We can’t let the week go without mentioning 1 million Americans killed by the covid. That’s 1 million moms, dads, brothers and sisters. That’s 1 million Memorial Day picnics missing a loved one. That’s 1 million broken strands in the interdependent web of life.

What can we say about this beyond loss and grief? I think it’s to reassess how we understand the role of public health in a republic. 

The thinking that animates public health is far more than the health and welfare of the citizens who constitute a society. It’s far more than stemming the spread of deadly infectious disease. The thinking that animates public health is by necessity rooted in political thought.

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When those who govern care for the people, they care for democracy.

When they don’t, they don’t.

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Think of it this way. In a country like, say, Syria, the health of the polity is of little or no consequence to the ruling class. If people are sick, if people die, well, that has nothing to do with maintaining the elite’s grip on power. If anything, sickness and death help them hold it more tightly. The sick and dying can’t and therefore don’t mount resistance. 

Syria is not a democracy, though it pretends to be. The Syrian people are not the ultimate sovereigns. Bashar al-Assad is. He will commit genocide to prove it. The United States, however, is a democracy.

Parts of it. 

The health and well-being of the people is important, or should be, to those whom the people have chosen to govern, because those who govern are accountable to the people, the ultimate political sovereign. 

A healthy people is strong enough for self-rule. Conversely, a people sick and dying cannot and therefore do not rule themselves. If those who govern fail to stem the spread of deadly infectious disease, they have failed politically. In effect, they have undermined the republic.

As a result, those who govern are closer to a ruling elite indifferent to the people’s suffering on account of the people, as long as they suffer, cannot and therefore do not mount resistance to the ruling elite.

What do 1 million dead Americans tell us?

It tells us the United States is not one country. 

Parts of it are democratic.

Here in Connecticut, where democracy is habitual and the common good cultural, those who govern slowed the spread of the covid, even though that meant briefly shutting down the economy. Governor Ned Lamont, who’s hardly a saint, behaved as if accountable to the people.

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In Florida, by contrast, those who govern behaved less with consent and more with entitlement – similar to the ruling elites in countries like Syria. Apparently, from the view of Governor Rick DeSantis and the GOP legislators who run the state, the sick and dying were too weak to consent and therefore too weak to resist control by ruling elites. 

As soon as the vaccines were made available, Lamont mandated shots for everyone. Since 2021, deaths by the covid dropped and stayed down.

DeSantis and the Republican governors in other southern states refused mandates. Deaths by the covid rose and fell, rose and fell, in proportion to the strength and weakness of the coronavirus.

That the United States is not one country tells us that “democracy” as a description of our form of government is doing a helluva lot of work. 

Democracy kinda.

A democracy in that the people of Florida do cast votes, but the power of their vote is mitigated by the relative strength of the whole electorate, which is to say, the health and well-being of a people previously undermined, or even sabotaged, by the state’s ruling elite.

That “democracy” as a description of our country isn’t quite right tells us the language of international relations might be more appropriate. 

You have probably heard of “failed states” – that’s a political entity, like Syria, that’s been so weakened by corruption and power that the government can no longer meet its responsibilities to its people.

Florida is probably best characterized as a “fragile state.” According to the World Bank, “fragile statehood exists in situations where there is low level of government performance, where state institutions are weak or on the verge of collapse and where the state either fails to perform core roles or performs them wholly inadequately.” 

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That Florida is probably best described as a “fragile state” tells us that the word “democracy” as a description of America is covering up for the fact that Florida is probably best described as a “fragile state.” 

The people of Florida think they live in a democracy, because their state is one of the United States, which everyone says is a democracy. But a democracy leaving its people alone to face death by the covid is a democracy straining the very meaning of the word. Indeed, it’s fragile. 

As fragile as the health and well-being of the people.

When those who govern care for the people, they care for democracy.

When they don’t, they don’t.

If we were one country, the people might be strong enough to resist.

As it is, 1 million Americans are dead.

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