Writing Personal Histories on Covid-19 for future generations - Part 1

 Heroes of a Pandemic is a good start on writing personal histories and experiences on this pandemic called Corona virus. I'll link this together with Differential Effects of Intervention Timing on COVID-19 Spread in the United States This study gives weight to one theory — and cautions against reopening the country without adequate ability to control new outbreaks. Researchers said 54,000 deaths could have been prevented in the U.S. had states implemented social-distancing guidelines earlier. And they warn tens of thousands more could perish as the country begins to reopen.

January 2020 news started to spread over the Corona virus in different context in the US. In San Francisco's bustling convention business for example, The Fancy Food Show, Intersolar-Photonics conferences that month had shown signs on the impact of conference attendees and exhibitors. Exhibition halls were drastically getting changed real time as show management had to fill and move exhibitors around. The issue that time was International Exhibitors like from China, Korea, Germany, the UK called off last minute that the shows had empty booths. 

Mid February 2020, San Francisco's big RSA Security conference took a toll when traditionally the long lines in Registration didn't turn out all these years. The Mayor of San Francisco, London Breed declares an Emergency for the City, the first one which raise eyebrows in all facets. Today, this step in history will be recorded as the first intervention which we could have turn the alarms as a nation. Kudos to San Francisco having suffered all the disparities of HIV and the 1918 pandemic notwithstanding economics to the most vulnerable that will eradicate a big part of the city's population if the tides were turned and it became the epi-center like New York.

Social distancing as the best intimidation for this virus then and now is a huge challenge to a bustling metropolitan cities like San Francisco and New York where everyone takes public transit, walks to work. San Francisco's huge housing problem and disparity having so many homeless and SRO's added to the low income minorities sharing an a one bedroom apartment with 4 people. So in March, San Francisco's mayor realized the nightmare at hand and again San Francisco became the first city to order a "Shelter in Place". This followed with 6 cities establishing a county effort and which immediately followed by Gavin Newsome, declaring the State of California to have a shelter in place order.  

These efforts where culminated with the Heroes on our public health sector, the epidemiologist, the scientist, immunologist science and data. As Governor Newsome of California mentioned the state is also blessed having some of the most advanced teaching hospitals and laboratories which is now heavily involved in the finding the cure and testing.

In March, a week and a half after the shelter in place order, with reservations I rode the bus. In pre-pandemic days the underground muni was the best method moving around the downtown area. The underground as a preventive measure after an operator turn positive for covid-19. Where I took the bus, there was an ambassador to ensure social distancing. Boarding was only through the rear side, I tried just to stand but concerned I might slip and fall standing and not trying to hold a rail, I took out a cleaning wipes for s chair and sat down. Half-way people had mask and where trying to distance. Another stop came the influx of vulnerable population, no mask standing and sitting. As we also know some of the city's vulnerable suffered on mental health challenges, so the way San Franciscan's deal with them is just let them have their own space. 

I went down on Market Street's Union Square shopping area with the plywood panels on Gap, Levis, etc., This Monday San Francisco finally allowed curbside pickup and delivery for retail stores. The Mayor says she is planning on Phase 2B in 2 weeks time.

Researchers expected to see a surge in new cases and deaths spiking in early to mid-June, even if social-distancing measures are put back into place. Even a one-week delay in reinstating social distancing could result in another 23,000 deaths by July 1. The Bay area and California did an aggressive step on the onset beginning with it's tech companies having their employees work from home even before there was a shelter in place program. This made a huge difference in mitigating as otherwise it would have been the epi=center.

The first days were crucial. “During the initial growth of a pandemic, infections increase exponentially. As a consequence, early intervention and fast response are critical,” the researchers wrote.A report in The New York Times, citing the analysis said that if the US had begun locking down cities and limiting social contact on March 1, two weeks earlier than when most people started staying indoors, about 83 per cent of the people who died so far from the virus could have been saved.

This is the part where historians are now looks like debating on writing history for the history books timeline and analysis. Presidential historians will have to make a fact finding aside from the TV clips on how the administration handed this pandemic since it's first reported case in the State of Washington. As preliminary reports come up it even narrates that the first case originated from the bay area. Density and contamination are culprits in exposure. The question now lies on what happens should be be a rise on cases and deaths again since the 50 states have now reopened. 

More to come in writing this personal history series on Covid-19. Stay safe. Social distance and wear a mask to save someone.

Pandemic recession on an election year

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Strolling down Market St. in San Francisco at 10 am today on it's Phase 2 re-opening not really seeing a lot of changes. Aside from a Cafe with huge sign on the window they are open May 5, a dollar store, a few mini liquor convenience store, the plywood's are still on the windows from brown to black. Phase 2 allows retail for curbside pickup or delivery but one of the things unaccounted is that the city since a few months ago had banned private cars along Market and 10th /St. all the way through Union Square. It's a very common sense to understand that of course curbside and pick-up cannot happen in this regard. However, my guess is that really the consideration is that are these businesses along Market St. have the confidence to really open in the absence of a vaccine or maybe will it be even financial feasible to make money to pay for the cost of being open with limited operations.

Bank of America warned that the next three months will be "brutal" as the economy falls into a recession. It will be a very hard challenge to go to Phase 4 in this city due to it's density while at present their is a corralled tent area at the Civic center where some of the city's homeless are temporary clustered. 

San Francisco  is just an example of a bustling metropolitan city that has disparities on health, income, housing etc.., So regardless how we paint the picture that everything will be back to normal as before, the effects of this pandemic recession will take along time to recover. San Franciscans should expect that some city and state services and benefits will effect life more while living in this city.

The realities we see today as a common layman doesn't need any politicizing or sugar coating  as were the ones experiencing the consequences. Feelings of confidence may have been the critical issue for the last U.S. president who was denied a second term, George H.W. Bush. A recession in late 1990 and early 1991 had long been over by Election Day, a fact the Bush team kept trying to drive home. But the downturn was worse and more persistent in some critical swing states, and its hangover (including relatively high unemployment into the second quarter of 1992) haunted the Bush campaign all year.

The on-set of finding a vaccine platform in November in time for the presidential election is a far stretch assumption as without a cure and containment of this virus will not make this economy recover. The corona virus could hurt the president, then, by making health care a defining issue in the 2020 campaign. However, that would happen only if the virus is not contained come fall. So instead of flowery statements, the key should be focused on containment and cure at all cost.

Thus then, this plywood windows will literally go down and open all business crucial to curing economic deprivation.

Curing a Viral Pandemic, the Impact on the Economy and Lessons from Past Pandemics

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I'll start the blog remembering the HIV/AID's epidemic as a graduating health professional then involved in the testing and seeing 2 of my former classmates then and after succumbing demise due to infection. This was a time pre-technology in my own terms that our team can get infected easily on the clinical side by either getting accidentally poke when we are drawing blood specimens from patients, or accidentally swallowing serum or plasma as we try to separate them for testing through pi petting and last when accidentally the auto-clave then for some reason explodes.

Today with the onset of the great viral pandemic, COVID-19, Coronavirus technology has been greatly changed the  laboratory settings and respiratory clinicians practices from way back. We can't accidentally swallow the hazard. But like any other health professional in the front lines, a future careful review of OSHA rules and the right adequate most talked about PPE (Personal Protective Equipment's) are eminent. Our front lines in hospital settings starts from the EMT's,  Admissions coordinators, Triage and Trauma staff, ER, Infectious disease to include bio-hazard teams, maintenance, janitorial, ICU/Acute Care, Nurses, doctors, food and canteen staff, the staff that we don't see much, Medical Assistants, Phlebotomist, Medical Technologist/Technician, Lab and Hospital Aides and our Clinical Laboratory Scientist,

I open the TV this morning alarmed to remember that one of the HIV patients stigma's then was the Laguna Honda Hospital in San Francisco, CA. Laguna Honda, the biggest nursing home in the USA also played and is playing a great service to the patients that have outlive the HIV epidemic. I'm alarm due to the fact the most vulnerable from COVID-19 are in this facility and the last I'd like to see is these patients who had so many years fighting HIV may succumb to this new viral disease if it spreads. As of today, the public health officials have started the best measures to protect the patients by locking down the facility and starting to test the more than 100 staff in the facility. This will at least start the identification and isolation's needed.

I'll continue by way of hovering on the concern on the national level on the economic impact this is causing the US and World economy. While reading through, Economic Effects of the 1918 Influenza Pandemic by Thomas Garrett, where he quotes on his abstract, "The possibility of a worldwide influenza pandemic in the near future is of growing concern for many countries around the globe".

As the medical professionals cited the 1918 pandemic came in 3 waves where they based the mortality rates. This is why we hear a lot in the news when officials and medical people talking on making assumptions as to density and apex which somehow touch bases on population, geography, ratio and percentage rank. Garrett continues, " The greatest disadvantage of studying the economic effects of the 1918 influenza is the lack of economic data. There are some academic studies that have looked at the economic effects of the pandemic using available data, and these studies are reviewed later. Given the general lack of economic data, however, a remaining source for information on (some) economic effects of the 1918 pandemic is print media". I mentioned this as this is the reality in "viral economics" Hence is why the economist zeroes on the point that the first step is deal with the virus on test and cure. 

In summary, let the scientist take the lead towards the date and assumptions. Let's focused on what we can do individually in terms of isolation, mitigation, being responsible from staying away from the vulnerable. We don't need to be in the front lines to be susceptible being exposed or being a carrier. The harsh effects will be great but were talking about lives and mortality.

I recommend reading this great article by Thomas Garrett. I will end on a paragraph on this article. 

"The influenza of 1918 was short-lived and “had a permanent influence not on the collectivist but on the atoms of human society – individuals.”31 Society as a whole recovered from the 1918 influenza quickly, but individuals who were affected by the influenza had their lives changed forever. Given our highly mobile and connected society, any future influenza pandemic is likely to be more severe in its reach, and perhaps in its virulence, than the 1918 influenza despite improvements in health care over the past 90 years. Perhaps lessons learned from the past can help".