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The Worst-Case Scenario Is Here

hospital beds

Maybe the pandemic couldn't have been avoided, but this terrifyingly bad response could have.

I have been told for most of my professional life that I'm exceptional at "connecting the dots." If you possess this innate ability to put facts, feelings, forecasts, as well as ideas, ideologies, idiosyncrasies, and other variables together and see the whole picture, it can be supremely eye-opening. It can show you a way forward, a way out, or ominously no way.

When you tie together everything that has happened to our country during the last several years -- debilitating divisiveness, smoke screens of distractions, invented tribulations, sham complications, runaway corruption, fantastical economy, skyrocketing debt, an understaffed government, ignorance of science, snubbing alarm bells, immunity from truth, sliced up health care, rise of mental illness, lack of preparation, dearth of immunization, crumbling hospitals, and vacuous presidential leadership -- well, do you start to get the picture?

Now add to all of this a pandemic of epic proportions, something bigger than a booming economy, full employment, a bellicose president, smarts of scientists, and 350 million people. If we are all just brought to our knees at the end of this crisis, we will be lucky. But most likely, we will have our legs taken out from under us.

We have been warned that a pandemic has been coming for years, notably from Bill Gates, who has devoted much of his life and money to the issue of infectious diseases. Scientists and health experts have cautioned us and tried to prep government leaders twice in the last three years about the calamity of an impending pandemic. Ebola and SARS gave us a forewarning and a chance to get it right for the next time. We did nothing. We took a gamble. Diseases and devastation were for other countries. We became complacent, aloof, and blissfully ignorant of our crumbling health care system.

Obamacare was an attempt to fix part of that system and make coverage more accessible. Over 8 million people signed up through limited portals for 2020. Republicans and Trump could kill Obamacare right smack in the middle of this pandemic. When Mike Pence tried to dodge questions about how those who don't have health care now sign up in case they get infected with COVID-19, it was a troubling sign. Millions will suffer not only physically but financially. Because there is no plan in place to protect those most vulnerable. The poor and newly unemployed may get sick, stuck, and screwed again.

Over 10 million people have filed for unemployment since mid-March. New York is reporting a 16,000 percent rise in calls and a 900 percent increase in web traffic to the state's Department of Labor. Lines form for blocks around unemployment offices around the country. People cannot get the help. Departments are distressingly ill-equipped, lightly staffed, and unable to handle the massive surge. Further, the virus has revealed the shocking financial instability of Americans, with 80 percent of workers living paycheck to paycheck.

So now we have millions without health care, without jobs, struggling to get benefits, and an inadequate safety net to handle the monster of financial pain and specter of illness ahead. When the disadvantaged start getting sick, they will rush to hospitals that will have difficulty trying to care for them. Not just because those hospitals will be stacked with patients, but because admissions personnel will be unable to register new intakes who have no insurance and no money to pay. Those who pay usually come first.

And those who can't pay have supposedly sent private hospitals into debt for the last several years. As a result, many hospitals have closed, particularly in rural areas; thus, there will not be readily available care for a large breakout of a virus in those communities. More to the point, those hospitals that have survived are understaffed and relying on broken-down equipment that they can't afford to replace because of dwindling budgets.

The coronavirus has now added almost insurmountable additional burdens, putting hospitals in dire and desperate need of more masks and other personal protective equipment, ventilators, and, since the beginning of the pandemic, testing kits. States are frightfully behind with testing, severely crippling efforts to identify and contain emerging hotspots in urban and rural areas.

The flood in demand for masks and PPE is another example. The purchasing procedure is loaded with dishonesty and disarray. The federal government is competing against states, states against other states, states against other countries, hospitals against other hospitals, and medical supply companies among themselves -- all in bidding wars vying for the same PPE. And criminally, scam artists and middlemen within this mangled web are causing prices to soar.

Equally, there is mass confusion over who is responsible for meeting demand for ventilators. Illinois, for example, asked for 4,500 and received 450 from the administration. We can't even figure out who owns the supply chain. Is it FEMA? The military? This "praise our leader" Peter Navarro guy? Jared Kushner (whose sudden appearance raised alarm about competence and who's in charge)? Mike Pence? Donald Trump? They all have a different story about how to acquire ventilators and PPE.

And they are all in denial, each promising that ventilators will "come soon" when in reality they are weeks and weeks away. Need a portentous sign of just how bad the national ventilator stockpile program is? Many states are reporting receiving ventilators that are broken or need repairs -- fatally useless devices, in other words.

And the one discussed, untested treatment for the virus, hydroxychloroquine, is suddenly in short supply. Not just for COVID-19 victims, but lupus patients and others who need the drug to survive. Hyped by the president, who is not a doctor, raising hopes, swelling demand, and risking lives. One more arrow shot into the battle-scarred medical field.

As a broken-down health care system admits to being ill-equipped and pleads for more protection for EMTs, nurses, and doctors, those who are on the front lines are in great danger. We are already starting to replicate what happened in Italy, where doctors and scores of medical personnel have become sick or succumbed to the virus.

With limited and sick medical personnel, with hospitals overflowing, with a lack of equipment and beds available and overworked staffs, physicians will be horribly forced to decide who gets care and who doesn't -- in other words, who will live and who will die, which is also what is happening in Italy.

With mounting fatalities and strict stay-in-place guidelines, victims will die alone, their bodies bagged, stacked, then loaded with forklifts into mobile freezers. Morgues and cemeteries will be overrun. There will be no wakes or funerals since gatherings of large groups are prohibited. Where, how, and when will all this grief manifest itself?

The desolation will be aggravated with frantic worries over lost paychecks and jobs that might never come back, deterioration in morale as conditions in the country worsen, uncertainty mounting at breakneck speed. This will be compounded by the country's impatience with staying at home, crushing loneliness, inability to socialize, making cabin fever very real. We are already seeing suicides related to the virus, and there are surely, and very sadly, more to follow. Domestic violence are incidents up. There will be terrible sadness and anger. Someone will have to take responsibility for this fatal fiasco.

State governments will point the finger at the federal government, which didn't do enough, didn't do it early enough, and didn't prepare nearly enough. Then there will be those governors who resisted, didn't implement shelter-in-place regulations until it was too late. They will claim ignorance, like the governor of Georgia who only learned weeks into the pandemic about asymptomatic transmission.

Other governors -- I'm talking about those obnoxious, holdout Republicans who did nothing or not enough -- will likely blame governors who did so much, like Andrew Cuomo, Gavin Newsom, and J.B. Pritzker, for "hoarding or using all of the equipment." An astonishing provoking of propaganda for why the wronged couldn't save parts of their constituencies. Those Republicans who waited played politics with lives, and they will play politics with death via their phony excuses. Their supporters will believe their lies and react with incidents like greedy pastors holding religious services for defiant congregations.

And that backlash is spreading. A Los Angeles train conductor deliberately ran his train off its tracks near the USNS Mercy because he believed the ship was part of a government takeover. The Federalist, a conservative blog, reposted about coronavirus-themed "chicken pox parties" that herd large groups of people into confined spaces with COVID-19 patients so everyone contracts it -- a joke about the "hoax." And more dangerously, threats have been made against America's leading and most revered infectious disease doctor, Anthony Fauci, because conspirators say he's part of the "deep state" resistance to Trump. This discontent will surely ignite more disturbing behavior.

Tempers aren't the only thing that are breaking. Everything is broken. A hodgepodge of examples: The small business loan program has been predicted to be "a mess." The military ships sent to help New York City have been deemed "a joke." House Speaker Nancy Pelosi has called for aggressive oversight of the rushed-through massive stimulus package because of the danger of corruption. Nothing seems to be functioning properly, efficiently, or effectively.

Overlaying all of this is the president, who The WashingtonPostcalled the "commander of confusion" for having delivered a "dizzying array of rhetorical contortions." We cannot even get a concrete answer on something as simple as should we be wearing masks? Yes -- maybe -- for us, no for him. And that's easy to explain. Wearing masks, we're told, is for protecting others, which Trump is unable to do.

And he consistently blames others. A president more worried about getting along than getting it done. And if you don't get along or go along with him, it doesn't get done, and you get the blame. With every passing day, it becomes clearer and more terrifying that this president is not getting it done and will be unable to get it done. And without solid leadership coming from the very top, we will be lost in a blinding, crippling blizzard of bewilderment.

Trend curves for those sick and dying, lack of equipment, stricken health care professionals, unemployment, poverty, mounting costs, lack of health care, psychological implications, anger, blame, and presidential errors are all heading to apexes and may not slant downward but plateau. The confluence of all these catastrophes could be colossal.

A barrage of mishandling, mistruths, mistakes, misstatements, missed marks, misinformation, miscalculations, missed deadlines, and missed opportunities will invariably lead to an explosion of misery. Will the proverbial indomitable spirit of America -- a country that has withstood a Civil War, two World Wars, a Great Depression and recession, and 9/11 -- prevail?

There are plenty of stories about acts of heroism, valor, bravery, compassion, love, and selflessness. Less about connecting these dots than sustaining and fortifying them. The triumphs of those working feverishly to save us from impending doom. It is because of the heroic efforts of many, the resilience of so many others, and collective efforts of all of us that we will have a chance to overcome this catastrophe.

However, this entire scenario may likely mimic a severe case of measles. There will be more dots to connect as this sickness spreads. And we have no idea where those dots of danger may appear. I hope and pray that the alignment of all the dots and this column were at most melodramatic misfires.

JohnCasey is a PR professional and an adjunct professor at Wagner College in New York City, and a frequent columnist for The Advocate. Follow John on Twitter @johntcaseyjr.

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