The Australia Letter is a weekly newsletter from our Australia bureau. This week’s issue is written by Dr. Amaali Lokuge, an emergency physician at The Royal Melbourne Hospital who wrote a dispatch in May about the race to prepare for Covid-19.
Soren Kierkegaard wrote that “Life can only be understood backwards; but it must be lived forwards.” I wonder how this time of Covid will appear in retrospect.
The mistakes that seem so obvious now may be viewed as unavoidable slips. Each country may have its own set of mea culpa in dealing with a disease so relentless that humanity could never have controlled it. Other decisions, their menace invisible now, may prove hardest to bear.
In Australia, people breathed a sigh of relief with the easing of restrictions in June, and came up for air like spring bulbs. The feeling was that we had dodged a bullet. At the hospital though, we suspected Covid would come for us later.
August, September, October? It was just a matter of time. The first lockdown had only bought us a reprieve: time to stockpile and prepare.
Now the second wave is here and that time seems like a precious gift. As the cases increased, the plans that we had refined over those months were implemented with meticulous precision. The emergency department divided into hot and cold zones as though it had been built that way. The masses of personal protective equipment we had time to procure meant that we could implement higher level PPE in the hot zone.
There was safety in knowing that we could protect ourselves and our patients.
We also changed in that brief moment of peace. The constant fear seems to have numbed us, replaced with a stillness and a fatalistic resignation. Doctors and nurses have become sick, sometimes from work, sometimes from community transmission. Many of them have returned and continue to look after Covid patients.
Will we get the disease too? Probably, but at least we know most of us will get better. Maybe it was the unknown that was so frightening back in March.
Here in Victoria, we are just gaining control of a second surge in infections. Similar to the rest of the world, the most vulnerable are being decimated by the virus. The nursing homes have collapsed and the elderly are dying too fast.
Thankfully, the health system still has capacity after months of preparation, but if we don’t control the numbers, the unnecessary deaths will haunt us.
I wonder though, if in trying to suppress it, are we allowing this virus — which is the antithesis of humanity — to win anyway? To me, the biggest threat of SARS-CoV-2 is not its virulence, it is the way it slowly erodes what it means to be human.
First it took away touch and that delicious proximity of a spontaneous hug. Then it took away social gatherings and shared meals. Now with mandatory masks we even lose the warming delight of a smile shared with a stranger. Crinkling eyes at them when they are about to pass just doesn’t seem right.
In the hospital, this loss is even more glaring. I still remember in May, the catharsis of hugging the nurse who helped me look after a patient who deteriorated unexpectedly. Now we stand apart, in silence, shielded from each other by layers of PPE which also trap in the emotions. Our eyes desperately try to communicate the stress, which is only released when, at the end of a shift, alone, we change out of our scrubs into civilian clothes.
In the patients’ eyes, the isolation is intense. Rules have been put in place to curtail the spread. No visitors are allowed.
The first sick Covid patient I managed in emergency, an older man, refused intensive care when it became clear that his family would not be permitted to stay with him. His son implored the intensive care team to allow him to stay, and for a long time we stood by the rules for the greater good. The panic settled on the patient’s face and didn’t dissipate until his son agreed to take him home.
In nursing homes as well, patients haven’t seen their families for months. If video chats are soulless to us, how must it feel to say goodbye via video link? A young doctor’s voice broke as she described her day to me, going from one sick or dying patient’s room to another with her iPad, digitally connecting the patients to their relatives at home and witnessing over and over the families fall apart with grief.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated August 27, 2020
What should I consider when choosing a mask?
- There are a few basic things to consider. Does it have at least two layers? Good. If you hold it up to the light, can you see through it? Bad. Can you blow a candle out through your mask? Bad. Do you feel mostly OK wearing it for hours at a time? Good. The most important thing, after finding a mask that fits well without gapping, is to find a mask that you will wear. Spend some time picking out your mask, and find something that works with your personal style. You should be wearing it whenever you’re out in public for the foreseeable future. Read more: What’s the Best Material for a Mask?
What are the symptoms of coronavirus?
- In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot, though some people don’t show many symptoms at all. Those who seemed sickest had pneumonia or acute respiratory distress syndrome and received supplemental oxygen. By now, doctors have identified many more symptoms and syndromes. In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms.
Why does standing six feet away from others help?
- The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It’s a rule of thumb: You should be safest standing six feet apart outside, especially when it’s windy. But keep a mask on at all times, even when you think you’re far enough apart.
I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
I’m a small-business owner. Can I get relief?
- The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.
What are my rights if I am worried about going back to work?
- Employers have to provide a safe workplace with policies that protect everyone equally. And if one of your co-workers tests positive for the coronavirus, the C.D.C. has said that employers should tell their employees — without giving you the sick employee’s name — that they may have been exposed to the virus.
This is why, despite the risk, I still see my father who is in his 70s and has Parkinson’s disease and heart problems. When the doctor in me advocated for isolation, he told me firmly that if he is to die from Covid, he would rather catch it from me. Ever the Buddhist, he says: “We will all die, it just may be sooner because of the virus.”
We eventually compromised: He isolates at home and I deliver his groceries twice a week. Do I hug him when I see him? Of course I do. If those hugs are numbered wouldn’t you want to increase the tally?
So even as we wonder and rail against the way the virus got away from us here, it also makes sense. Melbourne is a cosmopolitan, vibrant city which reveled in its connectivity and soul. It seems almost impossible to keep that spirit in check.
The groups gathering at the park are not being selfish or evil, they are just being human. The virus rips through large families like wildfire because even though we try, we can’t suppress the need to touch and hug and be together.
Maybe this is our resistance against a virus which has already taken so much away. Surprisingly, as a health care worker, what worries me most is that we will look back on this time of Covid and be traumatized, not by the fact that so many have died, but by the way we let them die alone.
Here are this week’s stories:
Around the Times
New Zealand Gives Christchurch Killer a Record Sentence: While the grieving and wounded watched, Brenton Tarrant was hauled away to face the certainty of dying behind bars after killing 51 people at two mosques in the worst terrorist attack New Zealand has ever seen.
Hong Kong Arrests Lawmakers and Bars Another Journalist: As a crackdown on dissent continues, officials are trying to frame it as a necessary remedy for an increasingly ungovernable city.
Republicans Insist Only Trump Can Stop This Chaos. But He’s in Charge Now. The convention seems engineered to prove that the president is in control of the good and not responsible for the bad, worthy of praise for the nation’s successes and exoneration for its struggles.
She Sought Justice on TikTok. Now Her Father Is Charged With Homicide. Alissa Turney disappeared in 2001, when she was 17. Her younger sister, Sarah Turney, has been investigating the case on social media.
The 3 Scariest Chemicals to Watch Out For in Your Home: They’re everywhere and can impair fertility and interfere with child development.
Move Over, Sustainable Travel. Regenerative Travel Has Arrived. Can a post-vaccine return to travel be smarter and greener than it was before March 2020? Some in the tourism industry are betting on it.
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