26 March 2020 – Thursday – #11

Musicians do what musicians do, and in Barcelona a trio called Homas is giving us music for our isolated souls. Here’s my new stay home and wash my hands anthem.

Not great news from the region or the country. We’re isolating and waiting for the curves to turn the right direction. Catalunya had another bad day of new cases, with the worst concentration in Igaulada. This table compares the intensity of the Covid-19 mortality in Igualada to other regions.

Region	Deaths per 100,000
Catalonia	6.9
Spain	7.4
Madrid	27.9
Lombardia (Italy)	41.6
Igaulada	63.1

The bad news out of Madrid was punctuated by this week’s story about bodies found and residents abandoned in nursing homes. According to the article, “Last week, one privately owned home in Madrid reported 20 deaths and 75 infections, claiming it didn’t have adequate material to take care of the sick residents and dead bodies.” The Madrid situation is dire.

I’m writing a lot today about what I’m doing to stay alive.

Yesterday marked my second shopping expedition in as many days. It’s risky to leave my Covid-19-free zone and I want to tell you about how I manage that risk.

I left earlier than normal because I discovered on the first expedition that store hours now are shorter and earlier. Most local bakeries and specialty food stores remain open for business. I wonder, though, what’s happening to the rest of the shuttered businesses. Barcelona is a ghost town. The hotels are especially eerie to pass, their grand entrances curtained and their bustling lobbies transformed into storage areas for plants and furniture from outside.

When I leave my apartment, I still take a fresh paper towel along in my jacket. I use it to wipe my face sparingly, touching my eyes, nose, and mouth as little as possible. The weather here is cold enough that my eyes tear, so sometimes there is no choice but to wipe.

Using a paper towel makes me aware of touching my face and reminds me to touch it as little as possible outside the apartment. I press elevator buttons and open doors with the elbows and forearms of my coat. If necessary, I also can use the paper towel for something I fear is super-contaminated like a door handle I can’t operate without my fingers. I don’t worry about touching things, but once I do, I consider my hands contaminated as well as things I subsequently touch like my mobile. I never touch my face directly when my hands are contaminated.

From what I know, though, I’m unlikely to get Covid-19 from a surface. Air transmission of Covid-19 is the most likely way for the virus to enter my respiratory system. Everyone is maintaining distance from everyone else in public now, so that part is easy. I stay in open air areas like streets and open markets (love the local Mercat!) as much as I can. I only enter interior spaces with limited occupants.

My decontamination process on return is streamlined from last week, a result of better knowledge about Covid-19 transmission. Here’s my what I do now when I return:

• Remove shoes and leave in foyer
• Drop shopping bags and leave the shopping cart in the foyer.
• Hang my coat on a chair that’s near the foyer (forgot to buy a coat rack before the pandemic!)
• Wash my hands with soap.
• Move bags and shopping cart to the rear covered patio, an isolated space outside.
• Store food in the outside refrigerator as appropriate.
• Wash my hands again, then wash mobile with soap, then wash my hands again.
• After 24-48 hours start bringing inside the items from the outside patio on the assumption that Covid-19 virus that might have been on containers and fresh food is deactivated.

The basic rule is: I treat any surface that enters from outside the apartment as possibly contaminated. I also consider such surface contamination as not highly transmissible to my respiratory system. Except for my coat and shoes, I assume my clothes are not contaminated in a way that the virus is likely to enter my respiratory system. As long as I’ve avoided breathing the virus outside, I think I’m safe from Covid-19 with this decontamination method.

Feel free to adapt my system to your situation. I’ve read about much more rigorous systems that include face masks, washing clothes that have been outside, and using UV to decontaminate surfaces. I think these are overkill. If Covid-19 were highly transmittable from surface to respiratory system, the infection rate would be much higher. Just wash your hands after you touch something that might be contaminated.

However, everyone needs to find the method that works for them to protect from Covid-19. It’s always a trade off. Do the best you can. It seems Covid-19 transmission is primarily through air particles, so once you’re inside your apartment, surface contamination is an unlikely vector unless you’re living with someone who’s infected.

Whew! Once I was back in front of my computer, I got a message from the greatest neighbors in the world, Ana and Timio. They’ve been reading the Covid Diary and, seeing that I wasn’t able to buy wine two days ago, wanted to make sure I didn’t go dry. I replied that I was okay, that I’d procured my jug wine.

Next thing I knew, the front door buzzer sounded and there was a gift box with wine at the door. How good that simple gesture felt. The three of us chatted in the hallway. I found out Ana and Timio didn’t go on that cruise trip they’d planned. I should have deduced that from the fact that they are alive. I still don’t know what the wine is because the box is in decontamination until later today, but I already know it will taste of neighborly love.

The other thing I’m writing about today is a feeling I got that the vast and diverse US psyche caught up with the European psyche in the last few days. Some parts of the US are ahead of others. It’s just a feeling, make of it what you will. It seems like there’s a point in a country’s Covid-19 journey where shit gets real, as they say in New York City, where Covid-19 is no longer that news story from far away China, no longer that crisis that won’t arrive for a month or at least a week. Blaming someone else for the problem doesn’t matter any more. The slightest tickle in the throat or tingle of a headache sparks panic. The only thing that matters is hanging on for dear life. The only thing that matters is social space and hand washing because that’s the only thing that we know works right this second.

I’m sure part of the reason I got this feeling was listening to a New York Times piece called Why the American Approach is Failing. It’s a capitulation to Covid-19. In 30 minutes, it lays out why it’s too late for Covid-19 testing in America, why it’s too late for America to copy the South Korean response, why it’s too late to sequester the people at risk and put the rest of America back to work. It dispels every fantasy about avoiding severe damage from Covid-19. With things going the way they are, millions of Americans are about to die.

Goldman Sachs said the same thing 10 days ago, but more bluntly. Its analysts estimated that 50% of Americans would get infected and 2% of those would die. You can do the math.

It’s the nature of exponential events that humans don’t comprehend until it’s too late that a disaster is unfolding. Remember how long AIDS was a homophobic punch line instead of a public health problem. Until Rock Hudson died, the middle of American had no real concern about the impact of AIDS.

When Tom Hanks said fifteen days ago that he tested positive for Covid-19, some Americans got the message. Covid-19 would be part of what makes America great, whether America liked it or not. A few weeks after Hank’s announcement, as New York City infection rates skyrocket, the rest of the US has got the message. Most of the rest of the US. A few are still praying.

An effective response to Covid-19 is more about math than prayer. I want to share a video from six days ago. The US Army Corp of Engineers explains its plan to create the hospital beds the US needs in the next few days. Not weeks, not months. Days.

What I dig is how much of a numbers guy this Lt. Gen. Todd Semonite is. He explains how to coordinate FEMA, USACE, and state governments to identify and transform facilities into hospitals in days. It’s math. “Right now we’re calculating what the curves are when they go exponential in all these key cities.” Music to my ears.

There is no miracle in responding to Covid-19. It’s a math problem. The death and economic tolls are becoming clear. It’s a disaster.

The cost of waiting for a Covid-19 miracle is high. The US blew its opportunity to contain Covid-19. It blew its opportunity to test enough people to make quarantines work the way they worked in South Korea.

The cost of waiting for a miracle couldn’t be higher for first responders. Yesterday it took the life of Detroit Police Captian Jonathan Parnell. 18 Detroit officers have tested positive and 233 are in quarantine. There are many, many more stories like this already. There are going to be many more.