Grieving our normal.

When I first heard of a novel coronavirus wreaking havoc in China in November 2019, I quickly perfunctorily read up on it and took a breath of relief. It was in China and hadn’t spread that badly in Hong Kong which shares borders with China .

Little did I know that Hong Kong had been watching the crime scene of SARS CoV closely since it had been its victim in 2002-2003 and couldn’t have been more prepared. Little did I know that when I was frivolously posting as most Americans were about New Year’s Eve and new beginnings, China was battling with the worst virus that humanity has seen in terms of deaths and nebulousness.

Very little has been studied with respect to corona viruses. They’ve caused some annoying cold-type symptoms since they’ve been known with two deadly strains, one that caused SARS in 2002-2003 and the other, MERS, that still occasionally shows its ugly face and kills its host usually.

But because corona viruses have been so sweet to humans over the years, scientists have been complacent in researching it as robustly as we have studied other viruses that have contributed to epidemics like the human immune deficiency virus, more popularly known as HIV.

In late 2019, early 2020 Hong Kong had closed its borders with China, had mass tested their population, had put trackers on its people so they were notified immediately of a positive SARS CoV2 when they were in the vicinity and distanced themselves.

Hong Kong, a few weeks since the eruption of COVID-19 in Wuhan which proved to be the epicenter of this new illness in the province of Hubei in China, had started social distancing aggressively with penalties for loitering and non-essential social interactions.

Soon Singapore and Taiwan caught on and even though the disease continues to spread, they have successfully hit the peak of this illness with enough resources for their population.

I watched the news as the virus traveled to Iran and started killing thousands in a week. Graves were left open and people were buried with special precautions so as not to infect healthcare workers and people involved with funeral practices. News is hard to obtain from Iran and the guess is that the number of actual deaths is much higher than what has been reported.

The virus traveled through Germany and Spain, was contained here and there occasionally but otherwise caused massive damage in its wake and then one unfortunate day in the history of mankind, it hit Lombardy in northern Italy, the region that proudly holds Milan as its capital and provides for one-fifth of the GDP for Italy. In the entire Europe this region is cherished and famous for its wealth and prestige .

COVID-19 spread like wildfire, reaching a peak within weeks and causing a huge number of deaths. Postulated reasons for high mortality also included lack of medical resources. For those who don’t know, Lombardy is an exceptionally rich place in Europe and has great medical care. They just couldn’t keep up with the surge and the peak of their COVID patients.

Until this morning, Italy has seen more than 10,000 deaths due to COVID.

But I’m not focusing on Italy anymore. My home is affected now and worse. The United States of America is slowly succumbing to the effects of COVID on its unsuspecting population.

Stats from today are disheartening particularly because we aren’t even testing as much due to test kit shortage.

What happened in Queens yesterday has made me speechless. If I had to call something of apocalyptic measures in modern medical history , this would be it. Elmhurst Hospital in Queens, New York is a place I interviewed for an internal medicine residency many years ago. I chose another program in New York City. My residency program isn’t doing any better. Everyone is overwhelmed, sad and angry at the asks from medical professionals of social distancing, hand washing and staying at home.

Life changed completely for Americans. And it’s continuing to change. It’s a change being brought through grief and sadness. Sometimes I wonder how I have snapped from watching China as an intellectually interested and emotionally invested physician and human but essentially distant and aloof to now, a physician in the trenches watching COVID harass social animals into confined beings.

I was in denial in November that this virus would trek through continents and come to me and mine.

I became angry in January when people insisted that Italy was our future when we diagnosed about a 100 cases in a nursing home in Seattle, Washington. “What are they talking about? It’s a nursing home in Seattle. Of course the transmission is rapid”.

“But our healthcare system is so much better than all countries out there”, I tried to make a bargain with the disease in exchange for resources. This was the beginning of February and Diamond Princess had happened. I quickly realized we don’t have enough for about a hundred and fifty million Americans to have COVID at the same time .

That phase didn’t last long though. New York happened and Louisiana seemed to be coming up fast at the heels of New York’s frightening death toll. I was taken over by sadness and grief. I felt helpless and like there was no recourse.

But just as sadness comes from the pits of despair, strength comes to the rescue. Strength is a wilder animal than any substantial energy out there because it is usually heroic in its ideas and headstrong in its ways. It doesn’t require strength of the body or mind. It can cause weak minds and bodies to become strong. It’s a self-fulfilling prophecy. It announces its arrival and makes its presence known. This is how we move on and make a strategy. This is a survival technique and a way to be self-reliant. So I have accepted that COVID is here and will not go away just because I wish for it to go. It will require every last ounce of our grit and resilience. It will require a community effort. It will require a lot of money and human spirit. It will require an empathy for humans going through it and a respect for the enemy that has been so shrewd.

Apathy isn’t the way to go in mass disasters. There is nothing romantic in social distancing, staying at home against our will, not being able to check on our loved ones, not having the liberty to play sports in summer. I don’t understand the glorification of it and it depicts an incongruent affect to me when people count the blessings of COVID and remind us how our lives were previously consumed by unnecessary socialization, shopping and sports. I find nothing good about COVID or forced social distancing. But that’s the only way we can ensure that the virus doesn’t take as many of us down as it threatens to at the moment. That is the stage of “acceptance” on the Kübler-Ross Model of stages of grief. Sometimes this stage causes people to settle down in one place in time and direct their energies to what makes them happy in the last days of their lives . But for COVID, this stage signifies strategizing, recognizing the enemy and a call for action.


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