View from your Quarantine

"If you know Syphilis, you know all of medicine," and other letters from my readers

Apr 27, 2020

18 Dalmatian Puppies Delivered in a Single Litter in Australia - I ...

I’m about to launch into a week of geopolitical reflections. They’re important, too, so pay attention, especially if you’re in the United States. Foreign news coverage had nearly dropped off the horizon even before this pandemic, but now there’s none. Zero. (Apart from comparative Covid-19 statistics.) If you live in the US, there’s a good chance you’ve heard nothing about the rest of the world for weeks.

But in fact, the world is still turning. None of the geopolitical problems we faced before have gone away. Indeed, some have become worse. So this week, CBIIT will take you on a journey to far-away lands—especially ones that might just be about to nuke us.

Before I launch into Geopolitics Week here on CBIIT, though, I thought I’d take a pause to share some of the letters you’ve sent me recently. Remember, if you’d like to send yours: Put MY LIFE IN QUARANTINE in the subject heading—even if it’s not about your life in quarantine. That way it goes directly to a mailbox I reserve for readers of this newsletter. If you’ve written to me and you didn’t put that in the subject, there’s a good chance I never saw the letter, so please re-send it. I’m not purposefully ignoring you, I just get so much spam that it’s all too easy to overlook an email from an address my In Box doesn’t recognize.

And do please keep sending these letters to me. I got this absolutely lovely letter, yesterday, from someone who kicked in to the “Just for Claire” PayPal account:

Hi Claire,

You're very welcome!

I don’t know you except through your writing, and that SUPER nice thank-you note you wrote last time I donated a year ago, and for some reason feel a need in some small way to take care of you. It’s like I can't fix what’s happening in the world and help all the people suffering badly, it’s overwhelming if I allow myself to really feel deeply, but I can click a few links on my screen and easily make YOUR life slightly more stable and safer for a bit, and feel like I matter in the world. I work long hours on advanced computer technology, used to make the Internet better, and my brain gets so filled with technical minutiae I can temporarily lose sight of being human. Reading what you write helps remind me we are all humans together in this thing called life.

I thought that was so kind—the idea that there’s someone out there who feels that way about me is so comforting—but it also struck me, again, that my readers know me so much better than I know them.

This is all a bit of a one-way conversation, unless you write to me or leave comments in the comment section—which, by the way, I love to read.

So please leave comments, please keep the mail coming, and please tell me more about who you are, where you live, and what you enjoy reading about in this newsletter. My subscribers are like beautiful, exotic birds who’ve flown into my apartment. I just want to know how to make them happy, so they’ll stay and keep me company.

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Puławy

I live in Puławy, a town of 50,000 people in Southeast Poland. I’ve been here for about six months. I don’t speak or read any Polish yet, aside from cheerfully bidding people “Good day” and “Good night,” and also thanking them. I teach English in a language school ….

I lived in Istanbul for fifteen years before this. … My son is in Turkey now, with his grandparents, out at their summer house. I haven’t seen him since January because the planned Easter visit was cancelled when Poland closed the borders around March 20. (Turkey was still allowing flights from New York, and pundits were claiming Turks’ superior genetic makeup and hygiene had prevented the disease from coming there.) His father can’t visit him from Istanbul anymore. For food, they’re reliant on a little shop for deliveries since the village is too far to walk; his grandfather is 65 and can’t go out; children can’t go out; and his grandmother doesn’t know how to drive.

Before coming here, I refrained from reading anything in the Anglophone press about Poland, since they seem so eager to lump Poland together with Hungary into stories about “creeping authoritarianism” in the EU. After all that time in Turkey, I’m circumspect about bringing up politics with people I don’t know well.

Still, when the first step of lockdown (closing schools) was announced, the evening of March 14, I asked my students if they trusted their government’s response to the virus. They said yes, that even if it was an overreaction, it was better to overreact early than have bigger problems down the line. They also thought the government was downplaying the actual case numbers and exaggerating the amount of supplies and hospital beds.

Bars, restaurants, tourist attractions, malls, and cinemas closed shortly after the schools. Grocery stores limited the number of people allowed inside and required gloves, which they hand out at the door. … There was a brief run on toilet paper and meat when the lockdown was first announced, but by 9:00 pm that night, stores had helpfully put large displays of toilet paper right in the front, and the meat supply was normal within a few days. …

The Puławy mayor sent everyone masks, which are now required outside your house. Passersby who used to give me dirty looks for stepping on the grass now give approving looks when I step on the grass to keep my distance.

The measures seem to be working. According to polandin.com, as of April 19, the official case count is 9,082, with 350 deaths. They’ve done 192,000 tests, quarantined 124,311 people, and put 17,436 under epidemiological surveillance.

I was alone a lot before the lockdown and that remains the same. Our school’s little staff of five scrambled to learn how to teach online, and we now conduct our classes on Zoom. Even though it’s a lot more work to prepare lessons, I’m grateful to have a job, especially hearing how my teacher friends in the US are struggling, looking at pay cuts or their jobs disappearing altogether.

Without a job, I’d lose my residency permit here, and I really have no idea where I’d go since the borders are closed everywhere and the US is a petri dish with no work, and impossibly far from my son. I’m also grateful for the government’s swift and seemingly heavy-handed response and that people here are following the measures without throwing fits. Poland has not seen the exponential growth in death that other countries have.

I’m sure facts are politicized here like everywhere else, but the virus doesn’t seem to be a question of politics. There’s a lot of anger at the government’s refusal to cancel elections in May since the ruling party (PiS) has been able to campaign freely in print and TV media while the opposition parties are mostly limited to social media. Right now, Parliament is dickering over mail-in ballots, and it seems that’s what they’ll do.

I know the economic fallout is next. My friend in Warsaw says a lot of restaurants and other shops around her aren’t just closed, but have completely liquidated everything inside. Aid packages have been announced, but I don’t think anyone really knows what will happen next.

I’ve just received an SMS saying more people will be allowed in stores as of tomorrow, and the forests will be open again. I’m assuming summer is the soonest I’ll be able to see my son, and that’s optimistic given the current clusterfuck in Turkey—I’m mostly just hoping to see him before his voice changes.

My top three things to do after lockdown are hug the people who’ve been helping me out here, eat a burger, drink a beer in the sun, and go for a walk in the forest that’s right outside my house. So maybe things are looking up a bit?

Geneva

What the world is going through has been so reminiscent of Syria … Overwhelmed hospitals and doctors, having to choose who lives, treating patients with a severe shortage of supplies ...

… I realized a few days ago that it also reminds me of living in Turkey in 2016 (compounded by the fact that I was working in Syria at the time—that was when Aleppo was falling). The security situation in Turkey was quite bad at the time, between the coup attempt and the crumbling of the Kurdish peace process, not to mention the political situation. So it had become part of our daily consciousness that every time we left the house, we were potentially exposing ourselves, in an invisible, unpredictable situation that probably won’t—but just might—harm or kill us. And it was all around us—we were getting a continuous stream of news of suffering, panic, and death. Sound familiar? …

I specifically remember that when we were making New Year’s Eve plans in 2016, we chose a place that was close to where we all lived, so we could easily get home if there was an attack. This isn’t a normal consideration or state of mind. I wish it had proven to be paranoia, but then that was the night the Reina attack happened. And today I feel I’m having to make similar calculations …

I guess one of the scariest parts is that if even Switzerland isn’t safe, then will we ever have a normal life again? Is anywhere safe? Where do I need to get myself to have some peace of mind? I don’t need it forever, but Christ, a break for a few years when I don’t have to worry about anything would have been very welcome. The moon?

… And then imagine if I lost my job. How does one even move in the middle of all this? Even if I postponed moving, rent is expensive here, so I’d have to sublet my place and go to Turkey and worry about moving my stuff some other time, but … how do you get on a plane? … Who would rent my place? I’m getting anxiety just thinking about it. And when I feel short of breath from anxiety, well, that just adds to my anxiety because then I’m like, “Corona? Is that you?”

… I’m grateful to be in Geneva during this period though. It’s not incredibly dense here, and there are a lot of parks and wide promenades along the lake. It’s not that populous, so there’s plenty of space for people to still be able to go on walks while maintaining distance. I even saw people sunbathing during my jog last week, each person two meters apart. …

Giannutri Island, middle of nowhere off the coast of Tuscany

Quarantine here is not an emergency situation: It’s the status quo, as there are usually no more than forty or fifty people here during the summer and about twenty right now in the winter. Information is sparse, connection to the Internet and the outer world scarce, but the local fishermen have been told that “on the Continent” there is a pandemic happening and that everyone is locked in their homes. Their superb response was: So they’re not locked up in their offices anymore? …

For myself, I say that if the global situation and the reason for my being here to seek safety weren’t this tragic, this would be one of the most blissful periods I have ever witnessed. The journey to Italy on empty highways was a dystopian delight and the arrival in a deserted Rome, returned temporarily to it’s originally-conceived splendor, a breathtaking experience.

Life here on the island is, as Virgil would call it, bucolic: The hours go by slowly, in a regimented schedule I’ve set for myself, early rise, exercise, run around the island, reading and writing while the sun lazily sets. I feel like Edmond Dantès: exiled on a remote island plotting my return home—albeit without the whole vengeance frenzy, just the craving of going back to my beloved Parisian cafes. If anything, this pandemic has reminded me of the veracity of what is considered a banal platitude: Very little is needed to be happy in life.

Claire to Mobile, Alabama

(This reader replied to a letter I’d sent her; I’ll reprint my original letter first so that her answer makes sense.)

This disease is just plain weird, in addition to everything else. I’m reading everything I can get my hands on. This article, in Science, just blew my mind. What kind of disease does this? What is this? This is nothing like the flu at all! Is there any known disease like this? This gives me a very bad feeling about the prospect of therapies and vaccines any time soon. We don’t seem even to have a theory of how this disease works yet, do we?

Also, it looks as if there are a number of strains of Covid-19, some more lethal than others. I thought the theory was that viruses don’t mutate to become more lethal, because if they get too efficient, the hosts die too quickly. Does this make sense to you?

Lot of other weird things are going on, too. If you look at the stats, you see that suddenly, in late March and early April, Parisians stopped having heart attacks and strokes. How does that make sense? Did they think, “I don’t want to burden the emergency departments right now” or “I don’t want to go to the hospital and catch Covid-19”—and then die at home?

That should still be showing up in the death rate, though, and maybe it is—maybe they’re just being classified as Covid-19 deaths because they don’t have enough tests yet to waste them on dead people? I can’t really imagine what else could be causing a sudden, sharp drop in non-Covid-19 all-cause morbidity and mortality.

Well, I can: There are a lot fewer accidents when people don’t drive or leave their homes. But why would there be fewer heart attacks?

We’re scheduled to end lockdown here, officially, on May 11. No one’s sure it’s a good idea at all. The serological studies show we’re nowhere near herd immunity. We’re still in the low single-digits. The moment the quarantine ends, it’s going to explode all over again.

I also get the sense that what they’re finding out about the virus is making them pessimistic about the prospects for a vaccine. I don’t quite understand why, but I keep seeing warnings (which I didn’t see a few weeks ago) that we shouldn’t get our hopes up. …

Mobile, Alabama:

A few random thoughts:

Actually, there is a disease that’s crazy like Covid-19. It’s Syphilis. We used to teach med students, If you know syphilis, you know all of medicine. I don’t mean to say that a virus and a spirochete have anything in common, only that it took years for us to understand that syphilis affected every organ system in bizarre and previously unknown ways.
I too have wondered about the possibility of different strains affecting different areas. Maybe we [could deliberately expose ourselves] to the kinder strain, and maybe acquire immunity to the more lethal version? Or maybe there’s something else going on. Or God forbid, maybe infection with the light version does not impart immunity to the more lethal version, in which case we’re in for a very bad time ahead.
As for the dropping rates of all other disease processes, my colleagues and I are talking about this at my hospital daily. What the hell?

Ok, we get fewer MVAs: No one is driving.
Fewer knife and gunshot wounds: The idiots are staying home.
A certain percentage of strokes, heart attacks, etc. are staying home and dying there. But what about all the appendicitis, cholecystitis, aneurysms, and cases of priapism? Folks don't stay home with those! We allow that maybe we overtreated 10 percent, maybe; 15 percent are staying home to die; maybe there are 50 percent fewer violent injuries—but that still does not account for our ER being down 89 percent!!! We were actually at 11 percent in the emergency department yesterday. We’re furloughing staff all over the hospital (except on psych), so we can’t figure it out, and I know it’s the same in other hospitals.

Most importantly, and I would NOT have said this ten days ago, but here goes;
We need to open up the world economy. Acknowledge that we are going to lose a lot of old and compromised people, I’m sorry. I can say that because I’m over 65 and one of the old, you can’t say it out loud because it would be so politically incorrect!
So, I believe we can open up stadiums or other large facilities, and set them up like Army field hospitals. Provide supportive care and treat Covid-19 patients en masse. No need for ventilators and ICU high-technology. They either make it or they don’t, but an ICU bed would only save 10 to 20 percent more people, and at an unbearable cost to humanity around the world. Huge numbers of young people starving to death or dying of violence from rioting and anarchy is worse than losing a smaller number of old and infirm, even if my friends and I are among them.
There, I said it. You can quote me, but make sure you add that I am old. I have a great life. I’m not suicidal. I don’t want to die. I’m looking forward to some great times, and yet I said it! Perhaps I could start a petition of over-65-year-olds. We could tell the world, “Do what you need to survive. We don’t want our children and grandchildren to suffer and die in a world gone mad trying to save us.”

Claire to Mobile:

I don’t think the global economy can be opened. It’s not under central command: Who’s going to go to restaurants, who’s going to get on a plane, who’s going to do anything they don’t absolutely have to do if they’re terrified of catching this disease? Sure, you can lift the quarantine orders, and yes, some people will go back to work. Some people will be forced to go back to work. If it’s that or starving, people will take the risk. But anyone who can stay home will. Anyone with savings will wait before venturing back out. People won’t consume; they won’t shop; they won’t spend a penny, they won’t leave their homes at all until we can test people at scale. That’s the only way to get the economy moving again. If you know who’s got the virus and who doesn’t, you can get people to leave their homes. But it won’t happen until we can test everyone.

Some people have a really high tolerance for risk and will say, “Que sera, sera, if I wind up dying in a field hospital, so be it.” But most people won’t.

Mobile, again:

I think you would be surprised how many young people will venture out, return to work, and shop—albeit with some significant modifications in social distancing. I would recommend that over 65 year-olds, and anyone with underlying conditions, stay in. They are still the most vulnerable. However, for the young and healthy, the risk appears to be pretty low. Haven’t seen a recent stat, but last I looked, it was statistically insignificant for under-50-year-olds. Not to say that it is irrelevant to the 1-in-1000 individual who gets hit by the bus!

You’re Both Right, and Wrong

By reader Anne Swardson

It’s perhaps unfair to base my critique on Tharp’s compilation of Berlinski’s argument, but it’s a concise way of ordering my own points. Where possible, I’ve tried to supply Berlinski arguments that show Tharp is stating her case correctly.

Assertion 1: POTUS was informed sufficiently to have taken aggressive action to prevent a massive COVID19 outbreak in the United States, but did nothing.

I agree with Berlinski that Trump himself shouldn’t have played down the virus and I agree with Tharp that U.S. agencies were well aware of the threat. Tharp doesn’t address the question (until lower down in his argument) of how or whether the White House was fully informed of—or wanted to hear—those warnings. He also loses points because his timeline failed to include all the misleading information disseminated by Trump during February (unlike Berlinski’s timeline), nor note that the famous White House timeline shown at the briefing skips February entirely. Win to Berlinski.

Assertion 2. China’s deceit did not preclude a timely and effective response.

Berlinski asks: “Is it true that China was so dishonest, so incompetent, and so thuggish that our elected officials were unable to limit the damage? No. This is nonsense.”

But she does not in fact engage in that argument, nor get into the various lies and deceptions the Chinese government engaged in. Tharp, by contrast, lays out clearly the cost of Chinese obfuscation. Win to Tharp.

Assertion 3. NOLA didn’t know, but should have.

Of course the mayor should have known. Any reasonable official should have been reading newspapers, coordinating with the state and listening to the various health warnings that had already been issued. Tharp also loses points by making the opposite argument that he made in Assertion 1. His timeline in that item lays out all the ways the Trump administration was made aware of the dangers in February. Then in Assertion 3 he says, “The fact is, we still did not know enough in February, and there had been no cases in Louisiana.” Well, there had been no reported cases. And people from New York go to Mardi Gras. Win to Berlinski.

Assertion 4. Trump downplayed the virus.

This is so blatantly obvious that I tried really hard to understand Tharp’s arguments. No luck. He asks what duty Trump violated. How about keeping the people safe? I’m not a constitutional scholar, but it seems to me a president who issues executive orders barring immigrants at the drop of a hat could have issued several to take leadership of production, testing, procurement of PPE, you name it. Not to mention dismantling the security and warning structures put in place by the two presidents before him. Especially given the follies that have occurred since this debate was posted, I like to think that Tharp, obviously an intelligent and reasonable man, would now fully agree with Berlinski. Win to Berlinski.

Assertion 5. The Red Dawn Emails mean something.

I agree they were important and I agree they don’t seem to have made it up the chain. But is that unrelated to the White House, as Tharp asserts? A president who believed in process would have had a structure where the concerns of these qualified officials climbed to the president’s desk, non? In fact, we don’t know if the president saw them or not, but Tharp “assumes” he wasn’t briefed. Still, Tharp’s good points about organizational failure are worth reading. I’m going to split the win here.

Assertion 6. Ending the Protect program was unreasonable.

If Berlinski was going to go there, she should have been more comprehensive about all the health-security programs and groups that the White House dismantled. Cuts to CDC and USAID, elimination of the National Security Council’s health-coordinator post, etc. Granted, Tharp pulled it out of her argument as a major assertion when it’s more of a passing remark. Tharp loses points by “assuming” again and saying it was reasonable because the decision was made “months before we knew this was coming.” Well, exactly, it’s called preparedness. Both lose.

And that’s this week’s mailbox.

Back soon with the news from the rest of the world.

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PS: Why the Dalmatian puppies, you may be asking? Just because. I mean, who doesn’t love Dalmatian puppies?