to maintain multiple years, particularly if death do stay, you know, at lower levels for a sustained period of time.

S1: I’m struck by what you’re saying and what some of the people you talked to have said, because it feels like even the good news is sort of not great, like you talked to some. Experts, you talked about this flu test idea that if the covid deaths got to about where the death levels are for flu at its peak, like 100, 150 deaths a day, that maybe that would be acceptable to people. And I thought about that. And I thought the flu kills a lot of people every year. And I guess we’ve decided we’re OK with it. But to layer another virus on top of the flu that is killing people at a similar rate. Could be a nightmare.

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S2: Yeah, I mean, it’s very it’s very hard because, I mean, it’s not like there’s somebody out there who, like decree is like, yes, this is acceptable. And this is not. I think the scenario that people are probably not considering enough is that covid gets like eighty five percent of the way better, but then just doesn’t from there. Like what happens. Like what, what happens if there’s just like six hundred deaths a day for a long, long, long, long, long time, given that there are real tradeoffs, you know, mental health, economic and otherwise. How long are people willing to sustain, particularly the social distancing aspects of of the interventions? I mean, that seems it’s just, you know, it seems to me I don’t know about you. This is not a professional opinion. It’s a personal one. I see everyone around me just like falling over. And, you know, everything has been kind of a state of emergency, but you can’t actually sustain that forever. I mean, I think that’s the reality is you cannot sustain a state of emergency kind of measures forever. And so what is our sort of if we have to find a middle path to keep transmission low or even if we can’t get to zero or near zero, then one, that that that’s kind of the thing that’s been haunting me is like I think things are going to get way, way better even from where they are now, particularly in terms of like a hospitalization and death perspective because of the vaccines. But what if we don’t get all the way? Then why do we do a society like that? That, to me, seems like a very hard question.

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S3: Alexis Madrigal, thank you so much for joining me. Thanks for having me. Alexis Madrigal is a co-founder of the covid Tracking Project. He’s also a staff writer at The Atlantic. While the future of the pandemic isn’t certain, we’ve been hearing from some of you who are starting to make plans about how you are going to navigate the world in the months to come.

S4: I’m in the process of getting my vaccine, taking care of myself, what one is in two weeks. And although I’m nervous and very excited, what I’m getting married to my sample on the Fourth of July, and I can’t wait to just embrace the and my family and friends that are coming in to that event. I actually started the clinical trials for AstraZeneca trials. Nothing has changed except that I was able to travel to see my last surviving grandfather who was diagnosed with Alzheimer’s recently. And so the biggest thing that I got to do was last time, knowing the time, maybe a year, my mom passed away unexpectedly in January of twenty twenty.

S5: I have now been vaccinated. My dad got his second vaccine yesterday. I can’t wait to see him again. Give a big hug.

S6: As soon as I get my vaccines, I’m going to go on my trip to Morocco to visit my family. It’s been five years before my pain. And as for my hair, yes, I’m going to cut it short. That’s going to be the first thing I’ll be doing my back.

S7: And that’s the show. This series would not have been possible without our slate plus members. So big shout out to you if you are one of them. But if you aren’t, I wanted to just give you a little reminder that you can join us at any time you get benefits, like no ads on this podcast or any of your other favorites. But most importantly, you’ll help us get the resources to keep covering stories you want to hear. It’s only one dollar for the first month, so please join us. You can do it by going over to Slate dotcom slash. What next? Plus that slate dotcom. What next? Plus What Next is produced by Elina Schwartz, Mary Wilson, Kamal Delshad, Daniel Hewett and Davis Land. We are led by Allison Benedikt and Alicia Montgomery. And I am Mary Harris. You can always find me on Twitter. I’m at Mary’s Desk. I will be back in your feed tomorrow.