Look to Literature

With a global pandemic going on, if you’re spending more time at home than usual and wondering what to do, maybe it’s time to read a book or two, or ten.

We’re in the middle of this pandemic, so maybe there’s some literature to enlighten us. I’m avoiding The Hot Zone or I Am Legend for now. I’m less interested in the fear, looking more at the strategic and moral questions and how they’ve been handled.

cover image from here

Last week, I think it was the very day we were directed to avoid gatherings of ten or more people, I was in the middle of Brandon Sanderson’s The Hero of Ages, third in the Mistborn Saga. That series is made up of two trilogies, the first three from an earlier age, and the second three of a later age—early industrial age, with trains and guns, but still the semi-magical aspects of the earlier trilogy. I’ve read them all, mostly out of order. This is the last one for me, the third in the earlier trilogy.

One of the main characters in The Hero of Ages is a leader named Elend. He’s now the emperor, after the defeat of the Lord Ruler in the previous book—which ended up setting free an evil force that is wreaking havoc in their world.

There are a couple of significant oddities in their world: mist and ash. The dark mist comes out at night. People have been superstitious about it for centuries, worried it can harm them. But the ones with the special powers know the mist is safe, just a part of nature. Until now.

Now the mists are starting to kill people. Also, the mists are coming earlier, before dusk, and staying later, after dawn, encroaching on the day and shortening the time the sun is out for crops, so the food supply is threatened. It’s further threatened because of the falling ash, possibly from some distant volcano. This ash is very black, not a normal ashy gray, and the growing ashfall has to be shoveled off paths and crops each day, also threatening the food supply.

So, in this natural disaster, Elend is trying to gather forces to fight off the evil. I don’t know how all of that is going to go yet. But he’s moving an army toward a nearby city state that has some particular resources they will need. The plan is to negotiate if possible, but fight if necessary.

Meanwhile, the mist is attacking villages, and anyone out and about. It is like a plague. It doesn’t strike anyone indoors, even inside a tent such as the soldiers are housed in during their trek. So the soldiers can safely stay inside until the mist passes. But that is getting later and later in the day.

The mist seems to arbitrarily attack some and leave others. And among those attacked, some are killed that very day, while others remain ill and then recover—leaving some of their cohorts worried that they are cursed somehow. But once the mist has passed over someone, they’re impervious to any future mist attack.

Elend realizes that they can’t get into a battle while his troops are hiding in their tents until the mist passes. They could be attacked by an army of mist survivors. What he realizes they have to do is purposely expose themselves. All of them. While they are far enough out from the city to be safe from attack.

He knows he will lose men. He is calling on them all to risk their lives: follow his order and probably survive to become inoculated soldiers, but possibly die. These are healthy men, so he hopes that will be in their favor. But he thinks long and hard before giving the order.

By the way, an exact 16% die. To the man. Of those attacked with illness, they remain ill for exactly 16 days. Something weird is going on. But now they have data to work with.

OK, so that is one approach: mass exposure, acceptable casualty rate—with the survivors becoming an immune population.

I’m looking at the ways various countries are handling this Wuhan novel coronavirus known as COVID-19.

Elend’s way looks something like Italy or Iran. His 16% is a pretty high casualty rate—ours is unknown because exposure is unknown, but will probably turn out to be more like 1-3%. But we live in an age where wiping out even one or two of every group of a hundred we participate in looks pretty ugly. Also, Italy has an older population, which seems to be more susceptible to serious illness. And serious illnesses require hospital beds, ventilators, and other resources that aren’t usually required in such high numbers. Italy’s leaders are making the tough decisions about who gets those resources. And the world looks on horrified as they decide not to treat people over age 80, but just let them die. 

Korea has been possibly the most successful. To start with, they knew not to trust the Chinese government. With their first case, they caused “social distancing,” as we’re doing here. And they tested widely. Anyone who tested positive was put in absolute quarantine. Having testing resources was a huge bonus for them, which we are just ramping up to here.

Other countries have been trying other methods. Quarantine the elderly and immune-system compromised, while others can go about their lives almost as normal. Denmark is trying this; we’ll get data from them that can be used in future decision-making. If it works, it’s less financially devastating than semi-quarantining everyone—or totally quarantining everyone, as China has had to do. Great Britain was on the Danish path but found casualties too high and moved toward more general lockdown.

We’ve had a more general lockdown in the US, getting more and more strict as the virus spreads. The plan here is to lengthen the time frame for people to get the virus, so that the supply of beds and ventilators and other resources does not get overwhelmed. To “flatten the curve,” as they say, based on this graph:

image from here

People have been spreading a meme that says, “Hey, remember when everyone rushed to the store to buy toilet paper at the same time and it ran out before the supply could be restocked and everyone freaked out? Now imagine the same thing at your local hospital. But instead of TP that’s out, it’s beds and ventilators. That’s why everything is cancelled. That’s why you should stay home.”

Another book that came to mind during this crisis is Sinclair Lewis’s Arrowsmith. It’s about a doctor/researcher. It has been too long since I last read it, but I remember a couple of things about Martin Arrowsmith, the main character. He is pretty flawed. He has some idealistic reasons for researching cures for plague outbreaks. But there is also a lot of excitement at the chance to take on a real life problem, to have personal purpose. Arrowsmith wants to find out who he is, and be more than he has been. And he needs to be better. His wife, Leora, and his mentor, Dr. Gottlieb, give him support in that quest. Gottlieb describes their world in religious terms:

To be a scientist—it is not just a different job, so that a man should choose between being a scientist and being an explorer or a bond-salesman or a physician or a king or a farmer. It is a tangle of very obscure emotions, like mysticism, or wanting to write poetry; it makes its victim all different from the good normal man. The normal man, he does not care much what he does except that he should eat and sleep and make love. But the scientist is intensely religious—he is so religious that he will not accept quarter-truths, because they are an insult to his faith (p. 267).

Often Arrowsmith is restless and dissatisfied. Then comes the excitement of a real outbreak in the West Indies. Bacillus pestis among rats, spreading to people, thought at first to be just a flu. He has the opportunity to experiment. And the ethical dilemma of experimenting on people. But he goes. And he makes what he thinks is likely to be a cure. Tragedy strikes. And guilt. And resolve. Go ahead and read it.

The book, from a century ago, is way behind the science of today. But it’s probably still worth reading, because it’s more about the life inside this man’s mind than it is about science (although a scientist did help Lewis with the writing of it).

I watched a video a couple of weeks ago, on body language, looking at a CNN interview with Dr. Robert Redfield, head of the CDC. Mandy, the bombardsbodylanguage.com commentator/instructor, points out how his face lights up, and he smiles, talking about what we would normally consider bad news. But this man is a scientist, with responsibility over outbreaks such as this. His work has suddenly gotten very exciting. He’s not thinking about the mass casualties or economic disasters about to befall us; he’s thinking about what energizes him: the opportunity for new and exciting discovery. This might not seem like a normal human response, but it is normal for a type of person who does a specific type of work—and we need people who do that work. 

CDC Director Dr. Robert Redfield
screenshot from here

There are actual people out there, doing research, working for a response to this virus as fast as they can. Just this morning Glenn Beck interviewed a man named Gregory Rigano, Stanford Advisor to SPARK, and Project Lead for Clinical Trials for COVID-19 prevention, who was reporting that two drugs—I think working together, but both are also being studied separately—anyway, these drugs have been shown to cure the disease 100% of the time in six days. He referred to an immunologist from France, so I think that’s where this combination has been tried. He’s was asking for healthcare professionals to join in the open-data clinical trial. 

He hoped that within a couple of months, the treatment could be widespread. He still calls for social distancing, so we don’t overwhelm the available resources. But these drugs may give us time for other remedies and possibly vaccines to be developed in a year or two—without the world economy having to shut down until then.

The drugs he mentioned are generics that have been around for several decades. One is hydroxychloroquine, which was developed shortly after WWII for treating malaria, and has also been used to treat rheumatoid arthritis. The other is azithromycin, the antibiotic often referred to as Zithromax, or in its package called a Z-pak. The FDA has already approved these drugs; they just have to approve them for this off-label use.

Later today President Trump held a press conference announcing the FDA’s allowing for hydroxychloroquine and a couple of other drugs (I didn’t catch all the names, but azithromycin wasn’t among them, so there are additional ones) to be used for the off-label purpose of treating COVID-19. This is a very hopeful development. 

The FDA Commissioner, speaking alongside the President, said that, when he was a cancer doctor and researcher, he knew how important it was to offer a patient hope. Not false hope, but real hope. He believes the announcement today, along with other efforts to combat this illness, offers real hope. I think he’s right. I’m much more hopeful today than I was even yesterday.

We live in interesting times. My Utah friends and family lived through an earthquake, and its aftershocks, yesterday morning. One meme started referring to all that’s been going on as “apocalypse bingo,” and the card is filling up.

Our literary friend Gandalf had this conversation with Frodo over such times:

“I wish it need not have happened in my time,” said Frodo.

“So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”        —J.R.R. Tolkien, The Fellowship of the Ring

image found here