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Thumbnail image for Jacinda_Ardern_at_the_University_of_Auckland_(cropped).jpg"One case!" railed a computer industry-adjacent US libertarian on his mailing list recently. He was scathing about the authoritarianism he thought implicit in prime minister Jacinda Ardern's decision to lock down New Zealand because one covid-positive case had been found in Auckland.

You would think that an intelligent guy whose life has been defined by the exponential growth of Moore's Law would understand by now. One *identified* case of unknown origin means a likely couple of dozen others who are all unknowingly going to restaurants, bars, concerts, and supermarkets and infecting other people. Put together the highly-transmissible Delta variant, which has ravaged India, caused huge spikes in the UK and Israel despite relatively high vaccination levels, and is vacuuming up ICU beds in vaccine-resistant US states, and the fact that under 20% of New Zealanders are vaccinated. Ardern, whose covid leadership has been widely admired all along, has absorbed the lessons of elsewhere. Locking down for a few days with so few cases buys time to do forwards and backwards contact tracing, 26 deaths, not tens of thousands, and an unstressed health care system. New Zealand has had months of normality punctuated by days of lockdown instead of, as elsewhere, months of lockdown punctuated by days of nervous attempts at socializing. Her country agrees with her. What more do you want?

The case was found Tuesday; lockdown began Wednesday. By Thursday, the the known case count was 21, with models predicting that the number of infected people was probably around 100. If all those people were walking around, that one case - imported, it now appears, from Australia - would be instigating thousands. Ardern has, you should excuse the expression, balls - and a touch of grace. I can't think of any other national leader who's taken the trouble to *thank* the index case for coming forward to get tested and thereby saving countless of his fellow citizens' lives.

Long ago - March 2020 - Ardern's public messaging included the advice "Be kind". This message could usefully be copied elsewhere - for example, the US, where anti-maskers are disrupting school board meetings andclassrooms, and anti-vaccination protests have left a man stabbed in Los Angeles. On Twitter and in other media, some states' medical staff report that among their hospitals'97%-unvaccinated covid caseloads are some who express regret, too late. Timothy Bella reports at the Washington Post that a Mobile, Alabama doctor has told patients that as of October 1 he won't treat anyone who is not vaccinated against covid. Alabama's vaccination rate, 36%, is the lowest in the US, the state is reporting nearly 4,000 new cases per day, and its hospitals have run out of ICU beds. His reaction is understandable. Useful motto for 2021: everyone is entitled to be anxious about the pandemic however they want.

Twitter has several "more of this, please"-type reactions. Tempting: there's the risk to other patients in the waiting room; the desire to push people to get vaccinated; the human reluctance to help people who won't help themselves to avoid dying of a preventable illness; the awareness of the frustration, burn-out, stress, and despair of hospital-based counterparts. And yet. This doctor isn't required by lack of resources to do triage. He just doesn't want to invest in treating people and be forced to watch their miserable, preventable deaths. I understand. But it's dangerous when doctors pick and choose whom they treat. Yes, barring medical contraindications, refusing covid vaccinations is generally a mistake. But being wrong isn't a reason to deny health care.

Ardern has - as she says - the advantage of being last. Working with less information, countries scrambling earlier to cope with new variants will inevitably make more mistakes. At the Atlantic, Howard Markel argues that we need to stop looking back to 1918 for clues to handling this one.

It's certainly true that the 1918 model has led us astray in significant ways, chiefly consequences of confusing covid with flu. In the UK, that confusion led the government to focus on washing hands and cleaning surfaces and ignore ventilation, a mistake it still hasn't fully rectified 18 months later. In the US, "it's a mild flu" is many people's excuse for refusing masks, vaccines, and other cautions. The 1918 example was, however, valuable as a warning of how devastating a pandemic can be without modern tools to control it. Even with today's larger population, 100 million deaths is too significant to ignore. For them, masks, ventilation, and lockdowns were the only really available tools. For us, they bought time for science to create better ones - vaccines. What we lack, however, is societal and political trust (whether or not you blame the Internet) and the will to spread manufacturing across the world. In 1918, the future, post-pandemic and post-war, was a "roaring" decade of celebration. Our post-pandemic future is more pandemics unless we pay attention to public health and building pandemic resistance, especially as climate change brings new microbes into direct contact with humans,

Markel is a professor at the University of Michigan, and his uncomfortable message is this: we are in uncharted territory. No wonder we cling to the idea that the pandemic of 2020-present is kinda-sorta 1918: without that precedent we are facing conditions of radical uncertainty. Be kind.

Illustrations: New Zealand prime minister Jacinda Ardern campaigning in 2017 (Brigitte Neuschwander-Kasselordner, via Wikimedia).

Wendy M. Grossman is the 2013 winner of the Enigma Award. Her Web site has an extensive archive of her books, articles, and music, and an archive of earlier columns in this series. Stories about the border wars between cyberspace and real life are posted occasionally during the week at the net.wars Pinboard - or follow on Twitter.


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