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Notes from the Plague

It started as a far-off speck in a faraway land. Reports of coronavirus started trickling in from Wuhan, China by November of 2019. By December it was clear a pandemic had taken hold. How bad would it be? Some made the case it would be the worst in 100 years, but we still won’t know for a while if COVID-19 is worse than Spanish flu. That pandemic killed roughly 50 million people around the world including 3 of my paternal grandfather/s grandparents. This peculiar fact of my own family’s history made my concern about COVID that much more acute.

The COVID19 virus has a two-week incubation period. This means that before Wuhan was locked down, and two weeks before the first case was identified and tested, the virus had already been spreading unabated around the world. Its infectiousness was like the flu, but the high death toll made it much worse. The WHO estimates the death rate at 3.4%, and even higher for the elderly and people with weakened immune systems or other underlying health conditions. The only logical response to such a virus would be a complete shutdown to slow its spread so people infected could be identified, isolated, and treated without crashing the healthcare system.

Some at the time would say this is an overreaction, but again, look at the numbers. If low estimates are used (again, I was looking at these numbers back in January), 20% of the country would get infected, 15% of those would be hospitalized, and 5% would need ICU care. So, 68 million infections, 10.2 million hospitalizations, and 3.4 million ICU patients. This would amount to 13.6 people per hospital bed in the United States and 75.5 ICU patients per ICU bed. Hospitals would be completely and utterly overwhelmed with these numbers. People without coronavirus who need care for other reasons would die from lack of care. The only way to prevent this from overwhelming our hospital capacity would be social distancing and isolation measures as advocated by public health officials. Ultimately, not to prevent these deaths, but to make the course of the pandemic more manageable.  And it appeared these measures would need to last a while, until late summer at a minimum.

This situation was even more concerning for me compared to the public. I’m in a very unusual medical situation, especially for someone my age. I suffer from a rare neuromuscular disease known as Becker’s muscular dystrophy, which causes progressive deterioration and weakness in certain muscle groups, and as a byproduct produces heart and lung complications. Essentially, I am a young man of 26 stuck in a body that is steadily declining in some ways, but healthy in others. It is hard to know exactly how my immune system would respond to this virus should I contract it. My vitals show that it should not be very diminished due to my intensive regular care, which possibly makes me healthier than others my age. But I have other conditions, like reduced lung function, and cardiomyopathy, that render me more vulnerable. So, it is much more likely if I catch the virus that I will need to be hospitalized and much more likely that I progress to severe complications.

Obviously, given my health situation, I monitored COVID news much earlier than most people. It became clear to me by mid-February what was coming based on what was occurring in China. Given how the global economy is interconnected, and how Wuhan is now one the world’s great industrial cities, it  seemed obvious that if a disease with a  two week incubation period was manifesting itself like this, then it had likely already spread around the world and we were just waiting for the symptoms to hit. Following that, I started to warn my friends to move investments around. But it was still an abstract thing, and it took analysis of epidemiological data to see the magnitude of what was going to happen. Analysis most people did not have the time and attention for.

So, I began to prepare.  I stocked up on groceries, medicine, and cleaning supplies a week before the run on the stores happened.  I also stocked up on first aid medical supplies on the assumption it would be safer to treat medical accidents at home rather than at overrun hospitals. My plan was to basically be a shut-in for about one month until people adopted better health habits, making it safer to leave. While I was doing this, several people expressed that I might be crazy or paranoid. But I was simply following the math.

Right now, I am mostly staying at home, and leaving only for essential trips. I could or could not be more vulnerable to this; I don’t know for sure how my conditions will exacerbate the disease or not should I catch it. This also makes me much more acutely aware of the struggles elderly or health compromised people will be affected, and much less desirous to go out and potentially spread it. That is the difficulty of the situation: most of the people who I regularly interact with are younger, healthy, and are at low risk of any complications. They often project this as invincibility and continue to go out and be active as before. But that also makes them vectors for the virus. There is an education and experience gap that makes it difficult for them to consider that they might need to adjust their behavior for others. Back in March, I would frequently look through my social media feed and see that many people were out at bars, or cramming into restaurants, and otherwise not paying attention. This was people not putting themselves in other’s shoes. I didn’t resent them, because if I were young and not dealing with a chronic disease, I would likely be doing the same things.

This is where I try to strike a balance to appealing towards compassion and empathy and persuading people I know to modify their behavior for others without being overly critical. Most people, and this applies to most situations, do not go out of their way to hurt others less fortunate, and willingly correct themselves if provided with the necessary information. So, one Sunday morning in March I was prompted to post about it. I used an image of a Twitter post advising people to take this seriously and take precautions, but not to panic. With this I added a message about how myself and others are part of vulnerable populations, and that the best course of action to protect these people was to stay home if possible. Everyone needs to remember that, as difficult as this situation might be, your social life will be there, and so will all the activities you normally enjoy once this time passes. Odds are, this will be the first and only major pandemic you experience in your lifetime. Enjoy the opportunity to relax and reflect; this will only be a blip on the radar in the long run. This is not pedantic advice: I’ve found the two best ways to pull through a chronic illness is to keep yourself in the present and to mentally re-frame challenges as opportunities.

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