Life in the Times of Coronavirus: Lockdown Day 32

Source: La Vanguardia

We’ve been in the government-enforced lockdown in Spain for more than a month now. People—those of who can still enjoy the privilege of being at home and minimize our risk of infection—seem to be getting accustomed to the lockdown. For the first few days of the lockdown, Spanish Twitter was abuzz with talk of the pandemic, with terms such as “coronavirus” “pandemia” and “COVID-19” trending. Today’s popular topics are República (today is the 89th anniversary of when Alfonso XII fled Spain resulting in the declaration of the Spanish Republic), Mariano Rajoy (the former PM who apparently violated lockdown regulations this morning) and All Might, which is apparently an anime show that, for whatever reason, is growing in popularity today. At the time of this writing, a hashtag related to the coronavirus is at number 7.

Those of us that live in Catalonia are slowly thinking about what our lives will look like once the pandemic comes under control and the virus is contained. Believe me, I know we’re nowhere near the end of the pandemic, but I can’t help but think about the many ways that my life will change once the pandemic falls under our greater control.

Specifically, there’s the fear of contagion. I certainly don’t want to contract the coronavirus, nor do I want to feel anxious all the time about potentially becoming infected. With workers all over Spain returning to work this week, there is the possibility of a dreaded second wave, or at minimum, an increase in cases.

I ran across this article by Josep Corbera in La Vanguardia which helped ease my fears. The title is “Perder el miedo al coronavirus,” or “Overcoming Your Fear of the Coronavirus.” I found it to be a balanced article which offers a healthy perspective to view the current pandemic, as well as to prepare ourselves for the months to come once the lockdown has been lifted. He talks about how our collective understanding of the virus must change as the pandemic progresses and offers a helpful glimpse at the summer. For those of you living in countries where the pandemic is in full swing, I highly recommend reading it. I’ve translated it fully for you below, and hope you find it as reassuring as I did.

OVERCOMING YOUR FEAR OF THE CORONAVIRUS

The countries that will fare better will be those that learn to live with the coronavirus. Living together does not mean eradicating it, an objective that is impossible at this moment. It means being able to detect new outbreaks, isolate and treat patients, identify and quarantine their contacts, and avoid uncontrolled chains of infection as was the case [in Spain] in February and the first half of March. It means losing fear of the virus. It means accepting that new outbreaks will appear and can be controlled.

To overcome your fear of it, it is useful to differentiate between collective risk and individual risk.

The individual risk of a person becoming infected with the coronavirus at work, in a shop or on public transport is currently not zero, but it is very low. The perception of the coronavirus as an invisible enemy that is everywhere, ready to infect us, does not match reality.

It should be remembered that the vast majority of the population - probably around 90%, perhaps more; seroprevalence studies will soon clarify this - have not contracted the virus. Among those who have, the vast majority have overcome it and can no longer transmit the virus.

No study has calculated how many carriers of the coronavirus are currently in Spain and are in the phase when they can infect other people. This phase of high risk of contagion does not cover the entire period of the disease but is concentrated from two or three days before to a few days after the onset of symptoms, according to a study by the LMU University Hospital in Munich published on April 1 in Nature magazine.

In any case, the percentage of the potentially contagious population must now be well below 1%. And those affected are concentrated in nursing homes - which have become one of the foci that keep the epidemic active in Spain, as Minister Salvador Illa recognized yesterday - and in health centers.

Even if a person is infected, the risk of serious complications is also low - although it increases with age. More than 80% of those affected overcome the disease without complications and without any permanent issues.

The fact that individual risk is low is not a reason to relax the precautions taken in recent weeks. Staying at home, maintaining a minimum distance of one and a half meters between people, good hand hygiene, learning about your lungs, not seeing friends, giving up soccer, canceling trips ... All this contributes to reducing both the risk of contracting the virus and transmitting it if we ourselves are the carriers.

But the argument for maintaining all of these measures is not individual risk. The reason is our collective risk, which is higher.

The main purpose of confinement, if you recall, was to flatten the curve. It was to avoid a spike in infections that exceeded the capacity of hospitals. Both in Spain and in other countries, the purpose was to protect health systems so that they were not overwhelmed by an avalanche of patients who needed intensive care. It reacted late.

But this shock therapy has been effective if you consider how diagnoses and deaths have been reduced after the declaration of emergency, and how the pressure on hospitals is being relieved. Still, it is having serious economic, psychological, and social side effects. When assessing whether aggressive treatment is maintained or modified, the key question is whether the benefits justify the side effects. Naturally, different doctors may have different opinions about the same patient.

In the case of Spain, the conditions to begin withdrawing measures will begin when the health systems are in a position to adequately attend to new cases that emerge. For this, the capacity of the ICU has been multiplied in recent weeks and the availability of respirators is being expanded. The diagnostic capacity to detect and contain new outbreaks still needs to be expanded.

Note that the goal is not to achieve zero contagion. It is to react quickly to the contagions that do occur, as China, South Korea and Singapore have done. These are the first three countries that have controlled the coronavirus, that keep their epidemiological surveillance systems on alert and that review the measures they are taking on a daily basis.

Also in Spain, when containment measures are relaxed, new infections will inevitably occur. If they are detected early and controlled, they do not have to be interpreted as a failure. On the contrary, they will be proof that the country can move forward.

The alternative, if the fear of the virus continues, if we do not accept that there may be new infections, either due to personal apprehension or political tactics, is to remain confined until there is a vaccine with enough doses for everyone. In that case, don't expect to leave before 2022.