The spread of coronavirus (COVID 19) has created widespread confusion about what to think and do in the midst of this unfolding pandemic. On the one hand, official information from the Trump administration tends to minimize the threat for most Americans, while independent news organizations and health care professionals warn of a rapidly expanding crisis, now officially designated by the World Health Organization as a global pandemic, threatening both individuals and our whole health care system.

However, numbers alone don’t always translate emotionally and can minimize our understanding of the human cost of this virus in terms of both anxiety and activity. Statistics can pale in their impact once we experience a single real-life incident, however minor, as we routinely go about our lives.

Yesterday my wife and I were visiting municipal court on behalf of a young man on trial. We had no direct knowledge of the facts in the case, but were there to show our support for him and his family, with whom we are close, and who also turned out in supportive numbers. We entered the crowded courthouse and shared hugs and handshakes with his family to underscore our support for him as he navigated the legal system. His case was called first. Immediately, the clerk announced that his lawyer had telephoned the court earlier that morning to report she had awakened with a high fever and felt it best not to enter the courthouse. The judge announced that, in light of “what’s going on in the world” (I don’t remember him using the term “coronavirus” at all), it seemed prudent to postpone the case. After general agreement, a new date was set for late May and everyone associated with his case left the courtroom.

After leaving, we learned that the lawyer had visited his family’s home just the day before to strategize for the trial. End of story.

Wait, end of story? Who really knows? What was this sudden fever about? Did her flu-like symptoms imply something more sinister? Had she inadvertently passed on the virus to her clients? Did we make mistakes by simply offering hugs and handshakes?

What is the follow-up to this story? Possibly, there is none. But how long will it take to really know? The incubation period for the coronavirus is fourteen days? Will we discover a different result later this month? How many people will we interact with between now and then?

The news is filled with cases where asymptomatic individuals (UK’s health minister Nadine Dorries; Rick Cotton, Director of the Port Authority of NY and NJ, Senator Ted Cruz and other legislators, newly appointed Presidential Chief of Staff Mark Meadows—and these are only those in the headlines) have engaged unsuspecting members of the public only to learn much later that they were infected, thereby unintentionally endangering the public, spreading the disease, increasing anxiety and disrupting countless lives.

The point of sharing this is not too elicit “thoughts and prayers” or expressions of sympathy, but rather to underscore the level of uncertainty that exists in our world right now and to demonstrate how simple run-of-the-mill engagements can produce unintended consequences. How many times, every day, is our experience in that courthouse replicated in towns and cities throughout the country (indeed, throughout the world)?

The same politicians who initially assured us that our potential for exposure was “very low” are now forced to make plans for school closings, the cancellation of large events and the establishment of quarantine zones. And, we cannot fully predict the scope of the virus until we have more widespread testing.

Until our testing protocols are refined and readily available to communities across this country, we will not fully understand the scope of this health crisis, and thereby will be unable to appropriately respond to facts on the ground.

I have been following the global trajectory of the virus and have noticed one surprising development. Countries like India, Bangladesh and Nigeria which have cities with exceedingly high concentrations of population have surprisingly small numbers of reported cases (less than 70 cases combined as of this writing). I don’t have the expertise to fully understand this, but my guess is that these countries do not have the capacity for adequate testing, especially in cities like Lagos, Dhaka and New Delhi where population densities are highest. Once testing is instituted on a larger scale in such places, we will see a rampant escalation of infected individuals.  

If my experience yesterday in a small, suburban municipal court in the US is any indication of what happens when people are thrust into conditions where human interaction is extensive and opportunities for health precautions are limited (think about jury rooms, prison wards, day care centers, nursing homes), then we have only begun to tame this monster. My fear is that once widespread testing is underway across the globe, we will see a pandemic that dwarfs what we are currently experiencing.

3 thoughts on “COVID 19 Cuts Close

  1. I agree. We just don’t have the numbers yet to get an accurate picture of the enormity of this thing. The tough part is just not knowing.. My daughter is fortifying herself – she believes – with a diet rich in antioxidants and leafy greens and I take spoonfuls of honey and apple cider vinegar. I just postponed a NYC appointment to a later date. We cautiously visit older loved ones but greet each other with only a wave and a mock kiss-offering gesture. We all wash our hands constantly and stock up on things like toilet paper and wonder if ANY of this will help anyway. We follow the TV news cycle, prepare as best we can and pray.

  2. Alabama also had no reported cases as of yesterday, but the reason is most likely the same as some of the nations and cities you mention–they just don’t report them. When we look at current technologies vs the past it is very difficult to back-test prior outbreaks. Asymptomatic cases? It’s even harder when reporting infrastructure is lacking. Fatalities, maybe. Remissions, more difficult; Asymptomatic cases, impossible.
    I do have pretty good recollection of some of the recent epidemics and pandemics (although not the 1918-19 flu), and I certainly would not have considered it possible to shut down whole sections of the economy–schools and colleges, international airlines, the NHL, NBA and NCAA (?!) for any of them. So OK, maybe we’re hypersensitive because we have decreased faith in government reporting, but maybe we’re just a little too easily hitting the panic button.
    We hope you and all involved in the legal case remain safe and well, but at least there are places for quick treatment if necessary.

  3. I think we were late on hitting the panic button, to be honest.

    As a person who derives most of my income from large scale, international gatherings, I became super concerned about this spreading virus about three weeks ago while in Las Vegas at one of those said gatherings. When my husband and I returned from Vegas, we started making plans for lost work, food reserves, future unpaid bills, medical needs, etc. I had numerous people look at me quizzically and tell me I was overreacting. Oh, how much has changed in the past two weeks.

    I read a really interesting article yesterday about the severity of the virus having a lot to do with the makeup of the population. For instance, the fatality rate in Italy is so much higher than the fatality rate in South Korea. Some are speculating that this is due to the population in Italy being much older than the population in South Korea. Also, the fatality rate is generally higher among men than women. Is this because women tend to wash their hands more? Or because men tend to smoke more? Or because men tend to have more underlying medical conditions than women? Why does the outbreak seem worse among people of means rather than in the communities that you mention? Is it because the people with means can get tested and the others can’t? Not likely, actually. Perhaps in poor cities in India and other places, where people live packed together in seemingly less sterile conditions, it is already harder to survive if you have emphysema, or cancer, or heart disease. Maybe those populations are younger and therefore “heartier” because they live in an area where survival of the fittest still reigns supreme, as opposed to survival of the richest. Perhaps in poorer neighborhoods there is less ability to travel so you already interact with fewer people. I don’t know if any of these hypotheses have any merit. But, these are all things that need to be studied.

    The biggest problems often have multiple causes and multiple cures.

    Right now, we are suffering from a total breakdown in leadership at the national level, but there are still leaders among us. Hopefully those voices will be able to cut through the noise and help us get through this with dignity and grace. With increased love and empathy for our neighbors, and with a new perspective on our shared humanity and vulnerability. And then, hopefully, we will be well enough, as a nation to turnout in November and elect someone that would never think to shut down the white house office pandemic office.

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