Go, and Do Likewise– COVID-19 and Kindness

Casual conversation, Facebook and Twitter threads, and the occasional bad joke indicate that Americans are already experiencing fatigue from media panic around the coronavirus epidemic. Citing statistics to suggest influenza is “worse” and admonishing the press for fear-mongering when only a few thousand people have died are, well, really bad takes on this. When an old friend innocently queried his Facebook buddies if we (Americans, I guess?) should be freaking out, most in the thread agreed that this is mostly media hype.

Um… no.

Let’s start with xenophobia, and then we can get into the immunology and medical stuff.

Three weeks ago, the Globe ran a story about anti-Chinese racism experienced by students since the epidemic began. I asked my boys if they were hearing any bad jokes (or let’s be honest, checking to see if Teddy was making any) when my husband piped up that it had happened to him already.

It was a crowded elevator in the hospital. Bernie was wearing his ID (and probably a freakin’ bow tie) and entered the lift with his team. “Are you… um… feeling OK?” she asked. Taken aback, he said he answered noncommittally, but everyone knew what she meant. He wasn’t flushed, feverish, or rolling luggage plastered with Wuhan stickers. The only way he looked… was Asian.

We spent a large part of the night giggling with the kids and crafting humorous, nasty, goofy, and smug responses to bank for future elevator-type inquiries. But I argued that if people are terrified enough to be casually racist toward a DOCTOR in a HOSPITAL, maybe the best response is kindness. Or, you know, just saying, “I’m not Chinese.”

Three weeks later, in spite of an alarming spread to 24 infected countries, there is an air of conspiracy about COVID-19 on this side of the Atlantic. It’s a Chinese bioweapon. It wouldn’t exist if Asians didn’t eat weird food. A quarter million people have died and China is covering it up. These theories all share the same theme: coronavirus is something that is happening to other people. And those people are a half a planet away and maybe eat bats and probably their government is lying and plus there’s, like, a billion of them. A since deleted Facebook comment said the virus was just culling “low hanging fruit.” This was meant to be funny.

Do we typically crack jokes and make silly memes when people are dying? Maybe this is who we have become. But after 20 years married into an Asian family with kids that don’t look white, as the TikTok teens would say, “this one be hittin’ different.” I jumped into my friend’s Facebook feed to share what the experts are telling us about COVID-19, but I didn’t write what I was really feeling. I didn’t admit that your, “it’s just a virus, calm down” sounds brutally insensitive to me. If COVID-19 is just virus that (so far) is killing mostly Asians… who cares? (I’m guessing its spread to Iran will garner a similar lack of sympathy.)

We may never learn the origin of this virus, or how it jumped from animals to humans, but let me tell you really loudly: IT DOESN’T MATTER. What does matter is that coronavirus is very contagious and coronavirus kills people. What does matter is that it is spreading at an alarming rate and there is no vaccine, no known drug treatment, and (over here) few kits to test for it. Most people (80%) will have a mild course of the disease and data show that until we have a system for identifying and isolating them, they won’t present for treatment for two weeks—two weeks while their viral load doubles daily and they are feeling well enough to ride subways, go to school, eat at restaurants, and infect at least 10% of their close contacts.

The scariness is not in the lethality of the virus, but its scale. Around 13% of infected individuals will endure a more severe course and 6% will be critical enough to require mechanical ventilation. If we cannot keep the sheer number of infected patients low enough, there simply won’t be enough hospital beds and ventilators to go around.

During a two hour debrief and Q&A on the WHO site, the leader of the fact-finding trip paints a picture of Chinese hospitals KICKING ASS at containing what will certainly be called a pandemic. They built a 1000 bed hospital in mere days. They shut down the entire city and created a culture of awareness that has reduced the time a contagious patient is at large in the community from 15 days to 3. Outlying cities mobilized entire medical teams and all of their equipment to go into Wuhan to treat patients and staunch the mortality rate. Bruce Aylward, the WHO expert who just returned from China, confessed that if he contracted the disease, he would want to be treated there.

China learned from the SARS epidemic ten years ago and had some preparations and plans in place. We are woefully unprepared. As I write this, COVID-19 has reached California, and this patient has no known ties to China or close contacts of infected individuals. It’s here now, and it is only a matter of time before we need to implement the transmission lessening tactics that we have not even begun to teach.

Here’s what we do know and what you can do. First, most patients suffering from COVID-19 will report a history of fatigue, malaise, and body aches; 88% will have a fever, 66% will have a dry cough, but only 4% report a runny nose. This is not an upper respiratory disease. Test kits so far have been hard to get and unstable. In China, CT scans are being used to identify a pathognomonic pattern of the pneumonia that can progress in a significant number of patients—a wildly expensive prospect if we need to scan thousands here.

Based on studies of other coronavirus strains, scientists report that it could live on surfaces up to 9 days. Forget masks for now, and Chlorox wipe your counters. Coughing etiquette (into the crook of your arm), frequent hand washing, and strict vigilance about exposing others if you have a fever (and prompt reporting) are simple things we can do now. Chinese citizens have been incredible about self-quarantining, and in public they maintain the 2 meter rule of how close you are allowed to get to others.

Some epidemiologists are estimating ultimately 40 to 70% of the population of the planet could be infected. I repeat, there is no vaccine and no treatment, therefore, no way to stop the spread of the disease aside from behavior modification. However, statistics show that 80% of those infected will be OK. Many won’t ever know they ever contracted COVID-19. For yet unknown reasons, children seem to be less affected than older patients, but co-morbidities like underlying diseases, smoking and vaping, and immunosuppression more often lead to respiratory and even multi-organ failure. If there was ever a time to convince teens to put down their vape pens, it’s now.

Should we be panicking? No. The vast majority of us will not die from this infection even if most of us ultimately contract it. But the “othering” of the disease and the refusal to recognize what it is and how it will affect all of us is unhelpful and insensitive. Replace your beer bottle memes with useful facts, recognize that “only” a small percentage of deaths are of real people with valuable lives and families that are devastated, and pray for the health care workers everywhere who will take care of us in spite of the risk to themselves.

And wash your hands.

Prayer for Healing

 

 

 

The Neighborhood

When the boys were very small and in car seats, I did all of the driving. The boys tortured me daily with the always something demands of toddlers (Help me! Watch this!), but even when they were pre-verbal they knew I was off limits when I was behind the wheel. Driving a half a day in traffic to visit family over holiday weekends was far easier than sitting in the back seat with them and tending to their oscillating requests, meltdowns, and ill timed poops. Similarly, the puppy has learned to take a rest or find a toy when I’m at the laptop. It’s an easy break from the always something demands of a tiny dog (Take me out! Play with me! Rub my belly. Love me love me love me!), but this morning I woke up with a fever of 102 and the only way I can get a respite from this dog is to feign productivity at the keyboard. So here I am. Writing about the puppy. Again.

After one month with this little guy, I’ve gotten to know the neighborhood much better. We’ve lived in this house for 13 years, but I haven’t taken many walks around the block. Now, it’s a twice a day thing and even if I haven’t made fast friends with new neighbors (this is New England and the stereotypes hold), I’m getting to know the Dogs of Princeton Road. Because Hero is a puppy and also THE BEST DOG IN THE WORLD, he wants to say hello hello hello hi hi hi to everybody. But because he isn’t fully immunized yet, he cannot do this with the dogs. This hasn’t stopped me from inventing nicknames and backstories for all of them, anyway.

Barks-a-Lot spends most of the time fenced in outside and based on Hero’s reaction to this fearsome pooch, his woof woof woof roughly translates as, “If I ever get outta here, I’m coming for you first.” There is Prancing Pooper (whose owner does NOT curb her animal) and that haughty bitch won’t even look at us. Yesterday we met a goldendoodle wearing a Patriot’s t-shirt and a tutu and I swear she told Hero, “I hope we can be friends in spite of this outfit.”

There are a lot of regular walkers in these parts, and now that I have become that person, I take a minor and fleeting offence when they won’t pause to pet Hero when he is straining at the leash and pleading with them to love him for a second. Even if they are allergic (as I am) or terrified of dogs (understandable), many don’t even acknowledge that we are sharing a street. Yesterday’s substitute mailman heard Hero whining and yelled from two doors down, “You talkin’ to me little guy? I’m coming over to meet you!” and then did. He’s my kind of people. So are the 9-year-old twins who now live in the Miller’s old house who told me they would “take care of Hero any time… FOR FREE.” I wonder what time they get home from school.

Hero is now a sleepy foyer lump and if I’m really quiet, he won’t notice me transferring from the laptop to the couch. I was a little panicked about spending an entire day alone with an almost but not entirely trained puppy while wondering if I have the flu. But like the boys in car seats on a road trip, I swear this pup senses I need a bit of a break today. Do dogs do that? Who knows. But this one is getting all of the good treats.

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