Monday, December 26, 2022

SARS #1 and Collective Amnesia

SARS #1 (Severe Acute Respiratory Syndrome) was a deadly coronavirus that hit Canada in February of 2003. It started in China in November 2002 then entered Toronto in a traveller flying in from Hong Kong. 

SARS #1 differs significantly from SARS-CoV-2 because the OG killed people faster, so it was easier to contain! It took 44 lives, but the first cases succumbed fast enough that the city shut down tight, so there were only 438 cases in total in Toronto from March to August 2003. 

Symptoms included a high fever, severe cough, and difficulty breathing. The first patient in the hospital, the son of the traveller who had died just two days earlier, waited in the ER for hours, unknowingly infecting others. He died within a week. Toronto hospitals closed ERs and refused new admissions, then public health jumped into action to contact trace and quarantine suspected cases. Toronto hospitals suspended non-essential services, restricted visitors, and created isolation units for SARS patients. Health care workers were put in "work quarantine" and were not allowed to use public transit or go anywhere besides work and home. 

It was able to die off completely because of drastic public health measures, but also because it was primarily contagious through people who were sick. It didn't spread much from people pre-symptomatic, and didn't have a third of all cases hiding quietly in a carrier, and finding and isolating sick people is easier that isolating anyone who might have had a contact. 

I was untouched by it all, just 90 minutes away, and would likely have no personal memory of it except I had planned a class field trip to Toronto months before that had to be cancelled, and it caused some outrage. Even back then, some parents thought they should be able to override public health concerns. One memorable mom was beside herself because this field trip was going to be part of her daughter's 16th birthday celebration! Sorry, but we have to follow public health rules. 

Compared to SARS #2, only 1 in 1,000 die, not 1 in 10, so it feels like less of a problem in the short term. But that very sentiment makes it more of a problem long term. 

Of the patients who survived #1, ten years later almost half still experienced symptoms severe enough to prevent them from returning to work: disabling fatigue, numbness in feet and hands, muscle and joint pain, shortness of breath, neuropathy, PTSD, and depression. They "take on an activity for nearly 20 minutes and need to return to rest. So this affects their lives profoundly." But with SARS #1, 50% of survivors is fewer than 200 people in all of Toronto. 

Right now we have a similar virus that's affecting nearly everybody. The CDC estimated that 20% are getting Long Covid, and a recent study said it's closer to 50%, but even if just 10% of people get it, that's more than a million more people who can't work in Ontario - people who will need to be taken care of. 

The sudden let-'er-rip strategy in China will likely affect our access to a wide variety of supplies as well. They make part of so much of our products. For instance, even if they don't produce a specific medicine, they likely produce the bottles they're sold in, affecting access to much-needed treatments. Doctors there report going from having never seen a Covid patient to having a constant influx, with a bottleneck in the ER because patients aren't getting well enough to free up beds. One nurse reported that 45 of 51 nurses in her department caught Covid since the abrupt 180° change in policy. 5,000 people are dying each day there, but, judging from ten years post SARS #1 and recent studies of Long Covid from SARS #2, hundreds of millions of people could need long term care in China. 

Today Jessica Wildfire explained the collective amnesia we're experiencing with Covid. We don't want to remember the last two years, much less look back for prior examples and solutions.

"Diseases pose a greater threat than ever, but our collective will to respond has been depleted. Worse, almost everyone actively rejects the slightest precautions. . . . When schools refuse mask donations and shame mask wearers, they’re trying to suppress memory cues. When medical offices unplug their HEPA air purifiers and hide them away in closets, they’re doing the same thing. When our friends and neighbors mock our precautions and blame their illnesses on lockdowns, they’re spreading memory ignorance. . . . Some experts say collective amnesia poses the greatest obstacle to our survival as a species. . . . We constantly 'ignore history and precedent when responding to the present or informing the future.' We erase the immediate past. Once the amnesia sets in, 'discarded ideas are repackaged; meanwhile, the expectations for these practices remain the same.' In other words, we talk about how to prepare better next time, and then we completely forget everything."

But she has a solution: 

"When you promote counter-memories, you’re doing activism. You document your own experiences. You report facts. You testify. You bear witness. You do it everywhere you can, including social media. You keep the inconvenient past in front of everyone. That’s what a lot of us are doing, and it works. It’s exhausting. Sometimes we need a break, but we have to keep doing it."

On it! 

And it is exhausting because it seems to be completely ineffective. I won't stop just in case I manage to convince one person to put on a mask and save a life, but at what cost? 

My youngest is at her dad's for a week. Last time she stayed for a month and was sick for weeks. This time she knew preemptively that her dad and his primary-school-aged step-daughter are both really sick (doctor said it's just a cold, but didn't do a PCR test, so how does he know?), and there's no chance of postponing their festive meal until they feel better. Her options are to come now or miss it entirely, so she feels compelled to go. No masks are allowed there, and I annoyed her by reminding her to carry her far-UV surreptitiously and actually use the nasal spray she carries around. She has a CR box in her bedroom, but refused a little portable one for the dining room table because it can't be hidden. She wants to live like a normal family, as if Covid doesn't exist. Her exams went right until Christmas Eve, when we celebrate in order to accommodate my kids' other families, and now she's gone for a week, then will quarantine here, and then school starts again, so I was lucky to have her here and healthy for one big meal and presents. It has to be enough. It's so much more than many others have been able to have with so much travel cancelled. 

Every time she gets sick it adds to the threat of Long Covid, but a New Year's Eve party is calling her name to top off her week of freedom from remembering that we're living through a pandemic. And I can't imagine living through all this as a young adult. It's hard enough to manage as a mum, instinctively fighting to protect my full grown little ones. My late teens and early 20s provided me with hilarious stories of outrageous risks and near-misses. She wants some stories too

My mother, a wise woman in many respects, didn't think I'd make it to 25 and resigned herself to losing one to debauchery. She had five others already successful and self-sufficient by then. I have a harder time with that kind of math. I get that we have to accept what we can't change - that's a central theme in many religions and philosophies, from Buddhism to Stoicism - but I'm not as good at actually doing it, stepping back from expectations and attachments to live in the present. The tricky part is always figuring out what we can change. I still harp about climate change, too, under some illusion that it might have an effect. I can wear masks in public, but I'm not sure how much longer I can get my kids to do the same. I'm not fanatical about it for my own health - if I can't work it doesn't much matter anymore - but for their health. I couldn't live with myself if I got any of them sick with this brain-invasive virus, needing to be taken care of for the rest of their lives, but I have to accept that she'll allow herself to get it, and I'm not sure how many years I'll have left to take care of her! Bugger. 

Memento mori. 

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