Until the pandemic arrived, I had been spending about four days a month in southern Ohio. It’s a rural area roughly 100 by 100 miles, bounded by the Ohio River on the south, the Indiana line on the west, Chillicothe to the north, and Athens to the west—home to 350,000 residents. For someone like me, Chicago-born and -bred, who has lived and worked in Baltimore, Philadelphia, New York, Washington, and points in between for the past 40 years, driving from town to town and hamlet to hamlet, with appointments often 60 miles apart, was an entirely new experience.

I began this effort because I had long thought that the kind of organizing that my colleagues in the Industrial Areas Foundation and I practiced, begun by Saul Alinsky in the Back of the Yards neighborhood of Chicago, had settled into urban and metropolitan areas, but had largely avoided rural communities. This was not a conscious decision or a conscious strategy. It was a drift. But the drift worried me. I kept looking at electoral maps and seeing a sea of red in the center of the country, in Ohio counties like Ross and Scioto and Gallia counties that once had been home to the United Mine Workers union and that had been mixed politically, but that now leaned strongly to the right.

I hadn’t concluded, as some progressives had, that these counties were so conservative, so reactionary, so racist, that they weren’t worth thinking about. How would they know? Most hadn’t spent 10 seconds there. I hadn’t spent 10 seconds there either. As I was fretting about the IAF’s lack of presence in rural America, I read Sam Quinones’s remarkable book, Dreamland and, a bit later, Beth Macy’s excellent account of the opioid crisis, Dopesick. Quinones starts his book with a description of the community pool that was once the center of civic life in Portsmouth, Ohio. So, about three years ago, I flew into John and Annie Glenn Airport in Columbus, found Portsmouth on a map, and drove the 100 miles or so south to pay my first visit.

I have to admit that I was apprehensive about how an older Alinsky organizer from Chicago and New York would be received in places that voted at least two to one—and often three to one—for Trump. Three hundred meetings later—meetings with clergy, journalists, bankers, librarians, businesspeople, addiction recovery specialists, local elected officials, retirees, young professionals, teachers, and more—I can report that Donald Trump almost never came up. Early on, at a coffee hour in an Episcopal church in Portsmouth, an elderly parishioner came up to me and said, “When the rector said some organizer was coming from New York, I said, ‘Oh boy, here comes another liberal from the big city to tell us what to think and do’”—she paused—“but you don’t talk like a liberal.” I said, “No ma’am, I grew up in Cook County. So I have no regard for either party.” And she said, “Then you might do all right down here.”

She was right. People have been gracious and, after some initial caution, open. They have been willing to tell me what they do think and care about, so long as I practice what we teach good organizers to do—ask real questions, shut up, and listen, listen hard. Almost every person I’ve met will at some point in the meeting mention a family member or dear friend or neighbor who has been affected by the plague of opioids that began nearly 20 years ago. An IT professional in a library in Ironton has on his crowded desk a picture of his teenage son, dead of an overdose. After he lost his boy, this man started a church for the addicted, which attracts about 150 members. “You should come sometime, but you better be able to stand cigarette smoke.” This is the fellow who, after our first meeting, said, “You look like a busy man.” I said I guess I was. “Then you aren’t coming back here. Busy people don’t come back.” I’ve been back several times now.

A teacher talked about her son, serving out a lengthy sentence in the prison at Lucasville, just up the road from Portsmouth, caught selling drugs in his late teen years. A librarian describes finding men unconscious in the restroom after overdosing. A pastor who just returned from attending a middle school graduation tells me how many students had lost one parent to an overdose death or a prison term but that he paid special attention to a young girl who had already lost both of her parents to overdoses. The sister of an EMT responder worries about the burnout she sees in him and his colleagues. The billboards on the main roads often advertise recovery programs and counseling services. One, just south of Waverly, has the faces of eight family members—massacred in what everyone believes to have been a drug-related hit—and asks for information, which has not been forthcoming. When I first visited Waverly, where hardened coal miners once lived, the first thing I saw was two scrawny fellows in their 20s concluding a drug deal in a parking lot. In this rolling, hilly, sometimes picturesque region, the opioid virus has penetrated every corner, no matter how remote, how lightly occupied, and has killed people up and down the income and social scales.

As I drove around and met more people, it occurred to me that this area had been visited by a plague long before the current pandemic—the first vectors being an army of salespeople pushing millions of opioids on rural pharmacies and supplying pill-pushing doctors with an endless supply. Years of aggressive marketing and sales hooked thousands in these counties. Once hooked, they were fair game for the second wave of this pandemic—triggered by the arrival of scores of drug peddlers from the Mexican state of Nayarit, who flooded the market with cheap black-tar heroin. This second set of vectors further institutionalized the dynamic of drug peddling, petty crime, and chronic addiction that has been part of this region’s life for a generation.

An arrangement of pills of the opioid oxycodone-acetaminophen. (AP Photo / Patrick Sison)

In 2018, 46,802 Americans died of opioid overdoses, 3,237 people in Ohio, many of them in the counties I was visiting. These dreadful numbers are slightly down from the previous two years. That plague, after 20 years, might have peaked, or plateaued, but no one is scheduling a victory celebration. And people fear that some new synthetic variant, or a resurgence of methamphetamines, will simply fill the vacuum as those struggling with addiction seek alternatives.

People here don’t just talk about opioids; and they are more, much more, than victims. But there are questions in the air, sometimes spoken, sometimes hinted at, sometimes prompted when I recount what others in the area have mentioned. How could this have happened? How could it have lasted so long? Where were both political parties during the fatal early years of the opioid pandemic? And where are they now? Where were the police and sheriffs as these trends were expanding?

They reminded me of the people I met when I first began organizing in East Brooklyn in the fall of 1980. If you recall that period, the condition of the city was grim, to say the least. It had just barely avoided bankruptcy in the late 1970s. The population was plummeting. The Bronx, as sportscaster Howard Cosell famously observed, was burning. But so were Upper and Lower Manhattan and eastern and central Brooklyn. The establishment was breezily tossing around terms like “benign neglect” and “planned shrinkage”—a form of mental redlining on a very large scale—as responses to this crisis. As I met hundreds, then thousands of eastern Brooklyn residents, I heard about every challenge they faced—violent crime, drug dealers running the lobbies of housing projects, arson by building owners, cops who either under-policed (never showing up) or over-policed (coming in droves and breaking heads), teens at risk, schools in chaos.

And yet, as in southern Ohio, that’s not all I heard. People talked about what they had tried to do to address these challenges. They identified remarkable but unrecognized leaders in the community whom they respected and trusted. They understood that real change would not be immediate or “transformational,” as the progressives like to call it. It would take time and preparation. It would require an attention to detail that those habitually attracted to the next mobilization or next charismatic savior or next election either lacked or derided. In short, they expressed a willingness to organize—to build a base, to train leaders, to raise their own money and pay their own dues, to do in-depth research and sophisticated power analysis, and to figure out what was possible in the shorter term and the longer term—in spite of the odds against them. They were skeptical, having seen so many efforts founder. But they still had hope—which we believe is a muscle, not a sentiment, something that only exists by exertion and that grows with regular exercise. In the 40 years since then, they have exercised that muscle relentlessly—and rebuilt and revived their community. Many of the leaders I’ve met in southern Ohio have that same muscle and grit and seem poised to organize once the coronavirus pandemic passes.

But why hadn’t the larger world, the Ohio establishment, Washington, someone, noticed? One clue was provided by my Avis representative in Columbus. When he asked me where I was going, I said, “Heading south, to Portsmouth, Chillicothe, Ironton.” He frowned and tried to give me some advice. “Why you going there? That’s not Ohio.” So even the more prosperous middle of the state itself had written off the portions of Ohio most affected by the opioid plague—perhaps blocking out the fact that the Columbus suburbs had seen their share of deaths and long-term addictions. A few months later, a veteran Democratic operative said the same thing: “Thirty years ago, we figured we could carry the state by concentrating on the half from Columbus north—the bigger cities and surrounding suburbs, so we mostly ignored the rest.”

Abandoned building in Portsmouth, Ohio.(Craig F. Walker / The Boston Globe via Getty Images)

What my rental car friend and many others were playing out was the gospel according to Margaret Thatcher, who famously preached, “There is no such thing as society. There are individual men and women and there are families.”

Then Thatcher’s co-conspirator, Ronald Reagan equally famously added, “Government is not the solution to the problem. Government is the problem.”

This proved to be a devastating one-two punch. The first time I can recall hearing these two pithy doctrines paired was in the late Tony Judt’s last public lecture in 2009. Judt spoke at the Skirball Center for the Performing Arts at NYU on a beautiful October evening. When the curtain opened to a packed house of 1,000 listeners, including my wife Sheila and me, there was Judt, in his wheelchair, on a ventilator, with the rise and fall of his assisted breathing audible for the first few minutes. Then he began to speak, first citing the “elephant in the room”—his struggle with advanced stages of ALS, Lou Gehrig’s Disease—and then launching into a 45-minute tour de force. Soon, we didn’t notice the sound of the ventilator as he laid out his understanding of how the world had pivoted from the postwar marriage of social democracy and somewhat restrained capitalism, which had lasted for three decades, from 1945 to the late 1970s, to the era defined by Thatcher and Reagan.

Judt’s words and analysis, later published as an essay in The New York Review of Books and then as a short book, Ill Fares The Land, like Lincoln’s Message to Congress in 1861, the cautionary writings of Isaiah Berlin, and so many of Marilynne Robinson’s wonderful essays, have echoed in my thinking ever since.

If there is no such thing as society, and if government is the problem, then all that remains is the market.

If there is no such thing as society and if government is the problem, then no one and no sector is responsible for what Angus Deaton and Anne Case have dubbed “the deaths of despair” taking place in America, largely due to drug abuse.

If there is no such thing as society and if government is the problem, then those with mental illness don’t merit a large-scale institutional solution. They should be cared for by their families (which assumes they have families—with the means and training to provide mental health care). And, if not, then they are on their own. The rental car agent’s remark echoes: “Those aren’t part of any community I recognize; they aren’t part of my reality. They are ‘homeless’ or ‘convicts.’” They are simply removed from the larger mental map of a shrinking picture of America. This neglect is not benign. And this shrinkage is not planned.

If there is no such thing as society, and if government is the problem, then there’s no point in preparing for a pandemic to save lives, no point in coordinating a collective national response, no point in using the lessons of the current crisis to prevent future ones. In fact, trying to address long-term conditions leads to heresy—a possible rejection or upending of the Thatcher-Reagan belief system.

If there is no such thing as society, and if government is the problem, then there is no way to think about or talk about the 60-year-period of job loss in southern Ohio triggered by the close of the coal mines, or the 50-year decline of our inner cities, or the 40-year betrayal of those challenged by mental illness, or the 30-year defunding of public housing, or the 20-year-period of opioid and heroin penetration and devastation.

As Judt said and then wrote, 11 years ago, “Why do we experience such difficulty even imagining a different sort of society? Why is it beyond us to conceive of a different set of arrangements to our common advantage? Are we doomed indefinitely to lurch between a dysfunctional ‘free market’ and the much-advertised horrors of ‘socialism’? Our disability is discursive: we simply do not know how to talk about these things anymore.”

The pandemic has shocked our nation into at least talking about these things once more. And there is new and convincing evidence, from the unlikeliest of sources, that there is such a thing as society and that government is something more than the problem. That evidence comes from the market sector. The corporations that have been staggered by the pandemic did not begin picking up the phone and calling individuals and families for help. They sent their lobbyists to Washington and begged the state for trillions in relief.

The US Capitol Rotunda was empty on Monday, March 16. The Senate took the weekend off and would return that afternoon.(Drew Angerer / Getty Images)

Of course, I was already reasonably confident there was such a thing as society. That’s where my colleagues and I have lived and worked. Over the past four decades, our organizations have been able to crack what many declared to be intractable problems. They have rebuilt entire neighborhoods with new and renovated homes and apartments affordable to the people who already lived there. They first invented and then implemented a young adult option to a family’s health insurance policy. They designed and initiated new small public schools better able to relate to students and help them achieve. They learned from pioneers like Judge Stephen Leifman of Miami and Leon Evans of Texas how to divert those with mental illness from jail or prison or crowded ERs, creating institutions and programs that help them stabilize and get well.

They worked with labor leaders like Audrey Soglin in Illinois and the late incomparable Larry Hanley of the Amalgamated Transit Union to rebuild union locals whose members were fully engaged and which, during the anti-union campaigns of recent years, grew in strength. This history, which I’ve written about recently, remains largely untold, hidden in the shadow of other super stories. I hear the Avis fellow echoed here, “That’s not Ohio. That’s not real.”

What people mean is that these stories of important, but limited, civic and social improvement do not fit the ideologies of the left or the right. They involve different mixes of market, governmental, and, most importantly, third sector or civic engagement. These mixes vary from issue to issue and period to period. They are never easy, never smooth, and never without tension. They do not lend themselves to charismatic or celebrity leadership cults. In just two Jersey City sites, a collective of religious and community leaders won, after a 25-year effort, $1 billion for environmental cleanup from PPG and Honeywell—four times the size of the Erin Brockovich settlement. Most people know about Julia Roberts’s portrayal of Brockovich’s estimable effort. Almost no one knows the names of the Jersey City leaders: Reverend Willard Ashley, Mrs. Ellen Wright, Fr. Geoff Curtiss, Joe Morris, and others. Such victories are never total—and never sustained without constant vigilance. And yet, this is how tangible progress eventually gets made.

A full and lasting recovery from this pandemic will in part depend on a rejection of the idolatry of the market, demonization of the state, and co-option or minimization of the role of the third sector.

This is not a call for socialism—an option, as Tony Judt recognized, buried with the many millions of those who were tortured and killed in socialism’s name in the last century and in the poisoned postindustrial valleys and plains of Eastern and Central Europe. Modern American socialism may be different, but right now we have more important tasks than rehabilitating a label many of our citizens rightly consider toxic.

Instead, it’s a call for a kind of remarriage of an updated version of social democracy with the more patient capitalism that thrived for the three decades between the end of World War II and the Reagan era. The wreckage created by that divorce is all around us now. Those in Silicon Valley who urged everyone to “move fast and break things” succeeded beyond their wildest dreams. They and their libertarian friends broke, literally, everything. Their silence is deafening. Perhaps they have begun to realize that you can’t bring an app to a pandemic. Or perhaps they are just too busy pursuing their predatory instincts, squeezing every last trillion from their buddies in DC.

I’m not claiming that this 30-year postwar period of relative stability and prosperity and predictability was without its downsides. All during those decades, the nation and the planet continued to ignore several profound “underlying conditions.” Environmental degradation didn’t just continue; it accelerated. Deindustrializing cities decayed and imploded. Racial and ethnic and social tensions simmered and stewed, occasionally erupting but never improving. Block busting—buying low from frightened white ethnics like my parents and selling high to African Americans seeking a better life—and racist redlining ruined neighborhood after neighborhood, city after city, undermining social and civic institutions, replacing slowly growing equity with rapidly increasing debt. The lost equity in just one West Side Chicago community, Lawndale, is estimated at more than $3 billion. Existential threats—locusts to North Africa, catastrophic fires in Australia, species after species facing extinction—multiplied and were either aggravated or ignored.

The socially democratic part of this relationship will drive the far right crazy. The patient capitalist part of it may drive the far left and impatient young socialists crazy. So be it. All of us desperately need a new and expanded vision of what “prosperity” and “stability” and “predictability” entails—environmentally and socially and politically.

I worry that Americans won’t ever agree on common goals—recovery plus resilience—unless we respect the role that capitalism still can play: the bursts of energy generated by rebounding and new businesses of all kinds and the extraordinary innovations waiting to be imagined and tested. That respect is also a form of recognition for the scores of millions of decent moderate and conservative Americans who value business and enterprise. But the recovery also must respect the role that government needs to play, in designing recovery plans from the ground up—every community, county, region, state—and then acting as a bloc to apply local remedies where possible and to demand federal assistance where needed. That respect in turn recognizes the instincts and values of scores of millions of decent moderate and progressive Americans, who value the ability of the state to perform functions that the market can’t or won’t fulfill.

Yet even that recovery will falter, unless the third sector—the civic sector, the sphere of organized citizens—builds and asserts its own power and injects its own values and insights and social knowledge into the mix, nudging the other sectors, supporting them at times, exposing them at times, and holding them accountable at all times.

Workers board up a bar in Nevada. All nonessential businesses have been ordered to close in response to the coronavirus.(John Locher / AP Photo)

How will all this look? What will a resurgent society have to tackle going forward?

Elder care will need to be decentralized, rooted in homes that are equipped with basic medical tools and renovated to enable the infirm and those suffering from Alzheimers to live safely, cared for by capable home health aides paid a decent wage.

Broadband connectivity needs to transform from a generally agreed-upon interest into an on-the-ground reality for every American.

Those suffering with mental illness should be diverted from prisons and emergency rooms into facilities and programs equipped to stabilize them and help them get well.

Counties crippled by opioids and other drugs will need to see a rapid expansion of medically assisted treatment and living-wage jobs for those who recover.

Existing jails and prisons need to be downsized and right-sized—so that enough space exists to ward off the next viral plague.

The lead and mold still poisoning and harming the young and the old—yet another quiet plague—should be finally removed from our housing stock.

Energy efficiency upgrades should be installed in the nation’s schools and congregations and apartment buildings.

And large stretches of our inner cities and rural communities, now mostly vacant and abandoned, should be rebuilt in the way that East Brooklyn Congregations has transformed the devastated acres of that borough—with new, affordable Nehemiah homes, that help families rebuild equity and avoid corrosive debt.

This list goes on and on. Each offers a useful social opportunity. Each opens the door to massive and sustained employment at a recovery wage. Each invites entrepreneurs and innovators to create new products and remedies. Each depends on deep and disciplined work by organized citizens and organized workers—more and better power organizations, revitalized or new labor unions, congregations retrofitted for the formidable challenges of the next several decades. Each will be resisted fiercely by the entrenched powers that benefit from the failed status quo: the for-profit nursing home lobby, or corrections unions fearful of losing prison jobs, or counseling companies that worry that medically assisted treatment will mean a reduction in their contracts. Each would require a period of transition that allows workers to move from one role to a new role. But each would leave our nation in better health—physically, economically, and socially.

Only a revaluing of the notion of society and a rebalancing of the roles of the state, the market, and the civic sector can set the stage for a defense against the next phase of the current crisis—or the next new pandemic. And only those realigned sectors can design and implement an offense—ways to do more than recover, but to rise and thrive, to build a future not merely safer but more promising and exciting for our children and our grandchildren.