COVID-19, Pandemics

COVID-19: The fire that darkened the world in 2020

Eight months ago today, I wrote my first post on the current coronavirus pandemic, and in a headline asked, ‘The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ (https://soundingsjohnbarker.wordpress.com/2020/01/23/the-fire-this-time-pandemic-prose-and-waiting-and-watching-for-the-big-one/).

I penned those words on a cold winter January night. At that time, COVID-19 hadn’t been invented by the World Health Organization (WHO), as the official moniker for what was then simply known provisionally as Novel Coronavirus 2019-n, or CoV2019-nCoV, designating it as a novel coronavirus discovered last year. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2. On Jan. 23, when I first wrote about it, the WHO was still a week away from designating the newly-discovered coronavirus a Public Health Emergency of International Concern (PHEIC). The WHO then waited another six weeks almost until March 11 to decide a global pandemic was under way.

As summer has given way to September’s still unseasonably warm autumn here in Northern Manitoba, the question mark, of course, can be dropped. It is indeed the fire this time. Except when it is not. That is the paradox of COVID-19. The vast majority of people infected with COVID-19 will recover. The elderly and those of any age group with comorbidities are at greatest risk. Except there will be apparently otherwise healthy young people who die of COVID-19, too. Many, in fact, although nothing like their elders.

People infected with the flu almost always get sick. They are rarely asymptomatic. Many people with COVID-19 are asymptomatic, presymptomatic, or only mildly symptomatic, but contagious in any of those three states, making them walking viral bombs. The estimate of a virus’s contagiousness is captured in a variable called R-naught (R0), or basic reproduction number, and is a key number used in infectious disease modelling for estimating pandemic growth rate. Seasonal flu has an R0 of 1.3, while measles is highly contagious with an R0 between 12 and 18. By way of historical comparison, the the R0 of the 1918 Spanish flu pandemic is estimated to have been between 1.4 and 2.8, which is within the range COVID-19 falls currently in many parts of the world.

COVID-19 has officially killed more than 200,000 people in the United States alone over the last eight months.

It is indeed the fire this time.

The 1918 influenza pandemic, widely known as the “Spanish Flu,” killed about 675,000 people in the United States, and perhaps 50 million worldwide, in a much less populated smaller world, As of mid-afternoon Sept. 22, the WHO reported there have been 31,174,627 confirmed cases worldwide of COVID-19, including 962,613 deaths.

COVID-19 in just eight months has killed almost 30 per cent of the number of Americans who died over three years between 1918 and 1920 of Spanish Flu, the worst global pandemic of modern times.

How does COVID-19 stack up against a more “normal” modern American five-to-six month flu season? The Atlanta-based Centers for Disease Control and Prevention (CDC) reports preliminary estimates from the 2018-19 flu season, the most recent data available, shows 34,157 deaths. Estimates from the 2018-2019 season are still considered preliminary and may change as data is finalized, the CDC notes. Looking back over the last decade to 2010, estimated influenza deaths in the United States ranged from a low of 12,000 to a high of 61,000.

The case fatality rate for COVID-19 in the United States is currently 2.9 per cent. The Johns Hopkins Coronavirus Resource Center (CRC) in Baltimore says Canada has reported 9,279 COVID-19 deaths with a case fatality rate of 6.3 per cent.

For seasonal influenza, mortality is usually well below 0.1 per cent, the WHO says. Countries throughout the world have reported very different case fatality ratios – the number of deaths divided by the number of confirmed cases. Differences in mortality numbers can be caused by:

  • differences in the number of people tested: With more testing, more people with milder cases are identified. This lowers the case-fatality ratio;.
  • demographics: For example, mortality tends to be higher in older populations;.
  • characteristics of the healthcare system: For example, mortality may rise as hospitals become overwhelmed and have fewer resources.

As for either a vaccine or herd immunity being the magic bullet to defeat COVID-19, consider the so-called common cold. The U.S. National Library of Medicine, an institute with the National Institutes of Health, notes there are now seven human coronaviruses (HCoVs) associated with upper respiratory tract infections that sometime spread to the lungs and other organs. Epidemiological studies suggest that HCoVs account for 15 to 30 per cent of common colds.

Are you aware of a vaccine for the common cold? Are you immune to catching colds?

Coronaviruses are enveloped positive-strand RNA viruses from the Coronaviridae family. Making a safe and effective vaccine is far more complex than making batches of an annual flu vaccine. And while herd immunity has been a factor in mitigating some disease pandemics, including influenza, the evidence that could happen with a coronavirus such as COVID-19 is preliminary and inconclusive at best.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

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Politics, Popular Culture

Demagoguery and demonization pass for discourse and civility vanishes from the public stage (2)

Compared to many other subjects I write about, I don’t write about Donald Trump very often. I don’t follow him on Twitter. I don’t watch Fox News (I cancelled my Shaw Cable TV more than three ago, back in July 2017, writing two months later on Sept. 5, 2017, “Two months post-cable television (and therefore post CNN and Donald Trump) and $150 to the good (me, not Shaw).”

Not being a complete media recluse, however, as there is still the internet, I do know The Donald – a.k.a. President Donald Trump – accepted the Republican Party’s re-nomination for president last night at the party’s national convention, promising to “rekindle new faith in our values” and rebuild the economy once more following the COVID-19 pandemic. He also said, being gathered on the massive South Lawn at the White House, known as the “People’s House,” they cannot help but marvel at the “great American story.” This is a common and recurring theme in American history. Earlier this month, I completed my eleventh Hillsdale College online course, titled “The Great American Story: A Land of Hope,” taught by Wilfred M. McClay, the G.T. and Libby Blankenship Chair in the History of Liberty at the University of Oklahoma, and co-director of the Center for Reflective Citizenship at the University of Tennessee at Chattanooga.

A little more than four years ago, as President Donald Trump was then running for president as Citizen Donald Trump, a man best known to many Americans in 2016 as the host for the first 14 seasons of The Apprentice, the American reality television program created by British-born American television producer Mark Burnett (of Survivor fame) that judged the business skills of a group of contestants, I wrote my first significant blog post about Trump on July 17, 2016 in a piece headlined, “Demagoguery and demonization pass for discourse and civility vanishes from the public stage” (https://soundingsjohnbarker.wordpress.com/2016/07/17/demagoguery-and-demonization-pass-for-discourse-and-civility-vanishes-from-the-public-stage/). The Apprentice, which I didn’t canvass at the time, was produced at Trump Tower in New York City between 2004 and 2015. Episodes ended with Trump eliminating one contestant from the competition, with the words “You’re fired!”

Interestingly, while the headline, “Demagoguery and demonization pass for discourse and civility vanishes from the public stage” may appear to be contemporaneous with Trump and Trumpland today, and certainly could be, it wasn’t written that way exactly:

“Consider the headlines for Sunday, July 17, 2016: CBS News is reporting in a July 16 its headline “W.Va. lawmaker: Hillary Clinton should be ‘hung’ on National Mall.” The story goes onto say, “A member of the West Virginia House of Delegates is causing a stir after tweeting that Hillary Clinton should be ‘hung on the Mall in Washington, DC.

“‘CBS affiliate WOWK-TV reports that Michael Folk, a Republican legislator who is also a United Airlines pilot, posted a tweet Friday night saying: ‘Hillary Clinton, you should be tried for treason, murder, and crimes against the US Constitution… then hung on the Mall in Washington, DC.

“Meanwhile, Charles P. Pierce has a July 14 piece in Esquire magazine, headlined, “This Isn’t Funny Anymore. American Democracy Is at Stake.” The subhead reads: “Anyone who supports Donald Trump is a traitor to the American idea.” Pierce writes at the top of the story that not “until Wednesday did we hear clearly the echoes of shiny black boots on German cobblestones.”

“Really?

“Is this the best we can do in terms of civics and public discourse in 21st century America? Call anyone we disagree with a traitor and perhaps for extra outrage allude to Hitlerism and Nazism? Is demagoguery the only currency we traffic in for what passes as ideas?

“We stand at a dangerous international moment in history when an intersection of events conspire to resurrect Fascism on a scale not seen since the 1930s.”

In retrospect, I think both the headline and story have held up well over four years. I also wrote at the time:

“If Donald Trump wins the presidency in November, the world won’t end. I may not much like a Trump presidency, but the Supreme Court and Congress will not be dissolved [although Trump will probably make several nominations for upcoming vacancies on the bench that will make me wish the court had been dissolved. But that’s OK; Republican life appointments to the highest court in the United States often prove over time to be stubbornly independent, demonstrating you couldn’t have asked more from a Democratic appointee. It’s kinda complicated.]

“Trump’s also unlikely to push the hot-war nuclear button, should he find himself ensconced in the Oval Office next January.  Want to know what was really dangerous? The dance Democratic President John F. Kennedy, the living Legend of King Arthur and Camelot, had with Soviet premier Nikita Khrushchev during the Cuban Missile Crisis of October 1962. That was the almost the end of the world as you knew it. Right then and there. Not Donald Trump hyperbole.

“There are plenty of examples in recent American history before where the crème de la crème cluck their tongues in displeasure at the electoral wisdom of the hoi polloi [think Brexit for the current British equivalent.] So what? Minnesota didn’t wind up seceding to Northwestern Ontario and amalgamating Duluth with Kenora when pro wrestler Jesse Ventura was elected and served as governor of Minnesota from January 1999 to January 2003.

“California survived when Arnold Schwarzenegger, the Austrian-born American professional bodybuilder and movie actor wound up getting himself elected to serve two terms as governor of California from November 2003 until January 2011.

“And speaking of California, an earlier Republican governor, Ronald Reagan, also a movie actor, went on from the statehouse to the White House, elected to two terms as president between January 1981 and January 1988. Each time – when Reagan, Ventura and Schwarzenegger were elected – Henny Penny cried out the sky was going to fall. It didn’t.

“I was living in Somerville, Massachusetts in November 1980 when Ronald Reagan was elected president.

“I had been working as supervisor for Cambridge Survey Research where I oversaw telephone call center employees for Democratic National Committee (DNC) pollster Pat Caddell’s firm in Cambridge, Massachusetts during the 1980 Jimmy Carter-Ronald Reagan presidential election campaign.

“We lost the election. Big time. I well remember going to work a few days after, late in the afternoon, riding above ground aboard a subway car on the Red Line “T.” The November sky was a foreboding steel-gray, with leaves all fallen now from the trees. And there it was, as we headed into Harvard Yard, giant spray –painted graffiti on a cenotaph proclaiming “Ray-Gun” had been elected.

“As it turned out, Reagan did have a fondness for his Strategic Defense Initiative (SDI), nicknamed Star Wars. But the dreamed-for global missile shield didn’t come to fruition. Instead, Reagan, along with Mikhail Gorbachev, general secretary of the Communist Party of the Soviet Union, managed to end the Cold War with perestroika [restructuring] and glasnost [openness] becoming part of the everyday vocabulary of Americans by the late 1980s, rolling from their tongues as if they had been saying the two Russian words forever.

“Demagoguery, while deeply disappointing as it is being manifested by Trump and his supporters, is neither new nor fatal to American politics. It is also not surprising when people feel that politics is a rigged game they can’t possible win at under the normal rules of the political elites.”

I admit over the last four years, I have reflected many times on the line, “”If Donald Trump wins the presidency in November, the world won’t end,” and wondered if I was being too optimistic because there have been days and nights with Trump when well, Trump, is Trump. And that can indeed be a scary thing.

My friend Bernie Lunzer from back in my Newspaper Guild union days from 1997 to 2001 perhaps put it best yesterday, writing, “Central frustration – we won’t change Trumpists by laughing at them or telling them they’re stupid. I share those feelings but they don’t help. They are motivated by other things. Maybe we can’t change them because their base motivation is racism? So then they are simply enemies? We still need to do something other than acting smarter and sanctimonious. I don’t have answers. But do take this election as serious.”

This reminds me indirectly of an article Thomas Frank penned for The Guardian and published on Nov. 6, 2016 – just two days before the last presidential election (https://www.theguardian.com/commentisfree/2016/nov/06/republicans-and-democrats-fail-blue-collar-america) headlined, “The Republicans and Democrats failed blue-collar America. The left behind are now having their say.” Frank, a political analyst, historian, journalist and columnist, is also the founding editor of The Baffler magazine, and author of the 2004 book, What’s the Matter with Kansas? as well as Listen, Liberal: Or, What Ever Happened to the Party of the People? published in 2016.

Do better.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

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COVID-19

Holy hyperbole, a.k.a. ‘HOLY MOTHER OF GOD – the new coronavirus is a 3.8!!! … It is thermonuclear pandemic level bad’

Eric Feigl-Ding’s Jan. 20 tweet on Twitter was one of the first to set off COVID-19 pandemic alarm bells. He is a Washington, D.C.  epidemiologist and health economist, and is currently a visiting scientist in the Department of Nutrition at the Harvard University T.H. Chan School of Public Health.

“HOLY MOTHER OF GOD – the new coronavirus is a 3.8!!!” Feigl-Ding’s tweet read. “How bad is that reproductive R0 value? It is thermonuclear pandemic level bad – never seen an actual virality coefficient outside of Twitter in my entire career. I’m not exaggerating.” The estimate of the virus’s contagiousness is captured in a variable called R0, or basic reproduction number for COVID-19, and is a key number used in infectious disease modelling for estimating pandemic growth rate. An R0 of 3.8 meant that every person who caught COVID-19 would transmit it in turn to almost four other people.

Feigl-Ding, 37, had tweeted after reading a paper called “Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions,” published on Jan. 23, and providing an early estimation of epidemiological parameters and epidemic predictions using case information from Chinese cities and other countries from Jan. 1-22 to fit a mathematical model to estimate outbreak parameters.

Still, there were problems with Feigl-Ding’s tweet, as Alexis C. Madrigal, a staff writer at The Atlantic, noted just eight days later in a piece headlined, “How to Misinform Yourself About the Coronavirus: Even if you avoid the conspiracy theories, tweeting through a global emergency is messy, context-free, and disorienting” (https://www.theatlantic.com/technology/archive/2020/01/china-coronavirus-twitter/605644/), which appeared online Jan. 28.

Feigl-Ding is in no way an unintelligent man or incompetent epidemiologist; by all accounts he is quite the contrary in both disposition and abilities. Nor is this in any way to suggest the COVID-19 pandemic, which hadn’t even been designated a “public health emergency of international concern” (PHEIC) by the World Health Organization (WHO) on Jan, 20 [that would come Jan. 30], much less a global pandemic [that would come March 11] was not worthy of a five-alarm fire bells general wake-up call or tweet even back then: it was.

His work focuses on the intersection of public health and public policy. Feigl-Ding has published in leading journals, including the New England Journal of Medicine, Journal of the American Medical Association, The Lancet, and Health Policy. In 2018, he unsuccessfully sought the Democratic nomination to run for the party in Pennsylvania’s 10th Congressional District, located in the south-central region of the state, and encompassing all of Dauphin County, as well as parts of Cumberland County and York County, including the cities of Harrisburg and York. But in his enthusiasm to tweet, he omitted some context, which he now regrets, he says. What he inadvertently omitted primarily were facts such as other infectious diseases, say measles for instance, also have very high R0 numbers (R0s for measles range from 12 to 18), and by the time he tweeted about the paper, the researchers had already lowered their R0 estimate from 3.8 to 2.5. “And R0, for that matter, is not the be-all and end-all of the danger of a virus,” Madrigal points out “Some highly transmissible diseases are not actually that dangerous.”

Madrigal also rightly observed that “one of the realities of the current information ecosystem” is that while “out-and-out conspiracies and hoaxes will draw some attention, it’s really the stuff that’s close to the boundaries of discourse that grabs the most eyeballs. That is, the information that’s plausible, and that fits into a narrative mounting outside the mainstream, gets the most clicks, likes, and retweets. Bonus points if it’s sensational or something that someone might want to censor.” When Twitter launched in March 2006, its timeline structure was simple: Tweets were displayed in reverse chronological order. In other words, each user’s feed contained tweets from their followers, from the most recent tweets onward. For “top tweets” now, Twitter uses an algorithm-powered feed organized by ranking signals. In addition to ranked content from followers, the feed will sometimes feature “who to follow” suggestions and, and content from other accounts. Users can also provide feedback on content shown in the feed by selecting “show less often.”

In an April-June 2017article in ASA footnotes, a publication of the American Sociological Association, R. Tyson Smith, a visiting assistant professor of sociology at Haverford College in Haverford, Pennsylvania, who conducts research in the areas of health, gender, social psychology, criminal justice, and the military, suggested, “Twitter is arguably the best way to reach the greatest number of people, in the quickest fashion, and in the least mediated way.”

Probably still true, but not necessarily always a good thing for academics perhaps, as Eric Feigl-Ding quickly discovered to his chagrin.

In all fairness, who among us hasn’t hit the send button on a tweet, email, Facebook post, or other social media platform expression, a tad too soon in retrospect? Not I, I admit.

Think? Yes. Send? Maybe – but only after a very long pause, which on most social media platforms, and perhaps especially on Twitter, is about as likely as successfully asking a multi-line slot machine player to ease up to dampen some of the audiovisual feedback.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

 

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COVID-19, Pandemics

Hope in a dangerous time: Projected peak in daily deaths and hospital resource use reached or at hand for U.S.

The Institute for Health Metrics and Evaluation (IHME) is an independent population health research center at UW Medicine, part of the University of Washington, that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. While there is no shortage of models to look at, IHME’s infectious disease modelling for estimating the COVID-19 pandemic growth rate and basic reproduction number (R0) for the United States has been among the best.

With that in mind, here are two reasons for hope this Easter Sunday 2020, although the payoff will only come later, so be prepared to wait until at least June, maybe even July, because this is going to be a case of delayed gratification, measured in months, not days:

  • It has been one day since projected peak hospital resource, including all beds, intensive care unit (ICU) beds, and invasive ventilators in the United States on April 11;
  • It has been two days since the projected peak in daily deaths on April 10 of 1,983 deaths (the actual number was slightly higher, 2,056);

While models differ on peaks, the United States is close to its peak of the novel coronavirus disease, Food and Drug Administration Commissioner Dr. Stephen Hahn said on ABC’s This Week earlier today.

Canada’s pandemic is in earlier stages. Many countries reached their first 500 cases before community transmission started in Canada.

Like any mathematical model, there are caveats and disclaimers to be noted. The Institute for Health Metrics and Evaluation model prominently notes that it is making its “COVID-19 projections assuming full social distancing through May 2020.” Assuming “full social distancing” from now through May 31 strikes me as one very big assumption. Still, the U.S. government’s early modelling suggested that only 50 per cent of Americans would observe the stringent federal social distancing guidelines, currently in effect until April 30, when in actuality U.S. Surgeon General Dr. Jerome Adams said last week that a much larger number – 90 per cent – were observing the guidelines.

My best guess is the United States will reboot the economy too quickly in early May, against public health advice, and there will be a resurgence of COVID-19 cases, but the resurgence, while regrettable and wholly unnecessary, will be a temporary setback, delaying, but not wiping out the gains being made right now through social distancing, and shutting down the economy, with the exception of “essential” work,  whatever that really means from state-to-state, community-to-community.

I wrote a piece Jan. 23 headlined, “The fire this time? Pandemic prose, and waiting and watching for the ‘big one’  (https://soundingsjohnbarker.wordpress.com/2020/01/23/the-fire-this-time-pandemic-prose-and-waiting-and-watching-for-the-big-one/) where I wondered, “How quickly we could we make a trip back to a modern-day equivalent to the Dark Ages of the 5th to 11th centuries?” I think the early evidence we have seen in the 10 weeks since then suggests not so very long, and that the best parallel in modern times will turn out to be the “Spanish Flu” influenza pandemic of 1918, although it killed about 675,000 people in the United States, compared to COVID-19, which will likely kill about 10 times less than that.  The Institute for Health Metrics and Evaluation in Seattle projects 61,545 COVID-19 deaths by Aug. 4. Well less than then the 1918 influenza pandemic, but a greater number of Americans killed than in the Vietnam and Afghan conflicts combined.

The National Center for Medical Intelligence (NCMI) at Fort Detrick, Maryland warned as far back as last November that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population. The report was the result of analysis of wire and computer intercepts, coupled with satellite images.

The medical intelligence (MEDINT) cell within Canadian Forces Intelligence Command (CFINTCOM) gave a similar warning in January.

In the summer of 2005, the Center for the History of Medicine at the University of Michigan in Ann Arbor was asked by the Defense Threat Reduction Agency (DTRA) to conduct research into and write a report on American communities that had experienced extremely low rates of influenza during the infamous 1918-1920 so-called “Spanish Flu” influenza pandemic.

They selected seven communities that reported relatively few if any cases of influenza, and no more than one influenza-related death while non-pharmaceutical interventions (NPI) were enforced during the second wave of the 1918-1920 influenza pandemic. The communities were:

  • San Francisco Naval Training Station, Yerba Buena Island, California;
  • Gunnison, Colorado;
  • Princeton University, Princeton, New Jersey;
  • Western Pennsylvania Institution for the Blind (WPIB), Pittsburgh, Pennsylvania;
  • Trudeau Tuberculosis Sanatorium, Saranac Lake, New York;
  • Bryn Mawr College, Bryn Mawr, Pennsylvania;
  • Fletcher, Vermont

Over time, it will be interesting to see what, if any, COVID-19, outliers there are in the United States. Internationally, there are a few countries in Africa that still have no cases, but the bulk of COVID-19-free countries are in the Pacific. Nations such as Vanuatu, Palau, Solomon Islands, Tonga and Samoa have been protected to date by their remoteness.

According to the most recent Institute for Health Metrics and Evaluation projections, subject to the caveats and disclaimers mentioned earlier, deaths per day should drop to 976 in the United States by May 1; 47 on June 1, and none after June 19, as a dread spring gives way to a summer of hope.

Here in Canada, the Public Health Agency of Canada says that ‘Prior to stronger public health measures, each infected person (case) in Canada infected 2.19 other people on average.”  When each COVID-19 infected person infects fewer than one person on average, the pandemic will die out, the agency says. “Models cannot predict what will happen, but rather can help us understand what might happen to ensure we can plan for worst cases and drive public health action to achieve the best possible outcome.”

Any backsliding, of course, in April and May on physical (social) distancing, self-isolation of cases, quarantine of contacts, and preventing importation of infection from other countries internationally through border controls and nationally through domestic travel restrictions, and all bets are off.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

 

 

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Compassion, Empathy

The World is now Mister Rogers’ Neighborhood

The World is now Mister Rogers’ Neighborhood.

The daily educational program for children debuted on PBS in 1968, after two smaller runs – in 1961 with Misterogers on the CBC, and in 1966 with Mister Rogers’ Neighborhood on the Boston-based Eastern Educational Network, a forerunner to the Public Broadcasting Service. Every day, Fred Rogers would get home from work, put on a cardigan and sneakers, and talk to his neighbours, delivering lessons on friendship, love, kindness, acceptance, and more. Viewers were an important part of the neighborhood, too. Now, the world is a great social laboratory for putting the ideas and values of Fred Rogers into everyday practice in a time of life and death a time of the continuous present, without past or future.

As the world hits bottom – which may paradoxically be when it hits the peak for COVID-19 cases, which in the United States, now the world epicentre of the coronavirus pandemic, may come in about two weeks time in mid-April – there will be, and already are around the world, early signs of recovery of a better us, and of a better world.

It is still both late days and early days simultaneously, but the 85-year-old argot of personal recovery can be applied now to public recovery, as well, I think: “One day at a time” and “just for today” should no longer be thought of as just private lifesaving advice for recovering alcoholics and addicts, but a public signpost for all for the rebuilding task that will be ahead, one person and one community at a time. The 12-step movement, dates back to June 1935, when Bill Wilson, a failed New York City stockbroker, and Dr. Bob Smith, an Akron, Ohio physician, both recently or newly sober (particularly Dr. Bob, although Bill W. wasn’t that many months ahead of him on the sobriety curve) became friends and Alcoholics Anonymous (AA) was born in Ohio. Both sayings, “one day at a time” and “just for today” are used interchangeably as both verbal slogans and written mottoes, the former coming from AA, and the latter, also a prayer to some, and a poem to others, from Narcotics Anonymous (NA), formed in 1953. They have proved useful as something pithy and easily grasped by the still-suffering in the early days of recovery, grasping for something tangible to hang onto for just one more second, minute, hour or day, grasping for those words every bit as much as a drowning person grasps for the rung on the ladder or life preserver.

Which is probably as good a description as any of the COVID-19 world we live in today, with a March that has birthed a dread spring in a month that seemingly never ends, where waking up every morning in March 2020 has been like having the voice of Capt. Jean-Luc Picard as a personal alarm clock inside my head, uttering such classic Star Trek lines as “damage report’ and “Red alert. All hands stand to battle stations” (https://www.youtube.com/watch?v=wV30YwXaKJg&feature=share&fbclid=IwAR1c8IoTcgboKQu3u12DNJ_rRNzvH6k0ZNDK3p3b3KLEGBIZLJ4ktx6XBMI).

Fortunately, Gene Roddenberry has been a reminder to me since 1966 that character, courage and goodness are not proprietary virtues of the religious, non-religious, believers or non-believers. We all can and do share in them. And we’re going to need those virtues, and all of us, believers and non-believers, in the days ahead. In this month of unbelievable sounds and images, where the next day’s sounds and images routinely exceeds the horror and scale of the previous day, two stand out for me, one very well known, the other not so much. The first is the image of the floating hospital United States Navy Ship (USNS) Comfort as it entered New York Harbor March 30 during the Biological Armageddon coronavirus pandemic response in New York City. Mike Segar’s photograph for Reuters illustrates why it is often said “a picture is worth a thousand words.”

Ordered to “lean forward,” a military term familiar to those who serve in the United States Navy, meaning the willingness to be aggressive, to take risks, the USNS Comfort (T-AH-20), homeported at Naval Station Norfolk, Virginia, sailed from port up the Atlantic seaboard Saturday. What those sailors, military doctors and nurses, officers, enlisted personnel and civilians aboard the Comfort must have been thinking as they answered the call of duty and sailed north into a Biological Armageddon. The Comfort will provide relief for New York hospitals by taking on non-COVID-19 cases and allowing the hospitals to focus on the most critical patients suffering from the virus.

The second that stands out for me is a brief audio clip I heard on Twitter March 24, the day after the “surge” hit New York City. Tim Mak is National Public Radio (NPR’s) Washington investigative correspondent – and an emergency medical technician (EMT), which is how he got the message. It is the most chilling on the pandemic I have heard to date. I think that’s because of both the subject matter, but also because there is something eerie about that electronically-generated voice on the automated message that went out:

“This an emergency message. This is a priority request for D.C. MRC volunteers (District of Columbia (DC) Medical Reserve Corps (DC MRC)…” (https://twitter.com/i/status/1241471610395267084)

The automated message went out March 21 to health care professionals in Washington, D.C.

The District of Columbia (DC) Medical Reserve Corps (DC MRC) supports the DC Department of Health (DC Health) in its role as lead for public health and medical emergency preparedness, response and recovery by recruiting, training, and deploying medical and non-medical volunteers to assist with planned events and emergencies.

Roddenberry, a Southern Baptist-turned humanist, held and spoke a truth held and spoken by another Southern Baptist, the Rev. Martin Luther King Jr., and others before him: the universe unfolds as it indeed should, and the arc of the moral universe is long, but it bends toward justice. A perfect illustration of this is “Lower Decks,” the 167th episode of the series and the 15th episode of the seventh and final season, which originally aired on Feb. 7, 1994. With remarkable simplicity and brevity, these five sentences from Picard are offered in a ship-wide address from the captain’s ready room off the bridge when Ensign Sito Jaxa, a Bajoran Starfleet officer serving aboard the USS Enterprise, is killed on a covert mission in the line of duty (https://soundingsjohnbarker.wordpress.com/2018/09/24/church-of-star-trek-the-next-generation-and-the-moral-arc-of-the-universe/):

“‘To all Starfleet personnel, this is the Captain. It is my sad duty to inform you that a member of the crew, Ensign Sito Jaxa, has been lost in the line of duty. She was the finest example of a Starfleet officer, and a young woman of remarkable courage and strength of character. Her loss will be deeply felt by all who knew her. Picard out’.” (https://www.youtube.com/watch?v=40XUt1HU5H8&feature=share)

Writing a decade after Bobby Kennedy’s assassination in his 1978  book, Robert Kennedy and His Times, the American historian, Arthur M. Schlesinger, commenting in the foreword, said Kennedy “possessed to an exceptional degree what T. S. Eliot called an ‘experiencing nature.’ History changed him, and, had time permitted, he might have changed history. His relationship to his age makes him, I believe, a ‘representative man’ in Emerson’s phrase – one who embodies the consciousness of an epoch, who perceives things in fresh lights and new connections, who exhibits unsuspected possibilities of purpose and action to his contemporaries.”

Such men and women arise from unexpected and unlikely places.

Abraham Lincoln, who in a speech delivered on June 17, 1858, at the close of the Republican state convention at the Illinois State Capitol in Springfield, reaching back to the first century and the words of the Apostle Saint Mark the Evangelist (“And if a house be divided against itself, that house cannot stand”) gave what would become one of the most famous speeches in American history.

Said Lincoln on that late spring day: “A house divided against itself cannot stand. I believe this government cannot endure permanently half slave and half free … It will become all one thing, or all the other.”

Five years later, he gave the most famous speech in American history. Republican President Abraham Lincoln’s 273-word “Gettysburg Address,” lasted less than two minutes, and was delivered at Gettysburg, Pennsylvania on Nov. 19, 1863. Edward Everett, the former senator and secretary of state – and brilliant Massachusetts orator – who, without notes for two hours, preceded President Lincoln in speaking at Gettysburg, gave a brilliant speech that day, as expected, but Lincoln happened to follow with what we now remember as the “Gettysburg Address.” Lincoln’s speech immediately struck a chord and remains the best-known speech in American history more than 150 years after it was given. Everett wrote a letter to Lincoln the day after their speeches, saying, “I should be glad, if I could flatter myself that I came as near to the central idea of the occasion, in two hours, as you did in two minutes.”

Said Lincoln that long-ago November day: “Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

“Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

“But, in a larger sense, we can not dedicate – we can not consecrate – we can not hallow — this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us – that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion – that we here highly resolve that these dead shall not have died in vain – that this nation, under God, shall have a new birth of freedom – and that government of the people, by the people, for the people, shall not perish from the earth.” (https://www.youtube.com/watch?v=U2a-S3rjDBw&feature=share&fbclid=IwAR1LKNwMramCkVoodunLwy1SGqQFCBsejS5cLU9Q0TgVYPPPGs7pFUBxdJw)

I wrote about AIDS in the 1980s. And I remember the climate of fear in 1986 that reporters were not untouched by when we were assigned stories that meant going inside provincial reformatories and federal penitentiaries to interview HIV-positive prisoners in Ontario. The high callings of journalism are to speak truth to power, as well as comfort the afflicted and afflict the comfortable. But exactly how AIDS was transmitted in terms of morbidity and mortality was not completely understood 35 years ago. So I watched with surprise and unexpected admiration as C. Everett Koop, an evangelical Christian, who served as surgeon general under U.S. Republican president Ronald Reagan from 1982 to 1989, and was well known for wearing his uniform as a vice admiral of the United States Public Health Service Commissioned Corps, had the singular political courage to speak the truth about the science of AIDS as our knowledge increased. According to the Washington Post, “Koop was the only surgeon general to become a household name” (https://soundingsjohnbarker.wordpress.com/2015/01/15/empathy-and-compassion-are-the-gifts-of-our-shared-human-experience/).

Former U.S. president Bill Clinton, a Democrat, also got it right in his first inaugural address Jan. 20, 1993 when he said, ”by the words we speak and the faces we show the world, we force the spring … we recognize a simple but powerful truth – we need each other. And we must care for one another.” He went on to say, we are “tempered by the knowledge that, but for fate, we – the fortunate and the unfortunate – might have been each other.”

Guardian columnist George Monbiot argued yesterday that power has “migrated not just from private money to the state, but from both market and state to another place altogether: the commons. All over the world, communities have mobilized where governments have failed.”

Joanne Rogers is 92 and the widow of Fred Rogers. She has been getting a lot of telephone calls at her apartment in Pittsburgh, says Los Angeles Times staff writer Amy Kaufman in a March 29 story wondering what Mister Rogers, who died in 2005 at the age of 74, would say and do to cope with the COVID-19 coronavirus pandemic?

“When Fred was a boy and scary things would happen to him, his mother used to tell him: ‘Freddy, look for the helpers.’ So he would have talked about the helpers,” Joanne said.

“Helpers,” she explained, are those individuals who – even at the height of global chaos – try to find a way to ease the burden for others; folks such as doctors, nurses, grocery store cashiers, and mail carriers.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

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Pandemics

Misplaced patriotism and public health propaganda are no disinfectants for a pandemic

John M. Barry’s 2004 book The Great Influenza: The Story of the Deadliest Pandemic in History, chronicles the 1918-19 Spanish Flu pandemic. It is a compelling read, and placenames such as Haskell, Kansas, an isolated and sparsely populated county in the southwest corner of the state, remain etched in my mind.

Barry also serves as an adjunct member of faculty at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

But what really struck me was the very, very rapid breakdown in public order, Barry chronicles, despite official protestations to the contrary.

Nurses, who were right on the front lines, and truly, truly heroic in the earliest stages of the pandemic, in many cases soon just stopped coming to work. Many, of course, were too sick to, gravely ill or dying themselves, but many who were still well stopped coming to work out of fear of becoming infected themselves, and perhaps also infecting their loved ones. The same happened across many different public offices. Can any of us really know what we would have done faced with similar circumstances? I think not.

Government in many cases, and particularly at the municipal level, pretty much ceased to function – and that happened very, very quickly. State and provincial governments weren’t much better in many cases, and federal governments were, to be very charitable, slow off the mark. The international institutions we have now, for the most didn’t exist in 1918.

Philadelphia is one of Barry’s chilling examples that has stayed with me. Things were so bad there in the fall of 1918, when the Spanish Flu pandemic arrived in the city, that a group of volunteer women, holding no official titles or offices, who lived on Philadelphia’s “Main Line,” home of the city’s old money and prestige, essentially took over the key functions of the city government and co-ordinated Philadelphia’s response to the pandemic.

In essence, the Ladies Auxiliary, albeit a very well off, and a very well connected one, saved the day in Philadelphia in 1918, but it was a very close thing indeed.

But how did things get so bad in Philadelphia in the fall of 1918?

On Sept. 28, 1918, despite sound advice and warnings to the contrary, Philadelphia public health director Wilmer Krusen insisted on allowing a Fourth Liberty Loan Drive parade, with some 200,000 people jamming Broad Street, “cheering wildly as the line of marchers stretched for two miles.” It was after all the patriotic thing to do in the final Allied push to defeat the Central Powers and win the First World War.

“Within 72 hours of the parade, every bed in Philadelphia’s 31 hospitals was filled,” Kenneth C. Davis wrote in Smithsonian magazine in September 2018. “In the week ending October 5, some 2,600 people in Philadelphia had died from the flu or its complications. A week later, that number rose to more than 4,500. Allison C. Meier in an article for Quartz last November noted that historian James Higgins, writing in Pennsylvania Legacies, observed that by the first week of October 2018, roughly five weeks into the outbreak, “Philadelphia’s mortality rate accelerated in a climb unmatched by any city in the nation –perhaps by any major city in the world.”

We really are not very particularly good at learning the lessons of history. Or when we think we have, we often draw the wrong lessons. Misplaced patriotism. Public health propaganda. These are no disinfectants for a pandemic.

The original name of the new coronavirus was provisionally known as Novel Coronavirus 2019-nCoV, before the World Health Organization (WHO) adopted the name COVID-19.  The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

The revised World Health Organization’s case fatality rate earlier this week of 3.4 per cent from 2 per cent for COVID-19 on March 3 is a 70 per cent fatality increase.

“I think the 3.4 per cent is really a false number,” U.S. President Donald Trump told Sean Hannity, one of his favourite conservative Fox News hosts, in a phone interview broadcast live March 4.

In the early 1980s, I watched with surprise and unexpected admiration as C. Everett Koop, an evangelical Christian, who served as surgeon general under U.S. Republican president Ronald Reagan from 1982 to 1989, and was well known for wearing his uniform as a vice admiral of the United States Public Health Service Commissioned Corps, had the singular political courage to speak the truth about the science of AIDS as our knowledge increased. According to the Washington Post, “Koop was the only surgeon general to become a household name.”

Who will be the next C. Everett Koop, with the courage to speak truth to power, afflicting the comfortable, while comforting the afflicted? Someone Ike the late Dr. Li Wenliang, the whistle-blower ophthalmologist who sounded the alarm after contracting the virus while working at Wuhan Central Hospital.

There have been some exemplary public health responses to the COVID-19 public health emergency of international concern, such as those of Dr. Bonnie Henry, British Columbia’s, provincial health officer, whom André Picard, the health columnist at The Globe and Mail, earlier today described as setting “the standard for public health communication. Too often, public officials are dispassionate and robotic. Using clear language and showing genuine emotion makes your message more relatable and impactful.”

And then there have been the less than exemplary public health responses – or perhaps more accurately – lack of response.

When is a pandemic not a pandemic? When the World Health Organization (WHO) has Dr. Tedros Adhanom Ghebreyesus as its director-general apparently.

“I think it’s pretty clear we’re in a pandemic and I don’t know why WHO is resisting that,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Devi Sridhar, a professor of global public health at the University of Edinburgh who co-chaired a review of WHO’s response to the 2014-16 Ebola outbreak in West Africa, said a pandemic declaration is long overdue.

While none of this is easy when we don’t yet have a clear idea of the transmissibility and virulence of COVID-19, it is equally true the absence of true, timely public health information and honest decision-making, we risk further fostering a not insignificant climate of international government and institutional distrust, leading to social media platforms being lit up with stories such as the ones suggesting that the novel coronavirus is a genetically engineered biological weapon with a protein sequence included elements of HIV, the virus that causes AIDS either a Chinese one that had escaped from a laboratory in Wuhan or an American one inflicted on Wuhan, or that COVID-19 is perhaps some kind of so-called “false flag” operation to distract us from someone or something else.

You can also follow me on Twitter at: https://twitter.com/jwbarker22

 

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