COVID-19: Two Things We Need to Know

“This virus is unforgiving to unwise choices.”

As the coronavirus is affecting all of us right now in a multitude of ways, it made sense to me to share the following missive.

This is from an infectious disease epidemiologist, as shared on this Facebook profile (with instructions to share widely. Please do!).

If you don’t want to read any further or could use a moment before diving in, I was looking at flowers this evening, deciding what I’d like to plant out on a gentle hill guarded by trees. These are the perennial astilbe.

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Here’s the post:

Hey everybody, as an infectious disease epidemiologist, at this point I feel morally obligated to provide some information on what we are seeing from a transmission dynamic perspective and how they apply to the social distancing measures.

Like any good scientist I have noticed two things that are either not articulated or not present in the “literature” of social media.

Specifically, I want to make two aspects of these measures very clear and unambiguous.

First, we are in the very infancy of this epidemic’s trajectory.

Our hospitals will be overwhelmed, and people will die that didn’t have to.

That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks.

This may lead some people to think that the social distancing
measures are not working.

They are.

They may feel futile.

They aren’t.

You will feel discouraged.

You should.

This is normal in chaos. But, this is also normal epidemic trajectory.

Stay calm.

This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse.

This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception.

We know what will happen; I want to help the community brace for this impact.

Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying.

You may feel like giving in.

Don’t.

Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics.

While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics.

Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit.

You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk.

Seemingly small social chains get large and complex with alarming speed.

If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with.

This sounds silly, it’s not.

This is not a joke or a hypothetical.

We as epidemiologists see it borne out in the data time and time again and no one listens.

Conversely, any break in that chain breaks disease transmission along that chain.

In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison.

These measures also take a long time to see the results.

It is hard (even for me) to conceptualize how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does.

I promise you it does.

I promise. I promise. I promise.

You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc.

From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

Until we get a viable vaccine this unprecedented outbreak will not be overcome in grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months.

This virus is unforgiving to unwise choices.

My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks.

It will be easy to be drawn to the idea that what we are doing isn’t working and become paralyzed by fear, or to ‘cheat’ a little bit in the coming weeks.

By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty.

Interlude: Singing

It was only yesterday morning that I finally achieved some measure of peace within myself.

This had nothing to do with my books or writing, mind you. No, I had been looking forward to a high school reunion on Saturday the 9th. I say “a” instead of “my” because it was a far bigger event than just for my class; a beloved teacher was also retiring, plus another class from an earlier time was having their reunion, too.

It was more than just the promise of catching up with at least some lifelong friends, be they classmates or teachers.

It was because I would have a chance to be on the stage again.

It was in high school that I discovered, to my astonishment and joy, that I could sing.

I’d always been a singer-along-er up ’til then; in fact, I think everybody can sing. Yet I hadn’t considered it as a real thing to do beyond that. I was musical enough; cello, clarinet, and guitar had all passed through my hands.

But this was different. This was more significant, though I barely would have grasped that at the time.

So it was in high school that I also tread the boards for the first time, in musicals and smaller sets, in chorale groups and as a soloist. We went out to churches, happily froze during caroling, brought our voices and accompaniment anywhere, anytime. Those were happy days.

I even sang at my graduation.

Whereveryouwalk

Aria: Where’er you walk (Handel)

Lately I’ve been revisiting in my mind those high school years, remembering how I was, how I’d made certain decisions, how paths had been both taken and not. And with that, I recalled my musical history, and wondered, would I be able to get out on the stage this weekend?

It suddenly was very important to me. I actually spent some time almost agonizing over what I’d do if the theatre doors were locked!

Fortunately, I began to let these thoughts simmer, and it finally came to me that I don’t need to do anything. I just need to show up and the rest would follow.

And it worked out splendidly.

The event was being held outdoors, and we arrived a bit earlier on purpose. All was wind-rippled grass under overcast skies, a field of tents and tables, and an air of still-setting-up with only a few catering staff and the persons manning the check-in table.

The school was unlocked, both for restroom use and for self-guided tours down memory lane. As I’d known beforehand, the doors opening out onto the patio and grounds for the event were also the closest doors that would lead us to the theatre inside.

So we walked in. We went past office after empty office, past end-of-year paraphernalia stacked in the hallway, past wonderful and new paintings on the walls, until we fetched up at one of the two entryways to the theatre.

The hallway lights were so dim in that section that I couldn’t even see the door I knew was there, but as I pressed forward, it became clear that it was already open.

I stepped into inky, welcoming darkness, and the whole place rustled alive.

Wherever the light switches were, they weren’t anywhere we could find, yet I felt no fear as I hastily summoned memory and touch so I didn’t fall over any (low yet potentially catastrophic) ledges or steps.

And then I was out on the stage, treading those remembered boards beneath my feet, standing, walking, living. I felt the theatre around me: Warm, benevolent, ancient with having seen so many productions, so many artists, so many performances, yet expansive enough to remember them all, even if just a nod here, a glimmer of recognition there. It even smelled the same.

At the same time, my husband found some of the stage light switches, so neither of us were in peril any longer.

And now all seemed ready, welcoming, and waiting, as if it had asked, “What are you going to do?”

Here’s what I did.

060918_me_Prairiestage

Basking in the glow of long-awaited lights

I started singing.

It was bliss.

I was gazing out, unafraid, into the seats whose audience I peopled in memory, my feet holding me up on the stage but my heart soaring above.

Mind you, I came up against an unexpected hitch right away: It had been so long since I’d been on any stage, that I was surprised at what the acoustics did! Instead of just hearing what amounts to me in my head singing back at me, at home or in the car, now the room was singing back at me.

I faltered a bit here and there as muscle memory had to grow accustomed to what I used to train daily to do. Plus a piece of rather large-sounding machinery in the shop backstage was running quite determinedly with godlike exhales, no matter how I glared in its direction.

I was also quite anxious that someone would bust in and chase us out—or worse, sit and listen!—for as both theatre doors on either side were open, every so often I could see people passing by. I didn’t want to waste any time by running over to shut them, and yet I thought about it.

These all amounted to nerve-wracking distractions.

Yet even as we found more lights on the stage and in the auditorium itself (so that the array of pictures and film I’m still going through are of varying stages of exploration and back-lighting), and even as I started to let my voice soar out like I used to, filling the space, nobody disturbed us.

And mercifully soon, I thought: Who even cares if they do? Even if we were to get dragged out of there because we weren’t supposed to be there at all, it wouldn’t matter. I was complete.

Nobody ever came in. Undisturbed, I was able to relive that part of my life. No matter what goofs or flaws came out, I wouldn’t exchange a single thing.

It was perfect.

060918_me_Prairiestage_lights.jpg

Singing from “The Phantom of the Opera,” now with lights

Guinea Pig Tarot

Once upon a time, I thought, “Why not?”

As is usual with such thoughts, strange things can abide. Perhaps it’s fortunate that there are only three cards; the world may not be ready for more. It may not be ready for these!

But as they exist still today and are faithful representations of guinea pigs I have known and cherished, here they are, in order of when I drew them!

IV. The Emperor: Rowan

Discerning, kind, just, and philosophical, Rowan had more worldly concerns on his mind than his luxurious Silkie hair.

Insta_Rowan

III. The Empress: Athena

If you knew our Athena, it would not surprise you that she’d take this role. Fierce in both affection and (minor) destruction, Athena always knew what she wanted. Who among us can say this with such certainty?

Insta_Athena

II. The High Priestess: Angela

Angela was an albino with just the slightest bit of tan on her nose, and you can see the results of drawing a white guinea pig on a white background. But! Her pleasant, slightly wistful nature is evident in her kind eye and expectant nose, and she loved nothing more than to talk to you about you.

Insta_Angela

That’s as far as I ever got. Perhaps I’ll pick it up again one day; I’ve had more guinea pigs in the house since then! 🙂