Wednesday, April 29, 2020

Life in the Time of Coronavirus, Snapshot #4

We've settled into a pretty good work and school from home routine here. This is not optimal, but it is doable for us and for that I am grateful. The kids and I go for a walk pretty much every day - Petunia skips some days, but she's coming more often now. She's picked out a favorite house a couple blocks over and likes to walk by and visit it. We all like looking for new teddy bears in people's windows and pretty flowers in their front gardens. The hardest part of this routine is scheduling - between my work calls, the kids' school calls, and some Zoom tutoring Pumpkin is doing for younger kids it can sometimes be hard to find a 30 minute block of time for our walk. We usually manage, though, and have only had to postpone the walk to after dinner a couple of times.

Some days are better than others, of course. Tuesday, work really wore me down. I had a Zoom call with a friend after dinner, and struggled to explain why, exactly, work wore me down. It was a mix of several different frustrations I think, of which the extra difficulties created by working from home were only a small part. I think the bigger problem is that my usual ways of letting go of work annoyances are blocked to me and I haven't really found good replacements. I need to work on that because I honestly expect to be working from home for at least another couple of months and probably longer. (That doesn't mean I expect the stay at home order to be unchanged, but I have the sort of job that is easiest to do from home and I think people like me will be asked to keep working from home even as other things open back up.)

Today, I woke up with a headache and ended up taking some ibuprofen with a big glass of Propel and going back to sleep for an hour. I'd arranged to donate my small supply of N95 masks (bought as preparation in case of high smoke during fire season) to San Diego county's PPE donation center so even though I started work late, I had to take a break around 9 a.m. to go do that. I had been planning to make a Target run tomorrow. Our toilet paper supplies were getting a bit lower than I liked and toilet paper is the one thing I haven't figured out how to get delivered.  Since I was going out already, I checked Target's website and saw several types of toilet paper in stock at my local store. So after I dropped of the masks, I went to Target.

I got toilet paper, but it is a brand I've never heard of, not one of the brands the website said was in stock. I got to the store before 10 a.m., and there were 10 packs of toilet paper left on the shelf. I took one pack with 12 rolls in it. I think Target is limiting quantities you can buy, and even if they weren't it would have felt wrong to take more. This extends our toilet paper runway to 6-8 weeks, and presumably sometime in that period we'll be in a store that has toilet paper again.

I also got almost everything else on my list. There was no Fresca, unfortunately, and also no parchment paper (for baking). But both of those things I can try ordering from the grocery store, so we'll cope.

Our order to wear face coverings if we're coming within 6 feet of anyone goes into effect on Friday, but already most people were following it. For the most part, people kept their distance, too. It was not a fun shopping trip but it was far less stressful than the early trips I took to grocery stores. I think I'll be OK with doing more in person shopping now, but we'll keep trying to minimize it.

Anyway, that's a lot of words to say "we're coping OK and settling into a routine we can stick with for as long as we need to." That has been my goal - to make life in these weird conditions feel OK, so that we can deal with the uncertainty about when conditions will be less weird. In conversations with friends and in the online discourse, it seems that the uncertainty about how long we'll be living like this is really getting to people.

I get it. There is no way we're all going to live like this until a vaccine is ready.  The timeline for a vaccine is too long and people's resolve is already fraying. Or if their resolve isn't fraying, their nerves are, and they're struggling to see the point of what we're all doing if we're going to have to open things up without a vaccine, anyway.

There are three things I hold on to that help me NOT feel that way:

(1) My state and local governments are building testing capacity, and they're starting to work out how they're going to be able to do contact tracing at the scale needed to make an impact on virus spread. This means that even without a vaccine, we will have a safer way to open things up if we wait a bit longer. Yes, it would be better if we had a national strategy for this but that's not going to happen until January of 2021 at the earliest so I'll just be glad for what my state and county are doing. Epidemiology studies are also starting to come in, which will tell us more about what activities are riskiest so that we can make better decisions about what to open up and what to keep closed.

(2) I am not a doctor or an expert on critical patient care, but it seems to me from watching what happened in New York and Italy that there is a lot of value in keeping the hospitalization levels low enough to allow doctors to have plenty of time for each COVID-19 patient they have. I suspect this decreases the fatality rate. I am sure this decreases the strain on medical staff, and also on the people in the area. I am willing to put up with a lot to keep the hospitalization levels well below capacity in my area. If I ever start to feel impatient with the stay at home order, I think about this.

(3) Even if no vaccine is developed and we're all going to end up getting this virus eventually, I think that every day I can delay getting it improves my chances of a better outcome if I do get it. Clinical trials are underway - as we get more results from those trials, doctors will have a better idea of what drugs might provide a favorable benefit-to-risk ratio. Doctors are learning from what seems to work best for their patients and are sharing that information as quickly as they can. As drugs start to show promise, we'll need a strategy to scale up manufacturing and we'll need to figure out optimal dosing. This work is already underway for remdesivir, but it will take time to build up supplies of the drug to the point where anyone who needs it can get it (if it indeed turns out to be helpful).

These three things all feedback on each other, too - if we keep case numbers low, we need fewer contact tracers and less amounts of any drug that is useful. If a drug is truly beneficial, it can reduce the load on hospitals. If hospitals are not overloaded, doctors have time to try more things and learn more about what helps their COVID-19 patients. And so on.

So even with no defined end in sight, it is worth going as slow as we can on opening things up. A slow approach also lets us learn what things have an impact on case load. We have no choice but to run experiments on ourselves to find out what is safe, but if we open things up slowly, at least those experiments will give us useful information and not just a big spike in cases.

I do think we'll get a vaccine eventually, but that we'll be very lucky to have one in 2021. I don't look to a vaccine as the way out of what we're living through now. It may be the way back to something that really feels "normal" but we'll get to something better before then. We just need to remember why we're taking things slow and be as patient as we can be.


  1. My sister's (large) company has interpreted the governor opening up our state as mandatory rather than optional and wants the set limit of every unit to be at the office at any point in time. This makes no sense for white-collar units especially since they're still expected to social distance. My university and town have interpreted the set limit as the maximum and are not making any changes for non-essential employees except to allow small businesses to have a small number of people inside at a time if they can effectively social distance. My university has also interpreted forcing people on campus at this time as an ADA class-action lawsuit waiting to happen.

  2. This is what I keep telling myself too. It's not easy or fun, but the whole point of staying away from people isn't to expect the virus to magically disappear or for a vaccine to appear overnight, it's to give people time to do the work needed to get us testing and vaccines without being overwhelmed by volumes of people being hospitalized, and to make sure that people who are sick can get good care when they need it. If we can buy them time by biding our time, that's not a bad trade.


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