In all my studies about pandemics I would always think about what one would look like today, we have made so many scientific advances since the 1918 flu but it’s now clear one thing hasn’t changed and that’s human behavior.
My dad talks about getting taken to the gymnasium when he was a kid to get his polio vaccine, and how grateful his mom was that there was one available. Polio killed but even more so it maimed in a ferocious way that children were put in iron lungs or if they were lucky only wheel chairs for the rest of their lives. The first big outbreak happened in 1916 in New York City, before that it had circulated but did not strike in the way it did that year. Until a vaccine was created in 1955, theaters and pools would shut down every “polio season” as they were often seen as hot spots in an attempt to prevent the spread. Those who could leave crowded cities often would escape to the country side in an attempt to avoid it and children often had to carry records showing that they were not infected with it. The March of Dimes came out of polio research and really spurred early philanthropy beyond the ultra wealthy. FDR took it upon himself to call on Americans to send dimes to help fund polio research (hence the name). Even when there were no known cures people would seek out remedies, FDR would escape to a bath house down in Georgia believing that the water helped with his rehabilitation (probably an early form of water therapy).
What was once a potential death sentence or a life filled with disability has been almost completely eradicated worldwide, there are less than 200 cases globally but without a vaccine it’s estimated that 17 million people who are otherwise healthy at this moment would be paralyzed. As of 2017, there were three individuals in the US who still depended on an iron lung to survive, which is one of the most inspiring and also heartbreaking medical devices we have. This article does a great job of painting the picture of those three lives. In the peak year of 1952, 60,000 cases of Polio happened in the US with 3,000 people dying, and an additional 21,000 paralyzed as a result. Polio gets into the body through the mouth then grows in the intestines, it can then travel into the blood stream reaching the nervous system where there it will attack the spinal cord or the brain, where it can cause paralysis. The death like most viral infections is not pretty, imagine a 6 year-old gasping for breath as their lungs become paralyzed and they essentially drown in their own secretions, parents only able to offer some comfort as they cradle their head as the rest of the body is in an iron lung working to force them to breath. Devastating. Jonas Salk started trials of a vaccine in 1953 (beginning with his own children) and by 1960s the reoccurring epidemics were 97% gone.
Why am I talking about polio, well with the current pandemic feel like I can finally spew out all this random knowledge about other diseases, and I still have a book due to the Notre Dame Library about it. But because I think a lot about polio right now with the discussion of schools opening up because polio mostly impacted younger children– but also if at it’s peak it killed 3,000/year by today’s measure we would have never focused on a remedy so maybe there is a lesson to learn about how society acted towards life during that time. There aren’t a lot of articles out there about movements during polio that contested the closure of areas; but I’m sure some mothers were exasperated when getting to the pool to realize it’s closed down and all the kids want to do is go for a swim. COVID-19 fortunately does not strike kids in the same way as adults and elders, or at least that is what current studies show but we’re still responding in real time to the virus so we still don’t know everything about it (the polio vaccine did a double blind study with 1.8 million school children). The most recent data shows that kids under 10 aren’t big spreaders of the virus, but with 1/3 of the cases in Florida being children that might change. A study that just came out of South Korea (n=65,000) shows that kids ages 10-19 are just as effective at spreading COVID-19 as adults (still limitations within the study). Those kids who are impacted tend to have preexisting conditions (much like adults) and symptoms are showing up differently with inflammation and rashes, and often triggering Kawasaki Disease (1/3 of kids who were diagnosed with this in NY had preexisting conditions).
Let’s take it back for all of you at home that stopped your science education in high school (and there is nothing wrong with that, that’s where my math career ended and always so grateful I have Heidi to message about math problems– and math is technically different than stats which I have painstakingly taken twice now for two different degrees….). A virus is a collection of genetic code (either DNA or RNA) surrounded by a protein coat that needs host cells to replicate itself, since it can’t replicate on its own. Viruses are different than bacteria–which are single celled organisms that can harm or help support life — think of gut bacteria vs. those that cause an infection. Viruses can’t be treated with antibiotics and instead need anti-viral medication or vaccines to eliminate them, non-pharmaceutical interventions are a way to reduce or mitigate the spread, think of hand washing.
Why does this information matter, well based on quite a few facebook posts I’m convinced that people don’t know how viruses function and behave. Because viruses can’t survive on their own, they need a host, and that host doesn’t necessarily have to be humans but most human infectious diseases are initially transmitted from animals. This is a great video that shows how host jumps happen. One more step that the virus has to take is going from just infecting humans to transmit the virus from human to human. H5N1 causes a severe respiratory disease in birds (avian flu) and human cases do occur with a 60% mortality rate but it’s very difficult to transmit humans to humans so the virus jumps from a bird to a human and there is no additional jump to another human– but if it jumped human-to-human and retained that mortality rate we’d have a problem.
Humans are hosts for COVID-19, it is transmissible from human-to-human which means each one of us is a potential host and potential spreader. How do we stop COVID, we make it hard for it to find a host. This is where all the non-pharmaceutical interventions come in that have been talked about; washing hands, wearing a mask, maintaining physical distance because we don’t have any antivirals or vaccines developed at the moment, and even if we did, a mass vaccine campaign is no small undertaking.
Right now the United States has 142,000 deaths from COVID–in the past two weeks alone cases are up 33%, hospitalizations are up 75%, and deaths are up 101% with 20 states being in the “red zone”. That’s a line of dead bodies that stretches 66 miles, or from my parent’s house to the nearest McDonald’s, pasture upon pasture filled with a person who was somebody to someone. So it’s been extremely frustrating and quite dismaying to see people’s response to this: “It’s not a problem here” “Masks are an infringement of my freedom” and “We just have to live with it” because we’re all potential hosts and we’re all potential spreaders. Even arguably those who have been previously infected because we don’t know how long immunity is lasting for, and it might not mean much if the virus keeps mutating beyond what immunity you had.
“It’s not a problem here”– this is really interesting to me because I think of 9/11, the twin towers didn’t fall in rural South Dakota and yet my community was shell-shocked on the attack. 3,000+ Americans died and it was enough that people felt called into action from around the country. I also think of what our reaction would be now to 9/11, how many would be quick to believe it’s a conspiracy theory, an inside job, a way to control the citizens, how much misinformation would have gotten circulated on facebook. If COVID isn’t a problem at the moment for your community, be grateful, but also work to take steps to prevent it from becoming a problem. We continue to take our shoes off at the airport, even though dying in a terrorist attack is a much lower threat than COVID-19 right now. Viruses don’t respect borders, it doesn’t stop at state lines or county lines.
“Masks are an infringement of my freedom” I’m not sure how this became such a rally cry or such a partisan issue. Masks aren’t an infringement of your freedom. Individual liberty isn’t an absolute. “In every well ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand” and that “[r]eal liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.” (Jacobson v. Mass, 197 U.S. 11 (1905)). Basically you’re arguing that everyone should have the freedom to unfettered rights and that rights come with no responsibility.
The mask argument just shows how unwilling we are at the moment to take care of one another. I get there was confusion early on with masks, I didn’t start wearing one until end of March when I went out. A lot of the mask data we have is from antecedent studies because it would be unethical to have a control group without masks exposed to COVID-19. We continue to learn new information about this disease, and we’re responding in real time. We know to be infected it’s time + exposure. Because I live in Alaska when I go to a trail I don’t wear a mask (I also don’t go to very busy trails), but will have a face covering around my neck that I can pull up like a bandana or buff. It doesn’t have to be this all or nothing, we know that inside, poor ventilated spaces are great for transmitting the virus, and that masks help if you can’t maintain distance (inside and outside). On a personal note, I would love to see the data of those who supported the Patriot Act passage and those who oppose mask mandates, my guess is that there is a large correlation but I would argue the Patriot Act was a larger infringement on your individual liberty.
“We just have to live with it” Nope, nope, nope. No other country is willing to live with it, if this is your view point, ask how many more Americans is it acceptable to die. I get frustrated because the amount of deaths we have are wholly unnecessary, and I’m quite ashamed of our response. I have spent the past three weeks in the weeds of other countries law and policies related to COVID and I can tell you almost every country is performing better on this test. Are we suppose to be okay that we’re doing better than early model projections, that we don’t have 500,000 Americans dead? What’s the threshold for you to take action? Washing hands, wearing masks, maintaining distance are what should also be part of broader testing and contact tracing. Look and see if you are able to get tested in your area without showing symptoms? It’s not happening in a lot of places and until it does we will be in this constant catch up game.
This past week I was in a pretty dark spot because I can’t believe that this our response and that people are okay with it. Do I think if I got the virus I would die, statistically no, but there are outliers, do I want to have prolonged lung damage or neurological damage, no. Do I think my parents are at a higher risk, absolutely. Do I want members of my community to die or have their lives impacted, no. This virus doesn’t just kill but wrecks havoc on one’s body in a brutal way (and in ways we won’t know for a while), and I know what you’re thinking, but Kate, asymptomatic people, you wouldn’t even know you had it, except that lung damage is shown in those who have shown no symptoms. Imagine going for a hike or a walk with 75% of your current lung capacity. Breathe through a straw if you want a full effect.
As schools talk about re-opening, we’re missing the part of the conversation that talks about what we can do in the next 6-weeks to make that more feasible. I don’t have kids so I’m not writing from a place of needing to get them out of the house so I can focus on my work, but I feel for those parents who are navigating this work space and childcare/school work at home. I think ignoring the disease is not a great approach– and think there are concrete steps we can be taking to ensure our schools are safe for when they do open up.
Viruses don’t care about our families, our work, we can’t negotiate with them. It’s the law of nature, not the law of man that we are battling with. Do you want to be part of the solution or part of the problem? Everybody is a potential host of this virus to replicate in. We don’t have to be in total lock down or completely open, it doesn’t have to be this divisive. We’re all battling the same enemy, we’re all on the same team. Until everyone realizes that the longer this is going to go on. The longer issues go on beyond COVID, immunizations are down, mental health issues, domestic violence. A lot of people had an idea of fissures happening within our society but this has exposed large ruptures in a way that we should no longer be willing to ignore. For me this is the longest I’ve gone without seeing my family. And everything just seems a little harder to deal with most days– as if I was going to graduate from therapy any time soon…
As for Alvin and I’s adventures, we have gone canoeing, hiking, backpacking–oh and he ran away from the boarder’s for two days and ended up 20 miles away, yikes. We just sent out a breed kit to find out what he is. If you haven’t placed your bet yet, you can here.
Congrats, if you made it this far, my next therapy session is about 3 weeks away and the turmoil in my mind was putting me in not a great place personally so welcome to my current therapy session. Happy to discuss anything further or provide references to anything that I have. Hope at least the pictures of Alvin helped you get through it. I’m sure if you’re reading this you’re probably on a similar page with the COVID response.
Kate Ginsbach 