{"id":8489,"date":"2020-04-28T23:24:45","date_gmt":"2020-04-28T23:24:45","guid":{"rendered":"https:\/\/adhc.lib.ua.edu\/pandemicbook\/?page_id=8489"},"modified":"2022-02-23T20:40:06","modified_gmt":"2022-02-23T20:40:06","slug":"04-28","status":"publish","type":"page","link":"https:\/\/adhc.lib.ua.edu\/pandemicbook\/04-28\/","title":{"rendered":"04-28"},"content":{"rendered":"\t\t
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Tuesday, April 28<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tUS Cases 1.03million
US Deaths 61,134<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Apr 28: The U.S. Covid death toll surpasses that of the Vietnam War. President Trump signs an executive order to force meat processing plants to stay open<\/a>.<\/span>  In response to Trump’s steady attacks on China as the cause of the chaos, the Chinese government accuses<\/a> <\/span>Trump of “bare-faced lies” in an attempt to “shirk responsibility” for his subpar response to the pandemic. Vice President Pence tours<\/a> <\/span>the Mayo Clinic without a mask, despite the hospital’s policy that masks are required.  The term \u201cdeferred care\u201d hits the news, referring to people avoiding a doctor\u2019s office or hospital for any procedure that can wait.  Even worse, a Gallup poll<\/a><\/span> finds that 1 in 7 Americans  will not seek care for a fever or dry cough\u2014the classic symptoms of COVID-19. The reason? Cost concerns<\/a>.<\/span> Those most likely to avoid medical treatment for symptoms are younger than age 30 and make less than $40,000 a year. A 14-year-old, African American boy with a heart condition is badly beaten by a police officer in Rancho Cordova, California.*<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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When examining the CDC estimates of how many people are killed by seasonal influenza each year, it does seem that the flu can be really bad\u2014with upwards of 50,000 deaths per year. The tragic 2017-2018 season saw 80,000 people die from flu.[1]<\/a> Worldwide, the WHO estimates that at least three million people contract notable cases of the flu leading to \u201c290,000 to 650,000 respiratory deaths.\u201d[2]<\/a> The logic on offer from those protesting stay-at-home orders is that, if the seasonal flu doesn\u2019t trigger lockdowns, why should this coronavirus?<\/span><\/p>

The problem is that there are historically-rooted issues with how the CDC and the WHO derive their influenza numbers. The World Health Organization created the Global Influenza Surveillance and Response System (GISRS) in the early 1950s in response to a flu outbreak.[3]<\/a> Following that H2N2 outbreak, various health services in the United States began a new method of tracking excess deaths due to influenza combined with pneumonia. The hope was that by tracking excess deaths over and above the expected seasonal deaths they could identify outbreaks early on, thereby preventing another 1957-58 outbreak. The problem was that they had no reliable way to report on influenza cases because states, cities, and individual physicians all reported differently. To solve the issue, they turned to mathematical modeling that could theoretically provide estimates of when influenza-plus-pneumonia reached epidemic status.<\/span><\/p>

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As the years passed, the CDC realized that it needed to change its modeling to capture a larger number of possible cases. They did this in part because they believed the flu was being under-diagnosed and in part because they needed to inflate the numbers of flu cases so that more vaccines would get made and distributed to the general public.<\/span><\/p>

These are the mathematical models that are currently in use by the CDC. They capture those actually diagnosed with influenza as well as a broad number of other groups who, by admission, may or may not have the flu.[4]<\/a> They estimate that for every diagnosed influenza\u2010related hospitalization, \u201cbetween 11 and 365 more\u201d cases occur\u2014an enormous margin. Importantly, the flu mortality rate is also based on this sort of overcount, incorporating even those listed as \u201crespiratory and circulatory deaths,\u201d because \u201cthe total deaths associated with influenza that occur each year \u2026 may be 2 to 4 times higher when other complications are also considered.\u201d[5]<\/a><\/span><\/p>

The point is that if we set aside these \u201cother complications,\u201d the flu kills an estimated 4,000 to 20,000 individuals a year\u2014terrible, but far lower than even the lowest Trump-quoted estimate. Ironically, the internet rumors presently circulating now fixate on a possible overcount of COVID-19 deaths. The reverse is more likely the case.[6]<\/a> A heart attack or stroke triggered by the infection was likely to have been counted as flu until clinical diagnoses were permitted without direct test confirmation just two weeks ago.<\/span><\/p>

\u00a0<\/span><\/p>

Notes<\/p>

[1]<\/a> Maggie Fox, \u201cFlu Killed 80,000 People This Past Season. Someone Infected All of Them,\u201d NBC News, September 27, 2018, https:\/\/www.nbcnews.com\/health\/health-news\/doctors-speak-bluntly-about-record-80-000-flu-deaths-n914246.<\/span><\/p>

[2]<\/a> WHO, \u201cInfluenza (Seasonal),\u201d November 6, 2018, https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/influenza-(seasonal).<\/span><\/p>

[3]<\/a> The College of Physicians of Philadelphia, \u201cAsian Influenza Pandemic, 1957,\u201d History of Vaccines, 2011, https:\/\/www.historyofvaccines.org\/content\/asian-influenza-pandemic.<\/span><\/p>

[4]<\/a> CDC, \u201cHow CDC Estimates the Burden of Seasonal Influenza in the U.S.,\u201d November 22, 2019, https:\/\/www.cdc.gov\/flu\/about\/burden\/how-cdc-estimates.htm.<\/span><\/p>

[5]<\/a> Melissa A. Rolfes et al., \u201cAnnual Estimates of the Burden of Seasonal Influenza in the United States: A Tool for Strengthening Influenza Surveillance and Preparedness,\u201d Influenza and Other Respiratory Viruses<\/em> 12, no. 1 (2018): 132\u201337, https:\/\/doi.org\/10.1111\/irv.12486.<\/span><\/p>

[6]<\/a> Angelo Fichera, \u201cSocial Media Posts Make Baseless Claim on COVID-19 Death Toll,\u201d FactCheck.Org<\/em> (blog), April 8, 2020, https:\/\/www.factcheck.org\/2020\/04\/social-media-posts-make-baseless-claim-on-covid-19-death-toll\/.<\/span><\/p>

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The cat is chirping in my ear. I\u2019ve got the comforter over my head because my CPAP started whirring like an old desktop computer on day 25 or so and the parts shop isn\u2019t returning my emails. Must not be deemed essential. I don\u2019t mind sleeping this way anyway; I feel like a kid hiding from an unrelenting parent. If the cat gets desperate, he\u2019ll walk right over my face. I live alone.<\/p>

It\u2019s 10ish am. In the earliest weeks I woke up in a cacophony of confusion, dread, and drive. There were articles I needed to read on the specifics of the Spanish lockdown, videos to watch of Italian neighbours, anxious student emails to answer. But these days, day 46, I wake in a kind of sandbag-heavy daze. I texted Sanchia last week to tell her that I had now emerged an apathy butterfly after incubating in the shock and horrible adrenaline of the mid-March. It\u2019s not exactly apathy though\u2014more like dissociation. The last three nights I\u2019ve had nightmares about ex boyfriends and high school bathrooms, dirty mattresses and apartment buildings that collapse from the inside. The bald anxiety of these dreams contrasts sharply with the even throbbing pressure on my chest when I\u2019m awake. Sometimes the shortness of breath and insolent resistance of my lungs to deeply inhale makes me think I have the symptoms.<\/p>

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I try to take a long walk first thing. I take my SSRI and say, \u201cI am taking my pill now,\u201d because sometimes I can\u2019t distinguish the days from each other. I wash my face and wonder if I should use the $45 Sephora-bought concealer or the $22 drugstore brand. It seems a waste to use the expensive brand; then I question why it would be a waste\u2014who am I wearing this for? The feminist dilemmas still exist. I go with the $22 bottle most days. I check the weather app on my phone. The spring temperatures in Toronto have been vacillating between 9C and 0C. Early last week it snowed hard pellets and melted before accumulation. I\u2019ve been alternating between several ancient Joe Fresh tshirts; I return to thoughts of \u2018waste\u2019 each day: I\u2019m not going to see anyone I know, and my jacket stays firmly on. I can live with these ridiculous and slightly sinister thoughts. I fleetingly wonder if this is the perfect time to reconsider and recalibrate my motives and behaviours before I wash my hands for 30 seconds, choose runners to wear, throw on my trench, and lock the door behind me. I\u2019ve got a paper towel folded up and a small bottle of hand sanitizer in one pocket, and lip balm and my phone in the other.<\/p>

I listen to ABBA Essentials on Apple music. It is the perfect sound to maintain hope without denial. Sometimes I listen to \u201cNobody\u201d by DJ Neptune because I saw a family in quarantine dancing to it together on Twitter. The music choice matters because when I step outside, I feel like both predator and prey and it doesn\u2019t feel safe. Predator because my breathe could be poison and prey because I am constantly retreating from the maybe poisons of others. I walk east towards the Tower. In the early weeks of these walks I realized that we were all surveilling one another; we walk down sidewalks in a state of hyper-vigilance that is exhausting but feels absolutely crucial. Sometimes I forget that the situation is not \u201cnormal\u201d and try to pet a dog. Such mistakes are characterized as malicious in ferocious social media posts but often only demonstrate how tired everyone is. I used to pet dogs in the street.<\/p>

Once on a walk a women\u2019s shopping bag broke and her goods fell out and I wasn\u2019t sure how<\/em> to help. I had a reusable bag with me that I would have gladly offered but was it safe? Would she feel uncomfortable or frightened if I approached her and spoke to her? Is she immunocompromised? Does she live with an elderly relative? On another walk a man sat on the curb of Spadina Avenue just outside a liquor store. As I passed, he asked me to open his can of beer because his fingers were numb and painful. I did so. Passed it back and offered him some hand sanitizer. He said, \u201cThanks, usually people think I\u2019m the dirty one.\u201d I said, \u201cWe are all dirty now.\u201d I agonized over this interaction: did I confirm his statement with mine? It still makes me cringe with shame.<\/p>

I pass the illegal weed store on my right and continue east. I have ground coffee in my freezer, and I own an unhelpful amount of travel mugs, but drip often makes my stomach burn, so I guiltily order an americano with nutmeg on the Starbucks app. There is a table pushed up against the doors and you don\u2019t interact with anyone as you pick up your order. I could walk a bit further to a locally owned caf\u00e9, but they don\u2019t have this system set up and allow up to 6 people to enter into a very small retail space. The coffee is a comfort. There is a Starbucks on the 2nd floor of the University of Toronto\u2019s Robarts Library, where I\u2019ve worked on this degree for many years. I don\u2019t even know if it tastes good but it tastes familiar, like the sound of a friend\u2019s voice. I usually turn north and walk up to King or Queen street before turning west and heading home. I call Dale to say hi and I can hear the birdsong on his farm in Manitoba through the phone.<\/p>

When I reach Bathurst and Fort York Blvd I look for baby groundhogs at Old Fort York, site of a colonial British settlement. I saw one last week eating grass on the slope. There are a couple tents set up underneath the rail-yard overpass, and two others near the fence of the nineteenth-century settlement. This city has failed its most vulnerable for years and this crisis has only exacerbated the failures. Racialized people and those with mental health concerns are over-represented and affected by housing precarity, and I\u2019m glad that there are many well-established activist groups fiercely challenging the lack of political leadership to protect human rights during this pandemic.<\/p>

I walk by a blue tent and notice a grey cat sitting on a piece of square cardboard just near the tent entrance. I think of all the videos of cats \u201ctrapped\u201d in circles and squares drawn on floors or made by placed objects. Is the cat comfortable in their square? I continue walking home. I turn on \u201cAdore You\u201d by Harry Styles.<\/p>

**<\/p>

I wash my hands and sit down to try to write chapter three of my doctoral dissertation. The laptop I\u2019m using was left behind when my ex moved out. It was his parents. I don\u2019t have my own laptop because I always write on the school\u2019s computers. I have a small iPad that I use for short writing stints and other business. The laptop is propped up on four books; my neck and back ached the first week because I was tensed up using a bad office chair and staring down at the screen. I hate working at home. I never did it willingly before this. For a couple weeks I refused to believe that I would have to finish this dissertation here. Alone. Isolated from friends and research materials. A couple days ago I found a computer monitor in the garbage room of my building, bleached it, and plugged it in to the laptop. Now I have my archival materials blown up on a separate screen and I may be able to do this thing. Maybe. I still feel dissatisfied. I can\u2019t pretend this is a totally new feeling though.<\/p>

I can write for about 3 hours before I lose focus. Sweep litter, clean dishes, do laundry, check Twitter, call a friend, Zoom with colleagues, make tea, go for a run. The hours pass quick and there seems to be less of them. I am afraid of how behind I am. I chatted with Caitlin about how time has fundamentally changed. I speculated that maybe it was because we were so future-facing, waiting waiting waiting for this to end, to be over\u2014for the Before to resume. I think the possibility of an academic career is no longer a thing. And this persistent realization makes the work seem irrelevant and indulgent. I wonder: am I using the pandemic to self-sabotage? Am I using it to procrastinate, to complain, to run away from the difficulties, to betray my goals? What is the normal reaction to this situation? Am I reacting normally? Is everyone else coping better than me?<\/p>

This comparison has been a consistent companion since this started. It\u2019s an old cruel friend that\u2019s become a bestie. Alone with my thoughts every hour of the day, staring down the domestic disorder I have come to accept and tolerate, feeling adolescent angst that becomes internal rage, examining my puffy eyes and fragmented thoughts, knowing that I am the only one who can erase this balancing sheet. So and so is working harder than me and so and so isn\u2019t as stuck as me. I\u2019m the biggest victim. I\u2019m the most alone. I\u2019m the most ruined. The shame of the narcissism coupled with self-loathing is gasoline on a flickering flame. Wallowing on Wednesday, a week peppered with small victories by Friday. Looping like a shoelace: up, down, through. I make draft emails to my supervisor that say, \u201cShould I take a leave of absence?\u201d and draft Twitter posts remarking \u201cI fucked my career up. I need someone to save me.\u201d I\u2019m afraid that I will be stuck in this space, literal and metaphoric, forever. I\u2019m afraid that everything I\u2019ve done and destroyed up to this point will now define me indefinitely. I sit in my bathroom with the lights off and let the wave of fear wash over me, feel the drag of hysteria across my stomach, and let fat tears arrive and drip drip. Still silent.<\/p>

The exhaustion that follows such an emotional thunderstorm is welcome. I text Matt to see what Disney songs his daughter likes. I record myself singing \u201cI Just Can\u2019t Wait to Be King\u201d and send it. I listen to the \u201cNightCall\u201d podcast; it\u2019s plastic surgery April and they\u2019re talking about \u201cDeath Becomes Her.\u201d I google \u201ccovid-19 memes\u201d and save my favourites for later.<\/p>

**<\/p>

I am hungry by 5:30pm. Regular meals have been a challenge. I don\u2019t eat much during the day and devour everything in sight at night. I\u2019ve never been a breakfast fan but the lack of structure in my day and the anxiety-driven bingeing at night requires me to be more strategic. At first, I visited grocery stores twice a week. I travelled to the cheapest stores and waited in lines. As the quarantine progressed, I started to feel like I was going out too much. Then I decided that I would try a food delivery service with a coupon I received. I have never been a person who likes cooking. I\u2019ve baked maybe three things my entire life. I\u2019m 36. This situation has forced me to consider the holistic benefits of cooking. I can\u2019t eat canned tuna and spinach every day, and my mood has always been tied to food. This delivery service brings all the ingredients and provides a specific recipe card. It\u2019s changed everything. I am learning to make sauces and time-out various components of the dish. I am learning that cooking for one is not a \u2018waste,\u2019 (there it is again), but an investment and meditative pleasure. Sometimes I think I should excavate these beliefs, figure out the why\u2014I usually decide that now it is not the time. Enjoy the progress, I remember. I am uneasy about personal positives emerging from this collective catastrophe. And yet, what else can emerge; what else is left? I\u2019m the only one in my condo to build a relationship with.<\/p>

As I eat, I watch TV. I started \u201cThe Leftovers\u201d week one and the dark world it builds is a relief. I think about loss and denial, the search for control, and what it means to surrender to the moment you\u2019re living. My friend Spirit and and I live-text Melissa McCarthy-centric comedies on Tuesday nights. I think the balance is just right.<\/p>

**<\/p>

Every second night, I jog three circles around the block around 9pm. I\u2019m not a cute runner. Loose black vinyl pants, giant pink, pilly sweatshirt, and a tight headband that flattens my hair. I often run in the one-way street, parallel to the streetcar track, and feel exhilaration when the massive red vehicle rushes past me. The air is fresh and the fluorescent city lights remind me that I\u2019m sharing this city. My inner left thigh muscle pulsates and my toes are squished in ill-fitting shoes but the overall embodied feeling is release and recognition. I\u2019m a big flesh suit of hormones and nerves; I can change my vision with a thirty-minute run. Exercise was helpful before but this feels more like an addiction. I feel betrayed by my knees that ache and prevent me from running everyday. I am keeping myself safe with this ritual. The despair of the day can only be tolerated with the promise of a chemical rebirth at night.<\/p>

As I run, I often listen to Janelle Monae\u2019s \u201cYoga\u201d on repeat.<\/p>

**<\/p>

I take a 4mg THC-CBD pill around 10:30pm and write some thoughts in my diary. \u201cI\u2019m grateful for the clouds that opened up for the moon like a theatre curtain.\u201d \u201cI wish they\u2019d texted me back.\u201d \u201cThe chill of the AC reminded me of Mexico City today.\u201d \u201cI had a craving for gummy bears so I bought some.\u201d The THC runs smooth through my body like a peanut butter cookie under my teeth.<\/p>

Laying in bed around 11:30pm, I listen to tarot card readings for my astrological sign. These often revolve around romantic love, and instead of reminding me I have none, these YouTubers read and interpret universal stories that collapse triumph and failure with a confidence that sends me to sleep. They trust the universe is guiding their voice and the cards. I want to absorb that trust.<\/p>

And maybe I am.<\/p>

Lindsay Sidders, American university student<\/em><\/p>

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PBS NewsHour. WATCH: Dr. Anthony Fauci Speaks about Coronavirus Pandemic with David Rubenstein – April 28, 20<\/i>, 2020. https:\/\/www.youtube.com\/watch?v=ZUEeTbJ9KFQ<\/a>.<\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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*If the pdf thumbnails are not appearing, please reload the page.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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