If you were an alien preparing to overcome Earth’s humans, how might you proceed? (Forget the titanic ships and WWII style air battles; most extraterrestrials are not as foolish as Hollywood popcorn sellers.)

Might you start with an invisible, microscopic pathogen?

Infect without any symptoms?

Spread through the air?

Confuse the human immune system with intense, conflicting signals?

Okay, you’ve checked off these boxes. Now, consider what humans value most besides money and food.

Consider: love.

Humans will do anything for love. Sacrifice themselves.

Love conquers all.

Consider AIDS, which has so far killed 32 million people. AIDS spreads through sex and blood. People can usually avoid blood infusions, but sex? How would the species continue?

Yet if the immediate goal is not procreation, humans can wear condoms.

But what can one do to breathing and talking? Those are the ways COVID spreads, along with singing, coughing, hugging, and kissing. And who do you meet and talk to more than the people you love? Even if there are times you feel less than loving, how does one avoid your family?

And that is how COVID strikes.

Family Survival

Consider the plight of some of my patients. They had cancer. They’re better now, but are immunocompromised, even if the tumor went into remission years ago.

Finances require the family to live together. And their parents, brothers, and sisters, are deeply annoyed with them.

These patients are scared. What do they hear? “Why can’t we visit the relatives in Pennsylvania for Thanksgiving?” Or “Why can’t we have friends over for a nice dinner?” And “What’s the big deal if we get a decent meal at a restaurant. We don’t have any fun. Everybody we know is doing it. Why are you trying to control our lives?”

COVID does not only infect via our loving relationships. It frays and tatters them.

An unraveling social fabric, where people fight over whether to wear masks, helps the virus win.

What do I tell these patients? That while everything in this life is contingent and tradeoffs frequent, their first task is survival. In Wuhan, where the first epidemic hit, 75-80% of the dead were family members. That more recently, weddings (https://www.washingtonpost.com/nation/2020/10/29/long-island-coronavirus-superspreader-party/), funerals, family reunions, and parties of all sorts, including for Supreme Court Justices, are now major superspreader events. That bars and restaurants are the first spots shut down by nations confronting their next wave of infection, because people close together, talking and drinking and eating, rapidly spread the virus, and infections may then leap exponentially.

I ask people to think like the virus. Since it spreads by breathing and talking, masks become like condoms for AIDS. Masks cut COVID’s viral load. They cut the number and severity of infections.

They are sadly far less effective than condoms. People have to breathe. Even the best “respirators” allow some viral particles to get through. But they are an excellent defense, including in the “safety” of one’s own home.

Consider what the Japanese, who despite their extraordinary social closeness have a death rate one-fiftieth (2%) that of the US, call the three Cs: close contact, closed spaces, crowded places. If you wish to visit people you love and care for, try to see them outside. See them where ventilation is accomplished by the atmosphere, not air-conditioning. Wear masks to make the protection more effective.

There are no absolutes. It is almost impossible to cut the risk of COVID to zero. Even Vladimir Putin knows this, who lives in a highly sequestered home, will not see others face to face until they quarantine for two weeks. If you wish to see him after your quarantine, you must still run the gauntlet of chemically laced tunnels.

Bottom Line

COVID infects us via extraordinary evolutionary ruthlessness. To counter it, you should think like the virus. It infects through breathing and talking. Wearing masks, socially distancing, cuts risk. Visiting in the outdoors cuts the risk further.

What also cuts risk is consistent, truthful messaging from the people pledged to protect us. Recently the White House put out “Advancing America’s Global Leadership in Science and Technology,” (https://www.whitehouse.gov/wp-content/uploads/2020/10/Trump-Administration-ST-Highlights-2017-2020.pdf), a listing of the highlights of the administration’s “many accomplishments” of 2017-2020. Included, in caps, was “ENDING THE VIRAL PANDEMIC.”

This morning eighty thousand new daily cases were announced for the U.S. Hospitalizations and COVID-related deaths are not over. They are rising. Fast.

There are fantasies and there are lethal fantasies. Telling people the pandemic is over means they can return to life as before COVID. Since your health=my health, that increases everyone’s risk.

Recently, the CDC listed 300,000 excess deaths in the U.S. since COVID hit. The coffins, placed atop one by one, would reach outer space.

Do the heavens weep? I don’t know.

I know we do.