2020年4月23日 星期四

How I Knew It Was Over: Stories From After SARS, Ebola, Polio, and the 1918 Flu


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One of the many unknowns of the coronavirus pandemic is the question of how we’ll be able to tell that it’s over. Though there’s the future promise of a vaccine, the stutter-start resumption of some semblance of normal life seems unlikely to wait that long, or to happen all at once. The major reopening decisions will be made by public health experts, business owners, and government officials. But for the rest of us, after everything we’ve been through, what will it feel like to go to the movies, or sit down at a bar, or throw a birthday party? Will I wash my hands this often for the rest of my life? And the more intangible: When will something else become the first thing I think about in the morning? When will we stop feeling afraid of each other?

With that uncertainty in mind, I reached out to a group of people who have had to make some of those calculations themselves: people who lived in disease hot spots through other major epidemics and pandemics. I asked people who experienced polio, SARS, and other widespread public health crises about their memories of what it was like to come out on the other side. It was mostly an exercise in hope. We don’t know yet what our own milestones on the road to normalcy will look like, but we can glimpse them in others’ stories.

No two epidemics are identical, and this is not an attempt at epidemiological comparisons. Several people mentioned how much more fearful and concerned they are now than they were during the previous epidemics. Sometimes that was because they were younger and felt more invincible back then; in other cases, it was because the disease progressed differently or affected a different population, or because a cure was available relatively quickly. These interviews have been condensed and edited.

“One of my first memories after the pandemic was the 1920 election. It was the first one where women could vote, and my mother was so thrilled.”

Nellie Dorothy Morris, age 105, on life after the 1918 flu in Brooklyn

I was born in 1915 and lived through the 1918 flu pandemic in Williamsburg. I had one brother who was born five years later, but in 1918 I was all alone with my parents. And they both got sick. They were in bed and I, at age 3, was walking all around the house and somehow I didn’t get it. One of my first memories after the pandemic was the 1920 presidential election. It was the first election where women could vote, and my mother was so thrilled to be able to vote. Her hair had been long, but she cut her hair short. She wanted to express her independence. I was 5 years old then, but I remember how happy my mother was that day.
—Nellie Dorothy Morris, as told to her daughter Holly Fruchter. On Monday, Morris died after a COVID-19 outbreak in her nursing home.

Three women vote at a polling station in New York City in 1920.

National Photo Company/Library of Congress/Corbis/VCG via Getty Images

“They vaccinated kids in schools. They came to school and gave them the shots and the Sabin cubes.”

Margaret Hinman, age 77, who contracted polio in Montana in 1953

I’m the oldest of seven children, and I was 11 when I got polio. My brother nearest to me in age, Jim, got polio, and a week later I was hospitalized with it. The doctors at the time figured that probably six of the seven of us had it. This was August of 1953. [Jonas] Salk started his [vaccine] trials in January of ’54. I missed it by just a few months. I’ve lived since 1953 disabled.

I was treated with Sister Kenny treatments: They used cut-up pieces of old woolen Army blankets that they made moist and heated and wrapped around the limbs. It stinks. After a week or so of isolation, I was moved into the local hospital. There must have been eight or 10 of us there. My brother was across the hall and I couldn’t go see him. Mother and Dad could come in after I was out of isolation, but my other siblings could not. I spent two months in the local hospital. Then my folks transferred me to a children’s rehabilitation hospital in Helena, across the state, about 400 miles away. I spent four months there. It was benevolent abandonment. My folks couldn’t get there to visit. From the middle of August to Christmas, I never saw my siblings except through the plate glass window of my room, six stories down. They stepped out of the car to wave and I saw them. I’m going to cry.

Every summer back then, we talked about the polio epidemic and how to avoid it. They counted the numbers of cases, I guess nationally and locally. In the summertime, since we were farmers out in the country, we practiced social distancing as a matter of life. We would go to the church on Sunday, and we’d hear on the local news that the swimming pools and public bathrooms were closed. I was in 4-H at the time, and it was very careful about social gatherings.

My parents made sure that when those vaccines were ready, we got them. Kids got vaccinated in schools. They came to school and gave students the shots and the Sabin cubes. It was a relief. I know for my parents, for my community, for the world at the time, it was a relief. I don’t remember that there were any anti-vaxxers out there. It meant there weren’t kids walking around with braces or in wheelchairs. There weren’t people in iron lungs. It was like a weight had been lifted off us. The line of dark clouds was no longer flying over the top of us.

“When the vaccine arrived, it was almost like you turned a light switch on.”

Jerry Apps, age 85, who contracted polio in Wisconsin in 1947

I was 12 years old. I was attending a one-room country school. We were farm people and had little or nothing at the farm, no electricity or indoor plumbing. There had been a number of cases of polio [in the area] and people were scared to death at the time. There was only one doctor, and he said, “I’m afraid your son probably has polio.” He said, “Take him home, keep him warm, and give him a lot to drink.” Well, our house was colder than anything in the morning when the fires were out. They fixed a place for me by the dining room stove and there I was for January, February, and much of March before I began to recover, with a paralyzed leg. In those days in central Wisconsin, the “Watkins man” sold products from farm to farm. My dad swore by Watkins liniment. It burned like hell. He’d put liniment on and pull on my leg. He had sworn to neighbors that he wasn’t going to have a cripple in the house. He meant that in a more loving way than it sounds. By the time it was May, I could walk.

The county fairs were stopped. The swimming pools were closed. All community activities would be canceled. But it varied. Some years, the intensity of the disease wasn’t as bad. Jonas Salk started working on the vaccine in 1952 and it took three years. When the vaccine arrived, it was almost like you turned a light switch on. Once the vaccination program spread across the country, polio disappeared just like that. It was a miracle. My brothers were vaccinated right away, but I didn’t have to be. Almost immediately there were no more new cases. What remained were those of us who were struggling to live our lives with the lasting effects of the disease, which in my case were both physical as well as psychological.

The fear was not knowing how it was transmitted. We know how COVID-19 is transmitted, but we did not know that about polio. So the fear was a double whammy. In the 1940s, there were still a good number of people who had witnessed and seen relatives die in the [flu] epidemic of 1918. My folks had been teenagers then and they remembered it. The most important thing I learned from the polio epidemic is to be optimistic. The words of my dad are ringing in my head: “Tomorrow will be a better day, and next year will be a better year.”

Schoolchildren in Eau Claire, Wisconsin, in 1955, the year the polio vaccine was first distributed to the public.

Keystone View Company/FPG/Archive Photos/Getty Images

 “We thought, ‘OK, this has passed.’ We’d actually had a pretty cheery summer.”

Shuai Dong, age 35, who was a college student in Beijing in 2003 during the SARS outbreak

I was in charge of monitoring everyone’s temperature. I had a leadership position specializing in “well-being,” and before all this, my job was to get people to write birthday cards to other members in the unit, organize outings, stuff like that. In 2003, we had one thermometer for each dorm. You were supposed to take your body temperature every morning and then go to everyone’s dorm room to record theirs. We didn’t do any particular social distancing, but we were quarantined within the campus. You couldn’t go out for more than 30 minutes at a time. Every time you wanted to leave you had to apply for a ticket. There was one gate you could go out through, and they would record the time you left. We were a really obedient crowd. Class got super easy, and the tests were very easy.

I remember when it started to recede. I helped organize certain activities, and we prepared a choral performance where we would go to the makeshift hospital that China had built almost overnight to treat SARS patients. All the patients in the makeshift hospital had been discharged, and so we went to thank the health care workers for their work. We thought, “OK, this has passed.” We’d actually had a pretty cheery summer. I just felt like: “We’re going back to the next school year and classes will be hard again.”

“I can still smell the disinfectant.”

Yige Dong (no relation to Shuai), age 36, who was also a college student in Beijing when SARS was spreading

I had been admitted to the University of Hong Kong, and my original plan was to stay in Beijing for a year and then transfer. When SARS broke out, my parents in Beijing asked me to go to Hong Kong earlier than I wanted to. There was a special train that went from Beijing to Hong Kong nonstop. There were, like, eight of us going from the university to Hong Kong. I remember we were the only passengers, at least in that car. That was July of 2003. But that same month, on the anniversary of the Hong Kong handovers, there was also the largest protest in Hong Kong in years. People were going into the streets to do that. So that was a sign people knew it was getting better.

A nightclub on the outskirts of Beijing in July of 2003, when the SARS epidemic was subsiding.

Getty Images

SARS really changed how people think about hygiene issues. I can still smell the disinfectant. One of my pairs of jeans got a big bright stain on it because I sat on a dining hall chair that was still wet with the disinfectant water. It was the same in Hong Kong; everywhere we went we saw hand sanitizer. In the bathroom you saw lots of posters showing you illustrations, like how to wash your hands. There were 12 steps. I got so used to it that when I was in Maryland in grad school at Johns Hopkins, whenever I saw the hand sanitizer in the library, I would use it. It was a habit from Hong Kong.

“Our first party afterward, I did have my doubts about going. It was a big wedding. I was like, ‘OK, it will be out in the garden and people will be far away.’ ”

Lorena Becerra, age 40, who was working for the office of President Felipe Calderón in 2009 when the H1N1 outbreak in Mexico began

I didn’t pay much attention at first. But the president was asking us to look into the numbers, and we stared realizing this was a big problem. They right away closed schools and restaurants and started making all these containment measures. And we decided to start giving daily press conferences.

My family used to help gather abandoned cats for the animal humane society. There was this young healthy doctor we used to deal with a lot. My mom called him and said, “This is the last time I’m coming.” The H1N1 flu epidemic had just started. Ten days later I wanted to talk to him to see if they needed help with the cats. They told me he had died. I was so shocked. That was a turning point for me.

We started doing thousands of tests per day because we thought this was the most important thing, to have a complete grasp of what we were dealing with. Inside the office, we could tell it was receding when we started seeing more separation between the deaths. We didn’t have 30 deaths every day anymore. We started seeing there was enough Tamiflu, [which in many cases lessened the duration of symptoms]. We decided to stop the daily briefings from the health ministry.

In Mexico, we say hi by kissing on the cheek. I remember saying, “Is this ever going to [come] back?” I used to go to a gym, and they closed the gym. But when I went back in mid-June, one of the people who used to go there came out and said hi with a kiss. I felt like [gasp] and then I realized there’s no danger. For me, I thought, “Maybe things are going back to normal.” We forgot pretty quickly. The next two weeks, it was over. We were going to parties again.

Mexico City in November of 2009, after the H1N1 vaccine had become widely available.

Eye Ubiquitous/Universal Images Group via Getty Images

Our first party, I did have my doubts about going. It was a big wedding. I was like, “OK, it will be out in the garden and people will be far away.” You will know things are getting better when you start doing your everyday life without this amount of self-awareness. You grab something and you’re not afraid of grabbing it, and you don’t have to run and wash your hands. It’s when you start gaining trust in what you’re doing every day, without thinking, “Maybe this is going to infect me.” It’s letting the valet get your car, and then just getting it and bringing it home instead of washing it out and asking the valet to wear gloves. When you start losing that sense of vulnerability, you’ll realize it’s starting to be over.

“Once they could trace the contacts, people just got much more confident.”

Georgina Ramsay, age 30, who was a researcher in the Democratic Republic of Congo in 2019 during the Ebola epidemic

I had this peripheral awareness of Ebola when I arrived, but it wasn’t until the zone of contracting the illness expanded that it exploded as a concern. Overnight, you had new protocols for entering public buildings and hospitals, and a restriction on people being able to move in and out of public spaces. You weren’t able to go into those spaces without stepping into a chlorine bath. They set up a plastic tray that had chlorine in it to disinfect your shoes. There was forced hand-washing with a chlorine wash that went up outside public buildings and the hospital at every entrance. A security person wouldn’t let you in unless you did the hand-washing and the chlorine. But businesses didn’t close and people didn’t stop patronizing them.

The Democratic Republic of Congo did a really good job of managing the Ebola situation, especially given what had happened in West Africa a few years earlier. It was mostly a local effort. [The outbreak subsided before Ramsay left, but Congo recently saw several new cases.] The main thing that was going on was the tracing of contacts. Basically every single case could be traced for eight different contacts for each person. There had been a few days of shutting the border between Rwanda and Congo, but once they could trace the contacts, they could open up the border and make it much more free. People just got more confident then. They also shut down travel between the rural areas that were hardest hit and the urban areas. Once those measures were put in place and strictly enforced, people who were living in a more high-density area breathed this sigh of relief, like, “Oh, it’s manageable now. It’s under control.”

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