My morning started with a good friend of mine who lives with some pets in a house in a rural area and, when there are no viral shut downs, she's a teacher in an international school. Oddly enough, she and some other friends of mine, many of them connected with schools but not all, came down with a really nasty flu, for lack of better identification, that involved high fever, aching limbs, a dry cough, and no real respiratory symptoms...but this was in November/December before COVID-19 had even been identified as far as we know. For my friends a penny dropped with the symptom description, but as far as anyone knows, this virus hadn't been even identified in China at that point. Egypt does have a huge number of Chinese companies and workers, but there is no way that I know of to identify what this was in hindsight. And just for the record, all of them survived the experience or I would never have heard of it. But recently she had gone to another part of Cairo where she walked into a shop to buy a bagel (most other things were closed) which she ate while watching the Nile. Later a couple of her friends were very upset with her for doing this and she was wondering where the anger was coming from. I suggested that the vitriol that sometimes is spilling out into statements of what someone should or shouldn't be doing in this time of concern over disease is probably based in fear.
All of the people that I know, not just this group that got sick before, are sheltering in place, trying to avoid contact and possible contagion. For some people this carries a lot of emotional baggage and I do know people who are spending much of their days in a fog of anxiety and fear. I know people who have dogs in the city who have to go for walks furing which they encounter people who demand to know how they can be endangering others in this fashion, and I know dogs that have been dumped by people who can't deal with that. Two of my dogs recently brought home a lovely spayed, flea and tick-treated female dog who had been hanging around my front gate for a month. She is definitely a family dog down on her luck and no one identified her on the page for lost animals that I run here on Facebook. She's quite happy to have a home. I have horses who live in a 3/4 feddan (acre) paddock where they can run around, and dogs who have all of 3 feddans (acres) to run in, so I don't have to venture off my farm due to animal need pressures.
I can hole up in my home, I can wander around and work in the gardens...for me this shut down is just fine, other than the fact that my animals still need to eat and I still need to pay for their food and my staff's salaries. I am one of the fortunate ones and I will never forget this fact. And for now I'm reading things online that are very thought provoking. Susan Sontag's Disease as a Metaphor was published in the New York Review of Books in 1978 and is primarily concerned with how we use disease to define our personal and political world, as in "Communism is the exasperation of the bureaucratic cancer that has always wasted humanity. A German cancer, a product of the characteristic German preparationism. Every pedantic preparation is anti-human….". However, what struck me as I was reading it was the automatic assumption that unless something from our environment like a bacteria or a virus attacks our bodies, we are somehow clean or healthy by default. In fact, research in science since she wrote this has indicated that every human body is a delicate balancing act involving billions of bacteria, viruses, fungi, as well our own tissues, and much of health is defined by keeping all of these things in balance. This is an entirely different world view. Yes, a virus or bacteria or fungus that throws off this balance can cause havoc as we are seeing with COVID-19, and some of the "risk factors" mentioned with regards to who is getting very ill as opposed to who is just sick, are in fact imbalances among the normal inhabitants of the human body.
Another article from the Atlantic that appeared in my timeline is more recent. The Pattern That Epidemics Always Follow is one of the most rational articles that I've read regarding the current situation in the world. Karl Taro Greenfeld was the editor of Time Asia and was based in Hong Kong during the SARS epidemic in 2002. This was an outbreak that was quite similar to the current problem. It was also a product of the wet markets for wild animals but it was spread quite differently, which meant that the "solution" to the problem was different as well. Where Sontag was looking at social and political systems that have been described as medical problems, Greenfeld is much more pragmatic and is discussing how people react to epidemics.
"Which brings us to the last stage of epidemic grief: rational response. After denial, panic, and fear, we can finally get down to the business of basic sanitary measures and infection protocols. At Time Asia, we urged better hygiene. We reminded anyone with a fever to stay home. We looked on as the medical establishment formalized the clinical response, determined diagnostic criteria, and isolated the virus."
Greenfeld reminds us that epidemics are inherently terrifying for people because they are larger than people. It is only recently that we have identified the tiny culprits, the bacterias, viruses, molds, and fungi, that instigate the epidemic, but still we are frightened because the imbalance in our families, communities and social structure is enormous and debilitating. When we take a deep breath and look at the data from the World Health Organisation we will see that there are 189 countries reporting cases of COVID-19, there are 267,013 reported cases of it worldwide, and that there have been 11,201 confirmed deaths worldwide. If we look at the numbers of deaths from road accidents alone in Egypt as reported by the same organisation we will see that there are generally around 12,ooo each year with the figure rising slowly but surely. There were more deaths from traffic accidents in Egypt last year than there have been deaths all over the world from COVID-19.
It is easy to say that this comparison is unfair. The figure for traffic deaths is for an entire year and we are looking at a few months for COVID. This is true. But again, this is only for one country. What if we looked at the worldwide figure for traffic deaths in a year? This is currently 1.3 million people. Cars and driving, especially when combined with alcohol, are still vastly more endangering. Will COVID-19 turn out to be worse? It is possible, but I don't think that any medical person would predict this.
What is so disconcerting to all of us is the sudden imbalance in the availability of medical assistance when many people need the services but hospitals and doctors are overwhelmed by a rush of demand for their help, the lack of transparency on the parts of many governments who refuse to acknowledge that any problem even exists (which adds a great deal to the general stress and anxiety), and the fear that each of us could be a target for some tiny thing that might make us ill in varying degrees...or that we might pass on to our loved ones. So it's time to take a deep breath and look at all of this rationally.
What do we do in this situation? COVID is spread by contact with a virus in fluids that can remain on surfaces or contact us directly. Staying as far apart as possible is a good idea. Isolating ourselves if we feel at all unwell or if the risks to us if we become sick are much higher than for other people is also a good idea. It isn't possible for some people to stay home from work, starting with medical staff, but also for people who have to transport our food from fields to markets, for people who work in the sources of our food such as markets and shops, for people who work in banks or other services, for the people who are in police forces or ambulance personnel , for the people who collect the refuse, for the people who work in gas stations, for farmers, for transport drivers (cabs, buses, metros and so on), for people who simply cannot afford not to work for fear that their families will have nothing to eat, for many more people than we have even thought about for many years. This is a good time to look at our links to our communities and consider how those links can teach us to care for each other.
May everyone remain well.
copyright 2020 Maryanne Stroud Gabbani
All of the people that I know, not just this group that got sick before, are sheltering in place, trying to avoid contact and possible contagion. For some people this carries a lot of emotional baggage and I do know people who are spending much of their days in a fog of anxiety and fear. I know people who have dogs in the city who have to go for walks furing which they encounter people who demand to know how they can be endangering others in this fashion, and I know dogs that have been dumped by people who can't deal with that. Two of my dogs recently brought home a lovely spayed, flea and tick-treated female dog who had been hanging around my front gate for a month. She is definitely a family dog down on her luck and no one identified her on the page for lost animals that I run here on Facebook. She's quite happy to have a home. I have horses who live in a 3/4 feddan (acre) paddock where they can run around, and dogs who have all of 3 feddans (acres) to run in, so I don't have to venture off my farm due to animal need pressures.
I can hole up in my home, I can wander around and work in the gardens...for me this shut down is just fine, other than the fact that my animals still need to eat and I still need to pay for their food and my staff's salaries. I am one of the fortunate ones and I will never forget this fact. And for now I'm reading things online that are very thought provoking. Susan Sontag's Disease as a Metaphor was published in the New York Review of Books in 1978 and is primarily concerned with how we use disease to define our personal and political world, as in "Communism is the exasperation of the bureaucratic cancer that has always wasted humanity. A German cancer, a product of the characteristic German preparationism. Every pedantic preparation is anti-human….". However, what struck me as I was reading it was the automatic assumption that unless something from our environment like a bacteria or a virus attacks our bodies, we are somehow clean or healthy by default. In fact, research in science since she wrote this has indicated that every human body is a delicate balancing act involving billions of bacteria, viruses, fungi, as well our own tissues, and much of health is defined by keeping all of these things in balance. This is an entirely different world view. Yes, a virus or bacteria or fungus that throws off this balance can cause havoc as we are seeing with COVID-19, and some of the "risk factors" mentioned with regards to who is getting very ill as opposed to who is just sick, are in fact imbalances among the normal inhabitants of the human body.
Another article from the Atlantic that appeared in my timeline is more recent. The Pattern That Epidemics Always Follow is one of the most rational articles that I've read regarding the current situation in the world. Karl Taro Greenfeld was the editor of Time Asia and was based in Hong Kong during the SARS epidemic in 2002. This was an outbreak that was quite similar to the current problem. It was also a product of the wet markets for wild animals but it was spread quite differently, which meant that the "solution" to the problem was different as well. Where Sontag was looking at social and political systems that have been described as medical problems, Greenfeld is much more pragmatic and is discussing how people react to epidemics.
"Which brings us to the last stage of epidemic grief: rational response. After denial, panic, and fear, we can finally get down to the business of basic sanitary measures and infection protocols. At Time Asia, we urged better hygiene. We reminded anyone with a fever to stay home. We looked on as the medical establishment formalized the clinical response, determined diagnostic criteria, and isolated the virus."
Greenfeld reminds us that epidemics are inherently terrifying for people because they are larger than people. It is only recently that we have identified the tiny culprits, the bacterias, viruses, molds, and fungi, that instigate the epidemic, but still we are frightened because the imbalance in our families, communities and social structure is enormous and debilitating. When we take a deep breath and look at the data from the World Health Organisation we will see that there are 189 countries reporting cases of COVID-19, there are 267,013 reported cases of it worldwide, and that there have been 11,201 confirmed deaths worldwide. If we look at the numbers of deaths from road accidents alone in Egypt as reported by the same organisation we will see that there are generally around 12,ooo each year with the figure rising slowly but surely. There were more deaths from traffic accidents in Egypt last year than there have been deaths all over the world from COVID-19.
It is easy to say that this comparison is unfair. The figure for traffic deaths is for an entire year and we are looking at a few months for COVID. This is true. But again, this is only for one country. What if we looked at the worldwide figure for traffic deaths in a year? This is currently 1.3 million people. Cars and driving, especially when combined with alcohol, are still vastly more endangering. Will COVID-19 turn out to be worse? It is possible, but I don't think that any medical person would predict this.
What is so disconcerting to all of us is the sudden imbalance in the availability of medical assistance when many people need the services but hospitals and doctors are overwhelmed by a rush of demand for their help, the lack of transparency on the parts of many governments who refuse to acknowledge that any problem even exists (which adds a great deal to the general stress and anxiety), and the fear that each of us could be a target for some tiny thing that might make us ill in varying degrees...or that we might pass on to our loved ones. So it's time to take a deep breath and look at all of this rationally.
What do we do in this situation? COVID is spread by contact with a virus in fluids that can remain on surfaces or contact us directly. Staying as far apart as possible is a good idea. Isolating ourselves if we feel at all unwell or if the risks to us if we become sick are much higher than for other people is also a good idea. It isn't possible for some people to stay home from work, starting with medical staff, but also for people who have to transport our food from fields to markets, for people who work in the sources of our food such as markets and shops, for people who work in banks or other services, for the people who are in police forces or ambulance personnel , for the people who collect the refuse, for the people who work in gas stations, for farmers, for transport drivers (cabs, buses, metros and so on), for people who simply cannot afford not to work for fear that their families will have nothing to eat, for many more people than we have even thought about for many years. This is a good time to look at our links to our communities and consider how those links can teach us to care for each other.
May everyone remain well.
copyright 2020 Maryanne Stroud Gabbani
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