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COVID-19 and The Queen’s Gambit: What will be the pandemic’s endgame?

Robert Pearl, MD
Conditions
December 13, 2020
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The Queen’s Gambit, a seven-part Netflix series, has been the darling of streaming television during the coronavirus pandemic. Seen by more than 60 million people, the story chronicles the life of fictional chess prodigy Beth Harmon, who grows up in a Kentucky orphanage and goes on to win a world championship.

With its three-dimensional characters and fresh spin on the coming-of-age plotline, the series has captivated the nation’s heart and imagination, appealing even to viewers who’ve never so much as advanced a pawn. Moreover, it has offered Americans a welcome reprieve from the relative chaos of 2020.

In one episode, Harmon describes the chessboard as, “An entire world of just 64 squares. I feel safe in it. I can control it. I can dominate it. And it’s predictable.”

Isn’t that what we all want right now: a sense of control and a predictability? Instead, our nation continues to reel amid a pandemic that has claimed 275,000 American lives and counting.

So, let us take a lesson from the game of chess, which offers important insights into our handling of the coronavirus crisis and outlines our best hope to checkmate this deadly opponent.

Openings 

The game of chess contains 1,327 possible “openings,” a sequence of initial movements, which are often given bizarre names like The Sodium Attack, The Bird’s Opening, and, indeed, The Queen’s Gambit.

Openings involve moving pieces in a unique combination of steps, each with a clearly defined strategic intent. Some openings are hypermodern and extremely aggressive, whereas others are more conservative and built around a defensive strategy.

There is no such thing as a “best” opening—if there were, all players would follow the same formula. Rather, what’s most important is selecting a specific strategy and sticking with it. Though it is practically impossible to win during this phase of the game, an effective opening can tip the balance of power in favor of one player or the other. For this reason, a player who fails to plan or alters his or her approach for no apparent reason wastes precious time. The same is true of a country’s initial response to a viral pandemic.

In the worldwide battle against the coronavirus, the United States completely flubbed its opening. Schools closed, then reopened, closed again, and then went online. Restaurants shuttered, then went to carry-out only, then outdoor seating and indoor dining, then closed again. Across the country, there was insufficient protective equipment, testing, or national guidance. With leaders unable, or at least unwilling, to provide a clear and consistent strategy, the United States found itself unprepared to deal with the ravages of the disease.

Other nations proved far more decisive. New Zealand, for example, pursued a clear defensive strategy aimed at suppressing transmission. Opting for strict border controls and a seven-week lockdown, the small island nation called its opening “go hard, go early.” The move resembled the Queen’s Gambit, one of the oldest known chess openings, making a small, early sacrifice to gain long-term board positioning. And it paid off big time. New Zealand has seen no major surges and only 25 deaths among 5 million citizens.

Alternatively, South Korea fended off a major surge in cases early on by assuming a more aggressive posture. Rather than shutting down the country, the nation ramped up its testing and contact-tracing programs. By early March, the United States had conducted just 2,000 tests, whereas South Korea completed more than 140,000. South Korea then used its large databases of cell phone information, credit card transactions, and closed-circuit TV to trace and quarantine known contacts of those who tested positive, helping to stamp out potential super-spreader threats. Though few countries have completely avoided flareups and most have faced new threats of surges, the United States could have learned valuable lessons from other nations’ openings.

The lesson: The coronavirus pandemic has shown that opening moves matter. A relatively small, short-term sacrifice like a mandatory lockdown or an aggressive contact tracing campaign helped some nations do what the United States did not: “gain control of the board” early on.

Middle game

Unlike with opening moves, where all players start with the same number of pieces, players entering the middle phase of the game inherit the consequences of what came before. Failing to execute a clear strategy in the opening forces a player to pay the price repeatedly in the more unscripted aspects of the match that follows.

The same theory holds true in a pandemic. A nation with only a few hundred or even a few thousand cases of COVID-19 can still get the pandemic under control through aggressive testing and the strategic use of contact tracing and quarantining (see South Korea above). But the United States, which suffered a series of testing blunders in February and March, saw its cases grow exponentially. By April, more than 30,000 Americans had tested positive, leaving the country with far fewer options in play.

Under such difficult conditions, a nation that enters the middle game at a disadvantage has little room for error and must show poise under pressure. The United States did not, continuing to flounder throughout the latter half of 2020. Leaders wrongly insisted the end of the pandemic was just around the corner. They touted unproven medical solutions like hydroxychloroquine and Remdesivir, wrongly promising they would diminish mortality. And as the year comes to a close, Americans have lowered their defenses amid growing pandemic fatigue. As a result, many hospitals once again find themselves at or near full capacity.

Lesson: With attacks coming from all sides, the middle game demands rapid and masterful decision making. And with each strategic mistake, the available options diminish. Once chess players or pandemic-stricken nations fall behind, they are at the mercy of their opponents. Invariably, the losses begin to pile up. In The Queen’s Gambit, Beth Harmon was often able to evade checkmate by using her intuition. Intuitive decision-making sometimes works for prodigies and grandmasters in chess. It never works against a steady and determined opponent like the coronavirus.

Endgame

Chess players entering the final phase of the game have fewer pieces and, therefore, fewer available combinations of moves. This makes every decision highly consequential.

The same can be said of the “endgame” in a pandemic. As recently as last month, the United States seemed grossly overmatched by COVID-19 and destined to pay the price. Because the nation made far too many errors in the middle game, health experts estimated the U.S. would lose up to half a million lives by the end of 2021.

But as it is in chess, it all comes down to one move: checkmate, the point at which the opponent can no longer escape defeat. Though it’s rare to see an elite chess player lose a commanding advantage in the endgame, it does happen. Take the 1996 World Blitz Championship between Viswanathan Anand vs. Garry Kasparov, which featured one of chess’s most surprising comebacks.

Likewise, a U.S. victory over the coronavirus suddenly and surprisingly appears to be in sight. This potential come-from-behind checkmate will depend on what happens with a vaccine despite all the nation’s past errors.

According to phase three reporting, the media are abuzz with excitement about Moderna, Pfizer, and BioNTech, companies that have produced safe vaccines with 90 percent or greater effectiveness. However, many obstacles still remain. For one, health officials continue to voice concerns about spotty disclosures and the limited early data released by vaccine makers. Supply-chain and logistics experts worry about the extremely low temperatures at which mRNA vaccines—like those from Pfizer and Moderna—must be kept before being administered. Still, others fear polling that suggests most Americans will refuse to take an FDA-approved vaccine.

Though victory over COVID-19 appears close at hand, there’s still plenty of room for human error. Scientists still don’t know the long-term effects of COVID-19 or for how long a person’s antibodies will remain effective. Meanwhile, leading public health officials have already warned that—even with a vaccine—the virus could be with us for years as it mutates and finds unvaccinated pockets of people. Dr. Anthony Fauci, the nation’s leading immunologist, cautioned that American life might never get back to normal after the coronavirus crisis.

There’s a name for this kind of outcome in chess: a stalemate. It occurs when neither side can checkmate the opponent, and the game ends in a draw.

Next year could bring the end of the coronavirus pandemic, or it could mark the beginning of an annual encounter, as with seasonal flu. Avoiding a stalemate will be vital if our nation wants to minimize the long-term risks from COVID-19 (both the physical health risks and the mental health risks). However, if we find ourselves in such a stalemate, we would need to be vaccinated and continue to socially distance, aggressively test, commit to contact tracing, and isolate people with the virus.

Lesson: On her way to becoming world champion, Beth Harmon had to overcome a series of personal demons, including drugs, alcohol, and loneliness. Going forward, our nation will have to overcome its own demons if we want to quickly defeat the next virus that threatens to become a pandemic. Winning will require us to address our lack of pandemic preparedness and uncontrollable incidences of chronic disease, our growing unscientific mindset and denial of danger, and our highly partisan political process.

Ultimately, Harmon slayed her demons to achieve victory. Will we?

Robert Pearl is a plastic surgeon and author of Mistreated: Why We Think We’re Getting Good Health Care–And Why We’re Usually Wrong. He can be reached on Twitter @RobertPearlMD.

Image credit: Shutterstock.com

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