Illustration by Graeme MacKay, The Hamilton Spectator – Friday December 24, 2021 (Two articles follow when clicking on the date above)
The pandemic’s terrible twos — lingering tantrums plague us
A pandemic is a hard, peculiar shape to wrap your head around, to fit your life, thinking, lungs and feelings around, to take sides about.
I’ll get to polarization and side-taking, in a bit. It’s true, this pandemic is not a world war, not global famine, but it is something. It has a shape. An ink blot maybe? Many things to many people? The shape of things to come?
Not a shape perhaps but more like a sensation, like walking through spider webs. It feels bad, you weren’t expecting it and, I mean, brrr, it’s spider webs, but then nothing bad happens to YOU and you feel silly because … I mean, like, it’s spider webs; gossamer. Chances would be slim that you’d be walking into actual spiders and even if you were, chances would be slimmer that they’d be black widows. Landmines don’t come in gossamer, do they?
You might feel that way sometimes.
Then you attend a memorial. I did, a few weeks ago, organized by a woman I know, a friend of a friend, who lost her beloved husband. They were in Europe. They both got it. He was hospitalized. She had to quarantine. She saw him once in the foreign hospital at the beginning. Then she never saw him again. She was sent home before the borders were sealed off. He died, overseas, two days after she arrived back in Hamilton, where she had to, in her insurmountable grief and confusion, quarantine for another two weeks. She never got to say goodbye.
So, I remind myself, floating in the helium of my Have A Good Day balloon, that it’s not like walking through spider webs. Not that easy. It’s like walking through razor wire. It can tear you right apart.
The man whose memorial I attended died a year and a half before he could be properly honoured. In a pandemic, it can take a long time to remember the dead. We all know that, who have lost someone — that’s most of us, I expect — during this pandemic.
In August 2020, I came down suddenly with an odd soreness in all my joints. I got up from my chair where I’d been working (at home, of course), and, without warning, I was woozy, off balance and achingly stiff. No fever, no respiratory ordeal but I could barely move, and I was light-headed and clammy with a cold sweat.
I had no car that day, so I walked a mile, a hard woozy, stumbly mile (feverish-feeling but with no temperature), to the old roller skating rink on Main West. They were testing there. I had to know. A nurse fed a tube up my nose about as far as it could go. Then I walked back, feeling worse (I rarely get sick). I made it home, slept for 14 hours after which I felt 95 per cent better.
I woke up in the middle of that long sleep to take a call saying I was negative. I dreamt of spiders. And other things — I’ll get to them later.
I feel stupid bringing it up. Inconsequential, stacked up against the rack and ruin, but it speaks to the oddness, warped perspectives, the anxiety, the shifting prisms of “rationality.” Himalayan molehills.
Sometimes, the molehills really do become mountains, or at least foothills, at least to those affected. My daughter’s housemate had a cough. Happens. A few days later housemate tested positive. Happens … to others, no? No.
My daughter had to quarantine. She’s 24. We kept our heads. But still. Six days no symptoms; fingers crossed. Seventh day headaches, worst she’d ever had. Tight throat. Two and a half days later the symptoms subsided. A week later all better, although her sense of taste was gone. A month later it was like it never happened. But it did.
OK, enough about me. I only come in to this as a placeholder for your own stories, probably similar. I hope not worse.
Where are we now, two years into this and counting?
A new variant. Variants — novel, Delta, Omicron, COVID 19, airborne, bat-borne, breech-born, gluten-free, two to a table, make up your own. When did you ever hear the word variant before 2020?
So, lungs, precious lungs, don’t fail us now. This is a respiratory disorder, and in more ways than one. It chokes up the normal flow of breath and freshness in our important passageways. We have covered many stories in The Spectator, over 175 years, but nothing quite like this, except maybe the wars — front page, every day, day after day, now year after year.
The daily numbers, the changing rules, the microbiology, the shifting catechisms.
We all know now what two metres look like, though sometimes it’s hard to tell because your glasses fog up from mask mist. Two metres. A small step for managing short yardage situations on second down in football; a giant step for “mankind’s” yardsticking of acceptable approach.
Where are we now? What’s that joke? The things that were punishments when you were a child are rewards in later years. Going to bed early; staying home; in your room alone; no visiting, no visitors.
Some people hate what COVID did/has done. Reduced social interaction; people home from school and workplaces. Closed shops. Other people, though, welcome this as tapping the brakes on runaway stress levels, traffic and rampant consumerism.
In some ways the virus has drawn us together. In other ways it has famously drawn us apart, divided us, polarized us, encamped us in our pitched positions, lined up at opposite ends of some dystopian Meyers-Briggs personality test. We’ve somehow come to misinterpret this vague, world-view ink blot as the gestalt of a battlefield.
I saw a mock gravestone on someone’s lawn around Halloween — the epitaph read: “Did my own research.” This would have meant nothing two years ago. Now, it does.
It’s one the many tragedies of the pandemic that its timing sucked.
Its arrival and evolution have coincided or at least overlapped with a frenzy sweeping through much of the world. Brazil, The Philippines, Hungary, Poland, Italy, U.K, U.S., Russia and more. It’s a frenzy that combines all the charm of cry-baby, militaristic nationalism with the hamster-wheel dizziness of conspira-gullibility and fake news denial-ism.
You left us, data sanity/issue clarity, just when we needed you most.
COVID confusion wasn’t bad enough, it had to get veined into the crazy marble of crisis that also included a kind of “We Didn’t Start the Fire” litany of George Floyd’s death, Boris Johnson, Putin, Megan Markle, fentanyl, the list goes on, and … in the role of the “really big picture,” climate emergency. Oh, let’s not forget Jan. 6, when Tweety Bird was heard to say, “I tought I taw a coup d’état!” He did. He did! An attempt, anyway.
Polarization. At least now we know where we are with each other, where, I guess we’ve always been but could pretend not to be. Virtually at war or at least staring daggers.
The pandemic happened at a time when a major population vector in the world, especially in terms of its influence and power, was being run by someone who deliberately downplayed it.
Now huge swaths of that vector won’t wear masks, won’t get vaccinated. You might think I’m talking about the United States and I am but I’m also talking about Russia. Same difference? One kept millions of its people in servitude on the land for centuries and the other, oh yeah, it did, too.
Putin is in trouble. Like the other guy, he spent so much time galvanizing the cheap seat fans in the bleachers, leading waves of “pooh-pooh COVID, masking, vaccination” that now he can’t put the virus back in the vial as it rips through huge portions of Mother Russia.
It’s being cast by some as a goal-line stand for freedom. Really? Freedom? Rights? Nothing’s free. You can say any plain-spoken thing you want — yes, everyone looks fat in that capitalism dress — but you pay a price.
You’re worried about vaccination? We’re being run by the puppets of people with such sociopathic tendencies and so little imagination that all they can think to do, once they’ve accumulated $800 million, is to reach for a billion and then a billion billion. Forget your precious rights. Once the billionaires finish their work we’ll be on rocket ships, whether we like it or not, with William Shatner and Michael Strahan, to cold and distant places. Maybe we’re already there — surveillance state social media.
Freedom? As the songs says, that’s just some people talkin’ or another word for nothing left to lose. I’m glad and thankful I’m not in a jail or being whisked away from my parents to a residential school or executed for reaching toward my glove compartment. That’s only by accident of birth.
OK, back to me. Someone I know who works in the health profession was accused by someone at one of the protests outside the hospitals of being a “crisis actor.” Another health worker had a drone flown by her window.
Most of the people I lost in the last two years, I lost not to COVID. That doesn’t make it any less bad. In some ways worse; they get swept out of the picture. I’m at that age. Death and illness are on a hill saying, “Hey, I can see your neighbourhood from here.” Anything that hasn’t to do with COVID seems to be a bit, by default, discounted, that’s how much COVID has become part of our very breathing.
Two years and counting. It does not seem to be going away. If you walk through spider webs, that means that maybe not here, not now, but somewhere and at length, there will be spiders.
The second part of my dream was Pandemic celebrating its birthday, to which were invited an A-list of scourges through history. The Bubonic Plague was there. The Spanish flu with its plus one, the First World War. The meteor that killed the dinosaurs, ebola, the frogs and locusts from the Old Testament, polio, diphtheria. They started fighting, comparing body counts and who did a better job killing. Then Pandemic hushed everyone by introducing Junior, the next one coming, to take how many? Junior’s T-shirt read “Billionaire.” Then I woke up.
COVID is definitely no country for old men or the old of any description. But, maybe even worse is what is happening to our young, reporting levels of hopelessness and mental unwellness that are unprecedented, be that from the effect of COVID, climate change or the socio-economic “order” we live in. Maybe all of it combined. Please, do not let the destruction of our very children be what it takes, as in the divided world of “Romeo and Juliet,” to get us finally to come to our senses.
Lungs, don’t fail us now. More than ever, two years in, we need to breathe. (The Hamilton Spectator)
Op-Ed: Lung failure leads to COVID tragedies, but lung disease was a crisis even before the pandemic
BY MEILAN K. HAN, JAN. 10, 2022 3:01 AM PT
The World Health Organization reports that more than 5 million people worldwide have died of COVID-19, with numbers rapidly rising again. When we look at how people with COVID-19 die, the most common cause is catastrophic lung failure.
Once the lungs fail, other organs soon follow, like a game of Jenga when the linchpin block is removed. At this stage, even for patients thought to be previously healthy, we cannot stop the virus from wreaking havoc. It’s a painfully familiar script for many admitted to the hospital with minor breathing issues: Blood oxygen levels drop. Supplemental oxygen isn’t enough. They end up on a mechanical ventilator. Days later they are dead.
Despite truly remarkable advances in our capacity to diagnose and treat disease in the 21st century, our ability to treat lung disease is still profoundly primitive — and, intensified by the pandemic, that deficit has tragic results.
The first successful kidney transplant occurred in 1954, followed by liver in 1967 and heart in 1968. The first successful double lung transplant happened in 1986. Yet even now, long-term survival for lung transplant patients lags behind that of other major organ transplants. For instance, the median survival of a lung transplant patient is 5.8 years, compared with 12 to 13 years for a heart transplant patient.
Before the pandemic, chronic lung disease was already the third leading cause of death worldwide, and pneumonia the leading cause of death among children under the age of 5.
Yet we failed to make the kind of strides seen in other diseases. In the latter half of the 20th century, for instance, mortality from cardiovascular disease dropped over 50% in the U.S. following greater research investment, targeted disease prevention and treatments, and clinical trials that led to the development of powerful new medications to manage cholesterol and blood pressure.
We have not adequately invested in lung research. While there are many reasons for research funding disparities, a major factor has been the stigma associated with lung disease, framed as an illness of personal responsibility: If you smoked, you gave yourself lung cancer or emphysema. But health behaviors play a role in many diseases, such as cardiovascular disease and diabetes where diet and exercise contribute.
Even before COVID-19, we had no specific therapies for acute respiratory distress syndrome — the pattern of severe lung injury seen in severe COVID-19. Treatment generally consists of supportive care with mechanical ventilation, which itself can cause lung injury if not properly employed. Nearly 200,000 Americans were dying each year of severe acute lung injury before the pandemic.
Risks to lung health are only increasing. Global air quality is getting worse. Dust and particle pollution are rising due to hotter temperatures and drought. Wildfires are also now driving extremely high particle levels, in some instances miles from the original fire. These exposures induce lung inflammation, contribute to the development of chronic obstructive pulmonary disease and exacerbate asthma.
And these changes ultimately did make COVID more devastating: Research indicated that wildfire exposure in the American West last year resulted in an excess 20,000 coronavirus infections and 750 COVID-19 deaths.
Chronic lung problems may also drive cases of long-haul COVID. My colleagues at the University of Michigan found that some patients now suffering from long COVID had undiagnosed lung inflammation evident on CT scans before they contracted COVID-19. SARS-CoV-2 was fuel for a preexisting fire. Yet unlike blood pressure, we never measure lung function as part of routine care, leading to, for example, an estimated 12 million individuals in the U.S. with undiagnosed chronic obstructive pulmonary disease.
Researchers have also found that a significant proportion of adults diagnosed with chronic lung disease had suffered impaired lung development before adulthood. While we think this damage might stem from factors like premature birth, repeated respiratory infections and secondhand smoke exposure, the truth is we’re not really sure.
But despite an influx of funding for COVID-19 research, shockingly little has gone specifically to understanding lung damage and how to treat it. While vaccines are incredibly important, as are treatments for COVID-19 itself, lung health too must be a national priority. We would never have been able to develop the COVID vaccines so quickly without years of basic science research investment.
Congress and government agencies around the world must appropriate funds for lung health programs including screening, research into mechanisms of lung injury and repair as well as aggressive drug and device development programs.
COVID-19 alone didn’t kill more than 5 million people. It exposed a dangerous failing in medical care. We must recognize the warning signs of lung injury much earlier and prioritize finding ways to prompt recovery.
MeiLan K. Han is chief of pulmonary and critical care at the University of Michigan, a spokesperson for the American Lung Assn. and author of “Breathing Lessons: A Doctor’s Guide to Lung Health.” (LA Times)