Pick Your Poison

As we reached 3 million global confirmed cases today, we are also fast approaching 1 million confirmed cases just in the United States. Of course, confirmed cases is a crude measure since we don’t have the ability to test enough people for the coronavirus to get a true picture of the scale of the pandemic[i]. This is particularly troubling because the pressure is high to reduce the restrictions and end the stay at home orders across the country for the sake of saving the economy, as 4.4 million more people filed initial unemployment claims last week, bringing the five-week total to more than 26 million[ii].

The pandemic is even more widespread than the testing shows, and likely spread much earlier than anyone knew. A model of the spread of the disease by researchers at Northeastern University suggests in early February hidden outbreaks were spreading almost completely undetected in Boston, San Francisco, Chicago and Seattle, long before testing showed that each city had a major problem.[iii] “There are other signs that the outbreak was worse at an earlier point than previously known. On April 22, Santa Clara County, Calif., announced a newly discovered coronavirus-linked death on Feb. 6, weeks earlier than what had been previously thought to be the first death caused by the virus in the United States.”[iv]

There’s also evidence that many more people across the world are dying compared to last year, suggesting that the true death toll could be much higher. ‘At least 36,000 more people have died during the coronavirus pandemic over the last month than the official Covid-19 death counts report, a review of mortality data in 12 countries shows — providing a clearer, if still incomplete, picture of the toll of the crisis.  In the last month, far more people died than in previous years. The totals include deaths from Covid-19 as well as those from other causes, likely including people who could not be treated as hospitals became overwhelmed.[v]

I’ve been looking back at January news reports about the coronavirus to see what was known early on. A Jan 6 article in the New York Times states that “In Wuhan, a Mr. Li, who works for a hotel restaurant, was one of the first patients to fall ill. He came down with a fever on Dec. 23, after visiting the Huanan Seafood Market.”[vi] If he showed symptoms on Dec 23, he could have been exposed to the virus as early as Dec 15, and working in a hotel, he could have infected dozens or even hundreds of travelers and coworkers before he showed his first symptoms. And whatever sickened him could be the source of contagion for hundreds of other people, who themselves could have been spreading the disease across the world.

Testing for antibodies is fast becoming the panacea for this crisis, though like every other solution, it has failed to live up to its hype. “The antibody tests, many made in China without F.D.A. approval, are often inaccurate, some doctors are misusing them, and the rollout is nowhere close to the demand.[vii]

Even so, many people are taking the antibody tests, and the results are impressive. According to testing in New York state, “Nearly 15 percent (14.9 percent) of those tested in this round had the antibody, meaning they had coronavirus at some point and recovered.[viii]” One might reasonably suppose that having a population that has been widely exposed to the virus, and shows antibodies for having defeated it, would be a good thing. Antibodies provide immunity, right?

Actually no. “The World Health Organization has pushed back against the theory that individuals can only catch the coronavirus once, as well as proposals for reopening society that are based on this supposed immunity. ‘Some governments have suggested that the detection of antibodies to COVID-19, could enable individuals to travel or to return to work assuming that they are protected against re-infection,’ the WHO wrote. ‘There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.[ix]‘”

So far, the people thought most at risk from the virus are old or have underlying health conditions, such as heart or respiratory diseases. But that picture is in question as new reports of young people suffering strokes after contracting coronavirus have begun to surface. “Reports of strokes in the young and middle-aged are the latest twist in our evolving understanding of the disease it causes. The numbers of those affected are small but nonetheless remarkable because they challenge how doctors understand the virus. Once thought to be a pathogen that primarily attacks the lungs, it has turned out to be a much more formidable foe — impacting nearly every major organ system in the body.[x]

To help doctors diagnose new cases without access to testing, “the CDC added the six additional possible symptoms of COVID-19 to three previously listed symptoms (fever, cough, and shortness of breath). New are: Chills, repeated shaking with chills, muscle pain, headache, sore throat, and loss of taste or smell.[xi] Other less common symptoms such as eye pain, pink eye and diarrhea have also been noted in Covid19 cases[xii].

To add to people’s anxiety, “outbreaks of COVID-19 among workers at major meatpacking plants are causing ripple effects across the supply chain, creating a backlog of livestock at farms and threatening to hike meat prices at supermarkets”[xiii]. Some plants have closed, others are trying to slow production and space workers farther apart, in order to keep production lines moving.

Amid all this uncertainty, people look to their leaders for answers, and Trump is there to offer solutions. The latest one was surprising, even to people who had lost all respect for him; “President Trump’s suggestion that an “injection inside” the human body with a disinfectant like bleach or isopropyl alcohol could help combat the virus.[xiv]” This idea didn’t just pop into Trump’s vacant head, “Mark Grenon, leader of Florida’s Genesis II Church of Health & Healing, which appears to be more of a moneymaking operation than a place of worship, wrote a letter to Trump earlier this week saying that chlorine dioxide, an industrial bleach, is a “wonderful detox” that can kill most pathogens in the body and cure people of COVID-19 (and other conditions, such as Alzheimer’s, autism, brain cancer, HIV/AIDS, and multiple sclerosis). Grenon is already the subject of a federal probe, which “claims the group is illegally distributing unapproved new drugs with misleading and false labeling and alleges the defendants’ products don’t contain adequate directions for use.[xv]

This laundry list of bad news is in contrast to the fact that government leaders are making plans to lift their stay at home orders. “State and federal officials have nowhere near the testing capacity that experts say is needed to track and limit the spread of the virus, and there is no vaccine yet. But states are already reopening, urged on by President Trump, who is eager to restart the United States economy. The governors of Georgia and South Carolina have begun allowing some businesses to reopen, even though both states continue to see new infections and what the Centers for Disease Control and Prevention call “widespread” community spread of the virus. It is a pick-your-poison fact of the crisis: The pandemic recession has knocked millions of the most economically vulnerable Americans out of work. Rushing to reopen their employers could offer them a financial lifeline, but at a potentially steep cost to their health. The virus has only exacerbated inequality, with minorities suffering both higher death rates and more financial harm.[xvi]

Reading as much news as I do, its hard not to feel like we’re racing towards disaster. People will continue to get sick, and even getting sick doesn’t spare you from getting sick again. People will continue to suffer financial hardship, lines at food banks will get longer, people will continue to file for unemployment, and the economy will spasm downward, whether we re-open the businesses or not. People with the means to stay home will, but most who have jobs will have to go back, without a vaccine, a treatment, or antibodies to protect them, armed with only a cloth face mask and a prayer.

I realized that the first weeks of being at home, I was grieving for the disruption of my old life. I soothed myself with alcohol and food, gaining weight and succumbing to despair. But 6 weeks in, I’ve adjusted to this new life. I know that I’m lucky to be able to stay home, to have a job, a safe home, food on the table, and a family that supports me. We’ve had the time to tackle projects that we probably wouldn’t have done otherwise, because all other obligations and distractions have fallen away. I’ve spent more time with my neighbors in the last month than I had in the last 3 years, letting our kids ride their bikes in the front yard. So even as things continue to look bad, and predictions for the future look worse, I know that I am fortunate indeed, and that helps me cope.

Citations:

[i] Testing Remains Scarce as Governors Weigh Reopening States. Sheryl Gay Stolberg, Farah Stockman and Sharon LaFraniere. April 25, 2020. https://www.nytimes.com/2020/04/25/us/politics/virus-testing-shortages-states-trump.html

[ii] Jobless Numbers Are ‘Eye-Watering’ but Understate the Crisis.  Patricia Cohen.  April 23, 2020.  https://www.nytimes.com/2020/04/23/business/economy/unemployment-claims-coronavirus.html

[iii] Hidden Outbreaks Spread Through U.S. Cities Far Earlier Than Americans Knew, Estimates Say. Benedict Carey and James Glanz. April 23, 2020. https://www.nytimes.com/2020/04/23/us/coronavirus-early-outbreaks-cities.html

[iv] A Coronavirus Death in Early February Was ‘Probably the Tip of an Iceberg’  Thomas Fuller, Mike Baker, Shawn Hubler and Sheri Fink. April 22, 2020. https://www.nytimes.com/2020/04/22/us/santa-clara-county-coronavirus-death.html

[v] 36,000 Missing Deaths:  Tracking the True Toll of the Coronavirus Crisis.  Jin Wu, Allison McCann, Josh Katz and Elian Peltier.  April 25, 2020.  https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html

[vi] China Grapples With Mystery Pneumonia-Like Illness. Sui-Lee Wee and Vivian Wang. Jan. 6, 2020

https://www.nytimes.com/2020/01/06/world/asia/china-SARS-pneumonialike.html

[vii]  Antibody Test, Seen as Key to Reopening Country, Does Not Yet Deliver. Steve Eder, Megan Twohey and Apoorva Mandavilli. April 19, 2020. https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

[viii] 2nd New York Antibody Test Shows Even More Widespread Infection, Some Parts of State to ‘UNPause’ May 15. April 27, 2020.  https://www.nbcnewyork.com/news/local/cuomo-outlines-reopening-roadmap-for-new-york-as-daily-deaths-hit-lowest-level-in-weeks/2390949/

[ix] ‘No Evidence’ Yet That Recovered COVID-19 Patients Are Immune, WHO Says.  Colin Dwyer. April 25, 2020 https://www.npr.org/sections/coronavirus-live-updates/2020/04/25/844939777/no-evidence-that-recovered-covid-19-patients-are-immune-who-says

[x] Young and middle-aged people, barely sick with covid-19, are dying of strokes.  Ariana Eunjung Cha. April 25, 2020. https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/

[xi] CDC adds six COVID-19 symptoms to its list, but many doctors, hospitals already were using them. Katherine Rosenberg-Douglas. Apr 27, 2020. https://www.chicagotribune.com/coronavirus/ct-cdc-coronavirus-new-symptoms-not-surprising-20200427-cxuoz7zatzck7plcwpo4zdcxy4-story.html

[xii] Google Searches Can Help Us Find Emerging Covid-19 Outbreaks.  Seth Stephens-Davidowitz. April 5, 2020. https://www.nytimes.com/2020/04/05/opinion/coronavirus-google-searches.html

[xiii]Higher prices, fewer options for meat lovers as coronavirus closes more Illinois meatpacking plants.  Alexia Elejalde-Ruiz. Apr 27, 2020. https://www.chicagotribune.com/coronavirus/ct-coronavirus-meat-processing-plants-close-supply-chain-20200424-zjod6ww76vcdjmjl23rp2wm2ue-story.html

[xiv] Trump’s Suggestion That Disinfectants Could Be Used to Treat Coronavirus Prompts Aggressive Pushback.  Katie Rogers, Christine Hauser, Alan Yuhas and Maggie Haberman. April 24, 2020. https://www.nytimes.com/2020/04/24/us/politics/trump-inject-disinfectant-bleach-coronavirus.html

[xv] Bleach Salesman Who Wrote Trump About “Miracle Cure” Investigated by Feds in Miami. Alexi C. Cardona. April 24, 2020. https://www.miaminewtimes.com/news/florida-church-leader-selling-bleach-as-coronavirus-cure-wrote-trump-11628259

[xvi] Job or Health? Restarting the Economy Threatens to Worsen Economic Inequality.  Jim Tankersley. April 27, 2020. https://www.nytimes.com/2020/04/27/business/economy/coronavirus-economic-inequality.html

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