Monday, March 16, 2020

What do you do when a bear comes into your tent?

Hey Everybody,

I'm from Chicago, and a number of years ago, I dated a woman from a very rural western state; She was the durable frontierswoman type, and I was the urbane city-slicker. Thus, she thought my fear of lions and tigers and bears was hilarious, and she was kind enough to send me a book called "When Bears Attack". It had a picture of a very unhappy bear on the cover, and when I got that book, and read it, cover-to-cover, in one sitting, without blinking my eyes, fifteen years ago, one anecdote stands out to me right now:

If a bear comes into your tent, don't panic, but don't stay calm, either. 
We'll get to pens in a minute, but that's what I want to talk about first.
You may not have heard this, but the World Health Organization (self explanatory) has recently declared a global pandemic. What that means is there is a disease that's going all over the world making people ill. To the best of my understanding, this sort of thing doesn't happen overnight, but they avoided using the word "pandemic" until very recently because it's a word that can provoke fear in anyone who knows anything about the history of the use of that word. And again, to the best of my understanding, the leadership at the W.H.O. began using this word because countries were not taking serious enough action. 

For the duration of this email, I’m going to substitute the name we’ve given to this particular new disease–named for the crown-like spikes on its surface–with something a little less emotionally charged, but which hopefully conveys a similar undesirability: Fruitcake. 

#fruitcake #nobodywantsafruitcake

I’m not a public health expert, so I trust the people at the Center for Disease Control [and Prevention] to give me the best information available on how to deal with the fruitcake.

I’m not trying to navigate this myself.

This is a bit like when taking a standardized test; to succeed, you have to pick the best answer, not necessarily the one you imagine to be the “right” one, and then keep with that program. I put aside my ego and trust the program. In the United States, we’re lucky to have some of the best public health experts in the world on our side, and I’m going to listen to their guidance.  

I’m 34 and in decent health. I am not elderly, and I don’t have a pre-existing health condition. Based on the reports from the CDC, I’m not especially concerned about what the fruitcake can do to me directly. I am, however, greatly concerned about the effects the fruitcake can precipitateI’ll elaborate on that in a minute. 

What preventative measures are the experts at the CDC telling us? I will leave to you to go read the full story on their website, but at the top of the list is basic stuff: wash your hands, don’t touch your face, sneeze into your elbow, avoid close (social) contact, et cetera. Again, basic stuff. Nothing terribly revelatory. I'll be honest, a while ago, after reading that, my first impression was “well, if that’s all they’re telling us to do, then it must not be that serious”. That was an incorrect inference. Let me explain.
  • This fruitcake can come out in respiratory droplets that we produce, and those droplets can either be inhaled or they can fall on things. If you touch one of those things, and then touch your mucus membranes (eyes, nose, mouth) fruitcake shall have its way with you.
  • This is also why the experts recommend “social distancing”, or staying far away from other people; these droplets are heavier than air, so you give them time to fall to the ground before you can breath them in.
  • The experts believe this fruitcake can live long enough on surfaces to cause trouble, but the fruitcake also responds well (i.e. can be broken down, deactivated or removed) to soapy water and alcohol in concentrations higher than 70%. This is why disinfecting high-traffic surfaces (like your hands or doorknobs) is believed to work. I use pure denatured alcohol in a spray bottle to hose down surfaces. Cheap and easy to apply. 
  • We touch our faces more than any of us thinks. Watch any long video of any non-professional doing anything. We touch our faces all the time. Wash your hands. Feel free to watch this video on how the World Health Organization suggests you do it!
  • Right now, the experts don’t believe this lingers in the air for hours on recirculating dust particles like measles can. (Infectiousness of measles is incredible. Incredible.) So, that’s why they said what they said, and didn’t say anything more severe, like buying all the goddamn supplies.
  • When I first heard the CDC’s advice, I thought hand washing was a weak choice. As you know, I definitely don’t think so anymore.
Ironically, if you watch the video on hand washing I linked to above, or read the other measures the CDC recommends on their website, you might go the other way and feel like some of these steps seem like overkill! I may have thought so before, but I don’t think they are.

Now, it’s time to talk about what I meant when I said I was concerned about “the effects the fruitcake can precipitate”.
First, there’s the easy stuff:
  • If you catch the fruitcake, you can give it to someone else. Nobody likes that, shame on you.
  • At the time of this email, widely available testing is non-existant, so, in the US, very few people know if they have the fruitcake at all. 
  • There is also evidence that you can catch the fruitcake, feel perfectly healthy, AND THEN give the fruitcake to someone else without knowing it. 
  • Right now, for every person who gets the fruitcake, from what I’ve read, we believe they transmit it to 2.3 other people. This is a recipe for the spread of the fruitcake to grow exponentially. 
Then there’s the hard stuff:
  • We expect a LOT of people to get the fruitcake. Many of them will recover fine on their own. But some percentage of people, however, will need medical assistance. 
  • When you multiply that percentage by the vast number of people in the US, you get a number; There are simply not enough machines, staff and hospital beds to support that number.
That leads to the stuff that concerns me: 
  1. All the hospital beds could be full with people who need help breathing because the fruitcake can give some people pneumonia.
  2. In a situation where medical resources are limited, and you can breathe, you usually get pushed to the back of the line. But remember what I said earlier? There aren’t even enough spaces for the people who will all have the same problem. There are going to be some weird questions and some hard choices. Meanwhile, all the rest of us might just have to wait. 
    • Sorry ma’am, you’re going to have to give birth in a birthing center, not a hospital. No room. 
    • That transplant you’ve been waiting for? It can wait, you can breathe.
    • That chemo you need to fight your cancer? It can wait, you can breathe.
    • Left the chuck key in your lathe? Sorry, Mr. Cyclops, you'll have to wait.
    • Gosh, 55 broken bones and no internal bleeding? Impressive, but you better lock up your Harley, sir, you’re going to be waiting for a while.
Yeah, so right now, the measures we need to take are not necessarily aimed directly at protecting our own personal safety, or that of those we love, we’re trying to protect the medical system itself–from being smashed. So it's there when you need it. Not to get all political up in here, but if you've ever been one of those people who says they like "small government", you'd better damn well start defining your terms. 

In short, don't panic, but don't stay calm either: find the public health experts (CDC, W.H.O., National Institute of Health, etc.) and do what they tell you. You don't need anyone telling you how to feel. You need to know what to do.