Sunday, March 22, 2020

The Unbearable Disappearance of Masks and Gowns

(Written on March 20; some facts have changed since then)

I should have been a reporter. I wish I were one right now; I would be an activist, in-your-face inquisitor of our government officials. I've been following one of the sadder, more tragic stories coming out of US hospitals, and it breaks my heart. I have been researching the facts regarding the shortage of personal protective equipment (masks and gowns) for health-care workers, and it is one of the worst travesties I have heard about our government’s inaction, and delayed action, on the coronavirus. Not to mention on preparing for pandemics in general.

You have undoubtedly heard there is a massive shortage in the US of N95 respirator face masks that filter particles as small as 0.3 microns, and thus provide effective protection against viruses for doctors and nurses.
Photo: Reuters
The latest news is that US citizens are sewing thousands of cheap fabric substitutes to give to hospitals. Some of my friends are sewing these, for what it’s worth. Bravo for them. I expect my sister, an accomplished seamstress, will do it as well if this story reaches her ears in Detroit (where news tends to be biased in the opposite direction of news in DC).

Why are people doing this, even though the homemade masks are nowhere near effective enough to filter out a tiny virus? Because last week CDC “loosened” its official guidelines for the personal protective equipment worn by health-care workers, to encourage them to re-use their N95s AND to wear homemade fabric masks when they run out of proper N95s. CDC used the language “last resort.” The US should never have reached the point of "last resort."

Normally, N95s are used only once. It’s for our protection as patients, as well as for the protection of medical staff. Doctors and nurses are incensed at this change in CDC guidance; you can see their protests all over the internet.

One of the most tragic news stories I saw is about a hospital already setting aside its used N95s aside for 5 days hoping the virus will die, then re-using them. But we know, don’t we, that science has found the virus can live on plastic up to 9 days? Another hospital is washing and re-using both masks and gowns. Several hospitals have pleaded for supplies to be released from the US national emergency supplies in the Strategic National Stockpile. A few hospitals, especially in Florida, succeeded. Why Florida? The government says it is based on population. Just curious: is Florida more densely populated than New York and California, which are the hardest hit so far?

Previously, all of our N95s for health care came from China, and —duh— they are having a bit of a struggle right now. Nonetheless, they are ramping up their manufacturing capability of N95s, and their surplus supply is primarily going to South Korea and Italy. Note, furthermore, that several NEW Chinese companies have starting making them, and doing so quickly. The US is trying to get in on buying them from China. As per our usual — start a trade war, then arm-wrestle. (But don’t get me started on that rant.)

The US produces N95s only for industrial/construction use. This week, the US also “loosened” a law that will now allow the industrial-style masks to be used in hospitals, without liability to the companies if they fail. Thus, those companies (primarily 3M) are voluntarily ramping up production. These masks are not quite as tight-fitting, and there will still be a massive shortage.

We have a Defense Production law that could be used to ram through more US manufacturing capability quickly, as we would during a war. President Trump pledged to do this -- repeatedly, according to news reports -- then repeatedly backed out. Naturally, Democrats have pushed back on this (in)decision.

Naturally, companies are reluctant to voluntarily take on the massive and expensive retooling that would be required to make N95 masks, claiming it would take months to ramp up manufacturing capability, the demand is short-term, and there is little money in it. (Yet - remember my note above about Chinese companies?) If we were at war, I bet the necessary retooling would be accomplished in a few short weeks—because the government would make sure it was profitable.

Companies who could make more hospital gowns also are resisting ramping up production, citing the short-term, unprofitable nature of the demand. So hospitals are washing and reusing them. In Spain, dress designer companies are making gowns for hospitals. Now. In the US, there is merely debate, in Vogue magazine, whether designers could/should do the same here. Later, baby. Maybe.
 Folks, given the US government and US industry’s inaction on saving the planet and its populations from climate change, why would we expect them to ramp up to save the population from disease? Short answer: we are not at all surprised. The only thing ramped up recently was favoritism to Big Oil and Gas, and insider trading in stocks by government officials after they were briefed on the virus, but before they told the public.
I am not a reporter. And actually reporters are already ramping up to cover this story from all the angles I’ve mentioned above; the stories aresifting out, one by one. One thing I haven’t heard all day, surprisingly, is that this shortage of masks and gowns is “fake news.” Could it be that the government is actually listening? ... Nah .... Too much to ask.

Coulda, Woulda, Shoulda - It's Human Nature

China “could’ve” told us sooner! Yes, but let’s look at the bigger picture.

In light of the glaring headlines yesterday, of our president insisting that China “could’ve told us earlier” about the virus, I got angry. I got angry at the president – which often happens these days. Others undoubtedly got angry with China, from the same headlines. Then I calmed down and did some research on what actually happened, and when.

As we all know, humans are conditioned to react unthinkingly to lurid headlines and sometimes-vicious accusations thrown out in the press—hence the popularity of “yellow journalism.” That’s our animal instinct. We regret, we question, we blame. For those of us who try to exercise our brain’s capacity to become more aware, thinking humans, however, it’s a good idea to check the facts. Here are a few I uncovered.

On December 16, a patient associated with the seafood market in Wuhan was hospitalized with infected lungs. Within a few days, reportedly, a lab realized the patient had a virus similar to SARS.

On December 27, a doctor in Wuhan reported the virus to public health officials, who began investigating its extent. On December 31, China reported the virus to the World Health Organization, who published 
a report on January 5  about an unknown virus associated with a seafood market. 

Separately, on December 30, a different Wuhan doctor warned his colleagues to wear protective gear because he was observing multiple patients with an unknown virus. Even though the virus was reported to the World Health Organization the next day, in early January this doctor was reprimanded and silenced by local police. He shut up, went back to work, caught the virus, and died -- but not before his warning got out to the world. This past Friday, the Chinese government formally apologized to the family of that second doctor.

The second doctor—the whistleblower—is the one we hear about, because he suspected human-to-human transmission long before China acknowledged it. Maybe even before China figured it out, definitively. This article is a good summary of that incident.

There was a second “whistleblower” attempting to spread the news on December 30 about a SARS-like virus. We’ve barely heard about her. She, too, was reprimanded in early January.

But note the timeline: on December 31, the report of a new virus was publicly available to the world. Even in the absence of details, such as the nature of the virus or number of infected humans, the CDC in the US started preparing immediately, including developing a test. By January 15 the US had banned foreigners who had been in China, and by January 17 the CDC was screening and isolating US residents returning from China. By January 21, the CDC announced availability of its test. Unfortunately, it was a little too late: the first infected person had arrived from Wuhan, unscreened, on January 15.

I’m not excusing China for its secrecy and delays. In early January, China was actively suppressing the “rumors” leaking out that the virus was like SARS. China didn’t formally acknowledge human-to-human transmission until January 21, and Wuhan was not locked down until January 23 -- allowing millions of people to leave the city. This article is a good summary of that timeline.

On the other hand, China did give a heads up to the World Health Organization on December 31. And on January 10, China publicized the genome of the virus, allowing scientists worldwide to begin multiple lines of research – leading to tests being made available in both Germany and the US within a few days. Today, China is assisting South Korea and Italy with medical expertise and supplies.

Yes, we “could’ve been” informed earlier of the number of cases and specific details. We could have responded differently in numerous ways in our own country. There is plenty of blame and responsibility to spread around.

What I want to emphasize, however, is that some public officials -- who take their responsibilities seriously -- did so in this case. Our CDC didn’t wait. The CDC acted quickly following the initial announcements, despite numerous obstacles, including a dearth of specific information and, possibly, resistance from our own government.

Let's remember to think, reflect, and seek the bigger picture, beyond the flagrant headlines. 

And, in this case, let's acknowledge the usefulness of public health officials, and applaud the actions they took. I would even venture to say: but for them, it could’ve been worse.

Anxiety? We Don't Need No Stinkin' Anxiety!

Anxiety is abundant these days. One of my solutions is to write.

I've had plenty of time to read. Reading got me thinking. And thinking, for me, leads to analysis, which leads to research, which leads to needing to write. Many writers complain of writer's block. That's something I got over long ago, working as a speechwriter with turnaround times as little as a day, a few hours, or even an hour.

Instead, my "problem" is that, when I get something in my head that I want to say, I can't resist whipping out pencil and paper, or iPhone "Notes," and writing it down. Surely others need to know! I think. And once I get started, I can't stop. 

When I started isolating at home, I had plenty of time to read, think, and analyze hundreds of reports from dozens of media outlets throughout the country. I had flashes of anger--at my partner, for not washing his hands often enough; at not-my president, for putting political and special interests ahead of public health; and, more recently, at China, for its missteps and cover-ups.

My anxiety level has been high from the beginning. Every tickle in my throat or ache in my belly, a cough from Pope or a moan in his sleep, sends my blood pressure up as I imagine the worst. I have to keep reminding myself: I barely recovered from a long sinus infection in January, Pope had a serious bout of bronchitis for weeks, I have a history of digestive and breathing problems, and allergy season has begun. It's probably just one of those, my left brain keeps reassuring my right brain.

I read. I walk. I clean house. I play my guitar and sing, practicing songs from classes at Augusta music camp and at Archie Edwards, a local blues venue. They all help.
Playing outside in the park
When the anxiety ramps up and threatens to overwhelm me, I turn to yoga techniques, including meditation and pranayama (breathing techniques).
Photo from Yoga in Daily Life center in Alexandria, 2016
Then, a couple of days ago, I was reading about the shortage of face masks and got angry. I began to pursue the subject with great diligence, writing things down--and remembered that, my whole life, I've been writing out my anger and anxieties. From an early family life involving violence and fear, to abusive marriages, sexual harassment at work, and bouts of illness, I've kept journals, written essays, even submitted a few articles for publication.
Writing my blog during a sailing cruise
For me, writing distracts me from emotion and helps me re-center.

So in the coming days I will publish in this blog some of what I've been writing on my iPhone and on Facebook about the virus. If you are interested in a few brief summaries compiled from hundreds of news reports, stand by.

It might not be a relief from anxiety, but it may help shed some clarity on some of the mysterious and frightening matters hinted at in the most dire and glaring headlines.