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Why we aren’t seeing the carnage

APPLE VALLEY, CALIFORNIA – DECEMBER 23: (EDITORIAL USE ONLY) A patient lies on a stretcher in the hallway of the overloaded Emergency Room at Providence St. Mary Medical Center amid a surge in COVID-19 patients in Southern California on December 23, 2020 in Apple Valley, California. The 213 bed capacity hospital in San Bernardino County is currently treating at least 140 COVID 19-positive inpatients while operating at approximately 250 percent of ICU capacity. Southern California remains at zero percent of its ICU (Intensive Care Unit) bed capacity amid the spike in coronavirus cases and hospitalizations. (Photo by Mario Tama/Getty Images)

I’ve wondered why we haven’t seen much footage of COVID in hospitals. I certainly understand why they would be required to blur faces of people who can’t or don’t want to give consent. But we see much more images of warzones than we have seen of the horror that’s befallen our health care system in this crisis.

Well, the Trump administration has made sure we won’t see it:

AS COVID-19 TORE through the United States in the spring, a senior official in the Trump administration quietly reinforced a set of guidelines that prevented journalists from getting inside all but a handful of hospitals at the front line of the pandemic. The guidelines, citing the medical privacy law known as HIPAA, suggested a nearly impossible standard: Before letting journalists inside Covid-19 wards, hospitals needed prior permission from not only the specific patients the journalists would interview, but also other patients whose names or identities would be accessible.

The onerous guidelines were issued on May 5 by Roger Severino, who worked at the conservative Heritage Foundation before Donald Trump appointed him to direct the Office for Civil Rights at the Department of Health and Human Services, or HHS. The guidelines made it extremely difficult for hospitals to give photographers the opportunity to collect visual evidence of the pandemic’s severity. By tightening the circulation of disturbing images, the guidelines fulfilled, intentionally or not, a key Trump administration goal: keeping public attention away from the death toll, which has surpassed 300,000 souls.

“The last thing hospital patients need to worry about during the Covid-19 crisis is a film crew walking around their bed shooting B-roll,” Severino said dismissively in a short press release accompanying the guidelines.

In the pandemic’s early days, when hospitals were first inundated with media requests, the prevailing HIPAA guidelines were quite restrictive, even on matters that had nothing to do with media access. Those guidelines predated the Trump administration and were not written for a pandemic. But the scale of the Covid-19 crisis quickly forced the Trump administration to loosen a wide range of privacy restrictions on medical providers — except, as it turned out, the ones that kept Americans from viscerally seeing the ailing and the dying.

For instance, HHS allowed hospitals to share Covid-19 information with first responders and with organizations involved in Covid-19 testing. Hospitals were told that they would not face sanctions for sharing information with the families or friends of Covid-19 patients. Doctors were freed to discuss or transfer patient information with technologies that were not secure, such as email, FaceTime, and Skype. As it relaxed these restrictions, the agency said that medical providers would not be punished for breaches of patient confidentiality if they acted in good faith during the pandemic.

The government’s permissiveness did not extend to journalists. The media guidelines announced by Severino in May reinforced HIPAA’s restrictions and warned hospitals that violations could bring fines in the millions of dollars. The announcement was not reported by general-interest publications, but news outlets for the health care industry noticed what had happened. The headline of one of those industry stories was blunt: “Patient Privacy Prevails Over Covid-19 Media Coverage.”

Severino’s guidance, little known outside the health care industry, may help solve one of the mysteries of the pandemic: Why have Americans seen relatively little imagery of people suffering from Covid-19? While there is a long-running debate over the influence of disturbing images of death and dying — whether they actually move public opinion — the relative paucity of videos and photographs of the pandemic’s victims might help explain why Covid-19 skepticism has thrived as the death toll in America reaches the level of a 9/11 every day.

“For society to respond in ways commensurate with the importance of this pandemic, we have to see it,” wrote art historian Sarah Elizabeth Lewis. “For us to be transformed by it, it has to penetrate our hearts as well as our minds. Images force us to contend with the unspeakable. They help humanize clinical statistics, to make them comprehensible.”

Michael Kamber, a former war photographer who directs the Bronx Documentary Center in New York City, recalls security guards shooing him off the sidewalks in front of Lincoln Medical Center. “This is the greatest loss of life on the American continent in such a concentrated time, and we’re seeing almost no images that really convey the devastation and the death,” Kamber said. “Photography has played such a key role in the civil rights movement, in ending the Vietnam War, and any number of key moments in American history — and it just seems missing in action on this crisis.”

Kamber, like other photographers, accepts that safety and privacy concerns need to be upheld, but he believes that those concerns are used as excuses for the repression of journalism that is manifestly in the public interest. In the cases in which hospitals have allowed journalists inside during the pandemic, there have been no privacy breaches — which proves that reporters can work at the medical front line without violating patient privacy. “The government and nearly all health care facilities have banded together in the name of protecting the privacy of the sick and have done an excellent job of keeping photographers as far away from the grief and devastation as possible,” Kamber said.

Trump knows that if it isn’t on TV it doesn’t exist for many Americans, especially his followers. It’s unlikely that Fox or Newsmax would show much of it, of course, but they might see some of it in passing while they’re out in bars and restaurants or traveling to visit family.

Here in LA the hospitals are overflowing and we have seen some pictures of make-shift waiting rooms in the parking lots and people being treated in the gift shop and lobby. It’s scary. I think for a lot of people, it’s no longer just COVID that scares them but the idea of something else happening and the hospitals not being able to adequately treat them. (Don’t get COVID, but don’t have a heart attack or appendicitis either!) Maybe if more people saw this they would take it more seriously.

I think it’s true that there is a distance between what people are personally experiencing and what’s happening with this virus. And part of the problem is that we aren’t allowed to see it. But that was part of the plan.



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