Los Angeles Times - 24.02.2020

A MEDICAL WORKERattends to a patient in a makeshift hospital established to treat COVID-19 in Wuhan, China.

EPA/Shutterstock

W

hen thenew

coronavirus,

COVID-19,

first broke out,

China’s

healthcare system was unpre-

pared. Hospital waiting rooms

were so packed with prospec-

tive patients that hundreds

more had no choice but to line

up outside. Many waited sev-

eral hours, only to be turned

away and urged to self-quaran-

tine. More troubling, experts

say, is that the chaos of this ini-

tial surge likely did more to

spread the disease than stop it.

The same fate awaits us here

if the new virus becomes a glob-

al pandemic.

Hospitals in the United

States are already so overbur-

dened, and their staffs so over-

worked, that one bad flu season

is enough to push them over ca-

pacity. Just two years ago, dur-

ing a particularly bad season in

California, patients seeking

treatment for the flu instead

found themselves in “war

zones.” Hospitals turned away

ambulances, imported nurses

from elsewhere and erected

parking lot tents when they ran

out of beds. Surgeries had to be

canceled and hospitals ran out

of supplies.

If the new coronavirus gains

momentum here, infecting

thousands, the outlook would

be even grimmer. To be sure, we

are better prepared than we

were for the last coronavirus

outbreak in 2009. Our hospitals

now have pandemic plans to en-

sure that enough equipment,

protective gear and administra-

tive controls are available to

deal with a surge of new pa-

tients.

But, on their own, these

measures are not enough.

First, we must do more to

make sure that if an outbreak

occurs, we can keep and treat

people where they are safest —

in their homes. That will require

leveraging or boosting the tele-

health capabilities of local clin-

ics to enable remote diagnosis

of emergent coronavirus cases.

Such virtual consultations

would divert pressure away

from hospitals and limit the

transmission of infections in

crowded waiting rooms.

Second, we must ensure that

any added costs of protection

and prevention are covered for

patients. Currently, payment

by insurance companies for vir-

tual urgent care is not federally

mandated, and many plans

don’t cover it. Without a guar-

antee that their costs will be

covered, patients may still head

to hospitals to avoid the fees.

Finally, we must prepare our

hospitals and our health sys-

tems now for future crises even

greater than the one we may

face with COVID-19. This latest

coronavirus is, by all appear-

ances so far, more benign than

some previous ones. Though it

is highly transmissible, it has a

low mortality rate, with the vast

majority of those infected sur-

viving whether they are treated

at home or in a hospital.

But there will come a time

when a coronavirus outbreak or

other biothreat emerges that is

more lethal and widespread

than anything previously seen.

Our hospital-centric health sys-

tem isn’t equipped to handle

such a crisis. We must forge a

new path toward a health sys-

tem of distributed care, where

patients receive care where

they need it most — not just in

hospitals, but in the home and

community.

The United States is home to

some of the world’s best health

providers and technological in-

novations. But we still hold to

an antiquated notion that ad-

vanced healthcare is best deliv-

ered in hospitals.

Countries like Singapore

have shown that distributed

care can be achieved on a na-

tional scale, and if they can do it,

so can we.

William Haseltinerecently

returned from Wuhan, where

he chaired the 9th U.S.-China

Health Summit. A former

Harvard Medical School

professor, he serves as chair

and president of the global

health think tank, ACCESS

Health International.

Preparing for coronavirus

By William Haseltine

LATIMES.COM/OPINION MONDAY, FEBRUARY 24, 2020A

OPINION

EDITORIALS

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OP-ED

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S

cientists at an Antarctic research
station recently recorded a one-day
air temperature of just under 70 de-
grees, a balmy afternoon in a region
of the world unaccustomed to them.
In fact, as far as researchers can tell, it has
never been that warm in Antarctica before.
The record was set against an increasingly
scary global backdrop of rising tempera-
tures and seas; more powerful storms,
droughts and floods; a reduced Arctic ice
cap, and accelerated melting and move-
ment of glaciers around the globe — includ-
ing Antarctica.
The culprit behind this crisis is the nearly
200 years that humans have spent burning
fossil fuels — primarily coal and oil — for en-
ergy. So it was mildly heartening to see that
BP, the London-based oil and gas giant, has
promised to achieve “net-zero emissions”
for its operations by 2050. That doesn’t
mean BP is getting out of the oil and gas
business. Rather, the corporation pledged
to eliminate some emissions from its
drilling, processing and business opera-
tions, and to compensate for others through
investments in green technologies, refor-
estation projects and similar offset
strategies. The announcement followed ear-
lier pledges by such European-based oil
companies as Royal Dutch Shell, Total and
Equino to reduce emissions from their oper-
ations, though the BP pledge goes further.
None, of course, goes far enough. And
new BP CEO Bernard Looney acknowl-
edged the corporation had not settled on a
strategy to achieve its net-zero emissions
goal. Those details will come in September.
But at least the goal was set, which is far
more than has been done by American-
based oil companies like ExxonMobil and
Chevron, which have acknowledged the role
of greenhouse gas emissions in propelling
climate change but have done little to ad-
dress their contribution. Both are part of
the corporate-driven Oil and Gas Climate
Initiative, whose stated purpose is to reduce
“our collective methane emissions by more
than one-third” by essentially stopping
leaks and moving the captured methane to
where it could be burned.
Of course, baby steps by a handful of oil
and gas companies aren’t going to do much
to combat overall emissions. Similarly, the
Trillion Trees initiative, which President
Trump touted in his State of the Union ad-
dress, won’t do an awful lot, either. In fact,
it’s one of those fig-leaf solutions that offers
a pretense of significant action against glob-
al warming while ignoring the most pressing
problem — the burning of fossil fuels in the
first place.
Which is not to suggest that reforestation
is a bad idea; in fact, continued forest clear-
ing in the Amazon is exacerbating global
warming and must stop. Because forests
store carbon, restoring them could help cap-
ture and slow the accretion of carbon in the
atmosphere, where it traps heat. One study
found that the Earth’s ecosystems could
handle an additional 25% of forests above
what it holds now (though increased
droughts and desertification related to cli-
mate change could whittle away at that),
compensating for about 20 years of human-
produced carbon. So large-scale reforesta-
tion falls in the category of “couldn’t hurt.”
Nevertheless, far, far more needs to be
done, beginning with converting our global
reliance on energy from fossil fuels to renew-
ables as fast as is humanly possible. The
best way to reduce carbon in the atmos-
phere is to not put it there in the first place.
So in that regard, the danger of the Tril-
lion Trees initiative is that pro-oil business
conservatives will wave it around as a solu-
tion to global warming. But that’s like some-
one hoping to lose a lot of weight by taking
daily walks while still eating the same calo-
rie-rich foods.
The nation, and the world, need sober
and aggressive policy changes if we are to
stand any chance of mitigating the worst ef-
fects of global warming. Despite heightened
awareness and national pledges under the
2015 Paris agreement to try to limit global
warming to 1.5 degrees Celsius (2.7 degrees
Fahrenheit) above pre-industrial levels,
global carbon emissions continue to rise. It
will be expensive to adapt to the new climate
reality and to fundamentally change the way
humankind produces and uses energy, but
it must be done before the supposedly most
intelligent of the animal species manages
through greed and willful ignorance to pro-
pel the collapse of global ecosystems.

Baby steps

won’t fix the

climate crisis

The Trillion Trees initiative and

BP’s net-zero pledge can’t hurt. But

more dramatic steps are needed.

I

nside a correctionalfa-

cility last year, men sat

segregated in a large room

— black men, white men,

Latino men, Asian men.

When they were asked to con-

verse with someone they ordi-

narily would not speak with,

many hesitated before seeking

out a partner. For the next hour,

heated conversations ensued.

Armed guards periodically

peered into the room. Occa-

sionally, the reluctant conver-

sationalists consulted the tools

I’d written on the blackboard.

At the end of the exercise, I

asked if anyone wanted to talk

about what it was like to have a

conversation about race. An

uncomfortable silence lingered

before a young Puerto Rican

man stood up. His eyes darted

nervously around the room.

“Yo, homey,” he said. We

both had grown up in the

Bronx. “You know, like it ain’t

safe inside here to do what you

was telling us to do,” he said,

striking the air with a down-

ward slashing motion. “Having

a conversation about race from

our hearts.” He shook his head,

paused.

My heart fluttered. Maybe

I’d gotten it wrong. Maybe he

was right: Prison wasn’t the

place to have this kind of con-

versation. Then he smiled. “It

ain’t safe, but, boy, is it a breath

of fresh air.”

A black man wearing a white

kufi, a traditional Muslim cap,

rose next. Everyone addressed

him as “Mr. Johnson.” Though

not the tallest, buffest or appar-

ently the meanest, he obviously

commanded the most respect.

He looked around. “Back on the

block,” he said, seeming to give

an order, “we don’t fight. We use

this.” His pronouncement

seemed to settle the matter.

Over the last two years, I

have crisscrossed Washington

— one of the whiter states in the

nation — to present an evening

simply titled “Let’s Talk About

Race.” It’s more of a workshop

than a lecture. Attendees are

given three basic tools for hav-

ing a difficult conversation be-

fore they are asked to engage

with a partner.

The first tool is an equation

for racism given by the 1970

Kerner Commission, which in-

vestigated the causes of urban

unrest in the U.S. in the late

1960s. Racism, the commission

said, is not the same as preju-

dice. Racism = Prejudice +

Power. The power to affect

someone physically, economi-

cally, politically or otherwise.

That is followed by a list of the

principles of active listening,

beginning with “listening with-

out talking,” and then advice

about how to listen and speak

from the heart.

The rest is up to them. Talk

follows. Tempers flare. Tears

flow.

The presentations take

place in prisons, libraries and

colleges, and with civic organi-

zations, church groups, and

tribal members on native lands.

The programs are funded by

Humanities Washington, an

affiliate of the National Endow-

ment for the Humanities,

In the ornate rotunda of the

Whatcom Museum in Belling-

ham, Wash., a middle-age white

man shook with anger a few

minutes into the evening. “I’m

tired of hearing about race,” he

said. “If you’re not going to talk

about everyone being racist,

then I’m not going to stay.”

He did stay, pairing up with a

black woman who shared her

experience with race and rac-

ism. At evening’s end, they

hugged.

In small towns and large cit-

ies across Washington, “Let’s

Talk About Race” has been

presented more than two dozen

times. I begin by recalling the

many people I saw 20 years ago

in Germany who talked

through even the smallest mat-

ter at length. When asked why,

they answered, “We don’t want

to repeat the mistakes of those

who never talked about what

was going on around them dur-

ing the Nazi era.”

The introduction continues

with a story from South Africa,

where I encountered the

Truth and Reconciliation

Commission, a restorative jus-

tice body that came into being

after apartheid ended. At meet-

ings, primarily white perpetra-

tors of apartheid violence were

allowed to talk about the often

horrific acts they directed

mainly against black South Af-

ricans — then they had to listen

to victims describe how that vi-

olence impacted and shattered

their lives. The courtlike body

had the authority to grant the

perpetrators amnesty, if they

confessed to and accepted re-

sponsibility for their wrong-

doing.

Talking is a means toward

restorative rather than retribu-

tive justice. South Africa is by

no means perfect nor is Ger-

many. But the willingness of so

many in these two countries to

engage in painful and difficult

conversations about race are

worthy examples of what we

sorely need in the United

States.

If we don’t want to be divided

by race, we’d better learn how to

talk about it.

Clyde W. Fordis the author of

“We Can All Get Along: 50

Steps You Can Take to Help

End Racism.”

Talking as a tool to help end racism

By Clyde W. Ford

latimes.com/opinion

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