Isn’t it nice to know that what you do really matters?
That was my first brave response to realizing that Covid-19 was here among us, and dangerous.
My ignorant response had been different. By about March 10th, my peers were tossing around the term “social distancing”–epidemiological jargon for get the heck out of my space. But I didn’t understand why. The Wuhan virus, as I knew it then, was a respiratory threat with an epicenter in China, and yeah, it was making its way around the globe thanks to international travelers. But from what I’d heard the illness wasn’t that big a deal. Most of us would develop mild symptoms, if any at all, and the death rate was lower than that of seasonal influenza. We don’t panic about the flu every year, I reasoned–why are people raising panic about Covid-19?
So on March 12th I called my friend, a physician with the VA in Montana and my go-to on medical questions, to ask why all the fuss? “It’s not even as bad as the flu,” I pointed out.
“Yes, it is,” she countered. “It’s worse.”
She told me to start reading the reports from northern Italy. She taught me concepts like “flatten the curve” and had me watch a video from CBS Boston where her cousin, head of infectious disease at Brigham and Women’s hospital, explained it clearly: social distancing was not about us, it was about preventing a melt down in our medical system.
The gravity of a Covid-19 pandemic started to sink in. I had been focused on the idea that as a naive population faced with a novel virus, our best defense against the disease would be the acquisition of herd immunity. As a large animal veterinarian I had been trained to think about herd immunity. With the mortality rate relatively low, why not let the infection spread through the healthy population and stimulate natural antibody production, while we protect the elderly and otherwise immune-compromised? We don’t have a vaccine for this disease yet, so outside of hand-washing, only natural immunity will prevent people from spreading disease.
(A few days later, on March 15th, I felt somewhat vindicated in my logic after hearing it echoed by the chief science adviser to the United Kingdom.)
Herd immunity is all well and good as a scientific principle, my friend acknowledged, but even a low mortality rate causes high numbers of dead in an urban population. Public health officials weren’t claiming that we could prevent people from getting sick, she continued to explain. Public health officials were stressing the importance of having fewer numbers sick all at one time. Flattening the curve means that the same numbers of people become ill, but at a slower rate.
There is a rate of infection at which our hospitals simply can’t keep up. Hence the warnings from public health officials; hence the advice to read and learn about what was happening in Italy. Northern Italy, a modern, western, wealthy economy, was overwhelmed with sick and dying patients. Doctors were having to ration ventilators, choosing who to treat and who to let die. Bodies were piling up in empty churches, backlogged on their way to crematoriums. If it could happen it Italy, it could happen here in the wealthy, invincible US of A.
I didn’t feel brave about this from the start. At the grocery store, faced with bare shelves which posted rationing notices in lieu of toilet paper, I actually felt scared. I remembered being a little kid and trying to understand my father’s explanations of beleaguered economies. He had been an international reporter for the Wall Street Journal, witnessing world economies first hand. I vaguely understood from him that other people, in other countries, had to line up for limited supplies of staples like bread and milk. But here I was looking at bare shelves in my home town; I’d never experienced this before in my lifetime. I’d never thought it was even possible to experience this in America, near a major city: there was no toilet paper to be had.
When I came to the store a few days later, scarcity had spread to the bread and milk aisles. And still no toilet paper.
I ended up accepting a few rolls from a friend. She handed them to me, in the sunshine outside her country home, reaching over from about six feet away. We were social distancing.
Why? Because it’s something we could do. Watching our economy crumble around us as a result of trying to slow the viral spread, it’s easy to feel helpless. But what epidemiology tells us about social distancing is that, if everyone participates, it works. Each and every individual one of us can actually make a difference in the spread of respiratory infection.
We have to embrace this concept, and we have to act on it. So much of being human is tempered with self-doubt, with wondering why we are here, or whether our measly little self can make an impact for the greater good. The Covid-19 virus is giving us a wake-up call: what you do matters!!
Please–stay home. We’re going to get through this, together.