The time approaches That will with due decision make us know What we shall say we have
And what we owe : Act V, Scene IV, The Tragedy of Macbeth, William Shakespeare
"There's nothing serious in mortality; All is but toys" (Act II, Scene III)
On the morning of 18th February, 2020, when I was standing at the Watson Kennedy Fine Living store with a wide grin on my face after buying one of the few trivial things that I got for myself from Seattle, little did I know that shortly the item would be in high demand: a soap!
I bought it with no intention of 99.99% germ removal. It was an out-and-out 100% fancy purchase. Only because it was outlandish in a good way.
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On the next day, before taking my return flight to Bangalore, I again smiled at it while packing. And I had no plan of using the 'Lady Macbeth's Guest Soap'! Not anytime soon.
Global travel bans were imposed few weeks later by several nations along with widespread news of flight cancellations, visa suspensions, border closures, health screenings, and quarantine measures. By then, COVID-19 made its firm grip on this planet. More so, on people's minds.
"And you all know, security Is mortals' chiefest enemy" (Act III, Scene V)
Among few other ritualistic measures to limit the spread, one concept became quickly implementable: Social distancing. Neil Ferguson, an epidemiologist at Imperial College London, reinforced the need of large-scale social distancing to mange the outbreak, “this will need to be in place for many months -- perhaps until a vaccine becomes available.”
In a world where people mostly learnt to live in their cocoon of self-interest and are anyway increasingly distant from one another as far as developing and nurturing true connection is concerned, creating an upward swing of poor mental health, feeling of isolation, heart diseases, anxiety, depression and even dementia, social distancing to arrest a group of virus creating trans-species infection is not counter-intuitive. In fact, it's the most doable and straightforward strategy. A stringent early lockdown can be optimal to minimize casualty and maximize herd immunity for a certain period. And the easiest way to wash your hand of!
Image: Collected from internet (unknown source)
“We are not at the mercy of this virus,” WHO Director-General said so at the 9th March media briefing. On 18th March, he also mentioned: "Don't assume your community won't be affected, prepare as if it will be. Don't assume you won't be infected, prepare as if it will be. But there is hope...". I heard “Things without all remedy should be without regard: what's done is done.” (Act III, Scene II)
The immediate implications of social distancing has been studied through mathematical modelling, epidemiological and clinical research, simulations, clinical observations during 1918 Spanish flu pandemic, 2009 influenza pandemic and 2014 Ebola outbreak, and so far, at its best, it is found to be moderately effective in transmission reduction and at its worst, can impose risk along with obvious normalcy disruption based on the evidence presented in Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic.
And the long-term impact? Social distancing is totally against our hard-wired evolutionary need for connection, against the entire imagery of people coming together to uplift the collective mood in the face of a threat, to foster greater cohesion, cooperation and an environment of mutual support.
Yes, one may say that they get 50 WhatsApp messages for that, or get that feeling of oneness through social platforms and media, but these means are not devoid of their own viruses: propagating myths and misinformation, bolstering fear with constant bombardment of information, creating an environment of perpetual gloom in the face of impending danger, and a false sense of support groups.
Personally, I have become sick of thoughtless WhatsApp forwards regarding this subject. Since when awareness turned into fear-mongering and macabre became this engrossing? And now to combat that atmosphere of panic, Canada is building a social movement called 'Caremongering'. Well-meaning, but it now takes us a movement or initiative to showcase camaraderie, care and kindness?
Also, virtual world with all its merits can never replace the impact of a real uplifting smile, the quiet stare of assurance, the gentle pat on the back, a chorus song with horrible notes and wrong lyrics, the hilarity of an inappropriate joke at the inopportune moment. In fact, according to the National Academics of Sciences report, chronic social isolation increases mortality risk by 29%, functional decline risk by 59%, dementia risk by 50% and stroke risk by 32% in adults.
But we all know that “Unnatural deeds do breed unnatural troubles.” (Act V, Scene 1) and so regular human proximity is now categorized as 'non-essential contacts' to 'flatten the curve'.
"Fair is foul, and foul is fair: Hover through the fog and filthy air" (Act I, Scene 1)
From the disease control and disaster management perspectives, however, self-imposed and/or state-imposed cordon sanitaire are now the only concrete suppression mechanisms. As and when I'm writing this post, The Prime Minister of India is addressing the nation and appealing for 'janta curfew' (self-imposed curfew by masses) on 22nd March. Just stay indoors. Clap and ring bells for expressing solidarity (I wish even this idea were original!). Not a single sentence is spared on Government's medical or economic strategy and investment in the event of rapid transmission.
Any isolation measure, let me make it clear, will not prevent the reach of SARS-CoV-2 virus. This will better prepare the health system and equip them to manage the outbreak by distributing the number of cases over a longer period. Even with complete lockdown, there's absolutely no conclusive evidence that this virus will not transmit. Refer to WHO's R&D Blueprint on COVID-19.
On 7th March, WHO in fact reminded us that "Every effort to contain the virus and slow the spread saves lives. These efforts give health systems and all of society much needed time to prepare, and researchers more time to identify effective treatments and develop vaccine."
Based on the current development, it will take us anywhere between 1 year to 1.5 year before global immunization becomes feasible, assuming there's no major interplay of divisive global politics, conflict of interest among big pharmaceutical companies and bio-techs, challenges of clinical trial testing and economic scalability are on its way. And I haven't even spoken about socioeconomic and other far-reaching impacts of long-term social distancing yet. We are already in the early days of a major recession. Learn more about the possible shift of global order.
Any pandemic is a serious threat, but in the long run there are much greater chances of us perishing due to isolation, not feeling as a part of the whole. But it seems we like to only address the short runs, that too as and when they knock. I understand that tomorrow comes when we survive today, but it indicates a lack of foresight and wholesome planning in the face of a global crisis. China's initial downplay didn't help in this matter.
However, social distancing and partial shutdown have couple of unintended positive side-effects too apart from susceptibility management. The most significant of them is reduction of CO2 and NO2 emissions and considerable improvement of air quality. Will the potential decline of global death toll by these toxic emissions and pollution (based on the recent statistics, approximately 9 million people gets killed by pollution every year) somehow balance out the number of human lives claimed by COVID-19? “If you can look into the seeds of time, and say which grain will grow and which will not ...” (Act I, Scene III)
“Though the treasure of nature’s germens tumble all together, Even till destruction sicken; answer me to what I ask you” (Act IV, Scene 1)
I get up from my desk and open the paper cover of Lady Macbeth's Guest Soap. The story flashed on my mind. Lady Macbeth plotted regicide and manipulated her husband to kill the king. Assuaged by terrible guilt, later she uttered these famous words while sleepwalking: ‘Out, damned spot! Out, I say!’ amidst delusion of bloodstains in her hand. This soap references those lines.
I stare at my hand. Full with tiny bubbles of water with air molecules trapped inside, my hand is looking clean. Albeit I am feeling somewhat trapped as the air inside the soap bubbles.
Living inside one's own bubble is great till it's not. And we are responding to the trap by getting further inside the cave. That's our only major plan of action. But if we continue to destroy the habitats of species and traffic endangered species that carry zoonotic diseases, it will continue to show inter-species jumps and eventually spread in humans in different variants. However, 'What need we fear who knows it when none can call our power to account?' (Act V, Scene I)
As Mario Gruber said, "At this point our civilisation is so closely intertwined and the challenges we face so complex, we have to leave the hunter-gatherer version of us behind. Humankind has yet to graduate High School." But will our posterity not question us about why there has been this lack of sustained research and globally-effective long-term plan formulation based on the history of previous flare-ups of infectious diseases? Apart from urban sections of developed and developing nations, most of the schools are not equipped to impart lessons online or it's simply not feasible as students have no internet connection at home. What about this vast next-generation majority's future?
Based on an Economic Times report, Professor of virology and president of the Belgian-based, International Society for Antiviral Research (ISAR), Johan Neyts, mentioned that "If we had invested starting in 2003 at the SARS epidemic looking for a medication that would be active against coronas by now we could have had a stockpile that would have been active against this new one."
Bruno Canard, a virologist at France's National Centre for Scientific Research, went one step ahead and said that coordinated research could have produced a broad-spectrum treatment against all of the seven known coronaviruses that are transmissible among humans, given their genetically similar profile. But scientific and medical research are reliant on Government funding. Who and what stopped this investment? And why?
While we are accountable for the present we created, what are we going to say to our future generation? That not touching your face is the only face-saving measure we got for you? Now send a socially-distant virtual hug to your imaginary friend and go to sleep? ‘Out, damned spot! Out, I say!’
PhotoStory Date: 19.3.2020
Place: Bangalore
Words and Photograph: Amrita Ghosh
Resource Credit and Citations:
National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.
Economic Times Article: History repeats itself: World failed to learn lessons for coronavirus fight from SARS and MERS outbreak
Foreign Affairs Article: The Coronavirus Could Reshape Global Order
Tags: #covid19, #coronavirus, #socialdistancing, #soap, #seattle, #watsonkennedyfineliving, #travelban, #macbeth, #ladymacbeth, #quarantine, #clinicalresearch, #pandemic, #fear, #scaremongering, #caremongering, #flattenthecurve, #disease #disastermanagement, #globalcrisis, #healthcrisis, #jantacurfew, #sarscov2, #virus, #environment,#cordonsanitaire, #shakespeare #nofearshakespeare #mariogruber
Loved reading this piece. Very well put together.. :)