Time flies, even without much fun. Nearly five months ago Canada’s first COVID-19 patient, returning from Wuhan, China, was admitted to Toronto’s Sunnybrook Hospital with fever and a hacking cough. We knew a storm was coming, and it arrived some weeks thereafter.
Alberta has generally been lucky to have political leadership with enough savvy to listen to public health experts. Our armamentarium is modest enough: Stay home. Stay six feet away from others. Wash your hands. Wear masks. Wear gloves. In some localities, it’s been difficult to get rambunctious citizens to comply. Elsewhere, crowds have formed to protest lockdown, encouraged by political animus at a global recession now costing trillions of dollars.
Most would agree that, nearly everywhere, we've been slower to respond than we might have, although we've become adept at the blame-game. In Canada, it wasn't until the end of March that borders were closed to non-essential travel, including that from the U.S.A., and 14-day quarantine periods were invoked for persons entering the country by any means, with or without symptoms. April brought frenzied purchases of personal protective equipment, an acronym we won’t forget, and once again we could have been better prepared. Fear of rationing ensued, and sales of toilet tissue and canned goods skyrocketed at the same time detergents and disinfectants were cleared off the shelves.
Luck has likely played some part in our experience with SARS-CoV-2, which has not been as extreme as seen in northern Italy, parts of the U.S.A. and South America. Everywhere, however, we’ve seen clear evidence of the effects of determinants of health. Combine low-paid workers and crowded spaces with one or two highly contagious sufferers – now called super-spreaders – and wait four to 14 days for illness to appear. Look especially in places where people congregate: meat plants, jails, church gatherings, long-term care facilities.
Lessons are abundant. To the extent that we’ve complied with public health measures, our preparations for an illness that we reckoned would be another version of the Spanish flu have been helpful. We’ve greatly welcomed the daily tallies and news from provincial health officers and other numerous quarters but might have benefitted from pronouncements, nationally and internationally, that could have been more specific, more consistent and better argued. There’s been much to-ing and fro-ing with regard to masks – yes, no, maybe so? – and gloves. The paramount need to stay home and away from others could still benefit from singular emphasis. Too often we’ve seen gloved, masked individuals – both citizens and workers – milling about, subverting the more important emphasis on staying home.
Certain lessons from our contagion are sad commentary on the way we live. In particular we are collectively rebuked at the care we’ve been providing (or, sadly, not providing) our elder folk. The firestorm of infection which has decimated many long-term care homes has been horrifying, especially when such elders have been left, incommunicado, to die alone. Our humanity deserves better.
I wasn’t happy with Texas Lieutenant-Governor Dan Patrick’s suggestion that gray beards should find their plight more agreeable in favor of the young (a distressing take-one-for-the-team approach) but even that would be less brutal than forced familial abandonment, which diminishes us and isn’t who we are.
With summer upon us, we’ve emptied larders most everywhere of resources and are tired of our constricted lives, so there’s understandable enthusiasm to end our lockdown. In many places, as case numbers wane, it may be reasonable to gradually open shops and businesses. On the other hand, especially beyond our borders, we’ve seen political leaders urge citizens to aggregate, to shop or work or worship, even as caseloads expand. Recrudescent outbreaks are likely to follow that will imperil us all.
It can be foolhardy to forego the physical distancing that has served us to date, especially when there is little else in our toolbox. Why is this happening?
Many legislators fear our recessionary economics and the hole we’re in, but others urge, sans evidence, that the wave of COVID-19 is past, that incipient and even mounting caseloads will wane in any case. When this is done without the support of public health experts, it may be less about fear and duplicity, and more representative of magical thinking:
“If I can think something, especially if I prefer it, it’s likely to happen.”
I consider this issue of magical thinking to be important. Will we, as a society, listen to experts and evidence over time, or will we listen to will-o-the-wisp reassurances from certain wrong-headed mayors, governors and autocrats, that all will be fine? I’m reminded of the tired refrain from a song years ago: “Don’t worry. Be happy.”
We may have enough experts to advise us about testing, look backs, and trace backs, but we’re going to need an army of new personnel to carry things out. As well, we could likely use more scientists working on vaccines and antivirals. But more urgently, we’ve got to listen to experts.
Experts remind us that whatever we do, there are more contagions and more waves of this contagion heading our way. We need more robust distant-early-warning systems as troubles appear on the horizon. Too often the messages we need to hear are blunted or diverted by persons deaf to such news. This may be a structural issue for us, as we need multiple voices to trumpet the stuff we need to hear.
There’s talk about “a new normal” that we can anticipate, though there’s little new or normal in our lives. Until effective vaccines and antivirals are ubiquitous – a period of years, not months – our moves must be cautious and limited.
Our struggle thus far has defined us, for viral defence purposes, as groupings of persons that share a home, though many if not most of us live alone, and large households are uncommon. We’ve learned to be wary of others lest they broach our six-foot perimeter. Though this may have saved us thus far, it’s a habit that our tentative selves may find difficult to break and which threatens to become its own type of imprisonment.
Not long ago, globalization was touted as necessary in an interdependent world. This notion’s been turned upside down as we and our communities become accustomed to lives that are ever more insular and solipsistic. Our crimped social structures couldn’t develop at a worse time, when we consider climate change and the expanded concern and altruism we need. Our outlook may be grim.
On the other hand, trouble isn’t new but comes in different flavors and we’ve dealt with it before. Remembering the carnage wrought by the Spanish flu at the end of WW I, we can be thankful for both universal health care and a well-developed social safety net.
Our digital technologies have served to distract us in this lonely time but may assist us in our struggles with contagion. Telephone apps that can discern our movements and gauge our proximity to infected persons may help us isolate the virus. As Uri Alon of the Weizmann Institute has suggested, we may benefit from the kinetics of the coronavirus and the observation that newly infected persons are not themselves infective for about three days. Arguing for a shortened work week, for instance, makes sense with a four-day work week, followed by a fallow period of 10-14 days thereafter. Any developing illness should, accordingly, be confined to the furlough interval, limiting workplace illness and planning care as needed.
I think that we count on both our creativity and our adaptability to confront our vulnerabilities. When the virus surfaced months ago, I was worried that we would miss old habits and, in particular, our tradition of shaking hands, which predates Greco-Roman times and is regarded as necessary for interpersonal trust, comity and cooperation. Even before the virus arrived, however, the habit was waning, similar to men’s experience with neckties, and the handshake’s demise may be overdue. Some refer to the custom as representing “microscopic grotesquerie,” possibly overstating the case.
There’s much to learn from our astronaut, Chris Hadfield. We’re in a marathon, Hadfield reminds us, not a sprint; he goes on urge us to “understand the danger, look at constraints and set objectives.”
This helped Hadfield in his six months in space, rolling around our blue planet and I find it good enough for me.
Bring it on.
Whatever …
Editor’s note: The views, perspectives and opinions in this article are solely the author’s and do not necessarily represent those of the AMA.
Banner photo credit: Marvin Polis