Dispatches From My Dining Room (No 1): COVID-19 Social Distancing: The Lead-Up

I read an article today in which a historian suggested keeping a record of your life during this strange time in which we are living. I myself have wondered – what was it like to be alive during the spread of the Spanish Flu of 1918? What was the atmosphere like in America in the 1940s and 1950s, as thousands of children (including my father) contracted polio? I wonder what my children will remember 30 years from now (and whether they will ask me to recount for them what it was like from my perspective). I wonder what questions my grandchildren will have. And for those reasons, and because my blog already serves as a sort of journal for our family, I’ve decided to do occasional blog posts about our lives during this time.

Today I’m sharing about our family’s particular experience of the time leading up to the day we started practicing extreme social distancing.

Having two daughters who were born in China, we try to follow news coming out of China. I texted an article to my mom (the Director of Emergency Management for her county) and the rest of my family about the coronavirus on January 22. It seemed potentially worrisome but still so far away from us.

On February 24, I sent an article to them that had the headline, “Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”.” By that point, the United States had only 14 diagnosed cases of the coronavirus (the first had been on January 21st), but 14 cases, across multiple states, of a disease that seemed to spread exponentially, seemed like just the beginning.

Our president, Donald Trump, had been making comments that downplayed the significance of the virus. According to a New York Times article compiling his statements and comparing them to what was going on in the world, he stated, on January 31, “Well, we pretty much shut it down coming in from China.” On February 10, he said, “Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away.” His statement on February 19 was that, “I think the numbers are going to get progressively better as we go along.” On February 23, he said that the situation was, “very much under control.” But on that same day, “the World Health Organization announced that the virus was in 30 countries, with 78,811 confirmed cases, a more than fivefold increase over the previous three weeks.”

On February 26, he said, “We’re going down, not up. We’re going very substantially down, not up.” That is not at all what seemed to be happening, though. That same day, this was the snap I sent to a few close friends (for fear of being seen as alarmist, I didn’t want to send it out to everyone).

I’d made a special mid-week grocery shopping trip to both Aldi and Hyvee and spent about $600 getting us stocked up on non-perishable food items, frozen vegetables, and toiletries. Little did I know that it was going to be toilet paper that was the big item (who could have guessed?) – but fortunately, we have that set to be delivered to us monthly through an Amazon subscription, so we’re fine for now! I may need to start looking for some, though, if Amazon is unable to fulfill my regular monthly order.

Trump continued to double down on his claims, stating on February 27, “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

Meanwhile, cities, states, and public and private institutions were beginning to prepare for the arrival of the virus. On March 5, the University of Missouri, where Matt is a professor, instructed faculty to begin thinking about how they could deliver in-person course material through other means.

Amid reports from all around the country that there was a shortage of testing kids, Trump said on March 6, “Anybody that wants a test can get a test.” This is patently untrue, as basically every media outlet has reported. On March 7, Trump stated, “I’m not concerned at all.” On that same day, Missouri’s first confirmed case of COVID-19 was diagnosed. Of course, because of the shortage of testing kits, no one knows whether it was truly the first case in the state.

On March 10, Trump said, “It will go away. Just stay calm. It will go away.” The next day, Wednesday, March 11, the University of Missouri sent out an e-mail in the morning informing the campus that some students and faculty had attended a conference the prior weekend from which another attendee (not from Mizzou) had later been diagnosed a presumptive positive for COVID-19. A few hours later, that afternoon, the University announced that as of 5:00 pm that day, in-person classes were suspended through the following Sunday, at which point professors would be expected to teach their formerly in-person classes remotely for March 16-20, the week leading up to spring break. They stated that they hoped to resume in-person classes on Monday, March 30, but honestly, I cannot imagine anyone actually thought that would happen. Even though Missouri had only 1 diagnosed case at that point, students, faculty, and staff could travel all over the world during that spring break week and come back to campus having faced innumerable exposures.

The University of Missouri putting into place its plans for remote instruction had a domino effect for us (and, I suspect, for many others). Up until that point, we had been living life relatively normally. We were expecting this to come, and we were beginning to prepare, but we didn’t know exactly when or how. The prior weekend, I had been visiting my best friend, Courtney, hanging out, riding horses, and just getting in some good, quality self-care time.

That day, Wednesday the 11th, I enjoyed a long lunch date with some friends and then came home and took the kids to swim practice. That’s where we were when we heard that Mizzou was canceling its in-person classes. A few minutes later, we received word that the swim meet that our club was supposed to host that weekend at the Mizzou Rec Center had been canceled by the university. I had been scheduled to work about 15-20 hours of volunteer time at that meet, and I’ll admit, I was getting increasingly nervous about it, knowing that swimmers (and their families and coaches) would be traveling from all around to attend the meet, and that there would be large numbers of people in close quarters at the arena. I was relieved when it was canceled.

The combination of in-person classes being canceled and the swim meet being canceled meant that we theoretically could begin staying home. Public K-12 schools here were still in session. There was not yet a mass effort at social distancing. But we knew it was becoming increasingly likely that the coronavirus could be present in and spreading within our community. Matt and I talked about it that night after the kids were in bed and decided that this was the moment – we were going to start staying home. We kept the kids home from their homeschool enrichment group the next morning, and though we did have to run one family errand, that day, Thursday, March 12, is what we consider to be our first day of extreme social distancing.

In my next post, I’ll share more about what these first days of staying at home have looked like for us!

Coronavirus 2020: Why We Are Staying Home – And Why I’d Encourage You to Stay Home, Too, If You Can

Like most of the rest of the world, I have been following the news of the coronavirus closely for the last couple months. Having two daughters from China, I was particularly struck by reports of this new virus killing people and shutting down cities in that country that will always have a piece of my heart.

And then it spread – and now it is here in the States. And each of us is faced with the question – what should we do now? Even if we could trust the leaders of our country (and the evidence is clear that we cannot), each of us is responsible for ourselves, and, in a broader sense, we are all bound together as a society, and we share responsibility for what happens to us all. We are all responsible for making wise choices, but when there is no clear, competent leadership, we have an even greater individual responsibility.

Initial data indicates that without intervention, each person infected with the coronavirus transmits it to somewhere between 2 and 3 other people. The World Health Organization (WHO) states that its incubation period is probably between 1 and 14 days – meaning that people can transmit the virus to others for up to two weeks before they develop symptoms themselves. And they also state that, “older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer or diabetes)  appear to develop serious illness more often than others.”

Its mortality rate, right now, seems to be around 3-4%. But, beyond that, we can see significant issues. For instance, “Around 20% of cases require hospitalization, 5% of cases require the Intensive Care Unit (ICU), and around 2.5% require very intensive help, with items such as ventilators or ECMO (extra-corporeal oxygenation).” Our hospital systems in America simply do not have the capacity to provide ICU care to the numbers of people who may need it. The same article states, “A few years ago, the US had a total of 250 ECMO machines…So if you suddenly have 100,000 people infected…Around 20,000 will require hospitalization, 5,000 will need the ICU, and 1,000 will need machines that we don’t have enough of today. And that’s just with 100,000 cases.”

As of yesterday, there were about 3,500 people who tested positive for the coronavirus in the States. However, one of our earliest failures in fighting this disease has been in testing. A Johns Hopkins physician was quoted last week (back when the official tally of cases was 1,600) as saying, “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus…No, that means 1,600 got the test, tested positive. There are probably 25 to 50 people who have the virus for every one person who is confirmed…I think we have between 50,000 and half a million cases right now walking around in the United States.” This article explains in great detail how we can estimate case numbers and project into the future.

There are no confirmed cases of the coronavirus in the city or county in which we live. But what does that mean? It certainly does not mean there are no cases. It means that there may be cases…but we don’t know it yet. And quite probably, those people who have the virus don’t know it yet either.

So what do we do?

I believe we need to start acting like there are cases here. And, as many are advocating, we need to do everything we can to flatten the curve. If everyone gets sick at once, our healthcare system (our hospitals, our ICUs, our ventilators, our ECMO machines, our doctors, our nurses) will be overwhelmed. This is already happening in Italy. They are having to make decisions about who to treat – who will live and who will likely die. No one wants that to happen here.

And there is something each and every one of us can do to work to prevent it. This brief Washington Post article with simulations does an amazing job explaining and showing why social distancing works. Please check it out. Look at what happens when everyone moves around normally. Look what happens when only one in four people continue to move around. And then look to see what the results are with only one in eight people moving around. The difference is dramatic.

Some people cannot stay home. Doctors and nurses, of course, cannot. My 66-year-old mother who is a Wisconsin county’s Director of Emergency Management cannot. We all need to eat, and those who work at grocery stores will continue to work. Many people have no savings and will be required by their employers to continue to come in to work. However, there are a great many of us who have tremendous privilege, who are able to stay at home. It would be impossible to get any of our cities to a point where everyone stays home 100% of the time – but can we get to a point where only one in eight of us are moving around regularly, or even one in four? Can we slow the spread of the coronavirus enough that we will truly flatten the curve, so that our healthcare systems and our doctors and nurses and other hospital staff members are not pushed beyond their capacities?

I hope so. Lives depend on it. You may be young and healthy, and likely you would be fine, even if you contract the virus (though there are no guarantees). But that is not true for everyone. The mortality rate for those over 80 is around 14%. China’s CDC indicates that the mortality rate, “was 10.5% for those with cardiovascular disease, 7.3% for those with diabetes, 6.3% for people with chronic respiratory diseases such as COPD, 6.0% for people with hypertension, and 5.6% for those with cancer.”

Within my little family, risks are high. I have exercise-induced asthma, which may (but also may not) be an additional risk factor. But for two members out of our family of six, their underlying medical conditions could make the coronavirus extremely dangerous for them. While we often think of osteogenesis imperfecta as primarily related to bones, it is actually a collagen disorder and therefore affects every system of the body. The OI Foundation reports that, “Respiratory complications are a leading cause of death for children and adults who have OI.” The coronavirus could be devastating for FangFang. Additionally and probably even more concerning, last year Matt was diagnosed with interstitial lung disease. His lung function is already so compromised that the prospect of him also facing a virus that attacks the lungs is terrifying. Most people who contract the coronavirus will be fine; would Matt and FangFang? It is less clear.

So what are we doing?

We are staying home. We are practicing extreme social distancing. We are canceling everything. I went grocery shopping on Saturday morning, and that will be our last grocery shopping trip for weeks, at minimum. We are not running errands. Mizzou has transitioned all in-person courses to be taught online, so Matt is able to teach from home. If he has to go in to campus for meetings or any other reason, he will, but he will do all he can from home. We are not attending church worship gatherings. Our kids are staying home from their homeschool enrichment group. Swim practice has been canceled through the end of March. We will not be doing horseback riding lessons. We will not go to the library or to the gym. We have canceled a spring break trip Matt was scheduled to take – unnecessary travel with thousands of other people through airports and on airplanes seems unwise at this time. We have rescheduled all non-urgent medical appointments. We are not visiting friends, and we are canceling visits from those who had planned to come to our home.

Would you consider doing the same? Will you help to flatten the curve? Will you do your part in reducing the risk to vulnerable populations, like the elderly – and like Matt and FangFang? Will you do what you can to protect our health care system and medical professionals? Some people cannot stay home – but if you can, would you please do so?

Maybe it will seem like an overreaction. But what if it doesn’t? What if we are facing an unprecedented pandemic? What if you could save lives with your decisions, by simply staying at home with your family? Would you do that?