{"id":"5fae60f36cee070007d20e28","slug":"apollos-arrow-en","title":"Apollo’s Arrow","audio_url":"https://hls.blinkist.io/bibs/5fae60f36cee070007d20e28/5fae60f36cee070007d20e2a-T1605263729.m4a?Expires=1652690636&Signature=dcRzgH1JFUN-OOHl8sJP7-7zhdeUMKMDLvm3k0PI7BmI0CVh1v59pangzsS1g6vMsuxV~Ajsox9ec2VfP2S-WOwa6saFn3b~2xCE5YGf1qKNsas3y7YFKhOUvGNpOxhQ486K0mnPogiNPyI~31fRdv41u5xaDCVPpLJxh1sThyI1FbikbkZuwKIxFilDgeZCawTih9yyXmYhnws-xfUpGjInerrz99wjpvppFLg3NUqgqBR7RffistBc~lcZulcDfQZj4eSZfu1Y4HfgCWD5N3n5RPzZAz4fn2EMG4YdtLW2LICunlxfPfQmPANh234CXs6zdXrPVDNB2lW~tl6aiw__&Key-Pair-Id=APKAJXJM6BB7FFZXUB4A","chapters":[{"id":"5fae60f36cee070007d20e2a","title":"SARS-2 began with a few infections in Wuhan but quickly got out of control.","text":"

December 26, 2019. Dr. Jixian Zhang, a doctor at the Hubei Provincial Hospital in Wuhan, China, reports a troubling trend. There’s been a sudden surge in cases of severe acute respiratory syndrome, or SARS. By the end of the month, there are 104 SARS patients. And there have already been 15 deaths.

At first, the Chinese health authorities are reluctant to raise any alarms. But patients keep being admitted, and the doctors are soon overwhelmed. In January, Beijing sends teams of expert epidemiologists to study the outbreak and orders local governments to close schools, businesses, and other public spaces. By January 25, nearly all of China shuts down to stop the spread of the disease.

On January 27, the Chinese Center for Disease Control identifies the culprit behind all this chaos: a new strain of coronavirus, dubbed SARS-CoV-2 or SARS-2 for short. In a few months, it will transform the world.

The key message here is: SARS-2 began with a few infections in Wuhan but quickly got out of control.

The first people to catch SARS-2 were most likely infected at the Huanan Seafood Wholesale Market, a “wet market” in the heart of Wuhan. Like many markets around the world, this bustling bazaar offers freshly butchered wildlife. This close contact between humans and animals makes it easy for diseases to jump from one species to another.

The SARS-2 virus likely originated in bats. However, it only became a threat to humans when it evolved the ability to infect people. This small mutation enabled it to spread among human populations with incredible speed. This type of person-to-person transmission is dangerous because the virus causes a sometimes deadly disease named COVID-19.

Scientists are still studying exactly how COVID-19 works. Its varied symptoms include cough, fever, fatigue, and – strangest of all – anosmia, the loss of one’s sense of smell. For some patients, the virus attacks the alveoli, a part of the lungs responsible for oxygen exchange, which can lead to severe breathing problems and, ultimately, death. Around 50 percent of patients display no symptoms at all, while an estimated 1 to 1.2 percent of people die from the virus.

Since its initial outbreak, SARS-2 has spread to nearly every country on earth. Along the way, governments have tried to control the spread with rigorous regulations while everyday people have adapted their work and social lives to accommodate the new threat. Still, as of July 1, 2020, more than a million people have died from the disease worldwide, and there’s no end in sight.

"},{"id":"5fae60f36cee070007d20e2b","title":"The SARS-2 virus has the ideal qualities to create a sustained pandemic.","text":"

In April 2020, things didn't look good for Marilee Shapiro Asher. She was 107 years old, and she’d been diagnosed with COVID-19. Doctors said her chance of survival was less than 50 percent. However, despite the odds, she pulled through.

Amazingly, this wasn’t the first time Asher had beaten a big-time virus. Way back in 1918, over a century earlier, she’d survived the Spanish flu, a particularly deadly strain of influenza. The Spanish flu killed millions around the globe, making it the deadliest pandemic in modern memory.

As Asher’s story shows, humanity as a whole will always have to fend off new viruses. Sometimes, an outbreak will be easy to contain. But, every few decades, we’ll encounter a new strain that is particularly hard to handle.

The key message here is: The SARS-2 virus has the ideal qualities to create a sustained pandemic.

As its name implies, SARS-2 isn’t the only coronavirus around. In fact, many varieties of coronavirus are endemic – or in constant circulation – within the human population. Luckily, these are mild and only cause common colds. However, in 2003, a new coronavirus called SARS-1 emerged in Hong Kong. In a matter of months, it spread to 29 different countries and killed more than 8,000 people before being contained.

So, why did SARS-1 sputter out while SARS-2 is still raging around the world? To start, SARS-1 was simply too deadly. Every virus has a case fatality rate, or CFR. This is the probability of someone dying after being infected. The CFR for the 2003 outbreak was 10 percent, meaning it killed many patients before they could spread the disease. The CFR for SARS-2 is closer to 2 percent, meaning people are more likely to live on as disease vectors.

Another key difference is the virus’s reproductive rate, or R0. This statistic measures a virus's ability to spread by showing the average number of people one sick person will usually infect. The R0 for SARS-1 was quite low. The rate for SARS-2 is estimated to be around two to three, making it much more contagious.

This is partially because SARS-2 has a long period of subclinical infectiousness. This is the stretch of time when a patient still feels healthy but is actually capable of passing on a virus to others. So, whereas people with SARS-1 could only infect others after showing symptoms, people infected with SARS-2 are contagious for more than a week before they even realize they’re sick. This makes the virus very hard to contain, as people are usually unaware that they’re spreading it.

"},{"id":"5fae60f36cee070007d20e2c","title":"We can slow and stop pandemics by changing our behavior.","text":"

Measles. Scarlet fever. Typhoid. Tuberculosis. Each of these diseases once claimed thousands of lives a year. Today, thanks to the discovery of medical treatments like penicillin, isoniazid, and chloramphenicol, they no longer do. So, thank you, pharmaceuticals!

But that’s not the whole story. If you examine the death rates of each of these diseases, you’ll find a curious pattern. The largest drops in yearly deaths occurred long before the introduction of any wonder drug. So if new medicines weren’t the original solution to these awful afflictions, what was?

Actually, a lot of these public health success stories stem from basic improvements in sanitation like the introduction of handwashing or increased access to clean drinking water. These may seem like simple fixes, but such non-pharmaceutical interventions, or NPIs, are often the most important aspects of disease control.

The key message here is: We can slow and stop pandemics by changing our behavior.

When SARS-2 first hit the global stage, scientists knew that it could take years to develop a viable vaccine. However, to save lives, it was still crucial to lower the virus' reproductive rate so that fewer people got sick and at a slower pace. This launched the now-famous phrase “flatten the curve.” To pull this off, health authorities recommended various NPIs intended to reduce the available avenues for the virus to spread.

In the USA, attempts to flatten the curve included “lockdowns,” which closed schools, businesses, and other public gathering places. These began in mid-March and peaked in April, when, according to the Washington Post, Americans spent a whopping 93 percent of time at home. This drastic measure did put a much-needed pause on virus transmission, but it came at an economic cost. By May, the unemployment rate had risen above 15 percent.

Another effective NPI is mask wearing. While this practice was originally discouraged to save equipment for medical professionals, most people eventually adopted the habit. By April, 75 percent of Americans reported using masks outside the home. Such numbers are significant as even a simple cotton mask can reduce the distribution of viral droplets by up to 99 percent.

Sadly, some people do end up catching COVID-19. In these cases, governments have tried an NPI called contact tracing. This means carefully tracking down and quarantining every individual an infected person has come in contact with. This is very effective; it’s also very time intensive. Effectively running a contract-tracing program in the USA might require 300,000 workers. That’s a tall order.

"},{"id":"5fae60f36cee070007d20e2d","title":"The coronavirus pandemic is made worse by fear and lies.","text":"

Meet Wanda DeSelle, a 76-year-old nurse from California. When she died of COVID-19 in March 2020, her grieving family had to say goodbye via video chat. The risk of infection was too high to visit in person.

Meet Richard Levitan, a doctor from New Hampshire. During New York City’s outbreak, he traveled to Manhattan to help the overwhelmed hospitals. He’d planned to stay with his brother, but when he got there, his brother’s landlord wouldn’t let him enter the apartment. The landlord worried that he might be contagious.

Meet Alex Jones, a media personality from Texas. As coronavirus deaths mounted, he began selling colloidal silver as a wonder cure – a substance that is completely useless against the virus.

During a pandemic, there’s more to worry about than the disease itself. The specter of illness affects every part of society by sowing the seeds of misery, fear, and misinformation.

The key message here is: The coronavirus pandemic is made worse by fear and lies.

Pandemics are dreadful events, and they’re made worse by their psychological impacts. Surveys have already found that the fallout from SARS-2 has significantly increased negative feelings throughout society. In 2019, 83 percent of Americans reported feeling joy. By April 2020, that fell to 64 percent. Meanwhile, over the same period, feelings of worry, sadness, and anger have all risen.

The emotional distress of losing loved ones, fearing infection, and potentially losing one’s livelihood makes people eager for any type of psychological relief. Unfortunately, this primes people to look for others to blame for their misery. In the wake of this outbreak, conspiracy theories have run wild. For instance, a recent poll found that 29 percent of Americans believe SARS-2 was intentionally designed in a Chinese lab.

Sadly, this untrue accusation isn’t the only popular bit of misinformation. Throughout the pandemic, government officials have repeatedly twisted facts for their own benefit. The Trump administration has downplayed the danger of the virus, going so far as to reprimand CDC officials in February 2020 for suggesting that the pandemic might reach the USA. Trump himself has repeatedly claimed that the virus is contained, even as infections and deaths have continued to rise steadily.

All this fear and bad information have the effect of making the pandemic worse. Across the USA, many ignore the real danger of the virus and continue to gather at crowded events. Others act on bad medical advice, such as one couple in Arizona who drank poisonous cleaning agents believing they could fight the virus. Both these extreme reactions lead to unnecessary and avoidable suffering.

"},{"id":"5fae60f36cee070007d20e2e","title":"The SARS-2 pandemic highlights and heightens existing social divisions.","text":"

Imagine this: You’re a well-off white-collar worker living in Manhattan. When COVID-19 comes to New York City, you simply pack your bags and head to a summer home up north. After all, you can work from anywhere. And, if you do happen to get sick, your health insurance will secure you the best care.

Now, here’s a different scenario: You’re a struggling janitor from Queens. When COVID-19 hits, you have a choice. Either keep going to work and risk getting coronavirus or try quarantining in your small apartment that you share with five other people, including your elderly grandparents. In other words, you can either risk getting sick or ensure that you go broke.

Surely, everyone would prefer to be that well-off Manhattanite. Yet, for many people across America, the second story is closer to reality.

The key message here is: The SARS-2 pandemic highlights and heightens existing social divisions.

It may seem like viruses are neutral parties. Yes, they cause suffering, but the pain is equally distributed. However, this isn’t the case. Diseases often affect different portions of the population in different ways, and SARS-2 is no exception. For example, the elderly are much more at risk. If you’re under 20, your chance of dying is about 1 in 20,000. If you’re above 50, that chance jumps to 1 in 100. Similarly, men seem to die at twice the rate of women due to differences in overall health.

One recurring trend through the SARS-2 pandemic is that marginalized communities are facing the worst outcomes. This is evident in the racial disparities in infection rates and mortality statistics. In the United States, when compared to white Americans, Hispanic and Black Americans are three times as likely to catch COVID-19 and twice as likely to die from the disease. Likewise, some of the most intense outbreaks have occurred in low-income and disadvantaged Native American communities.

These differences are partially attributed to the uneven socioeconomic statuses across these groups. For instance, racial minorities are more likely to have jobs that require in-person labor. This increases the chances of being exposed to the disease. Additionally, such jobs often pay little and provide no health coverage, two factors associated with chronic health issues such as diabetes, hypertension, and cardiovascular disease. These underlying conditions greatly increase the chances of dying from COVID-19.

Yet, however dreadful these divisions, the pandemic has also brought about some social solidarity. We’ll look at this dynamic in the next blink.

"},{"id":"5fae60f46cee070007d20e2f","title":"The threat of COVID-19 inspired many to work together.","text":"

In March 2020, Yale University canceled all in-person classes. The school’s undergraduates returned home to wait out the virus. However, one of them, an undergraduate named Liam Elkind, was not content to spend all day merely taking notes online.

Instead, he and his friends decided to help those in need. Together, they set up Invisible Hands, an organization designed to deliver groceries and other supplies to elderly residents across Manhattan. Within four days, they had 1,200 volunteers. Within a month, they had 12,000.

Clearly, the pressures of a pandemic don't always result in discord and distrust. In fact, such difficult circumstances often bring out our more altruistic impulses.

The key message here is: The threat of COVID-19 inspired many to work together.

Invisible Hands is just one of many mutual-aid organizations that sprang up in the wake of COVID-19. All over the country, people set up social networks to ensure their neighbors had access to food, shelter, childcare, transportation, and mental-health services. According to one survey, by May 2020, an astounding 37 percent of Americans had donated time, materials, or money to aid organizations.

According to social scientists, such acts of kindness are not uncommon during disasters. In many cases, adversity invites people to put the needs of friends, family, and even strangers above their own. For instance, a recent study examined the most effective way to frame public health messages. They found that people are more motivated to change their behavior if the messages are about protecting the health of others. People listen less if the advice is about protecting themselves.

This selfless dynamic is especially evident in the actions of the doctors, nurses, and other essential workers who continued to toil throughout the pandemic. Early in the outbreak, many hospitals lacked enough personal protection equipment to keep everyone safe. Undeterred, many staff fashioned their own supplies from garbage bags, made masks themselves, and continued to save lives despite the risks.

The search for a vaccine is fueled by this collaborative spirit as well. Researchers around the world are sharing information to speed up drug development. Moreover, individuals are already lining up for the dangerous task of testing new drugs. As of April 2020, more than 1,500 people have signed up to receive trial vaccines. Even though such testing is potentially dangerous, many still want to lend a hand in finding a solution.

"},{"id":"5fae60f46cee070007d20e30","title":"The impact of the pandemic will be felt in many ways, large and small.","text":"

Some may describe the worldwide outbreak of COVID-19 as a momentous event of earth-shaking proportions. However, if you ask Thomas Lecocq, a seismologist at the Royal Observatory of Belgium, it was quite the opposite.

You see, Lecocq’s lab contains sensitive seismological equipment capable of capturing every minute shake and tremor around the globe. However, in March 2020, as much of Europe went into lockdown, the instruments recorded a strange tranquility. The sudden drop in human activity was so dramatic it literally made the Earth stand stiller.

Such an unusual occurrence just goes to show the immense scale of the pandemic’s disruption. In the course of a few short months, this global event changed daily life around the planet. Furthermore, its effects will continue for years to come.

The key message here is: The impact of the pandemic will be felt in many ways, large and small.

As the novel coronavirus spread around the world, many things changed very quickly. Churches and concert venues emptied out as hospitals and funeral homes filled with bodies. Demand for fuel fell, and oil prices dropped, while liquor sales rose to an all-time high. These rapid developments were just the first of many changes that are sure to continue as the virus transforms every aspect of life.

One very noticeable adjustment to our daily lives is how we interact in public. Masks are now considered must-have accessories, and handshake greetings are considered taboo. It’s hard to say how long this new interpersonal etiquette will stick around, but it’s possible it will remain long after the virus is contained. Years from now, it may be common courtesy to say hello with a bow or similar distant gesture.

Other impacts are less benign. The rise of virtual schooling and teleworking have opened the door for new forms of intrusive surveillance. In many jurisdictions, test-taking students are increasingly supervised by facial recognition and eye-tracking technologies. Meanwhile, many bosses monitor worker’s productivity with similar software. Worse still, the data collected by these companies is stored and sold without users’ permission.

More changes are sure to come. Some cities are closing streets to cars to create more space for public strolling; others are seeing a mass exodus as wealthier residents flee to the countryside. Essential workers like grocery clerks and delivery drivers, invigorated with new energy, are increasingly fighting for more rights and recognition. How these changes will play out in the future is unclear. But one thing's certain: the world will never be the same.

"},{"id":"5fae60f46cee070007d20e31","title":"The future trajectory of the SARS-2 pandemic remains uncertain.","text":"

It’s the late 1880s, and the world is racked by yet another plague. It begins in the remote city of Bukhara, in what is now Uzbekistan, and spreads into Europe via newly built rail lines. Soon people are dying in St. Petersburg, then Berlin, then Paris and Lisbon. By the time it arrives in the USA, a quarter-million people are dead.

So, what happened to this vicious disease? How did the plague end? Well, it didn’t. At least, not really. Scientists suspect the pathogen behind the pestilence was OC43, a type of coronavirus. The name may not be familiar, but you’re probably already intimately acquainted with the virus. OC43 is still among us. Today, it causes a common cold.

It’s possible that SARS-2 will follow a similar trajectory. The pandemic will end, but the virus may remain.

The key message here is: The future trajectory of the SARS-2 pandemic remains uncertain.

It’s still too early to tell how the current coronavirus pandemic will play out. However, we can make some educated guesses. One possibility is that humanity will achieve herd immunity. This is when enough people are immune to the virus that the disease has difficulty spreading. We can bring this about with an effective vaccine, or it can occur naturally. However, this would occur only after around 70 percent of the world has contracted COVID-19.

Another possibility is that SARS-2 will mutate to become less deadly. A truly successful virus needs its hosts to survive long enough to spread the illness, so there is evolutionary pressure for disease vectors to become milder over time. This is possibly what happened with OC43. After its initial run around the world, a more mellow strain of the virus won out, which still circulates today.

And, of course, viruses aren’t the only organisms that adapt. There’s some evidence that certain genetic variations make some people resistant to the disease. Over generations, natural selection may make this trait more common, thus giving our descendants immunity. This has occurred throughout history. A similar dynamic makes populations in malaria-rich regions of the world more resistant to that disease than their European counterparts.

Setting aside biochemistry, the most meaningful measure of overcoming a pandemic is a social one. An outbreak only really ends when life begins to feel normal again. This requires that everyone, including the most vulnerable and marginalized members of our community, needs to feel safe returning to society. This may take a huge communal effort, but we’re up for the challenge. We have to be. After all, the next pandemic could be just around the corner.

"},{"id":"5fae60f46cee070007d20e32","title":"Final summary","text":"

The key message in these blinks:

Since the emergence of the SARS-2 virus in the fall of 2019, the world hasn’t been the same. Efforts to contain the spread have only partially worked. By the summer of 2020, an estimated 500,000 people had died of COVID-19, while billions more had had to alter their daily life. It’s unclear what the future will bring, but everything from our interpersonal etiquette to our economic systems may be permanently changed by the pandemic.

Actionable advice:

Protect others by following public health guidelines.

A future vaccine may provide relief from the ongoing outbreak. In the meantime, the best course of action is to slow the spread of the virus by following simple non-pharmaceutical interventions like washing your hands, wearing a mask in public, and avoiding large gatherings. Sure, it’s not fun, but it could save lives.

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What to read next: Wuhan Diaries by Fang Fang

You just got a thorough overview of the current state of the COVID-19 pandemic. For a deeper look into where it all began, head over to our blinks to Wuhan Diaries by Fang Fang. Fang is one of Wuhan’s most famous living writers and in these blinks, you get an intimate, frontline testimony of what life was like in Wuhan during the first wave of the pandemic.

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