Well, COVID-19 is back with a vengeance after a few precious months when it seemed like we might finally be able to breathe again. We thought it could be a chance to recoup, refresh ourselves, and move forward for those of us on the front lines.
I should say we hoped it would be all those things, in the same way Charlie Brown hopes Lucy will finally let him kick that football. Instead, it was the exact opposite—we lost some of our most experienced nurses, doctors, paramedics, and other highly trained providers, losses that will take years (if not decades) to replace even if we started training them today. It turns out if you ask people to burn themselves out to save the country because the then-administration can't be bothered to, as they are objectively pro-COVID, those people might just look for work elsewhere that pays more and is way less stressful.
So we're now in a worse surge than we've almost ever experienced at any point in the pandemic. Thanks to the delta variant, even in highly vaccinated parts of the country, emergency rooms and ICUs are being inundated, with the few pandemic veterans who are left to handle higher patient loads of sicker patients. Events like the Sturgis Motorcycle Rally are promising to bring a strain potentially as infectious as chickenpox roaring across the country, while right-wing fanatics storm school board meetings threatening health care providers that “We know where you live” and “We will find you.”
Which begs the question: how the hell do you even reason with people who feel like that?
Predictably, as mask mandates are once again becoming necessary (mostly since we seem to lack the cojones to pass robust vaccine mandates), we've started seeing legions of "anti-maskers" (like this chucklefuck) who are bound and determined to play politics, no matter the cost. So there's zero reason to try to convince them, and thus I would normally not even suggest you try. You will never out-message charlatans willing to lie.
Sadly, however, there are plenty of folks caught up in this avalanche of rhetorical diarrhea, standing quietly but willing to engage if they see like-minded allies out there standing up for what's right by exposing this malignant narcissism and total disdain for the health and safety of anyone but themselves.
So for those of you willing to wade into those debates and fight the good fight, let's discuss the right way to do it: how to rebut their inane points and expose their malignant narcissism. So that even if you can't convince them to do the right thing, you can show the rest of the world how little they care about anyone but themselves and how readily they’ll place the burdens and costs on the people who refuse to vaccinate and mask—and move on as best we can.
And maybe, just maybe, we can save a few lives in the process.
SACRIFICES
I want you all to remember the top-line thing about masking is that it's a simple sacrifice we're asking of our fellow citizens, a stop-gap measure primarily intended to keep our health care system intact. That’s it. And when I say “intact,” I mean just that. It’s already way too late for anything more than sheer survival for healthcare providers and systems at this point.
In World War II, our country asked its citizens to make immense sacrifices. We rationed critical supplies. We asked them to save scrap metal and grow home gardens. We asked people to abstain from indulging in everything from hot water to chocolate to coffee and to buy war bonds. We asked them to send their sons and daughters off to risk their health and their very lives to fight global fascism. Today, all we're asking people to do is wear a stupid piece of paper over their mouth and nose if they're going somewhere there's a lot of people around.
When I get into discussions with anti-maskers, I frequently bring up this example. While it certainly gets more and more diluted as time goes by, World War II continues to occupy a huge psychological space in the American psyche. You'd be hard-pressed to find people who were taught about the Tulsa Race Massacre or the Battle of Blair Mountain, but World War II gets top billing everywhere. The wartime propaganda posters, in particular, are in almost everyone's consciousness because they've been replicated time and again over the years.
And, I gotta say, a lot of them are pretty damn spot-on for use in today's crisis. So I ask them: If you disagree with mask mandates, then what are you doing to help the healthcare workers fighting to keep America going? How are they helping the folks on the front lines who have already been battered, bruised, and abandoned by their own government?
The answer, of course, is nothing—which is an answer everyone needs to see them be held accountable for.
PROTECTION
Surgical masks keep you from getting other people sick. They're a metaphorical finger in the dike—again, it's a numbers game. Every infection we can prevent pays dividends down the road to everyone. Especially now, with the delta strain that's potentially as infectious as chickenpox, every infection we can prevent makes a difference.
When arguing about mask protection, I like to compare masks to bulletproof vests. The more of a "hot zone" you're in, the more you want to be wearing one. And while they may not be perfect, they're damn well better than nothing. It's an imperfect analogy, I admit—bulletproof vests are made to protect the wearer, whereas surgical masks are made more so to protect other people—but I use it often because the people I generally have to debate about masks with are (for some strange reason!) the kinds of people who thirstily fantasize about playing soldier.
"Should we take bulletproof vests away from police officers or Marines just because they're not perfect?!" I ask them. I've yet to have a single person say yes, of course; they get indignant, claim that's not a good comparison (without suggesting why), and usually refuse to argue with me after that.
I also use this in the “didn’t you sign up for this?” rebuttal I get sometimes, as if taking a job as an ER nurse means being willing to undertake any hardships whatsoever. “You’re saying that when Marines enlist, they’re signing up to be sent into battle unprepared, unequipped, overworked, and with no protection?”
As before, they never argue against that because they understand perfectly well that there are times when something is better than nothing, and that nobody signs up for just “anything.” They just want to apply that rule to situations when they find it politically convenient.
99.8% SURVIVAL RATE
"COVID has a 99.8% survival rate!!!" is a common rebuttal I hear from people. Now, there are a lot of good takedowns of this; I could post a dozen or so. I could share dozens of my own: last August, I saw a healthy person in their mid-30s have a massive, right-sided stroke from having COVID. The last I heard, they were still in a nursing home ... and likely to be for the rest of their lives.
Think about that. Spending the next fifty years in a nursing home because of a blood clot you got from having COVID-19 gave you a stroke. Hey, they survived, though, amirite?
Here’s a startling fact: as near as I can tell (looking here, here, here, and here) U.S. servicemen and servicewomen “survived” a similar percentage of IED encounters during the wars in Iraq and Afghanistan. Car accidents also have a similar percentage of survival. Obviously, in both cases, “survival” is the only metric that matters, right?
No. Obviously not. My father was in a major car accident a few years ago, and while he's one of the lucky ones who went back to some semblance of normal, he was in the hospital for weeks. He was in physical therapy, he had to hassle with insurance companies, etc. But thanks to the heroic efforts from the health care providers he interacted with, he did, indeed, survive.
But obviously, there is more to this than survival alone, and that issue bleeds into my next one, which is:
WE ARE ALL PAYING FOR THIS.
My father’s car accident cost him several hundred thousand dollars. Luckily, he had health insurance, specifically Medicare, which means his out-of-pocket costs were a tiny fraction of that. That, of course, means we all paid for it. Personally, I have no problem with that, as I am a big proponent of single-payer in the form of Medicare for All, but wouldn't you know—again, for some strange reason!—the people who argue about masks think that's scary socialism!
But we have to understand that, right now, if you live in the United States of America, you are paying for single-payer health care, you’re just not getting it. This issue deserves a standalone article on its own, but the short version is that thanks to a law called The Emergency Medical Treatment and Active Labor Act (EMTALA)—signed by noted socialist Ronald Reagan—if you show up to an ER needing care, we have to take care of you, regardless of your ability to pay.
This is, of course, a good thing. Aside from a few dead-end libertarians, you won’t find anyone anywhere who’d argue against the need for a law like EMTALA. But the point is that regardless of if you have Medicare, or have no health insurance at all, we all pay for the costs of unmitigated pandemic spread.
No health insurance? Hey, the hospitals figured out a long time ago how to take care of that. They can write off their tax liabilities to a point where you personally are paying more in federal income tax than a multibillion-dollar hospital chain. They can shift the costs; a CT scan for you, a fully insured person, can cost ten times as much as the “self-pay” rate. And for whatever’s left, they can aggressively send bill collectors who will hound people for the rest of their lives for the horrific sin of getting sick once.
Pointing this out to the mask-impaired, and thanking them for agreeing to open their wallets to pay for the care of other people, is an almost guaranteed way to make them flee.
WHY DON’T YOU JUST QUIT
As a last-ditch rebuttal to the points I’m trying to make, the dead-enders love to tell me I ought to just quit. “Gosh, you’re so emotional,” they tell me as we argue online, assuming I’m female after identifying myself as an ER nurse. “You must be having a breakdown. You should just quit if you can’t handle it.”
Without unpacking the blatant misogyny in that provocation and the further implications of not caring about nurses because it’s a female-dominated profession, here’s the big problem: Quitting is exactly what’s happening. Listen, the turnover rate in high-acuity specialties has always been critical. I know of emergency departments and ICUs that have had turnover rates over 90% over the course of ten years. So if you start with a hundred nurses on staff in year one, by year ten, there are less than ten left.
These tend to be the providers that are the backbone of the department. They’ve seen it all. They train new nurses and doctors. They know what to do when things go wrong. And sadly, as I predicted last December, they’re the ones we are now bleeding the most, at the exact time we cannot afford to lose a single one.
For years, they’ve been told to spend some time in the ER or ICU (“you can write your ticket to anywhere!”). And after spending the last year saving the country from itself, they’re doing exactly that. Since emergency medicine is not a “profit-driven” field (if you break your leg or have a heart attack, you’re not going to be shopping around), corporate medicine has no incentive to retain experienced providers. One nurse or EMT or doctor is the same as any other, right? Well, wrong, of course—and the combination of those factors is quickly becoming an unsustainable problem.
Nothing against the brand-new residents or EMT-Bs who are attending to patients in the ER—they may be just as dedicated (or more so!) as anyone else—but in a life or death situation, do you want them taking care of you or your family members by themselves, with no backup?
Understand that, unless you’ve got a name like Ron DeSantis and can bypass the system with a single phone call to access top-notch health care with no wait whatsoever, that’s gonna be you and your family.
WE CAN ONLY DO WHAT WE CAN DO
Like I said, none of the methods above will necessarily change the minds of these folks. They’re the heroes in their own story, with “plot armor” galore, meaning they’re not gonna be the ones getting infected, even if this whole COVID-19 thing isn’t actually a hoax. They’ve sold their personality out on narcissism. They’ll scream it’s all a socialist plot, even after they seek help from the very people they’ve demeaned, and all the way up until the breathing tube gets placed.
We’re looking to change the minds of the people on the sidelines, afraid to speak up for fear of getting in the middle of two vociferous groups. I know, I know: one group is right, and one is (dead) wrong. But these folks want to avoid conflict, or at least want the ammunition to be able to take on these rhetorical battles—and we need to give it to them.
For those of us on the front lines of this pandemic, it’s already too late. We’ve been battered. Those of us that are left are burned out, demoralized, jaded, and barely hanging on. We’re going to have to take this one on the chin, saving the country once again, knowing that it didn’t have to be like this. We’re going until the fire’s out and reduced to a few smoldering flare-ups here and there. And then just hoping there’s some part left of us afterward.
Honestly, the fact I even have to write something like this exactly four years after I wrote about the Nazis who came to my town is … well. I feel like both problems are offshoots of the same extreme psychosis threatening our democracy.
But in both cases, we all have to keep doing everything we can. If we can save a few lives—particularly of the kids who are the most at-risk, since none under the age of 12 have been able to be vaccinated yet—and give our front-line health care providers even just a small break, it’ll all be worth it.
I should say we hoped it would be all those things, in the same way Charlie Brown hopes Lucy will finally let him kick that football. Instead, it was the exact opposite—we lost some of our most experienced nurses, doctors, paramedics, and other highly trained providers, losses that will take years (if not decades) to replace even if we started training them today. It turns out if you ask people to burn themselves out to save the country because the then-administration can't be bothered to, as they are objectively pro-COVID, those people might just look for work elsewhere that pays more and is way less stressful.
So we're now in a worse surge than we've almost ever experienced at any point in the pandemic. Thanks to the delta variant, even in highly vaccinated parts of the country, emergency rooms and ICUs are being inundated, with the few pandemic veterans who are left to handle higher patient loads of sicker patients. Events like the Sturgis Motorcycle Rally are promising to bring a strain potentially as infectious as chickenpox roaring across the country, while right-wing fanatics storm school board meetings threatening health care providers that “We know where you live” and “We will find you.”
Which begs the question: how the hell do you even reason with people who feel like that?
Predictably, as mask mandates are once again becoming necessary (mostly since we seem to lack the cojones to pass robust vaccine mandates), we've started seeing legions of "anti-maskers" (like this chucklefuck) who are bound and determined to play politics, no matter the cost. So there's zero reason to try to convince them, and thus I would normally not even suggest you try. You will never out-message charlatans willing to lie.
Sadly, however, there are plenty of folks caught up in this avalanche of rhetorical diarrhea, standing quietly but willing to engage if they see like-minded allies out there standing up for what's right by exposing this malignant narcissism and total disdain for the health and safety of anyone but themselves.
So for those of you willing to wade into those debates and fight the good fight, let's discuss the right way to do it: how to rebut their inane points and expose their malignant narcissism. So that even if you can't convince them to do the right thing, you can show the rest of the world how little they care about anyone but themselves and how readily they’ll place the burdens and costs on the people who refuse to vaccinate and mask—and move on as best we can.
And maybe, just maybe, we can save a few lives in the process.
SACRIFICES
I want you all to remember the top-line thing about masking is that it's a simple sacrifice we're asking of our fellow citizens, a stop-gap measure primarily intended to keep our health care system intact. That’s it. And when I say “intact,” I mean just that. It’s already way too late for anything more than sheer survival for healthcare providers and systems at this point.
In World War II, our country asked its citizens to make immense sacrifices. We rationed critical supplies. We asked them to save scrap metal and grow home gardens. We asked people to abstain from indulging in everything from hot water to chocolate to coffee and to buy war bonds. We asked them to send their sons and daughters off to risk their health and their very lives to fight global fascism. Today, all we're asking people to do is wear a stupid piece of paper over their mouth and nose if they're going somewhere there's a lot of people around.
When I get into discussions with anti-maskers, I frequently bring up this example. While it certainly gets more and more diluted as time goes by, World War II continues to occupy a huge psychological space in the American psyche. You'd be hard-pressed to find people who were taught about the Tulsa Race Massacre or the Battle of Blair Mountain, but World War II gets top billing everywhere. The wartime propaganda posters, in particular, are in almost everyone's consciousness because they've been replicated time and again over the years.
And, I gotta say, a lot of them are pretty damn spot-on for use in today's crisis. So I ask them: If you disagree with mask mandates, then what are you doing to help the healthcare workers fighting to keep America going? How are they helping the folks on the front lines who have already been battered, bruised, and abandoned by their own government?
The answer, of course, is nothing—which is an answer everyone needs to see them be held accountable for.
PROTECTION
Surgical masks keep you from getting other people sick. They're a metaphorical finger in the dike—again, it's a numbers game. Every infection we can prevent pays dividends down the road to everyone. Especially now, with the delta strain that's potentially as infectious as chickenpox, every infection we can prevent makes a difference.
When arguing about mask protection, I like to compare masks to bulletproof vests. The more of a "hot zone" you're in, the more you want to be wearing one. And while they may not be perfect, they're damn well better than nothing. It's an imperfect analogy, I admit—bulletproof vests are made to protect the wearer, whereas surgical masks are made more so to protect other people—but I use it often because the people I generally have to debate about masks with are (for some strange reason!) the kinds of people who thirstily fantasize about playing soldier.
"Should we take bulletproof vests away from police officers or Marines just because they're not perfect?!" I ask them. I've yet to have a single person say yes, of course; they get indignant, claim that's not a good comparison (without suggesting why), and usually refuse to argue with me after that.
I also use this in the “didn’t you sign up for this?” rebuttal I get sometimes, as if taking a job as an ER nurse means being willing to undertake any hardships whatsoever. “You’re saying that when Marines enlist, they’re signing up to be sent into battle unprepared, unequipped, overworked, and with no protection?”
As before, they never argue against that because they understand perfectly well that there are times when something is better than nothing, and that nobody signs up for just “anything.” They just want to apply that rule to situations when they find it politically convenient.
99.8% SURVIVAL RATE
"COVID has a 99.8% survival rate!!!" is a common rebuttal I hear from people. Now, there are a lot of good takedowns of this; I could post a dozen or so. I could share dozens of my own: last August, I saw a healthy person in their mid-30s have a massive, right-sided stroke from having COVID. The last I heard, they were still in a nursing home ... and likely to be for the rest of their lives.
Think about that. Spending the next fifty years in a nursing home because of a blood clot you got from having COVID-19 gave you a stroke. Hey, they survived, though, amirite?
Here’s a startling fact: as near as I can tell (looking here, here, here, and here) U.S. servicemen and servicewomen “survived” a similar percentage of IED encounters during the wars in Iraq and Afghanistan. Car accidents also have a similar percentage of survival. Obviously, in both cases, “survival” is the only metric that matters, right?
No. Obviously not. My father was in a major car accident a few years ago, and while he's one of the lucky ones who went back to some semblance of normal, he was in the hospital for weeks. He was in physical therapy, he had to hassle with insurance companies, etc. But thanks to the heroic efforts from the health care providers he interacted with, he did, indeed, survive.
But obviously, there is more to this than survival alone, and that issue bleeds into my next one, which is:
WE ARE ALL PAYING FOR THIS.
My father’s car accident cost him several hundred thousand dollars. Luckily, he had health insurance, specifically Medicare, which means his out-of-pocket costs were a tiny fraction of that. That, of course, means we all paid for it. Personally, I have no problem with that, as I am a big proponent of single-payer in the form of Medicare for All, but wouldn't you know—again, for some strange reason!—the people who argue about masks think that's scary socialism!
But we have to understand that, right now, if you live in the United States of America, you are paying for single-payer health care, you’re just not getting it. This issue deserves a standalone article on its own, but the short version is that thanks to a law called The Emergency Medical Treatment and Active Labor Act (EMTALA)—signed by noted socialist Ronald Reagan—if you show up to an ER needing care, we have to take care of you, regardless of your ability to pay.
This is, of course, a good thing. Aside from a few dead-end libertarians, you won’t find anyone anywhere who’d argue against the need for a law like EMTALA. But the point is that regardless of if you have Medicare, or have no health insurance at all, we all pay for the costs of unmitigated pandemic spread.
No health insurance? Hey, the hospitals figured out a long time ago how to take care of that. They can write off their tax liabilities to a point where you personally are paying more in federal income tax than a multibillion-dollar hospital chain. They can shift the costs; a CT scan for you, a fully insured person, can cost ten times as much as the “self-pay” rate. And for whatever’s left, they can aggressively send bill collectors who will hound people for the rest of their lives for the horrific sin of getting sick once.
Pointing this out to the mask-impaired, and thanking them for agreeing to open their wallets to pay for the care of other people, is an almost guaranteed way to make them flee.
WHY DON’T YOU JUST QUIT
As a last-ditch rebuttal to the points I’m trying to make, the dead-enders love to tell me I ought to just quit. “Gosh, you’re so emotional,” they tell me as we argue online, assuming I’m female after identifying myself as an ER nurse. “You must be having a breakdown. You should just quit if you can’t handle it.”
Without unpacking the blatant misogyny in that provocation and the further implications of not caring about nurses because it’s a female-dominated profession, here’s the big problem: Quitting is exactly what’s happening. Listen, the turnover rate in high-acuity specialties has always been critical. I know of emergency departments and ICUs that have had turnover rates over 90% over the course of ten years. So if you start with a hundred nurses on staff in year one, by year ten, there are less than ten left.
These tend to be the providers that are the backbone of the department. They’ve seen it all. They train new nurses and doctors. They know what to do when things go wrong. And sadly, as I predicted last December, they’re the ones we are now bleeding the most, at the exact time we cannot afford to lose a single one.
For years, they’ve been told to spend some time in the ER or ICU (“you can write your ticket to anywhere!”). And after spending the last year saving the country from itself, they’re doing exactly that. Since emergency medicine is not a “profit-driven” field (if you break your leg or have a heart attack, you’re not going to be shopping around), corporate medicine has no incentive to retain experienced providers. One nurse or EMT or doctor is the same as any other, right? Well, wrong, of course—and the combination of those factors is quickly becoming an unsustainable problem.
Nothing against the brand-new residents or EMT-Bs who are attending to patients in the ER—they may be just as dedicated (or more so!) as anyone else—but in a life or death situation, do you want them taking care of you or your family members by themselves, with no backup?
Understand that, unless you’ve got a name like Ron DeSantis and can bypass the system with a single phone call to access top-notch health care with no wait whatsoever, that’s gonna be you and your family.
WE CAN ONLY DO WHAT WE CAN DO
Like I said, none of the methods above will necessarily change the minds of these folks. They’re the heroes in their own story, with “plot armor” galore, meaning they’re not gonna be the ones getting infected, even if this whole COVID-19 thing isn’t actually a hoax. They’ve sold their personality out on narcissism. They’ll scream it’s all a socialist plot, even after they seek help from the very people they’ve demeaned, and all the way up until the breathing tube gets placed.
We’re looking to change the minds of the people on the sidelines, afraid to speak up for fear of getting in the middle of two vociferous groups. I know, I know: one group is right, and one is (dead) wrong. But these folks want to avoid conflict, or at least want the ammunition to be able to take on these rhetorical battles—and we need to give it to them.
For those of us on the front lines of this pandemic, it’s already too late. We’ve been battered. Those of us that are left are burned out, demoralized, jaded, and barely hanging on. We’re going to have to take this one on the chin, saving the country once again, knowing that it didn’t have to be like this. We’re going until the fire’s out and reduced to a few smoldering flare-ups here and there. And then just hoping there’s some part left of us afterward.
Honestly, the fact I even have to write something like this exactly four years after I wrote about the Nazis who came to my town is … well. I feel like both problems are offshoots of the same extreme psychosis threatening our democracy.
But in both cases, we all have to keep doing everything we can. If we can save a few lives—particularly of the kids who are the most at-risk, since none under the age of 12 have been able to be vaccinated yet—and give our front-line health care providers even just a small break, it’ll all be worth it.