Sam Brown is an ICU physician, and teaches pulmonary and critical care medicine at the University of Utah School of Medicine.
[Note: I do not speak for my employer or anyone else. If you are worried about the novel coronavirus, check the WHO and CDC or local State Health Department websites. As per their instructions, If you think you’re infected, self-quarantine and reach out by phone or video chat with your healthcare system to learn where and when testing might be available. If you are seriously ill, then cover your mouth and head to an Emergency Department or Urgent Care Clinic for evaluation and possible hospitalization.]
We appear to be in the early phases of a true pandemic, in which an infection circulates in many countries at a level where you can just catch it at the shopping mall or a rock concert or maybe just touching a doorknob at work and then touching your face. Whether we’re there yet or not depends in part on your baseline level of anxiety and/or pessimism; whether we will truly be there soon depends in large part on how aggressively we act now. There are many credible sources (again, WHO and CDC are most important) for the relevant medical information, which I won’t rehearse here. Instead, I want to think as a US Latter-day Saint about the human problems that loom large in this outbreak.
Forgetting for a moment how alien it may seem to live in close quarters with the bats in which this specific virus seems to have developed, once they enter human circulation, viruses like this are parasites of our human lovingkindness. To expand their reach, they require that we touch each other, that we stand close, that we embrace, that we minister and love. And not just the kind of ethereal love of late modern cosmopolitanism, but the concrete and relentless loving that takes someone to Church meetings or doctor appointments, that cooks meals for and with another, that tends a congregational nursery full of burbling children, that lays hands and consecrated olive oil on heads burned by fever. These viruses benefit from and exploit every instinct of our goodness and decency.
The best mechanism to limit their spread and the damage they do is to practice what the professionals call “social distancing,” which is a clinical euphemism for isolation. The most efficient way to control the spread of the virus is to stop doing the hands-on caring that is usually the best of us as people.
Simultaneously, we live in an age of anxiety far disproportionate in most cases to the actual peril we face. Part of the reason for that anxiety I suspect comes from the fact that we have already been engaging in certain forms of social distancing for a half century or so. We already struggle to find communities outside work, entertainment, or certain special interest groups. We already conduct a large proportion of our social lives via online platforms and mechanisms. We already struggle to understand how we might fit into robust local communities. That isolated anxiety can only intensify if we thoughtlessly approach the social distancing that seems necessary from a public health perspective to stem the tide of this novel coronavirus.
This anxiety and other cultural norms related to the structures of our economy and its social commitment to Darwinism can create a terrible risk to our goodness and lovingkindness that intensifies in a time of crisis. As so often, the vulnerable among us (plus the healthcare workers) will bear the majority of the burden of this pandemic, both medically and socially. This represents a moral crisis on top of a medical crisis. And this is a call for Gospel action.
Rhetoric about how “healthy people will do just fine, and what do we care if a few more old people die than usually die of seasonal influenza?” seems to me to be a Darwinist denial of what is best in Gospel and in us. It is beneath us as God-believers and disciples of Jesus. We are called to care and to sacrifice on behalf of those who suffer rather than to gloat that “it’s them, not me.” I’m not naïve—I know that there are economic consequences to caution, that preventing pandemic doesn’t come free. And I know that soldiers in opposing armies in the culture wars have been exploiting fears and anxieties to advance political agendas. But we are better than all that.
Fortunately, we as Latter-day Saints are good in crisis. The sometimes quaint-sounding millenarianism of our ancestors means that we are ready for pandemics. We’ve drilled for this our whole lives. When it became obvious that a more robust food storage would be useful to have, my wife sent me to the bishop’s storehouse, where I bought cheap, safe food that can last decades. The sister at the register explained to me which Church farms provided which types of food in the #10 cans with practical labels. Costco’s opulent shelves were reportedly bare, but we got about a month worth of wheat, beans, rice, carrots, and powdered milk for about a hundred dollars. When I was young, my family got our food from the storehouse for free. Now I’m glad to be able to pay for my part in maintaining community resilience. Following the lead of the marvelous Relief Society, we Saints have long known how to gather, store, and distribute food to those in need. It’s part of what I love about our occasional refusal to abide the strict separations of temporal and spiritual that contemporary society hopes to impose on us.
But having a personal supply to weather a month-long quarantine is just the first step. Our duty as Latter-day Saints is to not just undertake appropriate social distancing to help spare the lives of our vulnerable siblings in the human family. Our duty is also to assure that this social distancing does not harm them, does not betray our lovingkindness, our deep humanity. Church is not just a social club; it’s not an arbitrary hobby. It is a vessel for our gathering together in the presence of God. For those who participate, especially those for whom secular society has little interest or tolerance, Church participation is a lifeline. However one may feel about God, it is also true that for many people Church is in fact their home base, the source of stability in their lives. We who are hale and hearty and for whom the virus poses at most a slight personal risk have an awful lot of work to do.
What might our Gospel duty look like in coming weeks? I think it will involve setting up video feeds, both for broadcasting sermons in a remote sacrament meeting and for the give-and-take of classes or study groups so they can be managed via telepresence. It means monitoring supplies of food for people who were already homebound or those who become newly so. It means pitching in to community efforts (likely involving a combination of government and private and corporate philanthropy) to get people safely and effectively screened for disease to guide quarantines. It means pitching in where school closures isolate children from needed nutrition. It means intensive ministering visits via telepresence and careful monitoring of our own symptoms to assure that we don’t contribute to rapid spread of the virus. Game nights and scripture study over telepresence sound mundane but may be crucial to people who are homebound. We mustn’t forget parents of young children who may need multiple levels of reassurance and distraction during quarantine. We may find that our nightly rounds involve dropping food on the doorsteps of families placed into chaos by restrictions in work and school.
I’m not in charge of the Church and no one would or should ever want me to be. I admire and support the men and women who work tirelessly in support the renewal of heaven and earth as officers and leaders within the Church. I also believe that local wards are locations of substantial grace and creativity and there is much to learn as each ward or branch works to find its grace-filled path through social distancing. My sense is that within just a week or two, we in the US should be worshiping via telepresence; Washington state should likely be doing so now. I started telepresence worship this week (we used Facebook Live from a smart phone for sacrament meeting, and it worked great; we’re experimenting with Zoom for classes). There’s work to be done to figure out how to integrate the technology necessary for telepresence into the lives of vulnerable elders who may not find software interfaces intuitive or useful. There’s work to understand how LDS lay volunteers can help to mitigate the ill effects of quarantine for the vulnerable among us. There’s brainstorming work to be done to understand how to preserve and develop our lovingkindness in the midst of a viral exploitation of that very goodness. This is why we are God’s. This is what mortality is for.
We’ve got this. Jesus and the Relief Society are with us in this crisis. It’ll stretch us, but we’ve got this. It’s time to gird up our loins in courage and determination.
By Common Consent, a Mormon Blog 
Beautifully written and sound and sensitive advice. Thank you. Also the voice is so clearly you, Sam; I didn’t need the header.
One concern–you speak in crisis terms, which makes sense to me but is not shared in my local community. My interpretation (ymmv) is that the current U.S. Federal administration is managing information first for economic impact–effect on the stock market–and only secondarily for community health. This systematically downplays concerns. As a result, for the relatively large number of people in my community who get their information almost exclusively from and trust the current administration, there is no crisis.
Grateful for this, Sam. Thank you.
As one at ground zero, here in Redmond, WA, this is not theoretical or in the future. Our stake, along with a few more, have cancelled church meetings and activities for one week, to be revisited each Friday until the crisis passes. Our temple is closed now until April, at least, and it has interrupted proxy work I was scheduled to do for a friend who died about a year ago, as well as the wedding of the daughter of some other friends. What you have said is perfect. Our need to isolate does not eliminate our need to minister, and so far email has been the primary tool. I am looking at using some sort of live video, as yet undetermined, for communicating on a more personal level. Our local leadership is working closely with local government to make sure we are complying with their recommendations, Physical distance does not limit the reach of our Saviour’s love, nor should it limit our own.
Chris, we have a very brief window to avert crisis. Indifference now means the death of important members of our community later. Look around your ward or neighborhood–somewhere between 5-10% of your loved ones over the age of 75 or with health problems will be dead by Fall if we don’t get on the ball here. And if you love any healthcare workers–they’re going to be exposed at a high level and often unable to provide care due to COVID-19 surges and some of them will die. Don’t get your appendicitis or car accident trauma for the next few months (assuming we don’t spring into action now), as the hospitals will be overwhelmed with COVID19. To my eye, it’s dire and anti-Christian narcissism to refuse to take steps now to protect our vulnerable and help to keep our healthcare system from crashing. This can’t be partisan on either side at this point. People need to cancel political rallies, support NIAID and CDC and, yes, the federal task force, while supporting local/state-wide initiatives as well. China bought us a few weeks. Disney theme parks and cruise ships need to shut down for a couple months. We shouldn’t squander them. Yes, there will be a recession, but we can weather a recession.
Thanks, Sam. Excellent.
I am one of those healthcare workers who could be called to help where most needed, even in an area I’m not familiar with. I worry for patients, my coworkers, my family, and myself.
Economically I worry most for those who don’t have paid time off available. They need every paycheck they earn.
Sam, I see wisdom in not bringing partisanship into the discussion, but would like pointers on how to do that.
Your perspective is very much appreciated, Sam. One very minor clarification: a bishop’s storehouse is where members in need can take an order that they obtained through the bishop to receive food basics of all kinds (including fresh veggies and fruit, meat, bread) for free. The place where anyone can purchase canned storage (flour, oats, beans, powdered milk, dried fruit) is called a home storage center.
Hitchhiker, this is a great question. At times of stress, I think it gives us some sense of calm to able to demonize an opponent because it sets a moral framework that takes pressure off us. And if we’ve long hated a regime (as about half of Americans have for the last 4 years), it becomes easy to associate the regime with the problem and then imagine that the problem is improving when we defame the regime. But if our current problem is that 30% of the country refuses to take precautions because they believe that calls to action are partisan fear-mongering, then the solution I think is to NOT use partisan fear-mongering, and there have been multiple silly accusations made against the current US regime that are simply not true and are palpably partisan. Which sends more people out to conferences and cruise ships, coughing and touching their faces and refusing to support economic and medical relief. So look for language that can make sense within their world, and don’t spend as much of your worry in anger. Let’s save our vulnerable people and then get back to agitating for regime change once the virus is under control. I tried to model non-partisan thinking in a Twitter thread this morning directed to the Utah lieutenant governor, who is apparently in charge of COVID19 for the state. I’m open to lots of good ideas. Again, this is not a civilization-ending event. There’s no need to go apocalyptic. We have vulnerable people at high risk for imminent death, and we can actually step in and save them with modifications to our society that only last a month or two. This is a Willie and Martin Handcart company moment in my view.
Jennie, you are correct. Thanks for that. I was so nostalgic for the old storehouse that I merged the two. Where I went, they were housed in the same building.
Our stake president here in the South Puget Sound area (about 40 miles south of Seattle) sent out a letter that was read in Sacrament yesterday. As of yet, the only thing we are to do is stay home if we’re sick and to wash our hands well and to not to touch our faces and to not shake hands. No canceling of meetings currently, but to be honest, I wish they would. I’m over 60, which automatically makes me high risk. I have a cold (which I’m positive I caught from the runny-nosed children in my Sunbeam class) and had to go yesterday because finding a substitute last minute wasn’t possible (no, it’s not COVID-19, no fever). Fortunately, I co-teach with my husband because I also have laryngitis and couldn’t speak above a whisper. I was a little leery of taking the Sacrament bread because even though the priests blessing it wash their hands before breaking it (really, they should be wearing food-handler gloves), I can’t be sure that the bread isn’t touching the hands of those partaking while they’re taking their piece from the trays. Especially when parents allow their small children to take their own pieces and we all know how about the small ones who pick their noses (I teach Sunbeams and they do that constantly) and then stick their unwashed hands in the trays. As of last count, there were 3 cases of the virus in Pierce County and that number is expected to rise.
Amen, Brother. Who knew that the technically proficient would be administering the kingdom of heaven? What a project for our young people to be involved in!
Sam, do you believe the true prevalence of infections is much higher than the numbers publicized that are based on positive tests? It seems quite possible due to the limited testing.
I forwarded this to my SP and Bishop and suggest others do the same. It is that important. (And thanks for this excellent piece, Sam.)
for the person who succumbed to the temptation I’ve often felt but now resist to mock the somatization of anxiety as food allergies, Yes. It’s clear that the US has massively undertested and almost certainly has a higher rate than currently reported. That said, I think we have a couple weeks to get on this in a big way which could deflect/flatten the epidemic curve dramatically. The undertesting (and early inexperience in Wuhan) are the main reasons most scientists figure the case fatality rate is about 0.5-1% across the populations where it has been seen so far (5-10x worse than flu). Since we’re a bit younger population than Asia, we might come in closer to 0.5%, although this could rise if hospitals get overwhelmed and doesn’t take into considerations patients whose care suffers because the hospital is completely overwhelmed. But even at 0.5% if you assume that we do nothing and 70% of us get infected, that’s 0.7 X ~330M * 0.005 or half a percent of about 230M or about 1.15M people dead. If we do nothing, that could be a ceiling for the mortality, and doing nothing is not going to prevent recession either. That’s not a good place to be. That’s a lot of wonderful people struck down before their time. If we get our act together and move quickly, we could bring the death toll down to a tiny fraction of that number. It’ll take work, but we can do it. And I think we need both state and federal action as well as philanthropy and corporations and universities. Be asking everyone you know with means and influence how they’ll be putting their shoulder to the wheel. We have plenty of Chicken Littles. We need more Little Red Hens.
Thanks Sam. (Fixed my handle after your chastening.) It is becoming increasingly clear how absolutely critical is the ability to test reliably for this virus at large scale in order to have good information to base policy around. We should have mobilized our massive medical testing industry toward test development/production starting in late December, not like two weeks ago.
Jesus and the Relief Society❤️.
I’m the RSP in a ward that is predominantly elderly and sick with underlying conditions. Both of my counselors are over 60 and have some major health issues. My husband is a nurse in an ER and I have a daughter with a genetic disorder where illness requires immediate hospitalization. My own family has significant food storage that we eat from daily so I’m not worried about that. What I AM worried about is my husband’s exposure, my exposure, and my daughter’s exposure. I want to hide my family away.
And yet, I have to take care of my ward. There are only 5 sisters under 50 in my ward (yes, you read that right). My ward has huge boundaries and a huge elderly population and every single one of the elderly in my ward have underlying health conditions that make them extremely vulnerable. None of them know how to use their smartphones for even something as simple as listening to the scriptures or pulling up Conference talks, much less a Zoom Sacrament Meeting. My bishop doesn’t even have a smartphone or internet (that’s a whole different ball of problems there, don’t want to talk about that), so there’s no way to tele-minister. I’d ask ministering companionships but they’re all old and sick too! My best bet has been to work with the YM on proper hand washing. We are putting alcohol-based hand sanitizer in every room in our building. I’m encouraging them to STAY HOME if they are sick. I’m also encouraging them to stock up on enough food for a few weeks but most of them are also on SS, so they don’t have the means to do it. This puts me in a really tough spot.
I’m pretty darn concerned about how I’m going to effectively take care of them while also making sure my daughter is protected and my other kids are safe too. I just have no idea how I’m going to do both and if prioritize one, it will be my family.
I should also add that I feel absolutely terrible for considering the idea that I might have to choose between my daughter’s safety and the safety of the elderly in my ward. It’s an awful, horrible feeling to think I might have to choose.
Oh Sam, you are wonderful!
Justyouraveragemormon…I have been pushing the idea of sister wards for a long long time.
There are multiple scenarios where wards just need the help of others to meet needs.
You are in a tight spot and no one will judge you for putting your family first.
All the best.
Ally
Thanks for this beautiful, cogent, and thoughtful post. . . all the best things here. Sincerely, melodynew, RN.
Dr. Sam, thank you! After reading your post I went right to my phone and called a couple of vulnerable people. I asked them what food they have on pantry shelf and what they like. I will go shopping for one who is home bound and get her stocked. The other one I will purchase some of her favorites and deliver later. One of these women said to tell you thank you!!
Today I went to give my regular blood donation and fond the blood center oddly quiet — and I was told that last Friday the center (located in New York City’s Upper East Side) had received NO donations at all!! Apparently many people are scared to donate.
As a result I wrote a post that is very similar to what Sam says above. So let me just add here that one way to help is to try to make up for the failures of our fellow citizens. Give blood, show up where they aren’t showing up (as long as you aren’t contributing to the spread of the virus), make sure that the normal things that our society needs aren’t falling through the cracks because of the fear of our friends and neighbors.
Thanks for all this great thinking. (I’m mostly teasing you–I once almost wrote a book, The Metaphysical Colon, about the topic of non-medical food allergies. But the more I delved, the more it felt like there was real anxiety driving it, so I backed off. Wasn’t meaning to be a scold just to share my own time on that path.
AverageMormon–you are well above average. Thank God for your work. It’s okay to protect your family. I wonder whether your stake could be recruited to help or the full time missionaries? Honestly I think some of the work will be dropping off some food for them. I also wonder whether we could record meetings onto DVDs–do elders tend to have DVD players?
These are all great questions. Thanks for the goodness of your souls.
I still have not heard a word from church leaders on this issue or any cautions or modifications to meetings. BYU has not said much either. I’m quite surprised by this. My company is taking extensive protective measures and assessing daily, and my work environment seems lower risk than a sacrament meeting. Universities are starting to move to online classes. I have been telling people I serve with at church who are at-risk not to feel like they need to come to meetings or activities.
Elisa, it’s a complex time for all of us. I personally advise people at risk to stay home from Church and to encourage their wards to start providing video feeds. Our ward has already started doing this.
There is news and announcements from the Church about the Corona Virus and Conference/ MTCs/Large Meetings. https://www.deseret.com/faith/2020/3/11/21174868/general-conference-coronavirus-april-2020-mormon-mtc-missionary-church-of-jesus-christ-covid-19
Surely this ^ must be the big exciting events at conference President Nelson told us to look forward to.
I have been taking notes on Sacrament Meeting talks and emailing them to housebound members for several years now. It’s not perfect and probably not as good as a video feed, but it most people have access to email and find it easy to manage. I started doing it on my own when I was Relief Society President and realized how many people in my ward wanted to come to church but couldn’t leave their homes for whatever reason. Anyone can do it – it doesn’t have to be a calling or anything. It could even be part of ministering for those whose ministering families can’t or don’t feel comfortable gathering in large meetings.
The Handbook continues to prohibit video taping or broadcasting meetings from our chapels. To some that never made sense. Maybe it can be changed. FM actually installed a permanent video camera in our local chapel, but maybe that’s only because our stake has no building that can house stake conference and must broadcast to other chapel(s) or tell people to stay home.
Thank you Sam, this is helpful.
Villate, I did the same thing for the same reasons, plus also thinking of primary workers. I kept it up for about 2 years until I got a stake calling and was traveling for that often. Good on you for keeping it up. It’s a big job, but a lot of people like it. I got more comments about it after I stopped than when I was doing it. So, just know that anytime you wonder if anyone cares, they do, even if they don’t say.
For anyone frustrated with Relief Society, feeling like you don’t fit in, or bored with the lesson, it’s a fantastic way to really carefully listen to what people are saying, but also to keep yourself busy during the lesson and reflect on it afterwards as you type it up in an email.
Thank you! I wish this were sent to every member and leader in the Church. As part of the “permanently vulnerable” population due to heart surgery and a rare disorder that is immune suppressive, I can attest that few others understand that reality. I have also lived through a localized deadly epidemic and witnessed how aggressive action early on saved lives. That epidemic struck all ages (how different would response be if today everyone was considered vulnerable?) and it was the cancellation of ALL meetings and activities that halted the death and disease. The local leaders acted quickly and decisively. They saved countless lives. Let’s do that now and be grateful for technology.
On a side note, sadly too often the hale and hardy have little regard for the realities of the chronically ill.