“No pestilence had ever been so fatal, or so hideous.”
The coronavirus is now a global pandemic.
I am not remotely ready for it to be March.
I took the weekend to step back, disconnect, and catch up on a couple of things I hadn't done lately. Saturday afternoon, I participated in a "table read". A table read is when actors sit around tables in a large room (or sometimes your living room!) and read through the script aloud. Each person plays a different role, and sometimes they play several roles.
The script in question was a comedy; all told, it took about four hours or so to read through it, with everyone playing different parts, and some of us leaning into the character development way more than others. I hadn't read the script before the table read, because I wanted to approach it fresh, without preconceptions. That way, I'd read the character assigned to me organically, and grow them as I read along.
It went well. It also reinforced just how much I missed acting, something I've done off and on for the last 20 years. I missed sinking into a part; the feeling, the idea of being someone other than myself, of telling a story through someone else's eyes and voice. I don't know if I'll get back to it, but it's surely not a coincidence that on Sunday, I was half-seriously looking up various acting classes and wondering if I could make it work.
In any event: welcome. You're reading The Miscellanies; my name's Raf, and in theory you're getting this email because you're interested in things like politics, tech, style, books, and generally speaking what it's like to be a guy in 21st century America. If you think someone might like this newsletter, you can share it with them by clicking the button below. Thank you!
I spent the first two months of this year sick as hell. A couple of days after the New Year, I came down with a cold. It wouldn't go away; I'd get better for a day, maybe two or three, and then get sick all over again. It then spread into my sinuses, and then my lungs. My head; my ears; my chest -- my upper body was a cornucopia of misery. I would lie awake at night, my head throbbing rhythmically in pain, fitfully dozing off for an hour or two, then waking suddenly, gasping for ever shallower breaths. Every breath I took felt as if I were being stabbed right through the center of my chest.
I dragged myself to an urgent care facility the first weekend of February after a particularly miserable night, at which point I was diagnosed with pneumonia. Three weeks later, I'm just now feeling better; just in time, it seems, to be felled by the dread coronavirus.
I'm not exaggerating, either. James Hamblin made the case in The Atlantic that most of us are likely to be infected by COVID-19:
"COVID-19 is already reported to have killed more than twice that number. With its potent mix of characteristics, this virus is unlike most that capture popular attention: It is deadly, but not too deadly. It makes people sick, but not in predictable, uniquely identifiable ways. Last week, 14 Americans tested positive on a cruise ship in Japan despite feeling fine—the new virus may be most dangerous because, it seems, it may sometimes cause no symptoms at all."
Despite its popular name (Coronavirus), this is actually a fairly common bug. As Hamblin explains, we already have tons of experience with them: the common cold is caused by a coronavirus. And yet...this feels different. Maybe it's the fatality rate (two to four percent); if you assume, conservatively, that between a quarter and a third of Americans get infected, you're still talking about somewhere between 77 million to 103 million people; let's call it 85 million, just to pick a number.
That's a lot of people. If the fatality rate remains constant at between two to four percent, you're suddenly talking about anywhere between 1.7 million and 3.4 million deaths. That number is staggering. Sit with it a moment; imagine the societal cost of that. Imagine one more thing, now:
How confident are you in the Trump regime's ability to respond competently?
We've been extraordinarily fortunate to avoid any major disasters thus far. But I think this is where our run of luck ends. Consider this: Trump decided against naming a "czar" to coordinate the coronavirus response in part "after wondering whether such a person would be loyal to him, according to those familiar with the debate."
We have cases reported in New York City as of Sunday night. Given the spread of time and how disease transmission works, I am not kidding in the slightest when I say that, contrary to what reporting says, there’s no way Gov. Andrew Cuomo is correct in saying this.
New York City is home to two international airports. It’s almost certain that people infected with COVID-19 have been in the city’s population before Sunday, and have spread the disease. I think panic is unwarranted, and we should still be forthright about what’s going on, as opposed to downplaying the risks.
Growing up in a family with a medical professional (my mom was a research pharmacist), I was fascinated by epidemics. I'd eagerly devour books and magazine articles (what we used to call "longreads" in The Times Before Online) about things like the Spanish Flu of 1919, the Black Death, and the Ebola virus. I'd read about the CDC and how people would research epidemics, and the differences between epidemics and pandemics (reasonable people differ on this, but generally speaking a pandemic refers to the widespread occurrence of disease, in excess of what you'd expect in a geographical region).
To my mother's eternal disappointment, my interest in medicine and disease didn't translate into a career as a doctor (which is what she wanted to be, but couldn't, for lots of reasons) because I was god-awful at chemistry. That deficiency foreclosed a career in medicine, despite my lifetime fascination with the subject.
I've mentioned two of the big pandemics in history already; here are a few others.
Hong Kong Flu (1968) - Death toll: over 1 million
Influenza (which is what "the flu" is abbreviated from) is low-key one of the deadliest diseases anyone can get. Every year, hundreds of thousands are killed by it; we just don't realize it because we're inured to its mortality, and because most of us just feel crappy from it for a few days or weeks, and then we bounce back. In 1968, this flu pandemic was caused by the H3N2 strain of the Influenza A virus, a genetic offshoot of the H2N2 subtype. The first case was reported on July 13 in Hong Kong (hence its nickname). In 17 days, it spread to Singapore and Vietnam; from there, probably thanks to servicemembers fighting in Vietnam, it spread to The Philippines, and then to India, Australia, Europe, and America, all within three months. The death rate was fairly low (only 0.5%), and yet it still killed over a million people -- including a half-million in Hong Kong itself, around fifteen percent of its population at the time.
"Russian" or "Asiatic" Flu (1889-90) - Death toll: over 1 million.
This was probably the first true epidemic in the dawn of modern medicine. Yes, you read that correctly: modern medicine, in the sense of bacteriological and virological research leading to what causes diseases, is only around 170 years old or so. We're very much still in the "childhood", if not infancy, of what it means to study diseases. This strain of the flu was originally considered to be an outbreak of the Influenza A virus subtype H2N2, though recent discoveries have instead found the cause to be the Influenza A virus subtype H3N8. In May of 1889, doctors in three wildly disparate locations -- Bukhara in Central Asia, Athabasca in Northwest Canada, and Greenland -- saw the first cases. From there, the flu spread indiscriminately, thanks to the rapid, uncontrolled growth of urban populations in the 19th century. By the time the pandemic ran its course in 1890, over a million people perished.
Third Cholera Pandemic (1846-1860) - Death toll: somewhere between 2 to 5 million
I've focused on the flu thus far, but it's time to introduce another deadly microbe: Vibrio cholerae, a bacterium. This is what causes cholera, which made its first appearance as a pandemic in the 19th century. Starting in 1817, the first of now seven cholera pandemics began in India, near Kolkata. As immigration, commerce, and just general travel increased, so did the severity of the pandemics, thanks to the spread of transmission. The mortality was compounded thanks to general ignorance about how diseases spread. In India alone, the first six pandemics between 1817 and 1917 probably killed in excess of 38 million people. We'll focus on the Third Pandemic because it was the deadliest. It killed former President James Polk; 200,000 died in Mexico; 236,000 in Spain. In 1854, considered the worst year, 23,000 died in England alone. That year, the British physician John Snow, working in the London slums, identified contaminated water as the means of transmission of the disease -- what we refer to as a transmission vector.
After the 1854 Broad Street cholera outbreak, Snow mapped the cholera cases in London's SoHo district. He noted a cluster of cases near a water pump in one neighborhood. To test his theory, he convinced officials to remove the pump handle; immediately, the number of cholera cases in the neighborhood declined. Snow's breakthrough helped eventually bring the epidemic under control. Snow was a founding member of the Epidemiological Society of London, formed in response to a cholera outbreak in 1849, and he is considered one of the fathers of epidemiology.
Justinian Plague (541-542) - Death toll: between 25 million - 50 million
The Black Death wasn't the first outbreak of bubonic plague in Europe; it was simply the deadliest. Before the Black Death, the Plague of Justinian - which made its first appearance in 541 - decimated the population of the Byzantine Empire and the Mediterranean. Historians generally regard the plague as the first historically epidemic of Yersinia pestis. This is based on both historical depictions of the clinical symptoms of the disease, and the presence of Y. pestis DNA in human remains of the time period. Over the course of two centuries of reoccurrence, it may have killed over 50 million people, in addition to its initial toll. Over half of Europe's population was killed; somewhere between 13 and 25 percent of the world's population was cut down. The plague literally changed the course of history: when it struck in 541, thanks to infected rats and fleas hitching a ride from Egypt (the empire's "breadbasket") to Constantinople and other imperial ports, Justinian's armies had retaken all of Italy and large portions of Spain. The Byzantine Empire (then referred to as the Eastern Roman Empire) was poised to finish the reconquest of Spain, and potentially re-establish the Roman Empire. In addition to that, the plague's effect on Celtic Britain made Anglo-Saxon settlement easier, changing the history of Britain. Finally, the weakening of the Empire and its armies probably had a significant impact in the subsequent Arab-Byzantine Wars.
If you’re interested in reading more about epidemics and pandemics, here’s some of the reading I’ve done, both recently and in the past:
Spillover: Animal Infections and the Next Human Pandemic, David Quammen. Quammen is nigh prophetic in describing how we are certain to be felled by disease jumping across species. This book is a fascinating set of detective stories; each chapter explores one disease, and unfolds how the leap takes place. Quammen’s genius lies in his depictions of the people working tirelessly to quell these infections.
Pale Horse, Pale Rider, Katherine Anne Porter. Porter’s novel, based on her own experience of surviving the 1918 flu pandemic, is an absolute jewel. Set in Denver, it is a tragic love story demonstrating the impact of the disease on young people.
American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic, Nancy Bristow. Bristow’s book is a a fascinating story about a pandemic that literally 100 years ago was estimated to have caused perhaps as many 100 million deaths worldwide, with almost 700,000 deaths in the U.S. The scale of death was staggering, especially because this flu pandemic slew the young and healthy, instead of the aged and infirm. The most interesting part of Bristow’s book is that she so clearly shows the ways in which both the medical profession and municipal officials had no idea what they were dealing with. At the time, medical professionals thought the flu was caused by bacteria instead of viruses. Most of all, Bristow tries to investigate why an event that killed an enormous portion of the population in a very short period of time and affected every part of the country left so little mark on the American imagination and memory.
The Black Death, Philip Ziegler. This is the classic history of the Black Death. It’s still staggering to consider the toll that this plague took on Europe: between 75 and 200 million died in Eurasia; somewhere between 20 to 60 percent of the European population was killed. In some places, like Florence, the population didn’t return to its pre-plague numbers until the 19th century; in England, it’s estimated that 50% of the population was killed.
The Years of Rice and Salt, Kim Stanley Robinson. Speaking of the Black Death, this is a classic alternate history exploring what would’ve happened if the plague had destroyed European civilization.
The Hot Zone, Richard Preston. Preston’s book is probably the best popular account of how Ebola hemorrhagic fever (and the virus that causes it) was discovered. It is utterly terrifying, particularly when Preston describes one victim traveling aboard an airliner, with fellow passengers blissfully unaware that a pale horseman is stalking them.
And the Band Played On, Randy Shilts. Shilts’ accounting of the early days of the HIV/AIDS pandemic is searing. He writes in the prologue: “The story of these first five years of AIDS in America is a drama of national failure, played out against a backdrop of needless death.” It is a masterpiece of investigative history, and it changed the course of how HIV/AIDS was viewed. Tragically, Shilts died of AIDS in 1994 at his home in the Sonoma County redwoods in California.
This is likely going to be a long week; let's brace ourselves, just as we've done these first two months of what's going to be a massively turbulent year. Tuesday will be massive: it's the first and biggest "Super Tuesday" of the Democratic Presidential primaries. On Wednesday, we'll either have a strong front-runner for the Democratic nomination, or we'll be looking at a contested convention. We'll probably be seeing the first real indications of how widespread the COVID-19 pandemic is, both in America and the world at large.
Either way, know this: I love you, and I know you'll make it through this week, as rough as it may be. We're all in this together, even if it doesn't feel that way at times. I'm here for you; if you need anything, just hit reply. If you want to talk, just hit reply. Let's take care of ourselves and each other, OK?