Tuesday, June 30, 2020

Coronavirus: How We Help: Every mask is a prayer and a song!

Here's a photo published in nj.com of white-presenting New Jerseyans having a really good time, without masks and without social distancing.  Just like old times!  Obviously, they are driven to gather by encoding in our genome over which we have some, but not all that much, control.  The great American urbanist, Jane Jacobs, said that people like to be where people are.  That is why the vast parks of New York can be empty while Fifth Avenue is packed.  


But, as Paul Krugman pointed out in his column today, it is a bad idea to give into our genes so quickly.  They might be young and white and therefore at less risk than some others, but risk is a calculation of "if."  What matters is what happens when you get infected or sick.  And we literally haven't a clue.  As more and more people of all ages recover, grim stories of debilitation are appearing.  And what will we know five or ten years from now?

Yeah, I know that taking risks is also in our genes and those genes are expressed at just the age of the people in this photo.  Happily people also have highly evolved brains and we can use those brains to think.  One of the important ways to think with our brains is to accept reality. Here is the graph from the NY Times today of the rise of cases, which Dr. Anthony Fauci warned could go to 100,000 new cases A DAY:


We can also use our brains to learn geography.  

The geography of disease spread is well-known, and includes hierarchical diffusion (moving from major cities to their satellites), spatial contagion (moving in an area) and network diffusion (moving among groups that are connected).  

People have diagrammed how this unfolded with the Covid-10 pandemic.   The New York Times made a diagram of the spread of Covid across the nation, before we caught on to what was happening.  El Pais shared three studies of infection in groups of people, people working in an office, on a bus, and in a restaurant.  These give us insights into thinking about reopening.  

Here's my take:
  • First, being together indoors at close quarters is the heart of the transmission process.  We have to spread out.  And we have to wear masks at all times.  This means NO to indoor dining.  It seems possible to be inside far apart -- more experience will tell us if this is so.
  • Second, being outside seems to be OK.  Masks are still essential and distancing is good.  But the great expanse of air helps, and moving helps.  A runner without a mask going by me is not likely to get me sick.  Happily it's summer -- let's be outside as much as possible.  
  • Third, standing around on a patio drinking in close quarters with other people does NOT count as outside. 
  • Fourth, if everybody would wear a mask, it would have a powerful effect on transmission. 
  • Fifth, as Thomas Edison would want us to remember, every failure will be a time for learning how to do it better.  We must keep studying every outbreak.
And here are some words of wisdom from my dear friend, Sara Crystal, RN, posted on Facebook (emphasis added by me):
yes I like to push and prod each of you to wear a mask and use precautions and get realistic in these desperate and tragic times. but I want to say, I feel we WILL get through this, have parties and potlucks and a vaccine and restart businesses and projects. we are in a cocoon right now and we WILL bust out. not by ignoring and pretending the virus isnt there, but by using all our capacity as a human race to overcome it. we will be healed. we must first acknowledge it and protect each other in love. weep with those who weep, be kind to the stranger, love one another with a pure heart fervently. try harder. do all the good you can. those who are younger and healthier must bear some of the burden for others. we will manage. and not by "herd immunity" bs, but by finding the true medical answers and sharing and helping and fighting for a real cure. let us not sacrifice anyone, ever. but never lose hope. every mask is a prayer and a song, and we will survive, stronger and better.

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