What to do During a Global Infection: Part 3

Just three years ago, Laura Spinney's Pale Rider:  The Spanish Flu of 1918 and How It Changed the World was published.  Was it a best seller?  Did anyone read the book reviews?

Seems odd to quote the reviewers, but people were warned:

"Spinney's detailed discussions includes the why and how, the human devastation, and the effects on institutions and world affairs.  Now nearly 100 years removed from the Spanish flue, Spinney wonders what lessons it has imparted that might help us prepare and deal with the next, inevitable influenza pandemic."  Booklist

"Spinney evokes a world that seems farther from us than a mere century, and also uncomfortably close ... if we can;t reconstruct our memories of the Spanish flu quickly enough, millions more will die in the next pandemic."  The Tyee

"For all the tragedies and upheavals the book portrays, Pale Rider actually paints an oddly hopeful picture of a populations more sensitized to early warnings and largely more willing to heed them."  The National (not)

Spinney notes that a pandemic is a social phenomenon as much as it is a biological one; it cannot be separated from its historic, geographical and cultural context (I would add its economic and political context as well).

Spinney introduces her book with a recap of how viruses move from animal hosts to human; she then points out that historic pandemics, for example, the Plague of Justinian, a pandemic bubonic plague that killed approximately 25 million people in the sixth century AD and led to vast tracts of farmland being abandoned and forests growing back which led to the earth cooling because reforestation captured so much carbon dioxide, the opposite of today's greenhouse effect.

One of the themes she explores is the need of humans to know where the flu came from.  Is this an urge to know whom to blame?  And today's political sensibilities:  not to call it the China flu and China's attempts to prevent the rest of the world to know of its outbreak.  Even in 1918, the wondrous WHO issued guidelines stipulating that disease names should not make reference to specific places or people.  Glad to know they have a long, long history of political correctness

Other vignettes echo current impressions:  A satirical magazine in Brazil expressed fears that the authorities would exaggerate the danger posed to old people to justify a scientific dictatorship violating people's civil rights.  She cites football (soccer) being played to empty stands and all night life ceasing.

Another thought provoking insight she has is:  "Since disease is broadly defined as the absence of health, whether or not you recognize a set of symptoms as a disease depends on your expectations of health."  Align this thought against the evidence of COVID impacting more the "seriously ill with pre-existing conditions and minority communities."  What degree of "health" do both populations have?

A mere 76 pages into her book, Spinney recounts how people suspected that the Spanish flu arose from a secret program of biowarfare conceived by one of the participants in WW1.  (How about that lab in Hunan?)

She explains the bell curve of the disease, social distancing, the relative "effectiveness of masks and disinfectants, the notable immunity of school-age children.  She cites Alfred Crosby who argued that democracy was unhelpful in a pandemic:  the demands of national security, a thriving economy and public health are rarely aligned and elective representative defending the first two undermine the third. She posits that as the media began to censor itself (or display bias) compliance drops off even further.

By chapter 14, Spinney had reprised all the H1N1 strains and mutations, called the next pandemic inevitable and concluded that "since the method of virus reconstruction in on the Net, its production by rogue scientists is a real possibility.

And there are post-flu effects:  chronic fatigue syndrome, possible famine, painful readjustment, demoralization, and lawlessness.  On the other side of the coin, she points out that the higher the death rate, the higher the growth in per capita income in the 1920s that was not new wealth but the indication of society's capacity to bounce back after a violent shock.  The Spanish flu influenced art, literature and politics.

Her final section cites the US National Academy of Medicine that estimated there to be a 20% chance of four or more pandemics over the net 100 years.  "The only questions are when, how big, and what can we do to prepare ourselves?"  She cites unusual external factors to consider in predicting events:  El Nino, bird migrations, burning fossil fuels,  Her quote should be the basis of fall politics:  "Experience has shown that people have a low tolerance for mandatory health measures, and that such measures are most effective when they are voluntary, when they respect and depend on individual choice, and when the avoid the use of police powers."  Let that be an opening premise on the upcoming debates.

She also reminds us that the ones who bore the brunt of the Spanish flu were those living in ghettoes or at the rim and such victims find a way to express themselves in strikes, protest and revolution.

What to do During a Global Infection: Part 2 -- "Officialdom can never cope with something really catastrophic"

Then I read The Plague by Camus.  As fiction, this story was much more introspective, contemplative and interpretive.  What it shows, more than Defoe, is the effective global disease has on individual lives.

"Everybody knows that pestilences have a way of recurring in the world; yet somehow, we find it hard to believe in ones that crash down on our heads from a blue sky;  There have been as many plagues as wars in history; yet always plagues and wars take people equally be surprise."

"... in other words they were humanists:  they disbelieved in pestilences.  A pestilence isn't a thing made to man's measure; therefore, we tell ourselves that pestilence is a mere bogy of the mind, a bad dream that will pass away.  But it doesn't pass away and, from one bad dream to another, it is men who pass away, and the humanists first of all, because they haven't taken their precautions."

As Camus describes the actions taken by government, he is free to interpret the rational and likely effects:  "... measures enjoined were far from Draconian and one had the feeling the feeling that many concessions had been made to a desire not to alarm the public."

"The notice outlined the general program that the authorities had drawn up.  It included a systematic extermination of the rat population by injecting poison gas into sewers,  and a strict supervision of the water supply.  The townspeople were advised to practice extreme cleanliness, and any who found fleas on their person were directed to call at municipal dispensaries.  Also heads of households were ordered to promptly report any fever case diagnosed by their doctor and to permit the isolation of sick members of their families in special wards at the hospital."  A few pages later:  "That the regulations now in force were inadequate was lamentably clear.'

When Defoe writes at length about death counts and mass burials, Camus speaks eloquently on the personal effects.  "... the plague forced inactivity on them, limiting their movements to the same dull round .. and showing them day after day on the illusive solace of their memories ... the feeling of exile ... irrational longing to hark back to the past or else to speed up the march of time."

"... they came to know the incorrigible sorrow of all prisoners and exiles, which is to live in company with a memory that serves no purpose.  Even the past, of which they thought incessantly, had a savor only of regret ... with the man or woman whose return they now awaited .. they kept vainly trying to include the absent one ... and thus there was always something missing in their lives .  Hostile to the past, impatient with the present and cheated of the future."

"...the fact that they had been sentenced .. to an indeterminate period of punishment.  And while a good many people adapted themselves to confinement and carried on their humdrum lives, there were others who rebelled and whose one idea was to break loose for the prison house ... this feeling of being locked in like criminals prompted them sometimes to foolhardy acts."

Continuing to write of the disease long-term impact on individuals, Camus notes "the furious revolt of the first weeks had given place to a vast despondency, not to be taken for resignation .. a sort of passive and provisional acquiescence ... citizens had fallen into line, adapted to the situation because there was no way of doing otherwise ... listless, indifferent, and looking so bored ..."

Adding Camus to the recommended reading list for governmental policymakers might prove more difficult because he delves deeply into the impact the disease has on being separated from loved ones, finding new friends, trying to do one's job under adverse circumstances.  Maybe today, people are exposing these emotions more openly/anonymously on the Internet.  When considering whether to reopen schools, child psychologist are discussing the mental impacts of not learning socially; others report increases in domestic violence and adult depression.  Camus told you so.

What to do During a Global Infection: Part 1

It's not that I haven't been reading.  I have ... I just haven't been writing.

First, some general observations on COVID's impact on me personally.

1.  I prefer not to go to the grocery store because I don't like to wear masks that make the air I inhale hot and fog up my glasses.  (I met a man at a local garden store and when I gave these reason he replied, now you know why operating rooms are so cold.)  The unintended consequence of not shopping is I really don't want to cook any more.  I make the menu that is quickest to cook and can be made with whatever spices etc that are already in the frig or on the shelves.

2.  At first, I missed "window" shopping but now I could care less whether all the malls closed.  The world now belongs to Amazon (which I can actually remember when it only sold books), eBay, and ETSY.  What I might be giving up in style, I am gaining in variety of choices.

3.  Previously I thought that the neighborhood was finally investing in property improvement when the economy was going bust, but know I think many are just hiring handymen just to have a new face to see.  I fall readily into this category:  having the side lawn replaced; getting the garage repainted; and ordering the final facade of replacement windows.  The painter has three project going within two blocks and a different firm started on the house across the street yesterday.  The window salesman had a valise full of orders from earlier in the day.

But on to the numerous reviews.

What else to read now but Journal of the Plague Year by Daniel Defoe; The Plague by Albert Camus; and Pale Rider by Laura Spinney.

Defoe's history of London in 1664 clearly shows humanity has not changed for the wiser in 300+ years.  Governmental actions were exactly the same:  banning travel, imposing sheltering; closing shops and banning plays, casinos, music halls and dancing rooms; however, government officials moved the seat of power out of the city.  The responses of the populations were the same:  the rich leaving town for less infected areas; people not wanting to touch meat from the butchers and the butches not wanting to touch money payment; still gathering in taverns and churches.  Others acted impetuously, assembling carelessly, being foolhardy and obstinate.  The economy suffered as all manufacturing and merchandising stopped and trade died as others feared getting sick from exported goods.  As a corollary, Londoners tried to track what other nation had imported the disease to England.

"Surely never city, at least of this bulk and magnitude, was taken in a condition so perfectly unprepared for such a dreadful visitation, whether I am to speak of civil preparations or religious."  "... all trade, except such as related to immediate subsistence, was, as it were, at a full stop."

And as the plague eased up, "the morals of the people declined ...were more wicked and more stupid, more bold and hardened."  "... the distress of the poor was more now a great deal than it was before, because all the sluices of general charity were now shut."  "It was not the least of our misfortunes that with our infection, when it ceased, there did not cease the spirit of strife and contention, slander and reproach ..."

One of my most pronounced change from COVID is the recognition that being a nation of specialists, there are very few multi-disciplined or Renaissance people:  the public health experts seem to have never read history beyond science; politicians are doubly cursed, having neither studied biology nor historical literature.  Had someone assigned these three books as required reading before anyone tweeted or held a press conference, they could see history repeating itself, have a better understanding of how people would react, and what positive and negative effects all their decisions would have.  Or as Defoe stated this:

" I often reflected upon the unprovided condition that the whole body of the people were in at the first coming of this calamity upon them, and how it was for want ot timely entering into measures and managements, as well public as private, that all the confusions that followed ... which, if proper steps had been taken, might have been avoided."

When I worked at NYSDOH, I would attend multi-agency meetings to draft State disaster plans ... they all need to be revised again, like they were after Hurricane Sandy.