They Didn't Have to Play Us. They Just Knew They Could.
A retrospective on 2020 — and why you should be paying attention right now.
My mom called me in the early weeks of 2020, her voice tight with the particular panic that only mothers can produce.
“Have you heard about this weird China virus?”
“Yes,” I told her.
“Oh my God, I am so scared. Are you scared?”
“No,” I said. “I am scared at how they are going to play us. And how the public is going to react.”
I was not being brave. I was not being a contrarian. I was being a student of human nature and institutional behavior, and what I felt in my gut that day was not fear of a virus. It was dread. The specific, cold dread of watching something enormous click into place.
I was right to be afraid. Just not of what they told me to be afraid of.
Now they’re whispering about Hantavirus. <insert eyeroll>
Ooooo. Shake in your boots.
I’m not shaking. But I am paying attention. And so should you — not to the virus, but to the playbook.
They Sent the Sick to the Most Vulnerable and Called It Policy
Let’s start with the thing that should have ended careers, triggered federal prosecutions, and dominated every front page for a year. Instead, it got buried under an avalanche of “follow the science.”
On March 25, 2020, the New York Department of Health issued a directive: nursing homes could not deny re-admission to residents based on a confirmed or suspected COVID-19 diagnosis. No negative test required. Medically “stable” COVID patients from hospitals were to be sent directly into facilities housing the most immunocompromised, most fragile people in the state.
Governor Andrew Cuomo signed off on it. Thousands of nursing home residents died in the weeks that followed.
New York was not alone. New Jersey, Pennsylvania, Michigan, and California enacted similar policies. The U.S. Department of Justice was concerned enough to formally request data from four of those states in August 2020, investigating whether these orders “may have resulted in deaths of elderly nursing home residents.”
These were not mistakes born of ignorance. By late March 2020, it was well-established that the elderly were the primary high-risk population. The directive was issued anyway. The policy was rescinded in May — quietly — after the damage was done.
We were told to stay home to protect the vulnerable. Turns out the vulnerable needed protection from their own government.
The Ships Were a Photo Op
Remember the Navy hospital ships? The USNS Comfort steaming into New York Harbor, gleaming white, 1,000 beds, a symbol of national resolve? The images were everywhere. It felt like something was being done.
The Comfort treated 182 patients total over roughly three and a half weeks. At some points, as few as 20 patients occupied those 1,000 beds. The USNS Mercy, sent to Los Angeles, fared similarly.
To be clear: the ships were deployed initially as overflow for non-COVID patients, to relieve pressure on hospitals. That’s a reasonable idea in theory. In practice, bureaucratic admission criteria, infection control protocols, and the shifting nature of the surge meant they sat mostly empty while we applauded. My level of Momma Bear anger is on a chart that cannot be measured, currently.
The Javits Center field hospital in New York told a similar story. Grand. Expensive. Largely unused. But it photographed beautifully.
Follow the Money
Here is where I need you to read carefully, because this section will be twisted by bad-faith actors on both sides. I’m going to tell you exactly what happened, and exactly what it means.
Because I care. And long ago, my pockets became empty of anexpletive starting with the letter F to give. Zero are left.
Under the CARES Act (Section 3710), Medicare added a 20% bonus to standard hospital reimbursements for patients with a confirmed COVID-19 diagnosis. This was not a flat “per death” payment. It was a percentage increase on top of existing Diagnosis-Related Group (DRG) reimbursements, which already varied by severity.
What did that look like in practice? A respiratory hospitalization without a ventilator: roughly $13,000–14,000 with the add-on. With a ventilator running more than 96 hours: $35,000–42,000 or more. Those are not small numbers. And the 20% bonus applied specifically to confirmed COVID cases.
Now. Was this a deliberate incentive to over-diagnose COVID deaths? The ‘official ‘ answer is no. Confirmed cases required lab documentation, and coding had to follow guidelines. Hospitals also faced catastrophic losses from canceled elective procedures — the financial picture was genuinely complicated.
But here is what I will not pretend: it is never a good idea to create financial incentives tied to a specific diagnosis during a public health emergency when accurate data is the single most critical thing you need. Whether hospitals exploited these incentives systematically is debatable. That those incentives existed and created at least the conditions for perverse outcomes is not.
The broader Provider Relief Fund distributed approximately $175 billion to hospitals, clinics, nursing homes, and physicians. Some of it was desperately needed. Some of it went to facilities that saw relatively few COVID patients. The full accounting is still not clean.
So What Do We Do Now?
Americans are wiser now. I believe that. I have to believe that, because the alternative — that we learned nothing — is genuinely terrifying.
The Hantavirus headlines are beginning to circulate. Maybe it’s nothing. Maybe it’s something. I am not here to tell you that no virus can ever pose a real threat. I am here to tell you that the machinery of institutional panic — the press releases, the breathless coverage, the appeals to authority, the emergency authorizations — is not the same thing as truth. It never was.
Ask the questions they don’t want you to ask. Who benefits? What does the data actually say, and who collected it? What is being decided right now that we’ll find out about in two years?
My mother called me scared. I was scared too — of exactly what happened next.
Don’t be the person who only gets scared of the right thing in hindsight. Be the person who asks, right now: “How are they going to play us this time?”
Sources: NY Department of Health Advisory (March 25, 2020); U.S. DOJ statement (August 2020); CMS Special Edition article SE20015; HHS Provider Relief Fund reports; U.S. Navy / DoD deployment records.
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