Thoughts from Self-Isolation

I’ve been here before, actually.

A year ago, I watched my friends post updates about sealing themselves at home with their babies in New York and Detroit as I watched my own belly get bigger and wondered when measles would come to Baltimore.

And then, on April 5th, our first case was diagnosed.

On April 13th, I gave birth to a healthy (thank Gd) baby girl. A baby girl who was at least six months away from being able to receive a measles vaccine. A baby girl who could maybe, possibly, have some immunity from me, since I had been vaccinated as a child–but nobody knew for sure.

Measles is probably the most contagious disease we have today. Someone with measles, someone who might not even know that they have measles, can cough in a room and leave, and then someone else can come in an hour and a half later and catch it. To compare– the current R0 (number of people each patient will infect) of COVID-19 is estimated to be somewhere between 2 and 3 by most sources, and the R0 of measles is usually published as being between 12 and 18. It’s extremely contagious. The mortality rate of measles is somewhere around .2%, but higher for babies, especially newborns.

Visitors under 14 were not allowed in the hospital, so my toddler didn’t get to see me for two days, and she didn’t meet her baby sister until after we came home. Breastfeeding groups, a resource I relied on heavily during my first “newborn phase,” were closed. Everyone who was coming to visit us rushed to verify that they had been immunized (through vaccination or infection). We had to cancel a visit from friends who were bringing their almost-one-year-old, because the MMR is usually given at the 1 year appointment (barring extenuating circumstances, like an outbreak).

We isolated ourselves. We didn’t have playdates, because most of our friends had at least one child who was too young to have received both vaccinations. (93% of children are immune after one measles vaccination, and 97% after the second. We have more than thirteen friends, so the likelihood of having at least one friend with a toddler who was not immune was high.) We didn’t go to the library. We only went to the park when it was empty.

Over the next month, several more cases of measles were diagnosed in Baltimore. Thank Gd, our community was vigilant about vaccinating, which suffocated the spread of the disease. We were able to return to normal life–slowly, carefully. Fearfully.

How well I remember that extreme isolation. Desperately clutching at the person on the other end of the phone, wishing that they wouldn’t go back to their life and leave me in my lonely, mess-filled reality. Growing so sick of my house that I couldn’t pick up toys or do laundry. Craving the moments when my children were asleep and I could escape into the world of television. Wishing that someone, anyone, would come and rescue me from my spiraling existential dread by talking with me for an hour about work or strollers or their family or shopping or

Yes, I remember.

So I knew what I was doing.

It was February 26. For weeks I’d been telling people to calm down–we had excellent plans in place. Tests, quarantines. This was an fantastic test of our pandemic preparedness system. We were lucky to live in a country where, even if we had an epidemic of CoViD-19, we had the resources to combat it.

And then the news came through, of a patient who had been diagnosed with COVID-19 through community spread. The patient had been in the hospital for a week while doctors begged for them to be tested. They had been in another hospital before that, who may or may not have isolated the patient or used the proper protection equipment.

I started doing mental math in my head–the patient might have spent a few days at the previous hospital (where they could have infected who knows how many other patients and healthcare workers). They might have been experiencing symptoms for a week before getting admitted. They could have been infected two weeks before experiencing symptoms.

It was possible that the US’s first official case of community transmission had been infected in late January.

Who else had we missed?

I’ll admit, I panicked. For a full 24 hours I couldn’t eat or sleep–if we had missed this case, then we had missed countless others. If we had missed an outbreak, we were not prepared. We had wasted time. We had wasted resources. We had lost our chance to contain this, if we’d ever had one in the first place. Disastrous events started unfolding in the part of my brain that seems to exist to conjure up disastrous events.

I pulled my toddler out of school, at first telling her teacher that we were “enjoying some family time.” I wanted to protect my husband’s grandparents, whom we were planning to visit on March 8. But more than that, I wanted to watch how things unfolded over the next few days.

What I saw wasn’t reassuring. I watched testing continue to be stalled. I watched leaders and lawmakers fail to take action. I watched as researchers who study virus mutation estimated that COVID-19 had been spreading in Washington State for weeks. I watched the case count grow with an overwhelming nausea, knowing that it likely represented a larger, looming mound of iceberg coronavirus floating underneath the surface. I watched people continue to go about their everyday lives, using their refusal to change their routines as a sort of middle finger to panic and anxiety. I understood them, but it felt like a glass wall had been constructed between us.

I struggled to communicate clearly with my friends and relatives.

I’d been completely honest with them about my overwhelming feeling of panic those first few days. And now many of them saw my caution and my continued concern over the development of the virus as a sort of extension of that panic. They worried that I hadn’t put my daughter back into school. They worried about us, shut up in our house, only leaving for nature walks and to bring in groceries, which we ordered from Amazon. Which I wiped down with alcohol. Which made my eyes water and made me feel ridiculous.

(I would like to take this moment to point out that while I did buy a few extra cans of food and some other provisions two and a half weeks ago as recommended in a wonderful blog post by a very smart virologist here , I am not hoarding toilet paper, food, bottled water, or hand sanitizer, and I don’t own even one N95 mask. I use this as evidence to point out that although I was feeling panic, my actions were largely rational and based in thought, not in fear.)

I did try to nudge a few relatives my way–in particular, I have one high-risk relative who is very close to me who I tried (and failed) to convince to cancel a domestic trip. Mostly, I was dismissed.

Should I have been less open about my anxiety? I could watch myself compartmentalize in real-time, using my years of therapy to separate my emotions and my decision-making behaviors. But others couldn’t–how could they know that when I was warning them of how serious the situation was about to become, it was my science-trained, three-years-into-a-bio-degree-when-I-dropped-out-of-college brain speaking, and not my I-can’t-sleep-sometimes-because-I’m-too-worried-about-jet-engine-noises brain? Why should they trust me?

I have to admit to myself that I have no degree, and although I have a lot of friends who turn to me with their medical questions (especially regarding birth), that alone is less of a qualification and more of a condemnation. There is no reason why people should listen to me.

For a solid two weeks, I felt like I was watching a slow-motion train crash. I felt angry and frustrated and numb. My panic had worn off, leaving behind a sort of resolute defeat. No one wanted to talk to me, because I didn’t want to talk about anything else. I was worse than isolated.

I’d even given up Facebook last August, which is really the one place that know-nothings can go to spout off facts and figures and pretend like they’re experts.

And then this week happened. Something shifted in America–and we began to take this seriously. As schools and businesses closed and the true depth of the US CoViD-19 testing failure began to surface, my friends entered the phase of panic that I had left two weeks ago–and I began to see a light at the end of the tunnel.

People were doing the right thing. Maybe not all the things they should have been doing, and maybe not fast enough, but people were beginning to come around. And I felt myself able to cry for the first time in weeks, and able to eat semi-normally, and able to look forward again.

So I have a few messages for all of you. From the other side, sort of. From a non-expert, know-nothing, amateur virus sleuth.

Social isolation is really, really, hard–but it ends. And it’s worth it. Keep remembering, especially on the days when you just want to jump out of your skin, that it will end.

The panic fades. You will not be anxious about this forever. It will become your new reality, and you won’t feel awesome about it, but you will feel okay.

Reactive closures (like in northern Italy) are attempts to manage a bad situation. The closures that we’re experiencing are (as of now) an attempt to avoid the worst situation.

Things are going to get worse before they get better. Our case count right now is incomplete, and it’s also a picture of the people who were infected two weeks ago, not the people who are infected right now. It will seem like things are growing exponentially for a while. That doesn’t mean that the distancing isn’t working. It means we’re playing catch-up.

Every step that you take to isolate yourself and your family makes it harder for this disease to spread. Do what you can. Don’t feel embarrassed. Remember the people who are going to need life-saving care, who will have access to that care because you are less likely to get sick. Remember the nurse who’s fighting for peoples’ lives. Maybe she’ll get to have dinner at home because she’ll be working one less hour of overtime. Remember the elderly person who has access to a proven anti-viral therapy because she caught COVID-19 in August instead of in April. It’s impossible to know how much sickness and hardship you’re preventing by staying home, but you can know you’re doing something.

On the other hand, don’t feel guilty if you can’t do everything–doing some things is better than doing nothing.

In times when you feel like everyone is out for himself, when the news media are flooding your TV (/computer/phone) with images of empty grocery stores, you may be looking for stories of people helping each other. Now is the time to create those stories. If you’re like us, and you’re lucky enough to be working from home, and your paychecks are still coming in, and you have a little bit of money in the bank, now is a wonderful time to show how grateful you are for your situation by donating. Food banks are about to face a lot of increased demand–that’s a good place to start. It will make you feel good. It will make you feel hopeful. It will make you feel useful.

If you can’t donate money, donate time. Offer to help someone with something. Donate love–give someone a call or send them a message.

Remember that this is challenging and hard, but when we go through challenging and hard things we often grow. We often become smarter, and stronger, and better.

This is just my experience. These are just my thoughts. I don’t know if they’ll help anyone, but it helps me to write them down. Think about writing down your thoughts, too–this is probably going to be the biggest thing that’s happened to people in our generation (Millennials) so far. So write about it. Make art about it. Record you and your friends talking about it. So that in ten years, in twenty years, in fifty years, you know for sure how it was.