Flattening the Curve: The Plague and COVID-19

“Should we go see the grandkids in Virginia?”

We have the plane tickets. We’ve reserved the hotel and the rental car. And I would love to luxuriate in the embrace and enthusiasm of my young grandsons. But COVID-19 casts a pall.

Maybe we should drive. Less proximity to potentially-infected fellow passengers. Except neither of us likes to drive, especially over the Appalachian Mountains.

A Harvard epidemiologist said last week that when he travels, he carries enough necessities to weather a 14-day quarantine. That gave me pause. I don’t want to get sick; I don’t want to infect my son and his family or them to infect us. I don’t want any of us to have to endure a two-week quarantine.

Perhaps the decision will be made for us. CDC may recommend that 72-year-old people should “shelter in place.” Perhaps the sure-to-increase numbers of sick people, if only because they are finally being tested, will deter me.

MV5BM2I1ZWU4YjMtYzU0My00YmMzLWFmNTAtZDJhZGYwMmI3YWQ5XkEyXkFqcGdeQXVyNjU0OTQ0OTY@._V1_UX182_CR0,0,182,268_AL_The scope of this outbreak is unprecedented for most of us. One comparison is the 1919 influenza epidemic that

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Ingmar Bergman

killed more people than World War I. What comes to my mind is the Black Death of the 14th century. Or at least Ingmar Bergman’s vision of it in his 1957 film The Seventh Seal.

This is my first gonzo movie review. Even if you haven’t seen the movie, you would probably recognize the iconic scene of the knight playing chess with Death.

film-seal

In the 14th century, a knight (Max von Sydow) and his squire have returned home after ten years in the Crusades to find Europe ravaged by the Black Death. This adds to their disillusionment about the Crusades, about God and about their fellow man.

The knight meets Death at the seashore and challenges him to a game of chess. If the knight wins, Death will not take him (yet). They play throughout the film. The knight and squire encounter people who think they can outrun the plague by moving; people who whip themselves to appease an angry God; people who torture and burn a young woman they accuse of consorting with the devil.

They also meet up with a performing troupe consisting of a young family (Joseph, Mary and their baby) and another actor. The troupe joins the knight and squire (and a woman the squire has saved from rape) to traverse a forest together. Death and the knight resume their chess game.

When it is clear that the knight has lost, the knight spills the board, giving the young family a chance to escape in their wagon. The little family pass a perilous, stormy night in their cloth-covered wagon. They wake to a bright, sunny morning. Joseph, a dreamy sort, looks up a hill and sees that Death has caught all the others.

Unknown

Thank goodness that COVID-19 is nowhere as lethal as the plague bacterium that killed  upwards of two-thirds of Europe’s population. Still, we have a genuine crisis. I knew it when the Indian Wells tennis tournament was called off a week ago. My friend said she knew it in early March when the James Bond movie got postponed. Trump didn’t figure it out until a couple of days ago.

People’s reactions to an apocalyptic situation have changed little over the centuries: denial (The dad of the first St. Louis case broke quarantine on day one); hysteria (runs on TP and hand sanitizer), conspiracy theories (in the 14th century, it was God’s wrath; in the 21st century, the Chinese and the US blame each other); taking advantage of others (robbers of corpses vs. price gougers.)

Here’s the big diff: SCIENCE! Streptomycin, an antibiotic, would have stopped the plague. Science will eventually provide a COVID-19 vaccine. But Science needs data. Science needs curious minds. Science calls for changes of plans when the new data come in.

As of today, this is what science knows: COVID-19 is extremely infectious, much more than the flu. No one has immunity because COVID-19 is brand new. I remember a movie in the ‘70s with John Travolta playing a boy with a defective immune system. He lived in a space suit. Like that boy, our bodies are open-season as far as COVID-19 is concerned.

As yet, there is no cure, no drugs that blunt the disease. Medical treatment can only support you until your body wins or loses its battle with the virus.

It is projected that about half of the U.S. population will catch the disease. What we can do is to slow the rate of infection so that the medical system doesn’t get overwhelmed. This is what they are calling “flattening the curve.” You’ve seen the graph. We’re just trying to have people get sick over a longer period of time so that the health care capacity can handle them.

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Image credit: Johannes Kalliauer/ CC BY-SA 4.0

Our case studies are Wuhan, where they had to build extra hospitals lickety-split, and Italy, where doctors have to choose which patients get the ventilators. In a positive scenario, about 200,000 Americans will need to be in ICU. There are only 160,000 ventilators in the US, and of course, most of them are already being used by sick people.

How do we “flatten the curve?” Not many options there either. Basically, try not to catch the bug by “social distancing.”  Social distancing just means seeing fewer people and keeping literal distance between you and them. Because you can’t tell who has the bug — even the infected person may not know—we need testing. Who needs to be quarantined? Who doesn’t?

Sometimes social distancing feels awkward. I hug people. Politicians shake hands. You feel sheepish. It gets even more complicated when it’s family. 80% of Wuhan infections were from within the family.  How do you not eat and sleep near your family?

The film has a brutal example of social distancing. The squire stops a woman from giving water to a dying man. It seemed cruel but practical.

I have a social distancing story from my own family. When my mom was young, TB was a scourge in China. Her mother, a formidable woman, decreed that everyone in her house had to use serving utensils when getting food from the communal platters. No one was to use their own chopsticks, which may have been in their mouths.

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Grandma Shen

Protests came fast. It was inconvenient. Chinese tend to pick up small amounts of food from platters into their rice bowls, then replenish when they’ve eaten that up. Especially within the family, it’s habit to reach with your own chopsticks. Also, it was – and is – a sign of consideration to pick up some special morsel with your chopsticks and plop it into your guest’s bowl. But Grandma was adamant.

Now, as in the Seventh Seal, you cannot outrun an epidemic. You can just flatten the curve. In our case, by social distancing. You know the drill now: minimize close contact with people, wash your hands, cough into your elbow. Also, I dug out my thermometer. Fever is the most common symptom. Science now has a better way to measure temperature than putting the back of your hand to your forehead. Use it.

It strikes me that the knight’s distraction of Death so that the Joseph, Mary and the baby could escape was his way of “flattening the curve.”

Tell me: Do you have a social-distancing plan if a family member tests positive for COVID-19?

Author: cathyluh

I am a doctor, a writer and Grammy to Edin and Caleb. I live in St. Louis with husband Bill.

16 thoughts on “Flattening the Curve: The Plague and COVID-19”

  1. Ah, Bergman. I was really smitten by his dark films in the early ’60s – Wild Strawberries, The Magician, and of course The Seventh Seal. Was sorry to see the recent passing of Max von Sydow. As to the plague at hand, I already live a pretty distanced life, but this has cut off most of my remaining connections: writing group, book group, training at the Y. Looking forward to baby-sitting my granddaughter since daycare has been closed.

    Liked by 1 person

  2. Delete “to”….

    It strikes to me that the knight’s distraction of Death so that the Joseph, Mary and the baby could escape was his way of “flattening the curve.”

    Otherwise, bravissima!

    >

    Like

  3. That is the best explanation of why social distancing helps that I’ve seen.
    I am currently caring for my 2 1/2 year old grandson, who has an ear infection and his daycare is closed anyway (I live in western WA). So he, I and his mother must interact closely for the duration as she is the sole support of their family. But I am sure washing hands a lot!

    Like

  4. Your beautiful way with words, Cathy, delivers the message again. Thank you! I hope you get to see the kids soon but not too soon. Stay well.

    Like

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