COVID-19 is not a nightmarish hemorrhagic fever straight out of an apocalyptic contagion movie. It doesn’t kill 90% of people infected by liquefying their internal organs within 48 hours of first exposure. Of course it is a good thing we are not facing something so horrifying and deadly. But the virus we are facing is potentially lethal, and not just to those in the most vulnerable demographics. The combination of its infectiousness, its capacity for being carried asymptomatically, and the two to three week lag between infection and onset of symptoms are its most insidious weapons.
People being contagious while completely without any trace of symptoms is obviously a massive challenge in terms of tracking and containing its spread. If you have never had any symptoms it would never occur to you to seek voluntary testing and in large industrialized countries it can be difficult to mandate universal testing, just in terms of logistics and supplies to say nothing of the certainty of seeing at least some societal resistance.
But a large number of people walking around asymptomatically contagious isn’t just a logistical problem, it can have a powerful effect on the potential levels and vehemence of that societal resistance. If people don’t appear sick it can be difficult to convince an entire population to undergo major alterations to the patterns and quality of their lives.
We saw a fair bit of that resistance in the earliest stages of the pandemic as lockdowns and distancing restrictions were put in place. Even now all the way at the top of prominent national governments there continue to be those in leadership positions who still seem unwilling, or unable, to acknowledge the serious nature of the threat this virus presents.
And we are seeing more of it now that our lockdown fatigue, further fueled by very real economic desperation, is making the idea of slowly inching our way back out into functioning society even more painful than the lockdowns themselves. It is natural and understandable. We want our old lives back. We want all this strange mutation of our daily lives to stop and go away.
For those of us who don’t wear masks all the time they can be awkward, uncomfortable, and the minor increase in the effort required to breathe with even a thin barrier over our nose and mouth can make it feel like our breathing is being compromised. For the record, masks are uncomfortable not dangerous.
The psychological impacts of extended physical and social isolation are well documented and on some levels being out and about in public but still remaining protective and leery of distance from one another can feel as bad, or worse, than being quarantined at home.
Those of us fortunate enough to be receiving financial support while unable to work due to our places of employment being shutdown, even if that support is sufficient to sustain us, are aware it cannot be maintained indefinitely. The monetary realities of needing to be able to work and earn or to preserve our businesses makes reopening a necessity not just a desire.
With all of this pushing at us it is no surprise our psyches and impulses have us chomping at the bit to get our lives moving again. Continued patience and caution require a clear and relevant threat and this is where low but still significant illness and mortality rates show their true danger.
The vast majority of serious illness and death is occurring inside medical and long term care facilities. The resources of those facilities in many areas are being overwhelmed to the point it has become necessary to build emergency extra hospital capacity, to ship patients to other locations sometimes several hours away, and to stockpile bodies of the deceased in refrigerated trucks.
We hear about these things, and are concerned or even heartbroken by them, but very few of us see or come in contact with them directly.
Hospitals which are overrun still look like ordinary hospitals from the outside. They don’t look as though they are suffering the ravages of a full scale prison riot. Their stoic exteriors bely the chaos, extreme stress, and tragedy unfolding within.
We have been staying home to prevent the spread of the virus not because we are seeing every other household containing infected people fighting for their lives. We don’t have plague wagons rolling through our neighborhoods collecting the dead from houses with markings on their doors.
We are able to clearly see the social, economic, and societal impacts both on the personal and broad scale. We are not able, or being forced, to see the health dangers and costs in the same clear way. The ‘out of sight, out of mind’ factor makes this virus seem dismissible and all these pressures pushing at us would really quite like that to be the case.
The extra kick in our collective shins this virus gives us comes through the potential two to three week lag between infection and the onset of symptoms.
If we’re not sure whether something is too hot to touch reaching out to investigate will, for good or for ill, provide clear and immediate results. Thanks to the two to three week lag time we don’t have the same luxury with COVID-19. Our actions today may not have any noticeable consequence until as many as fourteen to twenty days later.
And what’s worse those consequences may not even be noticeable to us at all either because those within our circle wind up with only minor symptoms or no symptoms whatsoever or because any serious illness only occurs once the virus has bounced from us to the next to the next a couple of times and out of our awareness.
Without any barriers or restrictions this virus spreads on average at a rate of one to three, each person infected (even if completely asymptomatic) infects typically three people. After the virus has bounced just ten times away from the first person, with each successive person infecting another three, the number of infections comes in at just over 59,000.
Let’s trace a path hypothetically. Somehow I end up picking up the virus but am completely asymptomatic carrying on with life as usual. If I do not take any precautions and instead head to a public gathering of any size three other people leave that gathering will now be infected. Returning home they infect the other members of their family. The next time one of them goes to the grocery store they end up infecting three others who then go home and infect their family members. Some of them go to work passing the virus to three coworkers who then go home and so on and so on.
If unfettered by any precautions or countermeasures by the time the virus has done this little pin-ball routine ten times away from the my initial trip to the gathering, allowing for five days between jumps, in just under two months the numbers have gone from 1 to over 59,000. And just imagine if I attended the gathering with a partner who was also infected. Make that eventual total over 118,000 instead, in the same amount of time.
Sounds bad, we can all agree on that. But our concern starts to back down when we think that out of the 59,000 only 8,850 might become seriously ill. And only 26 might actually die. Comparatively 26 sounds like a much smaller and less worrisome number.
I would challenge you, however. Count up all the members of your immediate family and circle of friends then continue into the extended family until you reach 26 names. If all 26 of them were the ones to die the number might suddenly not seem so insignificant. While we can be grateful this virus doesn’t kill 50,000 of every 59,000 each one of those 26 are someone’s spouse, sibling, child, parent…
Each one of them had plans for the rest of their year, and years beyond, and people in their lives who are now devastated by their sudden loss. Just because that loss occurs out of the direct public eye does not mean it has any less meaning, causes any less pain, or is any less tragic.
So as we push and chafe and grumble and jostle towards restarting and reopening try to approach it this way. Assume one person you will come in contact with today will be one of those estimated millions of asymptomatic, undetected, and unrecorded cases of positive infection.
Will you be part of their chain of 10 which leads to 59,000 and to 26? Or will you take some simple precautions which, while potentially awkward and uncomfortable, can break that chain? Especially if it could mean preventing one of your loved ones from becoming one of the 26 to die at the hands of someone else’s chain of 10.