Starting a new week these days can be challenging. Every time it is a welcome back to another week in pandemic mode! You start asking: “Have I been staying home as much as I could, was I washing my hands for 20 seconds every time, am I practicing social distancing?” This is just an example of how COVID-19 has disrupted our lives. How did this happen?
Such a pandemic has actually happened twice since the beginning of the 21st century. Both times a coronaviruse crossed the species barrier to cause deadly pneumonia in humans.
The first one was SARS-CoV, which emerged in the Guangdong province of China in 2002 and affected 26 countries. From November 2002 through July 2003, 8,098 people became sick worldwide with severe acute respiratory symptoms. They had either pneumonia or severe respiratory distress syndrome.
The second one was MERS-CoV, which emerged in the Arabian Peninsula in 2012. From 2012 through the end of November 2019, there were 2494 laboratory-confirmed cases, and 858 associated deaths.
As a result, in April of 2018, the World Health Organization (WHO) established a priority list of pathogens, including Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and Disease X. The last one was defined as a disease with a pandemic potential caused by an unknown pathogen. The picture below shows a timeline for these diseases (Shuai Xia et al., Cell Research 2020).
The disease X seems to have finally appeared in late December 2019 in Wuhan, China – although there is an ongoing debate on the time and location of its first appearance. On February 11, 2020, WHO designated the virus as SARS-CoV-2 and the disease it causes as COVID-19. As of April 6, 2020, SARS-CoV-2 has infected more than 1,3 million people and caused 70,000 deaths worldwide. Today, with more than 330,000 infected, the US leads all other countries, including China, Spain, Italy, Germany, France, and other hard-hit nations.
The response of various countries, driven by local political and cultural norms, has been very different. However, people everywhere react in a similar way at the individual and societal level. That reaction can be simplified in 5 phases.
In phase one (incubation). People are unaware to accept the danger. They continue with normal life. For example, when a state of emergency was imposed in China, people paid little attention.
In phase two (panic). People become aware of the danger and some take action. One of the first things they do is stockpiling. People start hoarding staple foods, conserves, disinfectants, and for some strange reason, toilet paper. A wild-west behavior starts spreading, mask deliveries must be monitored by the police. Entertainment, travel, and restaurant businesses decline or come to a standstill. Media consumption spikes as people get hungry for the latest update, or start bingeing online games, Youtube videos, movies etc.
In phase three (isolation and depression). The government requires nonessential workers and the more vulnerable to shelter at home, self quarantine or lockdown. Schools, bars, restaurants, movie theaters and other places of public gathering are closed down. Knowledge workers work from home, and students attend classes using web conferencing and electronic tools. As time goes by, social isolation starts having an impact on the psyche of people.
In phase four (reflection and re-thinking). Introspection takes a hold, as life slows down. This can lead to search for new perspectives and new opportunities.
In phase five (back to normal). Normalcy inevitably comes, even though it is sometimes difficult to believe. Hopefully the society will have become wiser and better prepared to deal with the next pandemic, that is sure to come.
How are we (my husband and I) experiencing it the current COVID-19 pandemic personally? As of April 11, we have passed the first two phases and are in the middle of phase three and practicing “shelter-in-place”.
Phase 1 for us was probably early January. Global spread of COVID-19 was on the news, and Wuhan was in lockdown. Personally, we haven't paid much attention. We were planning a trip to Joshua Tree National Park in Southern California. The trip was to celebrate the commencement of Naim’s retirement. But the day before the trip, we canceled it abruptly to avoid coronavirus exposure at airports and in flight. Instead, we went on a road trip to Yellowstone National Park! Check out Naim’s story Yellowstone story or my photo album WinterInYellowstone.
Phase 2 started for us while we were driving back to Minnesota. But the situation became clear to us when we got home on March 9th. By that time, no hand sanitizer was to be found anywhere – let alone toilet paper. Fortunately, most other items were available, and we stocked up reasonably. The hand sanitizer problem was readily solved with a bottle of “Pure Proof” (75.5% alcohol by volume).
Phase 3 started on March 27, when “shelter in place” became effective for the entire state. Both of us are retired anyway but we miss our daily activities and routines. In our collective attempt to flatten the curve, grocery shopping has become a challenge. Now we shop only biweekly, instead of every other day. I miss getting a cappuccino with a fresh croissant after shopping. There are other things that have changed – both the obvious and the subtle. For example, before going shopping, now we have to arm ourselves first with gloves, masks and hand sanitizer. We also find ourselves wondering whether we can touch the vegetable, or why a person is standing so close, etc.
In a relatively thinly populated region like ours, shelter in place does not preclude going to parks or walking streets. We have been taking full advantage of the sunny, spring weather to explore the parks nearby. Here is an excellent list of regional parks just in the metro area Twin-Cities-Regional-Parks-System. This picture shows a sign in six different languages, placed at parks and playgrounds to remind people that they need to maintain social distance (in English, Spanish, Hmong, Somali, Hindi?, and Lao).
There are other aspects of our new daily lives that are less pleasant, for example getting a video conferencing app to work. I have tried Skype, Zoom, and Adobe Connect. But it is always the same: Can you hear me? Can you see me? How is the mute button working? How do I turn on the camera? It takes at least 10 min before the meeting can start without somebody’s voice missing or the video freezing. With millions of people working and learning from home during the pandemic it's a lot for the internet to handle.
Life in phase 4 and 5 are in front of us. We can't look into a crystal ball to see the future, but this is what is predicted. The virus will become practically harmless when roughly 60% of the population will have acquired immunity by having contracted the disease and recovering. That's what has happened with all viruses in previous epidemics.
The lesson we can learn from this disease X
Viruses are everywhere. Humans have been battling viruses since before our species had even evolved into its modern form. The deadliest flu pandemic, sometimes called the Spanish flu, began in 1918 and sickened up to 40% of the world's population, killing an estimated 50 million people. New strains of influenza have emerged from livestock farming, swine, cattle and poultry. Ebola, SARS, MERS and now Covid-19 have been linked to wildlife.
Yet the world’s strategy for dealing with pandemics is inadequate. Across the board, from politicians to the public, we treat pandemics as a disaster-response issue: We wait for them to happen and hope a vaccine or drug can be developed quickly in their aftermath. But even as Covid-19 rages, there still is no vaccine available for the SARS virus of 2002-3, nor for HIV/AIDS or Zika or a host of emerging pathogens.
To escape from the age of pandemics, we’ll need to treat them as a public health issue and focus on prevention. A radical shift is needed to develop vaccines and drugs, so that entire groups of pathogens are targeted instead of individual pathogens that are already known. The “Disease X” was added to the WHO's priority list two years ago, knowing that “X” is likely to be a currently unknown pathogen.
This year we are celebrating Easter in the midst of a coronavirus pandemic. Shelter in place and social distancing rules mean families and friends can't celebrate in person together (picture was taken a few years ago at the family Easter coffee table). For many families, dyeing eggs might be on hold due to limited supply of eggs currently. Here and in Germany, most most public events and services are canceled. Included are the traditional Easter fires in my hometown Wernigerode. However, we are grateful to be healthy and that we can connect to our family and friends in some way. We're going through this pandemic together and we have to stay creative during this time of separation.