A Tale of Quarantine in two Cities

Part of living abroad is knowing that you might have to experience a “reverse culture shock” when you get back to the US. Well, I got the exciting bonus twist of coming back to the US of the COVID-19 twilight zone reality.

I knew it was going to be interesting. But what I didn’t expect was how much I would be impacted by something so abstract as contrasting responses to the pandemic. For a couple of days, I felt like my grasp on reality was slipping like a sweaty palm holding on to another sweaty palm trying to keep me from falling into a mind warp.

  1. Quarantine in Argentina

For more than a month, I was living in a country whose response to the pandemic was a mandatory quarantine since March 20; the plan was to slow the spread of the virus while they shored up their medical facilities and waited for advances in treatment options.

The president had said frankly when announcing the quarantine that businesses were going to suffer this year in order to save lives, to protect the elderly and those most vulnerable to complications from the coronavirus.

He had a well-articulated nation-wide plan (constantly evolving as new information came in). Even if I didn’t agree with all the quarantine policies, I always felt reassured after his speeches, probably because of how well he articulated the plan, explaining that he was taking advice from a range of health and economy experts. He even used power point slides to explain the plan for flattening the curve and to visually show the successes they had had in preventing deaths by limiting the spread.*

The measures were strict, and we were only supposed to leave the house to buy necessities (food and pharmaceuticals), and you could get arrested if you were caught wandering around for any other reason.

Luckily, I was able to easily adapt to the situation; I paused my travels and stayed in a beautiful spot in Bariloche with a friend. With nature as my backyard, I took it as a fortuitous time to rest and write.

I would wake up in the mornings and look out the window into a forest of trees, listening to the river flowing in the distance. After a yoga and a meditation session, I would write and have lunch. In the afternoons, I would usually go running or hiking through the forest. The sun would set around 8pm, and I would cook and eat delicious, healthy food with my roomie, and later we would sing songs, listen to music, watch documentaries, or read.

When hiking, we would usually encounter quite a few other people out, often families, sometimes couples, sometimes single runners. Often everyone a little on edge at first, making sure it wasn’t the police or someone that would call the police to snitch on us for being out of the house. But after that initial awkwardness, we relaxed knowing that it was just other people who appreciated the benefits of being outside in nature during these stressful and confusing times.

I could go shopping every other day, according to my ID number (odds were allowed to go M,W,F and evens Tu,Th,Sa – a policy implemented after cases started increasing in Bariloche). Shopping was often a half-day adventure because of the long lines of people standing a few meters apart, waiting to go in a few at a time.

Taking the scenic route to go shopping

I was staying a few kilometers outside of the city center so I had more of a rural experience. I would ride Tomás’ bike to the main road, taking the scenic route. Along the main road, I would go to the bulk foods store to buy things like oatmeal, nuts, dates, rice, beans, and most importantly – dark chocolate. Then I would go to the fish market next door, later to the cheese (and meat) store, and finally to the fruit and vegetable stand. Every now and then I would go to one of the supermarkets, but I really enjoyed taking advantage of the more fresh and local options where I chatted with the store owners that recognized me and I supported the local small businesses.

I was not unaware of my privilege during these times. A friend working for the local government was tasked with helping distribute food for those in need since many people didn’t have income during the quarantine. Bariloche has a huge tourism industry, many people earning a good portion of their income during the ski season in the winter months of June-August, and many others are self-employed doing trade work. While the government prohibited price-gouging, provided financial assistance for unemployment, and mandated that deadlines for utilities and rents be extended, needless to say, some people were still struggling. And winter was coming. (Though a friend pointed out to me that she also saw that a lot of people really step up to help each other out during these times, a generosity that seemed to be characteristic of many Argentines that I had met.)

To prevent the import and spread of cases, national and international flights had all been cancelled since March 20, and travel was not allowed except for essentials (like transport of food). This happened just as some of my Argentine friends were vacationing in Peru, and they weren’t sure how or when they would get home. After a few weeks, they were repatriated on an Argentine Air Force, quarantined in a hotel in the capital for 14 days (flight, food, and room and board paid for by the government), until they tested negative and could return home.

Into the Twilight Zone

What a contrast to my repatriation experience! When I arrived in the US after traveling on a plane with more than 200 people for more than 9 hours, we arrived in Miami airport, and it was as if COVID-19 didn’t exist. Nobody took our temperature, tested us for the coronavirus, or required us to go into quarantine. No one even asked us politely to quarantine ourselves, nor gave us instructions to do so. Nothing was done to ensure I wasn’t bringing one more case into the US.

I shouldn’t have been surprised because over the last month I had had many friends return to the US from all over the world, and they had the same story. Of 11 friends, eight had not encountered any kind of intervention to ensure they weren’t bringing the virus in. The three others had their temperature taken and nothing more. Two were recommended that they quarantine.

This left me asking myself: “Is it so out of control in the US that they’ve given up trying to limit the spread?” Or maybe there’s just enough confidence in our health systems that they’re not worried about another collapse like happened in New York or like what happened in Italy?

When I exited the skywalk and entered the airport in Texas the next day, I was stopped by a gaggle of uniformed men (the Texas Highway patrol) and asked to sign a form saying I would do a 14-day quarantine. Finally, I felt a little reassurance that someone had acknowledged the benefit of trying to limit imported cases to protect my loved ones from this pandemic. That said, there were no guidelines on how to do the quarantine and there was no follow-up to make sure I actually did the quarantine.

Then I heard the Texas Lieutenant governor say that he thought it was reasonable to put lives at risk to COVID-19 to prevent an economic downturn. The faces of my many loved ones that live in Texas – my mom, my dad, my aunts and uncles, my cousins and childhood friends – came to my mind.

The stark difference in approach from what I had gotten used to in Argentina, was shocking. I felt like I was going from one extreme to the other in the blink of an eye. (Well, Brazil might be the complete other extreme, but this still offered a stark contrast to what I had gotten used to).

I was surprised to see how much I was emotionally impacted by those larger forces around me making policy decisions, creating two different sets of rules for the same game. (Unsurprisingly, a policy based on the assumption of protecting public health and the lives of our loved ones had been more reassuring than a policy protecting the economy first.)

But at least now I understood better why I had been struggling to adapt to the new reality during the first few days, and why it had been so shocking and upsetting at first.

I had been living in a place recognized as one of the countries that has best controlled the spread, and I suddenly entered the country with one of the highest COVID-19 deaths per capita.

I have to say that it was fascinating to have had the opportunity to live in these two different realities – where different value systems, cultures, and economic circumstances were creating two different sets of rules.**

One of the most fascinating aspects is that Argentina, a country whose economy was already struggling through a serious downturn this year, decided to prioritize public health – people’s lives – over wealth. And the US, with one of the strongest economies in the world decided to prioritize it’s wealth over protecting the lives of its most vulnerable people. It really aligned with the experiences I had had in Argentina – the hospitality I had felt and all the experiences of people taking care of people and not expecting anything monetary in return – and actually being offended if you tried to offer something monetary.

 

  1. Quarantine in Texas

I arrived in Texas when the “Stay at Home Order” was being lifted, which also happened to be the day after the state recorded its maximum number of deaths due to COVID-19 so far up to that point.***

I had 14 days of quarantine to do, so the official announcement didn’t really impact me (other than the psychological aspect of it). While my quarantine was not being enforced by anyone, I did not come all the way back to the US to be closer to family so I could put them at risk.

I probably don’t have COVID-19, but I might. I traveled on three airplanes (2 completely full), walked through 3 airports, stayed in 2 hotels, and traveled in 2 taxis in Miami.

I don’t have symptoms and I don’t believe deep down in my heart that I have been infected. But reality doesn’t care what I believe. Many carriers that have been responsible for spreading it were asymptomatic. Since I don’t know for certain, I am acting like I am a carrier so that I can protect my loved ones in case what I believe is wrong.

Since I am in the same house with my aunt, this quarantine thing is a little tricky. I walk around with a mask on whenever I leave my room and go into the common areas. I wipe everything down with disinfectant after I sit somewhere for a long period of time, or after I eat. I disinfect the kitchen after preparing my food. Just in case, I don’t share the food I prepare with my aunt, which makes me feel like a horrible person, especially after living in a Latin American country for 4 years.

I maintain the 6 feet of distance from my aunt, whether we are inside or outside. When we are outside together, I try to stay downwind from her. I don’t pet the dog or the cats (just in case).

I touch my face a lot. My nose always itches probably because of the allergens here and/or the face mask always touching my nose. So I wash my hands a lot and use a lot of hand creme. It is a weird life. I was never the OCD type, at least not like this.

I spend most of my time outside, where I don’t have to wear a mask and I can breathe fresh air (and because I’m an outside, nature-loving kind-of person.) One time I ran to a park to exercise, and it there were so many people there, running and exercising! It was like normal, pre-COVID-19 times. It was a real challenge trying to stay a good distance from everyone.

My uncle and his wife surprised me and came to visit when I first arrived. It really made my day to see them! They brought their own chairs and sat 2 meters away from all of us, and we conversed for a few hours without physical contact. I didn’t hug them and I haven’t hugged my aunt since I got here a few days ago even though we haven’t seen each other in over a year. In Peace Corps, I won the “Most Likely to Give You a Hug” superlative, so you can imagine how hard that is for me. It’s a weird life.

My quarantine time is coming to an end, so I’ll be able to hug my aunt and visit my parents. I can’t wait to start living a “normal” life. Except not normal. Since there is a lot more movement here in Texas, I feel like I have to be extra careful since many others are not. There will probably be a higher risk of infection in the next couple of months (or who knows how long?), and I still am not trying to be a carrier and accidentally infect my parents or loved ones.

Living in two different realities under this pandemic has allowed me to see some of the pros and cons of different approaches. When it comes down to it, I don’t have any control over the policy choices that have been made, and I can only adjust to the situation under which I’m living. I feel encouraged by the fact that every week there is better understanding about the disease, how to treat it, how it spreads and what we can do to prevent spreading it.

This article in particular, “The Risks and How to Avoid Them,” made me feel a little more assured that by eliminating large gatherings (like the cancellation of sporting events, conferences, etc.) and taking the precautions that most people are starting to take individually, we can keep the spread low enough not to overwhelm hospitals.

Maybe I’m being optimistic. But for me, that’s one of the most important things to hang onto, even as your hands get sweaty, during any kind of crisis. Hope for the best, while being prepared for the worst.

 

Famous Footnotes:

* The quarantine started as a two-week duration and was extended three times while I was in Argentina. In the third extension, the measures began to be loosened in places without cases or with few cases. More power has been given to local governments along with the guideline to keep the rate of new cases lower than doubling every 15 days.

**One thing that I keep remembering is that one policy solution does not necessarily fit all. There are different customs, cultures, ways of gathering, ways of greeting, ways of getting around, etc, in each place, and those all can have profound impacts on how a virus spreads. One example (of many): In the few days I have been here in Texas, I am reminded of how much people are in their own cars, live far apart, and have a larger “space bubble” around them, compared to my four years in Latin America. That expectation of “personal space” that pervades much of American culture is something that might actually help with the COVID-19 physical distancing to minimize the spread of the virus.

***Reported numbers of deaths and confirmed cases tend to reflect the reality of the impacts of the disease spread from about 1-2 weeks prior (due to incubation time and the time it takes for symptoms and complications to appear). This was more than a month after the “Stay at Home” order was put in place.

 

We’re Number One!

It happened a lot faster than I expected. I’m not surprised, but I’m still crushed. Sad. Scared. Frustrated.

Anyone who has been watching the trends, (checking the JHU graph every day and reading what the experts have been saying), has seen this coming for a few weeks now.

We knew it was coming. We hoped it wasn’t. And here we are. We now have even more cases than China. Just a few days ago, major newspapers published that Europe was the new Epicenter. And now, (as if the US were obsessed with being first place in everything), we have taken first place in contagion.

It didn’t have to be this way. We got the virus later than others. We had the good fortune to have seen what worked and what didn’t work in controlling the virus. Southeast Asia controlled it by cracking down fast and hard. Italy let it spiral out of control because they waited and didn’t want to restrict freedoms or hurt the economy (understandably). Knowing the consequences of overloaded hospitals and high death rates, we chose to follow Italy.**

And here we are. With a problem now even bigger than Italy or China ever had to deal with.  (And we have less hospital capacity than Italy, with just 2.8 hospital beds per 1000 people, compared to Italy’s 3.2.)

We are now the experiment. We are now risking the lives of family and friends to show whether it was worth it to try to protect economic activity and freedom to move about.

Some said that maybe we could acquire herd immunity if the virus was just left to do its thing, which guided the UK’s weak initial response, but when simulations showed disastrously overwhelmed health care systems under this scenario, they changed course.

Sometimes I ask myself, what in the world motivated US leaders to make this decision? Some say they believed God would make everything ok. My dad always said God gives us brains (in this case, a community of people who have dedicated their lives to studying math, science, and medicine) and if we don’t use them, that’s on us.***

Well, the decisions have been made and I can’t do anything about the past. A wise person told me that dwelling on the past doesn’t do any good; healthy people learn from the past and move forward.

So, my lesson here is that not making swift and informed decisions of prevention is the same as making swift decisions to deal with a bigger, more expensive and extensive problem later.

Now, the moving on part.

Other countries that all acted earlier than us faced overloaded and understaffed and under-equipped hospitals. So, we will have to rise the challenge to address those needs. We will have to use our resources and specific talents to help out where there is need.

It would be nice to have strong federal leadership with a plan, but it is clear that our leadership does not heed advice of experts and their plans seem to revolve around protecting the wealthiest engines of the economy instead of the people that keep that same economy running.

So this is where we come together in a grass roots kind of way, looking towards the experts and community organizers that follow the advice of REAL experts to figure out where we can make a real difference.

This isn’t just about surviving boredom in the quarantine (though that’s important too).**** This is about coming together as a community to help each other out.

I have updated the list of things we can help with from my previous blog, and please let me know if you have others…

What can I do while I’m sitting at home in quarantine? Individual Action – what we need to (and can) do:

“In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.” (b)

 

https://getusppe.org/give/

 

  • Plan for a few months of economic disruption the best you can, and if you can, help those that are more vulnerable and those who can’t work from home and won’t be able to receive income during the quarantine.
    • Check for a “Virtual Tip Jar” in your area (google it for your area).
    • Forward your payment to the handyman, keep paying your dog walker or cleaning person if you have one and are able.
  • Share ideas on how to help in meaningful and practical ways, according to your interests and experiences. Many people are giving free online yoga classes. People are sharing at-home kids activities and home-schooling materials.
  • For people with medical training, there’s the Medical Reserve Corps (but if you hear of a better-organized way to volunteer, please let me know si I can add it here).
  • Learn something new, practice singing and dancing, try yoga, try meditation, do home workouts to keep the blood (and endorphins) flowing.
    • Free yoga classes with Ari_NYT – around an hour on weekends and 30 mins on weekdays
  • Read my blogs about my travels to take a break from the COVID-19 stuff. I promise, I will be returning to sharing my adventures in my next posts!

Most importantly, let’s help each other out and take care of ourselves too. Don’t ignore the anxiety and stress from the situation, accept and manage it by giving yourself some self time, by connecting with others – even if it’s phone calls and video chats.

We’re #1! Not because we don’t make mistakes, but because we get back up again every time.

Footnotes:

*Just yesterday (3-27), the JHU dashboard showed the number of US cases jumping past China and Italy. However, that is not to say that just yesterday we had a surge in people contracting the virus; actually it means that it happened a week or two ago. Since it takes between 2-14 days to show symptoms, the data today shows us what was happening about a week ago. This time delay means we also won’t immediately be able to tell if the measures we are putting in place are actually working because we won’t see the effects for a week or two.

**The US has been working hard to bring US citizens home, but it has been doing almost NOTHING to make sure those coming home don’t spread the virus. Eight out of 11 people I know who have gotten back to the states in the last few days told me they had absolutely ZERO screening related to the virus as the entered the US. Two of them had their temperatures taken. One of them was asked if they had been to China, but not asked if they had been through Europe, which is actually the current epicenter.

***This paragraph has been updated because its intention could be easily misinterpreted. My intention of referencing this saying was to point out that we have a well-established scientific and medical community of people that have dedicated their entire lives to studying math, science, and/or medicine so that we as a human society can make better decisions,  especially in circumstances like these. The current administration has consistently ignored, downplayed its value, and arrogantly contradicted its recommendations (citing one or two random people that have proposed contradictory theories that go against an entire community of people with evidence), and this situation is one of the more obvious consequences this attitude towards the scientific community.

****I am personally trying to view my time in quarantine as a type of meditation retreat where I am prioritizing time for myself each day and prioritizing time for relaxation. I know this isn’t as easy for everyone, depending on the circumstances, but I encourage everyone to try to carve out some self time. If not now, when?

Thank you to everyone who contributed ideas of how we can help, including: Monica Kang, Emily Tolos, Katherine Buckingham, Melanie Vant, Michael MacHarg, Catherine H. Clark, Stephen Zerfas, Stuart Murphey, Adrian Reif, Alyzza May, Stacy Kane, Nora L, Ari Isaacman Bevacqua, Harvey Floyd II.

COVID-19 Health Info Summary and What We Can Do

I found it incredibly helpful when a friend sent a summarized document with good sources about key information on COVID-19, so I thought I would do the same in case it is helpful for anyone.*

It has been tricky to filter through and find reliable information. However, after many days of intense investigation and the help of other people’s investigations, I was able to find some emerging themes of agreement by the majority of experts (as opposed to politicians and journalists) that I’ve compiled here. I am not an expert, and I have done my best to keep my opinion out of this and only repeat what experts have said.

While the situation continues to change, the trends tell a story of the seriousness of the situation due to the threat of overloading the health care system with the problems from this virus. Here’s my brief analysis looking at the charts from the JHU dashboard.

If you have come across better sources, contradicting information, other ways to help, or additional important information, please let me know so we can keep each other informed and wade through the good and bad information to make the best decisions for our families and communities.

Why we’re worried: Overload of hospitals due to the rapid spread and respiratory problems caused by this virus. (Leading to having to choose which patients will receive critical treatment and which will be left to luck, as they have had to do in Italy. (a))

What we need to do: Quarantine ourselves NOW and prepare to respond to increasing hospital overload – lack of personnel and lack of equipment (ventilators, oxygen, and PPE (masks and gloves) for health professionals). Note that this could last as short as two weeks, but more likely a month or more.

https://tincture.io/dispatch-5-from-the-front-lines-eb672f2f2988

But can’t we just quarantine affected areas?  – To some extent but not really. Why?

  • Symptoms can take more than a week to show up, so seemingly healthy people continue to infect others, and areas that seem to be free from cases could actually have cases.
  • The virus has spread to all 50 states rather than being contained in one or a few controllable areas, due to not being able to test and contain it early on. Since it’s too late to easily isolate it, a more extensive quarantine response is needed to control it.
  • We don’t have enough tests to do widespread testing and be able to isolate all existing clusters.

But do we really all have to stay at home in this draconian measure of isolation? -Well, yes, if we want to minimize the overload of hospitals and extra deaths caused by that overload.(a)

  • For the measure to work, a full quarantine is needed for at least a couple of weeks. At this stage in the spread of the virus, full quarantine is the only thing that has been shown to help slow the spread. (b)
  • Examples of how other countries have handled a late response (Europe’s weak restrictions) show that “the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.” (b) At this point, limited restrictions don’t work and a nation-wide freeze is the only strategy that has been effective in slowing the increase in new cases. (Some Asian countries didn’t use the full country-wide quarantine, but they also acted early and contained the virus quickly. Unfortunately, the US has most likely long passed that window of opportunity.)

“If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt. The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.

The crisis would be over.

Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.” (b)

“Active Cases 3-26”. Southeast Asia, while it used to be the epicenter of the epidemic, is controlling the spread, whereas Europe has exploded as the new epicenter. The US is currently following in Europe’s footsteps in terms of policy actions and rate of increase. https://coronavirus.jhu.edu/map.html

Personal Prevention (for the next few weeks to a month, at least):

  • Quarantine ourselves – practice physical distancing. Don’t visit others. Do video meetings, create social events over video.
  • Wash hands with soap and water often and keep surfaces disinfected. The virus can live on surfaces for up to 9 days.(c)
  • To get groceries (or go where there are other people) maintain 6 feet between people and wash hands with soap and water afterwards.
  • Don’t hug or shake hands with neighbors and those outside of your house – do the elbow bump or wave from a distance
  • Stay home if we are sick or vulnerable to get sick (ask for help and send someone else to do the purchases), (except for seeking medical attention if necessary).

 

What if I show symptoms or someone I know is does?
Most common symptoms of COVID-19: Fever, Dry cough, Difficulty breathing (c)

  • If you have these symptoms but they are not critical, the ideal thing is to get tested. The CDC is recommending that you stay at home (c) so as not to spread the virus and overwhelm hospitals. If you decide to recover at home, isolate yourself from others in your house to prevent spreading it to your family members. (How to isolate: https://hub.jhu.edu/2020/03/23/how-to-self-quarantine-self-isolate/) (Note that 70-80% of transmission in China occurred among families, so experts recommend isolation, as crappy as it sounds.) (b). HOWEVER, If you decide to seek medical care instead of staying at home, I personally think that’s a great idea for your own health, the health of your family, and also because getting tested can be helpful in tracking and controlling the virus.
  • Wash hands with soap and water often and keep surfaces disinfected. The virus can live on surfaces for up to 9 days(c)
  • Notify all those that you’ve been in contact with in the last 14 days so they can be sure to quarantine themselves and be extra careful not to spread the virus to others just in case they were exposed.
  • CDC says: Definitely seek medical care if you have these symptoms: Trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face. (c)
  • You can check your symptoms here: https://c19check.com/terms-and-conditions

 

What if I was in contact with someone that tested positive

  • Symptoms appear 2-14 days after exposure (c)
  • Stay in isolation for 14 days, checking your temperature daily. “Finding and testing all the contacts of every positive case is essential, experts said. Contacts generally must remain home for 14 days and report their temperatures twice a day.” (b)

 

What can I do while I’m sitting at home in quarantine? Individual Action – what we need to (and can) do:

“In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.” (b)

  • Help each other out, have a little more patience and compassion since we’re all going through crazy times
  • Do you happen to have nitrile gloves, hand sanitizer, surgical masks, or especially N-95 masks that could help protect a medical professional? Find a donation center here: https://getusppe.org/give/ and donate N95 masks here too https://www.projectn95.org/
https://getusppe.org/give/
  • Plan for a few months of economic disruption the best you can, and if you can, help those that are more vulnerable and those who can’t work from home and won’t be able to receive income during the quarantine.
  • Check for a “Virtual Tip Jar” in your area (google it for your area). Forward your payment to the handyman, keep paying your dog walker or cleaning person if you have one and are able.
  • Share ideas on how to help in meaningful and practical ways.
  • Be creative in connecting with family, friends, roommates, etc. whether it be virtually or those with whom you live. https://www.convers-ate.com/
  • Learn something new, practice singing and dancing, try yoga, try meditation, do home workouts to keep the blood (and endorphins) flowing.
  • Ask to your reps to prioritize health worker protection: https://p2a.co/LPxXH7j
  • If you’re into communicating with our representatives, here’s the experts’ thoughts on action at the national level:

Federal Intervention Necessary:

  • Coordinate an effort for the production of ventilators. “The roughly 175,000 ventilators in all American hospitals and the national stockpile are expected to be far fewer than are needed to handle a surge of patients desperate for breath.” (b)
  • Coordinate an effort for an increase in supply and delivery of oxygen. “The United States must also work to increase its supply of piped and tanked oxygen, Dr. Aylward said.” (b)
  • Coordinate a mass scale of training volunteers. “With training, volunteers were able to do some ground-level but crucial medical tasks, such as basic nursing, lab technician work or making sure that hospital rooms were correctly decontaminated. Americans often step forward to help neighbors affected by hurricanes and floods; many will no doubt do so in this outbreak, but they will need training in how not to fall ill and add to the problem.” (b)

“Federal intervention is necessary for some vital aspects of life during a pandemic. Only the federal government can enforce interstate commerce laws to ensure that food, water, electricity, gas, phone lines and other basic needs keep flowing across state lines to cities and suburbs.” (b)

 

-Footnotes-

*I found that finding reliable information on the COVID-19 situation is full time work, especially if one actually looks across the spectrum of sources (because unfortunately much of the information is politicized, some outdated, and some misleading.) Here’s the best readable source I found, in case you want to read a doctor’s perspective: https://tincture.io/dispatch-5-from-the-front-lines-eb672f2f2988

a. Situation in Italy: https://www.npr.org/2020/03/21/819645036/u-s-hospitals-prepare-guidelines-for-who-gets-care-amid-coronavirus-surge

https://www.nejm.org/doi/full/10.1056/NEJMp2005492

Text message received from a contact in Italy (Carlos, Wednesday, 25 March) (translated from Spanish): Here in Italy hospitals are overloaded and don’t have the PPE (masks, gloves, etc) for the hospital personnel, but every day they are mobilizing more to create space in hotels and other sites. The military has also helped build infrastructure for aid. Everything has been closed for 17 days and until April 3rd, though this timeline will probably be extended. Since yesterday, the number of deaths increased but the number of cases decreased. This week is the key week that will tell if the quarantine measures are working and if the decrease in the spread has started.

b. This is one of the best summaries (though still really long) of all the most common conclusions among reliable sources: https://www.nytimes.com/2020/03/22/health/coronavirus-restrictions-us.html

c. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

d. “As soon as possible, experts said, the United States must develop an alternative to the practice of isolating infected people at home, as it endangers families. In China, 75 to 80 percent of all transmission occurred in family clusters. Instead of a policy that advises the infected to remain at home, as the Centers for Disease and Prevention now does, experts said cities should establish facilities where the mildly and moderately ill can recuperate under the care and observation of nurses.” https://www.nytimes.com/2020/03/22/health/coronavirus-restrictions-us.html

 

Maps visualizing case numbers:

  1. https://coronavirus.jhu.edu/map.html (I find it more helpful to view the tab at the bottom of the map “actual cases” to see the current situation. In my opinion, the most important information is in the bottom, right hand corner, watching and comparing the “Daily Increase” of each country.
  2. https://www.nytimes.com/news-event/coronavirus

 

Note that Europe is now the epicenter and Asia is controlling the epidemic, with Italy and Spain our examples of the worst case scenarios. https://www.npr.org/sections/coronavirus-live-updates/2020/03/25/821370109/spains-coronavirus-death-toll-soars-past-china-s-trailing-only-italy