Coronavirus: Preparing for the dragon

[su_quote]“It does not do to leave a live dragon out of your calculations, if you live near one.”

              – J.R.R. Tolkien[/su_quote]

New Albany, MS – When I was eight, my six year old brother, Phil, was one of the many US polio fatalities in 1954, the very year that field trials began for Salk’s vaccine. Phil fell ill on a family visit to my grandparents in Pontotoc.  A physician assured my parents that, while he was very sick, he definitely did not have polio. When the doctor thought a car trip was feasible, we drove home to Memphis. My 2 year old sister and I were dropped off with family friends. Phil was taken to the Gaston Isolation Hospital in Memphis. My parents were not allowed to be with him, and he died of bulbar poliomyelitis ( a somewhat uncommon form) the same night he was admitted. He died calling for his mother, only about five days after falling ill. She never really recovered from his death.

Our family was in quarantine for weeks. There was a brightly colored sign on our front door. But we were not unique. Other neighborhood families, as well as the friends who had looked after me and my sister, had quarantine signs. Phil’s was the only death I’m aware of.  My folks did not go out to work or buy groceries. Friends and neighbors helped with that. The following year, I was among the 4 million people, mostly school children, vaccinated with the Salk vaccine – with practically no questions asked by my parents or anyone else’s. They had lived through the nightmarish alternative. This childhood experience colored my life in many ways. For one thing, I am more likely than some to believe that situations arise where consideration of the “greater good” must trump individual rights.

Individual rights versus the public’s health

During that polio epidemic and epidemics of many stripes, individual rights often took a back seat to public safety. In failed attempts at prevention, communities restricted travel and commerce. Quarantines of varying duration were imposed on families of victims. Often, those diagnosed with polio were confined, isolated in hospitals, often against the will of their parents and loved ones.  These measures seem draconian to some. Though I abhor the thought of them, I do understand the reasoning behind them.

In 1952, Jonas Salk directed the first tests of a killed-virus vaccine on human subjects – institutionalized, physically and intellectually disabled children. In 1953 he tested the vaccine on his family.  In April of 1954 a randomized double-blind study involving over 1.3 million school children began. Only the testing team knew which children actually received the vaccine. When results were announced in April 1955, the vaccine was said to be safe and 80-90% effective. That same day, Salk’s vaccine was licensed by the U.S. government.

We had a notice similar to this on our door in 1954.

Then, over the next several weeks, reports surfaced of children with paralysis in their vaccinated arm. Most had received vaccine produced by Cutter Labs in California. Use of all vaccine was suspended in May, 1955. Eleven people died and hundreds more were paralyzed. Investigations were done and production changes were instituted.  Vaccinations were soon continued.

Since 1979, no cases of polio have originated in the United States. That is over 40 years without several thousand “Phils” dying annually of polio.

Better living through science…and vigilance

Sign barring children under sixteen from entering town, posted on a tree during the 1916 New York City polio epidemic Courtesy of March of Dimes

Public health improvements, preventative vaccines, and public education have made it possible to bring many dragons under control. Smallpox,diphtheria, measles, mumps, rubella, whooping cough and tetanus have largely disappeared for our lives. This is not something to be taken for granted. Many places in the world are still struggling with some of these illnesses. Dropping our defenses, becoming complacent, could mean we see them again.

The “Spanish Flu” pandemic killed over 50 million people world-wide in 1918. Now we’ve come to have yearly influenza vaccines available against expected strains. Often, those vaccines are offered free. Still, more than half of our citizens do not get the vaccine.

Yet another healthcare dragon needs slaying

Today, many public health officials believe us to be on the edge of a possible coronavirus pandemic. According to World Health Organization, there are now 81,000 cases in 44 countries with about 3000 deaths. Information varies wildly in this rapidly changing situation. However more and more officials are using the word “pandemic” in their updates. Many consider it inevitable that the US will soon be caught up in this emergency.

According to  Nancy Messonnier, director of the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases: “It’s not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses. Disruption to everyday life might be severe.” Other officials have mentioned travel restrictions, school closings, enforced isolation, etc.

I am optimistic that this dragon, too, will eventually be slain. However, it is unlikely to happen quickly, or without problems and inconveniences. It is our responsibility to do what we can to smooth our own pathways. Unfortunately, taking responsibility for ourselves is becoming less and less of a national trait.  “The government” cannot be counted on to do everything for us in this situation, nor should it.

Having been a pharmacist for over 40 years, I often get questions from folks about medical issues. I recently sent texts to many of my family and friends outlining some facts about coronavirus and making one major suggestion. This includes a lack of known treatment, the absence of available vaccines, even lack of knowledge of exactly how this virus spreads. Additionally, many are critical of the US State Department’s handling of several patients with active infections. Memphis officials have chosen to let about 20 persons possibly exposed to COVID-19 “self-isolate” in their homes. no one knows what is actually happening in China, the source of this immediate outbreak. And the list goes on.

At my house, we have purchased several weeks of non-perishable foods, animal supplies, medications, toiletry items, batteries, cleaning supplies, etc. –all things we would eventually use under normal circumstances. Our goal is to be able to immediately begin avoiding public stores, restaurants, etc., as much as possible, when we hear of coronavirus is in our region.

Within the past few hours, reports have surfaced of what is believed to be the first confirmed coronavirus case in the US  of unknown origin. CDC officials have said that it may be time to begin practicing “social distancing.” See: https://www.usatoday.com/story/news/nation/2020/02/27/coronavirus-update-cdc-test-covid-community-spread-case/4889999002/

Today, while you have time and a window of opportunity, make a plan that will make things easier and less stressful.  Should the worst predictions come to pass, things will get unpleasant for all of us very quickly.  If this happens, you will be prepared to deal with the situation. If it does not come to pass, you have lost nothing.

Don’t be like the last person to hear the “snow” word in a Mississippi weather forecast. You know all the milk, bread and pop tarts will already be gone.

–NLS

For more information on COVID-19 virus and protecting against it.

Protecting against coronavirus: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

The latest news on the virus: https://thehill.com/policy/healthcare/484530-top-health-official-warns-coronavirus-spread-in-us-inevitable-its-not-a

General preparedness ideas from Union County Emergency Management Director, Curt Clayton: http://newalbanyunionco.com/emergency-management-director-gives-home-preparedness-hints/