The pendulum has swung. The virus that seemed so singularly urban is now ravaging the rural areas of our country.
To be honest, we knew from the start this was an equal opportunity virus, a sliver of RNA that was incapable of recognizing whether its host shopped at Target or Fleet Farm, wore chinos or Carhartts.
Even so, it made sense on some level that the virus would hit population-dense urban areas the hardest and spare rural communities. After all, the virus is airborne, but it cannot fly. Like a nuclear chain reaction, if you spread humans out far enough the virus simply can’t find enough of them to keep the chain of infection going.
Much has been written about how masks were politicized, but in fact, the virus started the process. Making its debut in Seattle before opening on Broadway and then moving on to other major metropolitan areas, it seemed like Sars-CoV2 actually preferred Democrats over Republicans, blue states over red states.
Small-town America seemed safe from the virus—until it wasn’t. Tom Dean, a physician in rural South Dakota, told the The Washington Post:
“How do you go from nothing to the worst outbreak in the country? I don’t know. I don’t have a good answer. We started to see a few little pockets of it, but the virus seemed fairly contained. There was a small outbreak at a cafe, and that led to seven or eight cases in our farming community, but then it seemed to go away. There were a few cases up north at the beef jerky plant. A couple of our students came down with it. Then a few teachers,” Dean said.
He was thankful for the virus’s lack of staying power in his small community, but not relieved. “I was worried about how fast this could spread through town. We have one grocery store, one bank, one pharmacy — it’s all the same Petri dish.” Then one day in the fall the phones started ringing, and Dean had 11 new cases in five hours. It has been bad ever since.
It turns out that Sars-Cov2 has no political affiliation: It votes a straight human lung ticket. Now that the virus is raging across rural America, with infection and mortality rates that top anything seen in heavily paved areas, the change in fortunes has led some to pile on. “I told you so” and “You didn’t listen” reflect basic human emotions, and come naturally to parents. (My parental version of this was, “We can’t save you from yourself.”)
It is understandable that people might respond to the White House Rose Garden super-spreader event with a sense of righteous anger, with a feeling that justice has been served. And it is understandable that infections of prominent Republicans like Minnesota Senate majority leader Paul Gazelka, or Iowa’s Sen. Chuck Grassley might encourage some to sneer with a distinctly rural metaphor, “Looks like the chickens have come home to roost.” Only they’re dropping excrement, not eggs.
As both a hospital physician and an English major, here’s one word that I think should not be used: deserve. We should not say, “They got what they deserved.”
It is a little like when a smoker gets lung cancer. Should we say they “deserve” it? It’s not entirely accurate to say that “smoking causes cancer” because that suggests everyone who smokes will get lung cancer. That isn’t true. More accurately, we can say with certainty that smoking increases one’s risk of cancer. Many smokers will not get lung cancer, and some people who never smoked also will get lung cancer. Did either “deserve” what they got?
We all have choices to make about how we live our lives, and how healthy we are. Those choices can alter the likelihood of acquiring a particular disease. Obesity increases the risk of diabetes, but one would never tell an overweight diabetic patient that they got what they deserved. Physical distancing and masks can lower the risk of getting COVID, and not doing so increases the risk. But let’s agree that no one deserves to get COVID.
All of this might seem to be the hair-splitting of a word nerd. And yet the difference between seeing a fellow human being as deserving of their illness, versus having increased their risk for it by their behavior, is the difference between shame and empathy. Shame is almost never a good motivator. Sometimes shaming is counterproductive, motivating people to double down on risky behavior. We would be far better off using our imaginations to empathize with someone we do not know, have never met, and do not fully understand.
If I have learned anything from a career in healthcare, it is that none of us deserves any of this. Health, and life itself, is a gift. Somehow or another, God or the Universe decided to mold 7,000,000,000,000,000,000,000,000,000 (7 octillion) atoms into the shape of You, free of charge, shipping included. So let’s skip the shaming, and be grateful instead.
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