Mass Death Is a Choice

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We are approaching nearly a year of the pandemic in the United States and to say that I am tired would be an understatement. Sure, staying home all the time and communicating with others outside my household through Zoom hasn’t been ideal—but at the end of the day, I’m healthy and alive, and I thank God for that. There are three groups in this country; there are those of us who are staying home by working remotely and don’t want to catch this virus, there are those of us who want to stay home but have to work in-person jobs, and then there are those of us who do not care. What has absolutely exhausted me is not the isolation but the acceptance of mass death—that is what has really taken a toll on me.

On the day that I publish this piece, 480,663 deaths have been attributed to COVID-19 in the United States. Yesterday, 5,459 people died. The CDC predicts by March 6, we will have a range of deaths from 515,000 to 540,000—that is anywhere from 35,000 to 60,000 people. Joe Biden has warned Americans to expect a death toll of upwards of 600,000 by the time this is all over; that’s at least 100,000 more deaths. This is the size of a small town filled with friends and family. We have become numb to these numbers and they have become meaningless. Unfortunately, this mentality is quite familiar to those who work in overdose prevention.

For years now, overdose deaths (mainly but not only from opioids) have stayed around 70,000 each year. After a small downturn in 2018, there was a 4.6% increase in overdose deaths in 2019—the pandemic is expected to balloon these numbers. One recently released study showed that visits to the ER for opioid-related overdose in 2020 grew 29% from the year prior. Thousands continue to die and still the government, while pledging action, has barely made a dent in these numbers.

I have already opined about how I believe the term “harm reduction” is misused to justify non-adherence to public health measures and the lack of a proper government response. Let’s be clear: true harm reduction does not view any life as disposable or collateral damage. Harm reduction is not a societal calculus that makes a decision on what number of other people’s deaths is acceptable for the rest of us to resume our lives. The ultimate harm we are trying to reduce in overdose prevention is death. This is why for years advocates have held vigils, have protested for safe injection sites, and have called for more to be done. Every overdose death is a tragedy and every COVID death is a tragedy.

Calling for the country to respond to mass death has long felt like an exercise in futility. People (especially those in power) acknowledge that is what is happening is terrible but act like our hands are tied in trying to stop it. Make no mistake, we have the power to dramatically reduce deaths with COVID and overdose—we are just unwilling to do what is necessary. For COVID, that looks like a paid shutdown that allows the government to orderly vaccinate people and allows as many people to stay home, while tackling concurrent crises in hunger and housing. For overdose, it looks like allowing safe consumption sites, allowing a safe supply, and really expanding access to harm reduction services.

Mass death is a choice, and it is one we can stop making at any time.