March 20, 2020

Waterhouse – The Decameron

In a different life, I’d be on stage, roughly half way through the opening night of Massenet’s Cendrillion at Samford University’s Wright Center. But a burgeoning viral pandemic had other ideas and that process came to a crashing and premature halt about ten days ago. I’ve now spent more than a week either at work or sequestered away from the world in hopes that I don’t get infected with Covid 19 at a time when I might either become a disease vector for the frail elders for whom I care, or may have to serve as part of a reserve unit for the hospital doctors that are more than likely to fall ill from their front line duties. Those of us who normally do ambulatory care are transferring the majority of our work to telephonic, trying to minimize our contact with others, and stay healthy for the time we will be needed.


When I began these long posts at the time of a tragedy of a more personal nature, I had no idea I was going to end up as some sort of 21st century plague diarist. While I think I write rather well, I have nothing on Boccaccio or on Camus (although his plague was fictitious in nature). I tend to use more words than are needed and my syntax is sometimes arcane, at best. But these essays are essentially brain dumps written in a single pass without rewriting other than to fix glaring spelling mistakes and not massaged and edited into something that they are not. Like the rest of the world, I’ve had a lot of my assumptions about life come crashing down around me in the last few weeks. I feel relatively optimistic about the ultimate outcome (history shows we tend to do rather well after a major crisis passes), I am quite concerned about the more short term issues of how we hold our institutions together under incredible strain, especially in this country when half the country seems to be living in one reality and the other half in another.


Alabama entered the triple digits of diagnosed cases today (that’s up from single digits last weekend) and they’re starting to turn up at the hospitals A lot of planning by a whole lot of very bright people has happened over the last two weeks so we should weather the initial surge well. The biggest immediate issue is shortages of PPE (personal protective equipment) for the front line doctors, nurses, techs, respiratory therapists etc. who are going to be exposed over and over again. Our societal decision to treat health care as an industry like any other (one which manufactures patient/provider ‘encounters’) had led to a business model where you keep no excess inventory and order ‘just in time’ so you don’t have to pay to store, discard outdated supplies, or staff unneeded hospital beds. The side effect of this, of course, is that when there’s an instantaneous nationwide demand, it’s not possible to ramp up quickly. The beds don’t exist. The supply chain buckles. There’s a shortage of trained staff. Some of my craftier friends who sew have already started on making cloth masks to donate when the stocks are depleted. It’s better than nothing.

The local authorities have gotten more serious as the week has gone on. We’re not on full lockdown but most shops are closed. All food establishments are carry out only. Gatherings of more than ten people are strongly discouraged. I have a couple of friends working as grocery clerks who are just about to call it quits on the human race as they try to deal with panic buying. Fortunately, my local Piggly Wiggly has been sane and relatively well stocked. For those of my friends who have suddenly found themselves unemployed, most groceries are hiring. Not the most glamorous of jobs but essential and likely to provide steady employment for the duration. I personally shouldn’t need to go to the store for about a week. I’m pretty well stocked and, as one person, I don’t eat that much. I did have a major score today when I found a liter jug of hand sanitizer in Tommy’s wig studio, so now I’m stocked up on that.


I’ve been looking at the differences between Western and Asian societies and their approach to containment. China has nearly stamped it’s original epidemic out. South Korea’s is beginning to come under control. It never really took off in most of the other Asian countries despite early transmission through travel routes. Meanwhile, we and Western Europe continue to rocket along. I think at least part of this comes from a fundamental difference in our conceptions of who we are. Western thought, starting in the post Renaissance period with Cartesian dualism and then expanded by the Enlightenment thinkers, places all emphasis on the self. I am who I am, you are who you are. We are individualists at heart. We will come together for the common good, but we do it as individuals. Many Asian cultures, which developed without those changes in philosophy still use the community, the tribe, the family as the unit of existence rather than the individual. If one conceives of oneself as being a part of a larger collective, collective action for the good of the larger group is easier. I think they understood the need for individual behavior change in a deeper and more logical way than we can with our ‘no one can tell me what to do’ ethos. I hate making these kinds of generalizations because I’m always afraid I’ll end up stereotyping people and if I’ve offended anyone, it’s unintentional, it’s just me trying to process big ideas in inadequate words.


I figure our next big hot spot will be Florida, thanks to young people refusing to give up the beach and crowded theme parks that were relatively late to close. It takes about two weeks from the introduction of the virus in an area for the rate of cases to become majorly noticeable so I’m thinking next weekend should see a surge in the sunshine state. I saw an interesting article earlier today on the manufacturers of a smart Bluetooth thermometer that can upload your temperature to your home computer or to a hospital information system. Apparently, all those temperature readings, stripped of any identifying data, go to a central data bank and the company can look for trends. They usually see a hot spot of increased temps a couple of days before a flu or other viral outbreak and are better at predicting where flu is circulating than the CDC – another use of big data systems. According to this report, Florida is starting to light up like crazy, far more than most of the rest of the country.


I wonder what Steve or Tommy would have made of all this. Steve would likely have alternated between mild hysteria and laughing over YouTube videos of middle america emulating WWF smackdown in the toilet paper aisle. Tommy would have been miffed at the shutting down of the music and theater world, and then gotten out some new music to learn, gone to work in the garden, and gotten out the sewing machine and a mask pattern and gotten to work, all the while with a big ‘I told you so’ on his lips. Tommy had a keen eye for the fissures and fallacies of American society and was very much a realist about the rot at the top. If Tommy were still alive, we’d be arguing about the politics of it all, but after that was done, we’d still love each other and head off to bed to watch Star Trek with a bowl of ice cream. That’s the hardest thing at the moment for me. Just having to be on soft lockdown by myself. I’d go stir crazy if it wasn’t for the age of social media which allow me to feel somewhat connected to my communities.


I’ll try to keep this up roughly every other day and post interesting or informative news pieces in between. If anyone has a topic they’d like me to ruminate on, feel free to let me know. Going to have that bowl of ice cream now.

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