2020
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Monitor Daily Podcast

April 06, 2020
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TODAY’S INTRO

The choices that will shape a post-coronavirus world

Clayton Collins
Director of Editorial Innovation

Today we look at a moment for telemedicine, the push for group prayer, Finland’s effective young leader, refugees helping refugees, and a sit-down with America’s poet laureate. First, a look beyond our current crisis. 

Medical science stays focused on the curve-flattening it maintains is needed to keep the coronavirus from running rampant before it can be crushed. 

Where might we focus next, while we act prudently in our present? By many accounts, on the choices that will shape the world when we’ve all come through this, however long that takes

In facing those choices, writes Yuval Noah Hariri in the Financial Times, “we should ask ourselves not only how to overcome the immediate threat, but also what kind of world we will inhabit once the storm passes.” Might we work our way to a better normal?

Some smart, hopeful takes: More stillness could nudge us to less frenzied lives, perhaps even in places where extreme overwork has been ritualized. To accept that “calamity is a great teacher” and to adopt behaviors that soften generational lines, and borders. 

Global imperatives may more likely be seen as demanding global collaboration. We might be better able to listen to the Earth and its other inhabitants. 

“We perfected systems for making an ‘us’ and an ‘other,’ writes Krista Tippett in Orion, and “we made of the natural world an ‘other.’ Now ... we are grasping new forms of agency. ... [F]or all our awakening to the power of digital technologies to divide and isolate us,” she writes, “this too is true: our technologies have given us the tools ... to begin to think and act as a species.

“We are strange creatures, hope reminds me: again and again we are made by what would break us.”

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A deeper look

‘The doctor won’t see you now.’ Rethinking health care delivery in a crisis

Like much else about the current global crisis, sufficient distribution of medical workers was a long-running issue that suddenly loomed large. We wanted to look at an innovative field that could be both short-term stopgap and long-term solution.

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Long before COVID-19 hit the headlines, health care systems across Europe and the U.S. had been struggling to plug recruitment gaps, particularly in their nursing ranks. Now that shortfall has become a crisis, leading to a call-up of recent retirees and new graduates to support front-line staff treating patients. 

In Washington state, Gov. Jay Inslee last week told recent medical retirees and qualified students, “Like Uncle Sam, we want you!” 

Hospitals and clinics are also ramping up telemedicine, out of necessity, amid a pandemic that requires social distancing and has put huge strain on health care resources. This pivot has drawn attention to telemedicine as a longer-term solution that could help overcome, at least in some aspects of medicine, the shortfalls in medical staff in rich aging societies like Italy and Germany. 

“If there is one positive aspect, this crisis is proving that reforming healthcare doesn’t necessarily take decades. It’s just a matter of will,” says Nicola Draoli, an Italian nurse. 

‘The doctor won’t see you now.’ Rethinking health care delivery in a crisis

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Courtesy of Carolyn Grant
Carolyn Grant, health services manager at the University of Washington Medical Center and a registered nurse, returned from retirement to help run COVID-19 testing centers. She is shown preparing materials for drive-up testing locations in the Seattle area.

Veteran Seattle nurse Carolyn Grant had just finished kicking off her retirement with a trip to Hawaii when she got a text from her old boss: Would Ms. Grant come out of retirement to help the medical center’s COVID-19 testing program? That night, she said yes. 

In Germany, where “not a single hospital has enough staff,” says a Berlin ICU nurse, the government is calling medical students to action, and dissolving bureaucratic hurdles so hospitals can mobilize more medical workers. 

In Italy, which has seen the world’s highest coronavirus death toll, the government has asked recently retired doctors to come back to work, and allocated funding to hire 20,000 more health professionals. 

Editor’s note: As a public service, all our coronavirus coverage is free. No paywall

Chronic worker shortages can be patchworked during normal times, but as the COVID-19 pandemic slams medical systems around the globe, having the right personnel can mean the difference between life and death. Administrators are rehiring retired professionals, tapping medical students before they even graduate, and turning to the military and volunteers to supplement a stretched workforce that even before the current crisis was coming up short.

“It is like we have a blanket that is too short and everyone is trying to pull it to his side,” says Nicola Draoli, an Italian nurse.  

From Berlin to Seattle, hospitals and clinics are also ramping up telehealth options, which in a few weeks have been overcoming medical, bureaucratic, and consumer resistance that had stymied advocates for years. As COVID-19 brings waves of patients through hospital and clinic doors, health care systems are turning to solutions that might become increasingly attractive going forward.  

“If there is one positive aspect, this crisis is proving that reforming health care doesn’t necessarily take decades. It’s just a matter of will,” says Mr. Draoli, a member of the central committee of Italy’s national federation of nursing.  

In Berlin, a nurse in an intensive care unit who prefers to be called Nico because he’s not authorized to speak to the news media loves working with patients, and the undersupply of nurses means ironclad job stability. “I think I could work at any hospital or any ICU in Germany,” he says.  

But the shortage has downsides: The hospital had closed a quarter of its ICU beds over the last two years due to lack of staff. Nico was constantly on call to pick up extra shifts, and also needed to clean patient rooms and tidy pharmacies due to a shortage of assistants. Over the years, Nico has seen colleagues vote with their feet. “The workload is so heavy,” he says. 

Today, Nico’s hospital is prepping for the COVID-19 crisis by adding ICU beds and training non-ICU staff. Administrators are also preparing to hire medical students, who now have government-mandated flexibility for education, training, and licensing requirements.  

“We’re waiting for the big wave of patients, expecting it to hit in late April,” says Nico.

A structural staff shortfall 

Germany is currently facing a shortage of 70,000 nurses in hospitals alone, according to Verdi, a German trade union. “We’ve lost 300,000 health care workers each year to retirement,” says Stefan Sell, a professor of economics and social policy at the University of Koblenz. “And the younger generation is very small, and young people go into other jobs.”  

The situation is no better in other developed countries. Italy is currently short about 53,000 nurses, estimates Mr. Draoli of the nursing federation. The United Kingdom’s National Health Service is missing about 100,000 health care workers of all kinds, and the United States needs to recruit at least 200,000 more registered nurses each year. All have aging populations that need more elder and long-term care. 

The main reasons are high turnover and not enough new nursing graduates entering the workforce in wealthy countries. Sociocultural factors also come into play; most health care workers are women, who are more likely to take part-time shifts because of child care requirements, says Dr. Sell, meaning you need more hires to provide full-time coverage.

Put simply, the job isn’t attractive enough, as pay for nursing and medical assistant work hasn’t remained competitive. In Italy, for example, health care salaries have declined from roughly 40% of the country’s annual public health budget two decades ago, to less than a third today.

“In the U.K., we have a lot of vacancies that remain unfilled,” says Dr. Rocco Friebel, a London School of Economics health policy professor. “Working conditions are poor. It’s a very high-pressure job.” 

Staffing projections worldwide are sobering. By 2030, countries in North, Central and South America are expected to face a combined shortage of roughly 2.5 million doctors, nurses, and other workers, with Europe’s shortfall at around 1.4 million, according to a 2017 study by medical researchers.

Recruiting foreign nurses

Governments in the U.S. and Europe have attempted to tackle shortages by shifting workloads, digitizing services, providing funding to create elder care positions, and looking at worker wage increases, among other initiatives. 

“In the U.K., we’ve seen a push to employ clinical assistants, who can do bookkeeping and a lot of the day-to-day tasks, which then frees up fully qualified nurses to take care of the most severe cases,” says Dr. Friebel.

But the main strategy in wealthy nations is to fill their ranks with foreign nurses and health care workers. The German government is working with Kosovo, Mexico, and the Philippines to integrate workers into its health care system. In the U.K., the National Health Service has long tapped European Union nationals, especially those from Poland and other Eastern European countries, to fill jobs. 

That’s only a partial solution, says Dr. Sell, the German economist, in part because of the competition. “A lot of other countries such as the Netherlands, France, and Switzerland are also trying to get people from Russia, Ukraine, and other countries,” he says. Also, he points out, many potential migrants don’t speak the adopted country’s language.

“Ultimately, we have to get additional staff from our [home] labor force,” says Dr. Sell. “That will require a multidimensional strategy such as improving working conditions and education” for workers. 

A turn to volunteers, telemedicine

A shortage that will take decades to solve feels acute in the face of a pandemic.

In the U.S., top officials are crying out for medical volunteers of all stripes. In New York, more than 50,000 health care workers have answered Gov. Andrew Cuomo’s pleas. In California, a newly created health corps to expand the workforce has garnered more than 70,000 registrations from “underemployed” medical professionals of all stripes. 

In Washington state, Gov. Jay Inslee last week told recent medical retirees and qualified students, “Like Uncle Sam, we want you!”  

Another infusion of medical manpower is coming from the U.S. military. Three hundred soldiers from an Army unit in Fort Carson, Colorado, arrived in Seattle last week to set up a 250-bed hospital inside the Seattle Seahawks’ football stadium, and a Navy hospital ship has docked in New York City. By caring for patients without COVID-19, they can free up local hospital beds for those who have the virus.

Health care workers are also being asked to shift gears, as they’re redeployed to other units, such as from transplant ICUs to respiratory care. 

Italy’s worst-hit regions like Lombardy are also tapping another strategy: emphasizing primary-care monitoring and home care rather than hospital admissions. “Hospitals have always seen too many people that don’t belong in the hospital,” says Dr. Friebel, the analyst. 

As Italian doctors have discovered by necessity, initial screenings of suspected COVID-19 patients can be done without a physical visit. 

“It turns out that a lot of both screening and follow-up of [COVID-19] patients – the mild cases – is about asking questions about symptoms,” says Joseph Kvedar, a Harvard Medical School professor and incoming president of the American Telemedicine Association. “It’s a perfect setup for [telehealth] technology.”

Advocates of telemedicine say many health care needs can, in fact, be serviced without stepping foot into an office, clinic, or hospital.

Inquiries from U.S. clinicians about telehealth have skyrocketed, Dr. Kvedar says, at the same time that states and the federal government are loosening requirements for licensing across state borders and privacy issues around technology. They’re also reexamining what’s defined as a “visit” for insurance purposes.

“There’s been a staggering amount of creativity and collaboration,” says Dr. Charlotte Wu, a physician and founder of Harness Health Partners, a Boston-based consultancy. “We’re seeing an increased acceptance of virtual medicine, leveraging the skills of diverse team members, and collaborating across institutions – who were traditionally competitors.”

Virtual care, digital fixes

At Asian Counseling and Referral Service in Seattle, counselors are now offering mental health care by phone and video apps such as Zoom and Doxy.me. “We can accept consent via telephone versus in writing” in treating substance use disorders, says Michael Byun, who runs the nonprofit. 

COVID-19 is spurring innovations that might eventually pave the way for routine remote-monitoring of chronic illnesses. The possibilities are legion. Seventy percent of U.S. health care costs go to treating health conditions like high blood pressure or high cholesterol that are attributed to or worsened by smoking, lack of exercise, or poor eating habits; they can be followed by a virtual-care quick check-in, says Dr. Kvedar. 

“We don’t have enough people to deliver service one-to-one in a room at a time,” says Dr. Kvedar. “There’s a lot of inefficiency in the way we deliver care. When the dust settles, I hope we don’t go back to doing every single thing in the office.”

New technologies are also helping tackle staffing shortages. Germany recently called on the public to suggest COVID-19 related innovations, and among the entries was a “digital waiting room” that vets a patient’s symptoms, and an app that rotates nurses more effectively. Practitioners and researchers are also using artificial intelligence to help forecast disease spread, implement rapid-testing technologies, and develop new approaches to contact tracing. 

Back in Seattle, the veteran nurse Ms. Grant has bid her short-lived retirement goodbye; she’s now working 10- to 12-hour days, six days a week, managing COVID-19 testing sites. Her day begins early to ensure adequate supplies for the testers, as she leads a team of nurses at the University of Washington Medical Center – Northwest who were displaced from outpatient surgery centers and clinics.

Ms. Grant was part of a wave of nurses who entered the workforce during a severe nursing shortage in the U.S. during the 1980s. “Many people in that age bracket are exiting the workforce,” she says, so it’s no surprise they’re being called back to fill the gaps they’ve left. Ms. Grant feels a “loyalty” and a call to duty. “I am able to help this community at a difficult time.”

This story was reported by Monitor correspondent Lenora Chu in Berlin, staff writer Ann Scott Tyson in Seattle, contributor Daniela Sala in Rome, and contributor Austin Davis in Berlin.

Editor’s note: As a public service, all our coronavirus coverage is free. No paywall

Prayer services during a pandemic: Why some churches stay open

This next piece goes to the intersection of rights and responsibility. Among the questions conservative religious groups are asking amid coronavirus restrictions: If liquor stores are considered “essential,” why not religious services?

Delcia Lopez/The Monitor/AP
Liza Garza and her children Faith, 8, Christian,10 and Joseph,11, sit on top of their vehicle while they pray during a 'drive-in' worship mass on Sunday, March 22, 2020, in McAllen, Texas.
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It’s one of the most fraught questions for people of faith during the pandemic: Should we go to church?

In Florida last week, a sheriff arrested the pastor of a megachurch for violating a local shutdown order. Days later, the governor  exempted houses of worship when he issued a statewide stay-at-home order.

“We’ve got to understand when God is in control of our life, then we can rest in the fact that we know that God,” said Pastor Darlene Bishop Driscoll during her March 29 sermon at an Ohio megachurch that continues to meet. “OK, so they call us stupid. That’s OK.”

More than 80% of U.S. houses of worship have stopped meeting in person. AlabamaTexas, and Missouri, however, issued executive orders that include places of worship as “essential” services. Other states offer similar exemptions for religious gatherings.

“Few of the public health measures put in place around the country hit as close to home for people of faith as restrictions on when and how congregations can gather,” says Dallas attorney Brad Nitschke. “And the tension between the First Amendment’s protection of the free exercise of religion and recommendations of public health authorities is clearly top of mind for elected officials, as well.” 

Prayer services during a pandemic: Why some churches stay open

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Rusty Reno has been a bit alarmed over the past few weeks as both civil and religious authorities began to restrict the number of people who can gather together to pray.

The Catholic theologian and conservative political thinker bristled when the New York archdiocese shut down most services over three weeks ago in response to the coronavirus crisis – even though Democratic Gov. Andrew Cuomo’s executive order stated that houses of worship were not ordered closed. 

“I mean, right now I’m looking out of my window at the construction project on a very tall apartment building, and it’s ongoing,” says Mr. Reno, editor of First Things, a Manhattan-based journal published by the Institute on Religion and Public Life. “So the trades in New York got an exemption for construction projects, the liquor stores are deemed essential services, the hookah stores are deemed essential services,” he says.

“So I still wish that the churches, the leaders of the church, had pressed for reasonable accommodations,” continues Mr. Reno. Their concern, especially now, should be to sustain the spiritual health of those entrusted to their care, he says.

Editor’s note: As a public service, we’ve removed the paywall for all our coronavirus coverage. It’s free.

It’s been a refrain among a number of religious conservatives during the current contagion, but last week, after President Donald Trump warned Americans that “hard days lie ahead” and his administration issued sobering projections of COVID-19’s impact, the nation’s stay-at-home landscape began to change in unexpected ways. 

Carlos Barria/Reuters
A person in a dog costume accompanies kids as they leave the Life Tabernacle megachurch after attending Sunday service challenging state orders against assembling in large groups to prevent the spread of COVID-19 in Baton Rouge, Louisiana, April 5, 2020.

Last Monday, the sheriff in Tampa, Florida, arrested the pastor of an Evangelical Protestant megachurch, charging him with unlawful assembly and violating the county’s emergency public health rules. On Wednesday, police in Lakewood, New Jersey, broke up a funeral for a Hasidic rabbi, charging 15 people with violating Democratic Gov. Phil Murphy’s executive order banning large gatherings.

“This ban applies to everyone,” said Ocean County Prosecutor Bradley Billhimer in a statement. “To be blunt, ignoring the Governor’s Order places lives at risk – not just the lives of everyday citizens, but the lives of our brave men and women in law enforcement who are required to respond in order to break up these unlawful gatherings.”

As more states began to issue versions of stay-at-home orders, responding to President Trump’s warning that the country would have “a rough two weeks” ahead, many have listed places of worship as essential services exempt from bans on public gatherings. 

In Florida, Republican Gov. Ron DeSantis issued a new statewide order that listed “essential activities” including religious services, in effect superseding the local health rules behind the arrest of the Tampa pastor.   

Last week, Alabama, Texas, and Missouri issued executive orders that include places of worship as essential services. Michigan, too, exempts places of religious worship from penalty, and Kansas exempts activities necessary to “preserve constitutional or legal rights,” including to “perform or attend religious or faith-based services or activities” and “manufacture or sell firearms.”

“Few of the public health measures put in place around the country hit as close to home for people of faith as restrictions on when and how congregations can gather,” says Dallas attorney Brad Nitschke, a partner with Jackson Walker. “And the tension between the First Amendment’s protection of the free exercise of religion and recommendations of public health authorities is clearly top of mind for elected officials, as well.”  

The vast majority of the nation’s houses of worship, including most Catholic dioceses and Evangelical Protestant congregations, have already stopped meeting in person, according to a March survey by the American Enterprise Institute. Still, about 12% of Americans who attend a church, temple, synagogue, or mosque say their congregations still continue to meet as before. 

Public health officials, including the federal Centers for Disease Control and Prevention, have urged communities of all kinds to avoid gathering in groups, in an effort to stem the spread of COVID-19 and alleviate the strain on the health care system.

Some of these congregations have downplayed such warnings, and many maintain a skepticism toward secular science and a deep suspicion of the encroaching power of government regulations. Some, too, express confidence in divine protection from what could be a moment of reckoning for the country. 

Carlos Barria/Reuters
Local residents leave Sunday service at the Life Tabernacle megachurch challenging state orders against assembling in large groups as the spread of coronavirus disease (COVID-19) continues in Baton Rouge, Louisiana, April 5, 2020.

“We’ve got to understand when God is in control of our life, then we can rest in the fact that we know that God,” said Pastor Darlene Bishop Driscoll during her March 29 sermon at Solid Rock Church in Monroe, Ohio, a multiservice megachurch that has continued to meet. “OK, so they call us stupid. That’s OK.”

Later in the sermon she claimed the pandemic, in which 1.3 million people worldwide have been diagnosed, is God punishing the U.S. for legalizing abortion in the 1970s.

Earlier in the week a local health commissioner sent Solid Rock a letter noting the complaints from those in the surrounding community, many worried about the church’s large gatherings. Ohio, like other states, has also exempted places of worship from stay-at-home health directives.   

“Bringing together a large number of people during a pandemic increases the pace at which the virus spreads, overwhelming our hospital systems, and posing a significant risk to members within the congregation,” the commissioner’s letter said, echoing the guidelines given by the Trump administration and the CDC. 

In a statement, Solid Rock Church responded: “As Christians we are charged by Jesus Christ to obey the laws of our land. Therefore, if the laws of our nation should ever change with respect to our First Amendment right to assemble, thereby restricting us from having our church doors open, we will willingly comply.”

Such postures during the crisis could do lasting harm to the cause of religious freedom, long a central concern for many Republicans and religious conservatives, says Robin Fretwell Wilson, associate dean for public engagement and a professor at the University of Illinois College of Law.

As a legal issue, Professor Wilson cites Supreme Court precedent that permits certain restrictions of religious expressions so long as they are applied neutrally to everyone. Religious liberty does not mean “every citizen can become a law unto himself,” she says. 

At the same time, Congress and dozens of states have also instituted Religious Freedom Restoration Acts, which demand authorities present both a compelling government interest for any religious restrictions, and if they do, these must be the least restrictive possible.

“But at a time like this, in a crisis that affects all of us, religious people should have to cooperate with the program just like everybody else,” says Professor Wilson, who has helped the Fairness For All initiative that works to bridge the divides between advocates of religious freedom and LGBTQ rights. “Every religious person cannot simply say, nope, not me. They could then be like a traveling bubble of contagion, like Typhoid Mary.”

Mr. Reno at First Things, however, sees a deeper theological problem with the country’s virtual shutdown and is concerned that damaging changes could outlast the pandemic.

“It’s the modern conceit that we can control the time and the hour of death,” Mr. Reno says. “People are anguished by the reality of death, and my heart goes out to the health care workers who must face it. But we as moderns, we believe we have the technological ability to simply send it away, which of course is an impossible task.”

Editor’s note: As a public service, we’ve removed the paywall for all our coronavirus coverage. It’s free.

Stepping Up

Profiles in Leadership

How millennial Premier Sanna Marin won Finland’s approval

Finland leads in superlatives for its levels of happiness, its education system, its social safety net. Now it's reinforcing that effective national leadership can come along with being young and female.

Christian Hartmann/Reuters
Finland's Prime Minister Sanna Marin arrives for the European Union leaders summit in Brussels, Belgium, Feb. 20, 2020. In the latest poll by Finland's leading newspaper, the Helsingin Sanomat, Ms. Marin earned an 85% approval rating for her handling of the coronavirus crisis.
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In the United States, she wouldn’t be old enough to be president. But four months into the job as prime minister of Finland, Sanna Marin and her mostly young and female cabinet is managing one of Europe’s lowest rates of COVID-19, and earning high approval in the country of 5.5 million.

The new government reflects a modern face of Finland that’s more confident on the world stage, say observers. “Sanna Marin is a one-in-a-generation natural political talent,” says former Prime Minister Paavo Lipponen. “I have been greatly impressed by the way the five government parties and their young women leaders have been able to work together. They are all competent, hard-working, solution-oriented politicians.”

As minister of the interior, Maria Ohisalo is responsible for managing the non-essential travel ban around the capital region. She stresses that combating the epidemic has been very much a group effort, involving not only the government, but the entire Finnish society. “I feel that the Finnish people have been really supportive of our course of action, and that is very gratifying.”

How millennial Premier Sanna Marin won Finland’s approval

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COVID-19 has already made heroes and goats of many leaders, as the pandemic that envelops the world is revealing whether their governments are equal to the crisis. 

Among the former is Sanna Marin, the world’s youngest head of government at the time she became prime minister of Finland last December. In a recent poll, 85% of Finns supported her handling of the pandemic, a striking level of confidence in these uneasy times. 

When she took office last year, Ms. Marin and her mostly female cabinet faced a minor storm of social-media criticism. “Spice Girls” was one taunt, “Lipstick Cabinet” another. Four of the cabinet’s five parties on a left-to-center spectrum – a so-called red-green coalition government – are headed by women in their 30s. Ms. Marin is 34.

But as the severity of the health crisis has become clear, skepticism of Ms. Marin has fallen away.

Editor’s note: As a public service, all our coronavirus coverage is free. No paywall.

“Marin has really stepped up,” says Eddy Hawkins, an American who has lived in Finland since the 1970s and reports for Finnish Broadcasting. “Her performance at press conferences and in parliament, has been just what works best for Finns – clear, concise, unemotional; but with an undertone of warmth.” Mr. Hawkins adds that Ms. Marin’s style complements that of Sauli Niinistö, Finland’s popular 71-year-old president, with each effectively appealing to different demographics.

Ms. Marin, who was elected to parliament in 2015, is well known for her straight-shooting style. A YouTube clip of her as vice chair of the Tampere city council, calmly cutting off one long-winded member after another during a fractious debate about transportation needs in 2016, has nearly half a million hits. She easily won reelection last spring, after which her Social Democratic predecessor, Antti Rinne, appointed her his minister of transportation.

Now, Ms. Marin is learning how to be prime minister while also steering Finland through its greatest crisis since World War II. 

Vesa Moilanen/Lehtikuva/AP
Minister of Education Li Andersson (from left), Minister of the Interior Maria Ohisalo, Prime Minister Sanna Marin, and Minister of Finance Katri Kulmuni on the day they took office in Helsinki, Finland, Dec. 10, 2019. Of the 19 ministers in Ms. Marin's cabinet, 12 are women.

Paavo Lipponen, prime minister from 1995 to 2003, gives her high marks. “Sanna Marin is a one-in-a-generation natural political talent,” he says. He feels that the new government reflects a modern face of Finland that is more confident on the world stage. “She is a very balanced person, focused on the job, with a human touch, but without populism.”   

Mr. Lipponen, who helped oversee Finland’s recovery from the worst recession in its history in the 1990s, adds, “I have been greatly impressed by the way the five government parties and their young women leaders have been able to work together. They are all competent, hard-working, solution-oriented politicians.” Like Ms. Marin, he is a Social Democrat.

Ms. Marin “comes across very much as primus inter pares” (first among equals), says Mr. Hawkins, the journalist, and notes her willingness to defer to her fellow ministers. “That’s a style that works very well here, post-Kekkonen,” referring to Urho Kekkonen, Finland’s authoritarian president from 1956 to 1981.

The success of Finland’s strategy in controlling the epidemic within its borders remains to be seen. At 2,176 cases in a population of 5.5 million, the country’s COVID-19 rates are still low compared with its Nordic neighbors, and most of the rest of Europe. Its health care system’s high state of preparedness includes an ability to tap into a national stockpile of personal protective equipment that it has amassed since the 1950s, the New York Times reports. 

Yet many Finns are still upset about how slowly the government enacted a quarantine for the 200,000 nationals who returned in early March from areas with high COVID-19 rates. Officials blamed the contretemps on an information disconnect between the government’s Institute of Health and Welfare and the state company running Helsinki’s bustling international airport.

Nevertheless, Prime Minister Marin refused to pass the buck. “I can’t say that we the government will be completely successful in all its actions,” she conceded March 26, in response to a query about the airport imbroglio. “We live in insecure times, and only one day at a time at the moment.”

“But I can say,” she continued, “that we are doing our best to control the disease and save lives.”

Ms. Marin and her cabinet colleagues are keenly aware of the social impact of the approach they recommended March 25. Most notably, nonessential travel is prohibited in and out of Uusimaa, the region where the capital is located, and the area hardest hit by the contagion.

“I feel badly that as a result of the measures we feel necessary to save people’s lives and sustain our health care system, problems in less privileged households are escalating,” concedes Maria Ohisalo, the Finnish minister of the interior, of the Green League. “Mental health problems, shortcomings in child support, and drug use represent the dark side of the lockdown.”

Ms. Ohisalo stresses that combating the epidemic has been very much a group effort, involving not only the government, but the entire Finnish society. She says that she is pleased by the way the blockade of Uusimaa – involving one-third of Finland’s population and a large proportion of the national police force – has been accepted by the country. “I feel that the Finnish people have been really supportive of our course of action,” she told the Monitor, “and that is very gratifying.”

Some observers have likened the spirit and virtual unanimity with which the Finnish people have responded to the crisis, as well as the entire government’s coordinated strategy for dealing with it, with the way Finns responded to the Soviet invasion of 1939 during the Winter War. Except this time, the invader is an invisible one.

For young Finns, “of course she is a role model,” says Vuokko Schoultz, a 26-year-old graduate student in history. “Look at where she came from,” she says, referring to Ms. Marin’s humble roots, which included a stint as a cashier while at university. “I think she is the best prime minister we have had in many years.”

“I think anyone who serves the country at this time is a hero,” says Ms. Schoultz. 

Editor’s note: As a public service, all our coronavirus coverage is free. No paywall.

Difference-maker

Their past was a nightmare. For many refugees, the Dream Center offers hope.

This story looks at another strain of leadership: A U.S. organization founded by well-rooted refugees offers support and compassion – and a sense of family – to other refugees trying to get their bearings.

Lindsey McGinnis/The Christian Science Monitor
Omar Bah and Teddi Jallow, both Gambian refugees, founded the Refugee Dream Center in 2015 to support people escaping violence and persecution.
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As a political journalist, Omar Bah was often at odds with Gambia’s authoritarian regime. He says he was nearly beaten to death by security forces on a reporting trip. After it discovered he was publishing stories online under a pseudonym, the government issued a warrant for his arrest. Mr. Bah barely escaped Gambia in 2007, eventually landing in Providence, Rhode Island. He struggled initially, but his loneliness began to subside as he met refugees from other countries.

Three years after his arrival, Mr. Bah’s wife, Teddi Jallow joined him. As refugees themselves, the couple understand how long it takes to rebuild a life from scratch. That’s why, in 2015, they founded the Refugee Dream Center. The U.S. offers refugees 90 days of government assistance after arrival. Mr. Bah and Ms. Jallow aim to fill the gaps.

Maybe someone needs a ride to the hospital, they can’t pay their electric bill, or their child is being bullied at school. The Dream Center’s approach mixes compassion with pragmatism: They’ll give them a ride, provide some cash, set up a meeting with the guidance counselor. 

The goal, says Ms. Jallow, is that one day, their clients stop needing them. “I want to see them move forward.” 

Their past was a nightmare. For many refugees, the Dream Center offers hope.

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Teddi Jallow’s clients often call her “mama,” or “Mama Dream.” Or sometimes just “sister.”

In many ways, she and her husband, Omar Bah, are like family to the 300 refugees they serve at the Refugee Dream Center in Providence, Rhode Island. 

Founded in 2015, the center provides case management services to people who have fled violence or persecution, and runs programs that focus on health, youth mentoring, and adult education. But the couple also want to make sure Rhode Island refugees have a place to turn when they run into trouble. 

Maybe they need a ride to the hospital, they can’t pay their electric bill, or their child is being bullied at school. The Dream Center’s approach mixes compassion with pragmatism: It will give them a ride, provide some cash, set up a meeting with the guidance counselor. 

“We try to fix the problem,” says Ms. Jallow. “We always talk about problems, but how do we fix it?”

Mr. Bah escaped Gambia in 2007, and Ms. Jallow joined him in Providence three years later. As refugees themselves, Mr. Bah and Ms. Jallow understand how long it takes to rebuild a life from scratch.

In the United States, the government promises 90 days of assistance after arrival. Refugees can seek further aid from state programs, but that varies depending on the person’s location and individual circumstances. The process is geared toward rapid self-sufficiency.

Mr. Bah and Ms. Jallow aim to fill the gaps, offering not only immediate problem-solving but also long-term support so refugees can thrive in the U.S., even as fewer and fewer are being accepted. It’s like having an aunt or uncle in your new neighborhood – an anchor.

“The government gets refugees set up, the refugee resettlement agency is responsible for helping them navigate all of these transitions, and then refugees are enrolled in some sort of public benefits system, but that’s all time sensitive,” says Danielle Grigsby, interim director of Refugee Council USA, a national coalition of refugee advocates. “And while that ticks boxes – like rent, housing, job, school – we all know that life is so much more than that.”

What it means to be a refugee

In Gambia, Mr. Bah and Ms. Jallow only had two months together as newlyweds before Mr. Bah went on the run. As a political journalist, he was often at odds with the country’s authoritarian regime. He says he was nearly beaten to death by security forces on a reporting trip and lost his popular newspaper column during an editor turnover. When the government discovered he’d continued publishing stories online under a pseudonym, it issued a warrant for his arrest. 

“I had a dictator who had a price over my head, literally announced my name and picture over the TV,” he says. Mr. Bah barely made it to Ghana alive. 

After a year in limbo, he was placed in Providence. Mr. Bah was the only refugee from Gambia in the city when he arrived, and he was afraid to interact with Gambian Americans due to his wanted status. 

Lindsey McGinnis/The Christian Science Monitor
Isabel Kayembe (from left), Teddi Jallow, and Astou Lo meet with staff at Nathan Bishop Middle School on February 21, 2020, in Providence, Rhode Island. With the help of the Refugee Dream Center, Ms. Lo's daughter is able to transfer schools.

But his loneliness began to subside as he met refugees from other countries. His English and computer skills meant he could help file paperwork and advocate for better housing.

“That’s how I built my community,” says Mr. Bah. “That became my life.”

Since he arrived, more than 2,000 refugees have been placed in Rhode Island, including Ms. Jallow, who arrived in 2010. Mr. Bah noticed that even one or two years after their arrival, refugees were failing to integrate – they were still struggling with English, overwhelmed by bills, feeling isolated.

That’s why the couple founded the Dream Center, a nonprofit that could serve the needs of Rhode Island’s refugees after the government aid period ended. Mr. Bah deals with most of the outward-facing business, including fundraising, meeting with officials, and educating the public about refugees. Ms. Jallow focuses on the clients. 

She works closely with Isabel Kayembe, the center’s case manager and a refugee from Angola, to make sure clients get the assistance they need. Together, they speak nine languages. Even amid the current health crisis, the Dream Center has continued looking out for its clients, with staff members making daily rounds to deliver food and household supplies and provide translation services.

Although temporarily closed to slow the spread of the coronavirus, their shared office space is typically packed. Staff and visitors step around boxes of donated coats, while volunteers conduct English as a second language classes in an adjacent room. As Mr. Bah returns from a meeting, Ms. Jallow and Ms. Kayembe are piling into a minivan, off to pick up Astou Lo, who came to the U.S. 10 years ago after fleeing ethnic violence in Mauritania.

Recently, Ms. Lo noticed her daughter’s grades were slipping, and she relied on the Dream Center to obtain an individualized education program and eventually transfer her daughter to a better school. During a meeting to finalize the switch, Ms. Jallow came prepared with questions and translated while Ms. Kayembe took notes. Ms. Lo left the building with the counselor’s contact information, a Monday morning game plan, and a sense of relief. She’s known Ms. Jallow and Mr. Bah since she arrived in the U.S., but she was especially happy to have them in her corner that day.

“I’m so grateful I have someone I trust,” she says with the help of a Dream Center interpreter. “I could not do this alone.”

Family reunions on hold

Laurent Tumba has been coming to the Dream Center for more than two years after escaping conflict in Congo. He’s worked with several resettlement agencies, but nothing beats Ms. Jallow and Mr. Bah for immediate assistance. “[Other groups] help, but they help on their own time,” he says through an interpreter. “It’s not like here.” 

But even the Dream Center has its limits.

Many refugees, including Mr. Tumba, are waiting for relatives to join them in the U.S. But since the Trump administration halved refugee admissions in 2019, reunification has slowed to a crawl.

“They are not coming. There’s nothing we can tell them,” says Ms. Jallow. 

Combined with travel bans targeting African countries that clients may pass through on their way to the U.S., Ms. Jallow says the government has effectively stopped the flow of refugees into the U.S. In the meantime, the Dream Center focuses on improving the lives of its clients. Ms. Jallow hopes that one day, they stop needing the center.

“I want to see them move forward,” she says, “get jobs, know English, be able to do things for themselves.”

Books

A Q&A with Joy Harjo, poet laureate of the United States

Finally, why is poetry so important? Our writer sat down with America’s first Native American poet laureate. Part of her very timely answer: “We go to poetry to find a road to understanding.”

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When asked by our reporter to describe the gift of poetry, poet laureate Joy Harjo answered: “Every gift comes with sacrifice. There is always something demanded. To take care of the gift of poetry demands listening, even when it seems as if there is nothing or no one there. It remembers listening to history and beyond history. It means walking a road of language alone, until you teach someone how to hear you. My mission is to take care of the gifts that I carry, to develop and feed them, and then to share them. We must all take care of our respective gifts, because with them we will find the answers to our problems. With poetry, we can sometimes sing the answers.”

A Q&A with Joy Harjo, poet laureate of the United States

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Joy Harjo became the 23rd poet laureate of the United States in 2019.

Joy Harjo is the 23rd poet laureate of the United States and the first Native American to hold that post. A member of the Muscogee (Creek) Nation and an acclaimed musician, she has published nine books of poetry and released five award-winning CDs. After her inaugural reading in September 2019, she traveled extensively, performing solo and with musicians for audiences of various backgrounds and political affiliations. She lives in Tulsa, Oklahoma, where she is a Tulsa Artist Fellow.

Q: Why are poems so necessary?

Poetry tries to hold all aspects of human memory – grief, failure, love, joy – and moves toward a liminal space in the borderlands between here and there, in between yes and no, what was and what is to come. The great paradox is that poetry uses language to create a place you can go when human words fail. 

We go to poetry to find a road to understanding, and not just any road – it must be compelling, and take us somewhere we’ve never been before. Even before the pandemic,  sales of poetry books had gone up. The audiences for poetry have grown dramatically since the last national elections four years ago.

Q: You have described poetry as a conversation of the soul. How is poetry “soul talk”?

Just about every poet out there – from Walt Whitman to Emily Dickinson to Marilyn Nelson – is ultimately writing a conversation with their soul. Each one has a different patterning, of course, a kind of sound frequency you can hear. And every poem has poetry ancestors. 

My own poetry ancestors include a great-grandfather who helped me enter the realm of poetry. He was a good speaker and I think some of my sense of language comes from him. I have some of his handwritten pages of sermons. I also consider Emily Dickinson a forebear. I hear her in her phrasing, a single human voice rising from the seclusion of a room or darkness or loneliness.

The whole country seems to be in that kind of place right now, so quiet you can hear the collective heart. We might feel especially alone because we have been individually isolated. We don’t know what’s going to happen next. All sound becomes magnified; that’s when we can really listen.

Q: Why is listening important? 

Listening is the tool required for life, and for any art. It doesn’t matter if it’s literature, painting, or architecture. You might listen with your eyes to color or to the line or just shape. But it’s all about listening with all of your senses. 

Q: How did you come to love poetry?

I didn’t start writing poetry till I was almost 23. But I came to poetry as a child because my mother, with her eighth grade education, loved and read poetry, mostly Tennyson and the visionary Blake. 

She also wrote love-song lyrics – ballads were her form – and worked with some of the best country-swing musicians. 

What I have discovered is that most traditions of poetry have their roots in music, and when you go back to those roots we all have, you’ll find poetry hanging out with music and hanging out with dance. They form a threesome.

Q: When did you start writing?

I started writing poetry around the time of the Native American Renaissance, which began in 1969 when N. Scott Momaday, a Kiowa novelist and poet, won the Pulitzer Prize in fiction. I was an art major at the University of New Mexico and had an eye towards a career in art, which made sense since I had a grandmother and a great aunt who were painters. Then I started attending poetry readings, and discovered Native poets. That’s when I realized that poetry was part of me, and could reflect my own life as a Native person. 

Q: As poet laureate, do you feel that you provide the same validation for other Native writers?

This position has made it possible for me to open a door of self-affirmation for Native Americans, who still don’t see themselves represented much in the culture. This position has enabled me to open a door for many. I represent poetry and the power of what poetry can do: It can speak across chasms, through gunfire. It has saved lives – including mine – and enlarged countless levels of meaning. I am only one of many gifted poets, one of many Native poets, one of many voices who have something to offer in these times and in timelessness.

Q: How would you describe the gift of poetry?

Every gift comes with sacrifice. There is always something demanded. To take care of the gift of poetry demands listening, even when it seems as if there is nothing or no one there. It remembers listening to history and beyond history. It means walking a road of language alone, until you teach someone how to hear you. My mission is to take care of the gifts that I carry, to develop and feed them, and then to share them. We must all take care of our respective gifts, because with them we will find the answers to our problems. With poetry, we can sometimes sing the answers. 

Eagle Poem

To pray you open your whole self
To sky, to earth, to sun, to moon
To one whole voice that is you.
And know there is more
That you can’t see, can’t hear;
Can’t know except in moments
Steadily growing, and in languages
That aren’t always sound but other
Circles of motion.
Like eagle that Sunday morning
Over Salt River. Circled in blue sky
In wind, swept our hearts clean
With sacred wings.
We see you, see ourselves and know
That we must take the utmost care
And kindness in all things.
Breathe in, knowing we are made of
All this, and breathe, knowing
We are truly blessed because we
Were born, and die soon within a
True circle of motion,
Like eagle rounding out the morning
Inside us.
We pray that it will be done
In beauty.
In beauty.

– Joy Harjo

“Eagle Poem,” from “In Mad Love and War,” copyright © 1990 by Joy Harjo, published by Wesleyan University Press, Middletown, Connecticut, and used by permission.

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In worship, still touching hearts if not each other

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For most of the world’s faithful, large in-person gatherings are on hold. The vast majority of religious leaders recognize that suspending their services inside buildings is an act of love for both their congregants and the public at large. A March survey of Protestant leaders by the Barna Group found that 73% reported their places of worship were not open to the public. Many Christians have taken to heart a phrase often seen on the roadside boards of churches: “Be the church.” It seems to say, “How are you expressing godliness to others in your daily life?” The question carries extra meaning this year. The act of coming together as believers must not only be done from afar, the crisis itself demands a collective spirit of giving to others.

The comfort, camaraderie, and familiarity of meeting in person, praying and singing side by side, has been temporarily put aside. But this moment in history also offers opportunities to be the church in fresh ways, seeking to reach people at another level, even as believers still support each other through prayer and communion.

In worship, still touching hearts if not each other

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A worshipper attends a Mass being broadcast at an empty Roman Catholic church in Vilnius, Lithuania, April 5.

For the three Abrahamic religions, physical distancing during the pandemic seems like a crisis in the wilderness. Adherents of each faith must forgo traditions of worshipping together in person. Yet the crisis could also turn out to be a welcome blessing.

For Jews, the celebration of Passover (April 8-16 this year) usually means among other things families gathering for a special meal and observances. A week later, Muslims will begin the month of Ramadan (April 23-May 23), which typically includes families gathering for a special evening meal (iftar) after daytime fasting, as well as the regular attendance at mosques, where those praying are often shoulder to shoulder. For most Christians, Easter falls on April 12 or 19, and would customarily include a special service followed by meals with loved ones.

For most of the world’s faithful, large in-person gatherings are on hold. The vast majority of religious leaders recognize that suspending their services inside buildings is an act of love for both their congregants and the public at large. A March survey of Protestant leaders by the Barna Group found that 73% reported their places of worship were not open to the public.

Many Christians have taken to heart a phrase often seen on the roadside boards of churches: “Be the church.” It seems to say, “How are you expressing godliness to others in your daily life?” The question carries extra meaning this year. The act of coming together as believers must not only be done from afar, the crisis itself demands a collective spirit of giving to others.

Using technology to practice one’s faith is hardly new. In the early 20th century, American preachers used radio and later television to spread the gospel, drawing large audiences of people at home. Today, congregations are able to stream services over the internet, allowing people to watch from anywhere. For Christians, this virtual togetherness can still help achieve one purpose: As the Gospel of Matthew puts it, “For where two or three are gathered together in my name, there am I in the midst of them.”

Nonetheless, religious leaders worry about an erosion in attendance or interest if the crisis persists for months. On the other hand, by focusing on digital services, churches can inspire new interest from those who are unable to attend a particular church or are uncomfortable with entering one.

“The church’s absence, its literal emptying, can function as a symbol of its trust in God’s ability to meet us regardless of the location,” writes Esau McCaulley, an assistant professor at Wheaton College, in The New York Times. “The church remains the church whether gathered or scattered.”

The comfort, camaraderie, and familiarity of meeting in person, praying and singing side by side, has been temporarily put aside. But this moment in history also offers opportunities to “be the church” in fresh ways, seeking to reach people at another level, even as believers still support each other through prayer and communion.

A Christian Science Perspective

About this feature

Each weekday, the Monitor includes one clearly labeled religious article offering spiritual insight on contemporary issues, including the news. The publication – in its various forms – is produced for anyone who cares about the progress of the human endeavor around the world and seeks news reported with compassion, intelligence, and an essentially constructive lens. For many, that caring has religious roots. For many, it does not. The Monitor has always embraced both audiences. The Monitor is owned by a church – The First Church of Christ, Scientist, in Boston – whose founder was concerned with both the state of the world and the quality of available news.

Engaging with the news productively, not fearfully

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Though staying informed about public health issues is important, the barrage of information about the coronavirus – and, in some cases, misinformation – can feel overwhelming. But opening our hearts to God’s love inspires wise and reasoned actions instead of panic-impelled reactions.

Engaging with the news productively, not fearfully

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Today's Christian Science Perspective audio edition

Often while driving or cooking, I enjoy the companionship of familiar voices on my favorite news program, keeping me informed while I sit in traffic or slice tomatoes. Lately, though, I’ve found listening a bit less pleasant because it seems the main topic is how I might catch the coronavirus if I leave my house. One might start to conclude that there is no safety anywhere, and it’s understandable that lately the anxiety in the air feels as thick as smog during rush hour.

I appreciate the media’s sharing of facts, which helps to combat the spread of misguided theories and false stories. It’s responsible to have accurate information about the current situation. Reporters doing their work in the face of frightening conditions are to be commended. But how we choose to consume and respond to the wide range of information is also of utmost importance.

Mary Baker Eddy, who discovered Christian Science in the 19th century, had a deep respect for the role of the media, as well as direct experience with its complexities. She once wrote: “Looking over the newspapers of the day, one naturally reflects that it is dangerous to live, so loaded with disease seems the very air. These descriptions carry fears to many minds, to be depicted in some future time upon the body” (“Miscellaneous Writings 1883-1896,” p. 7).

I’ve found it’s not helpful to get swept up in the general drift of fear. When we let an emotional response lead, it can lead to unwise actions.

Recently, in a moment of feeling overwhelmed by the torrent of coverage of the coronavirus, I actually asked myself, “What would Jesus say about all of this?” I recalled an instruction he gave to his disciples at one point while talking to them about the future: “Don’t panic” (Matthew 24:6, New Living Translation). He wasn’t saying that problems would never emerge. But his entire ministry showed that we can actively trust in God, infinite Love itself, to protect us.

When we turn our thoughts to the presence of God and God’s pure goodness, this lifts the fear that can overwhelm us. The Bible says that Love destroys fear (see I John 4:18). This divine Love is deeper than a human, emotional love. It’s solid, infinite, spiritual, expressed in all of God’s children, which includes each one of us. This presence is so powerful, its tender care so universal, that we can trust and rely on it, moment by moment, for anything we are facing.

As we let this divine Love lead us, rather than yielding to panic or anxiety, we contribute to the general mental atmosphere of peace and calm that comes from discerning God’s supremacy. God’s power is a force for good – in fact, the only legitimate force in the universe – and the divine Spirit, or Love, is omnipotent and supremely reliable in every circumstance. We can feel it when we actively choose to listen for the calm, clear, productive thoughts God is sending us at every moment, rather than drifting along with the tendency to overreact or allowing ourselves to be carried away with worry and expectation of evil. Indulging these unproductive sentiments can contribute to an unhealthy movement of thought.

In her book “Science and Health with Key to the Scriptures,” Mrs. Eddy wrote of a way to counteract unhelpful atmospheres of thought: “Truth and Love antidote this mental miasma, and thus invigorate and sustain existence” (p. 274).

Though I still tune in to the news to stay informed, these ideas have helped me respond more productively. In the quiet moments between reports, I find peace and strength in reflecting on the goodness of divine Love that permeates the universe, despite whatever challenges we face individually and collectively. These clear, simple thoughts contribute to a mental atmosphere that is safer and supportive of health and progress for all, inspiring wise and reasoned actions rather than fear-impelled reactions.

Each of us has the power to share in this effort. We can engage with the media – and appreciate the brave, thorough work of many reporters – and respond in a constructive way that brings not panic and loneliness, but peace and unity. Then, even the most discouraging moments give way to a more certain sense that divine Love is encircling us all.

A message of love

Pas de deux

Johanna Geron/Reuters
Pal, 41, does ballet with his daughter Marilou, 4, during a lockdown amid the coronavirus disease outbreak, in Brussels, Belgium, April 6, 2020.
( The illustrations in today’s Monitor Daily are by Jacob Turcotte. )

A look ahead

Be well, and come back tomorrow. The sudden shift online has left many people out in the virtual cold. We’ll look at how that has given new life to the idea that the internet is an essential service.

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