Journal of the Virus Year: My experiences with the virus: March 17, 2020

William Henry Holmes, born Cadiz, OH 1846-died Royal Oak, MI 1933 Public Domain Smithsonian American Art Museum

Now we have gatherings limited to no more than 10 people, isolation zones, health emergency, shelter in place, and last but not least social distancing. In the "good old days" they simply put a sign on your door that said "quarantine." I realized that I have been "social distancing" for years. The irony of my being an online social networking maven is that I am actually not a very social person. As the coronavirus pandemic further limits my social contact, I begin to realize how little social contact I really have every week even without the virus. Due to the fact that our neighborhood is made up of mostly really old people, we are already socially distanced just by our membership in the category of the elderly.

I guess from my perspective all the references to "those over sixty" being at an increased risk from the virus are somewhat amusing. We are at an "increased risk" for just about every other possible category of life-threatening conditions imaginable. See "Age-Related Diseases and Clinical and Public Health Implications for the 85 Years Old and Over Population." for an example. This article starts out by listing all the conditions that are part of "normal aging" such as the following:

• Sensory changes
• Muscle strength and fat changes
• Immunosenescence (say that ten times rapidly)
• Urologic changes

Despite the threat of being infected with the coronavirus, I can spend my isolated time worrying about cardiovascular disease, hypertension, cancer, osteoarthritis, diabetes mellitus, osteoporosis, and several other chronic conditions. Not to mention the fact, of course, that many of my friends have already died off long ago and continue to die off all the time.

But look at the bright side, now we have something to take our minds off of all these background conditions. We can spend our time in social distancing worrying about the coronavirus. What a relief.

Well, I can add more to the list. What about walking speed, mobility disability, falls, frailty, continence, depression and psychological and cognitive disability? Guess what? According to the article cited above, "social isolation predicts mortality and other adverse outcomes in older adults." So we are doomed if we go out in society from the virus but we are equally at risk from the imposed isolation. By the way, no one read me my rights before I got old.

At one time, I obtained an insurance license and so I became aware of the actuarial tables. Here is a link to one from the Social Security Administration: https://www.ssa.gov/oact/STATS/table4c6.html. At my age, my probability of dying within one year from all causes is about .035963 and my life expectancy is about 11.18 years. One of my neighbors is 92 years old. His life expectancy is about 3 years. What does it mean to him that he is now subject to "social distancing?" I am guessing that he is even only contacted by his family infrequently because he has outlived most of them. How socially distant can you get?

You can see why someone with a short life expectancy might get depressed.

What can you do in your social distancing condition? How about using social media and the telephone to talk to your older (really old) friends and neighbors? That might help them avoid some measure of depression and ameliorate the effects of your own and their social distancing.

Journal of the Virus Year: My experiences with the virus: March 15, 2020

I wasn't going to write again today until I started to read some of the comments on Facebook. I also have the first potential cases of infection from the coronavirus in my own family living in another state. In addition, the number of people infected in Utah began to rise dramatically in the last two days as testing finally began although presently, Utah’s state lab had the capacity to test only 41 patients a day for the disease. See "Utah patients who tried to get tested for coronavirus describe what happened."

The discussion on Facebook centered around the idea that "what's the big deal?" Those discussing the issue were reflecting the idea of a meme that is currently circulating that compares the Coronavirus COVID-19 to Influenza. Their discussion also reflects statements made by the President of the United States. If you are wondering why the coronavirus is such a big deal, I suggest you do your homework and start looking at some of the statements made by competent medical authorities. You can start with this article: "This Coronavirus Is Unlike Anything in Our Lifetime, and We Have to Stop Comparing It to the Flu." 

Here is the simple beginning of an explanation about the serious nature of this particular pandemic:

https://coronavirus.jhu.edu/map.html Track Reported Cases of COVID-19

What you see above is an exponential curve or an extremely rapid increase. This is from the Johns Hopkins, University of Medicine, Coronavirus Resource Center on March 15, 2020, and is tracking the number of Coronavirus COVID-19 Global Cases. Unfortunately in the United States, the number of cases is skewed downward by the lack of testing facilities. Quoting from an article entitled, "Coronavirus vs. the Flu: The Difference Between a 1% and 0.1% Fatality Rate Is Huge" in the National Review, 

Exponential growth of some diseases means that the number of Americans infected can multiply from a single case to 60 million in a year, as was the case with the H1N1 swine flu in 2009.

If you are listening to popular talk radio hosts comment on the coronavirus, you need to get your head out of the sand and start reading a variety of news articles from a huge variety of sources. Before writing a post like this one, I probably read 50+ articles from a huge variety of news media sources. Ultimately, I form an opinion based on what I believe to be my best evaluation of the most educated and competent authorities. The statement quoted above refers to the H1N1 Swine Flu of 2009 that had a death rate of .02% and infected between 700 million and 1.4 billion people. It is estimated that the swine flu epidemic of 2009 killed about 203,000 people. Here is one comparison of the mortality from the flu compared to the COVID-19 from the ProPublica article cited above (See https://www.propublica.org/article/this-coronavirus-is-unlike-anything-in-our-lifetime-and-we-have-to-stop-comparing-it-to-the-flu)

The flu kills less than 1% of infected people who are over age 65. By comparison, in China, COVID-19 killed 8% of those infected who were 70-79 and almost 15% of those infected who were age 80 or older. That’s a staggering difference.

Since I happen to fall into the 70-79 age category, I am taking all this about the coronavirus seriously. 

Journal of the Virus Year: My experiences with the virus: March 14, 2020

(Credit: Walter D. Mooney Ph. D., U.S. Geological Survey. Public domain.)

No, I am not sick. No, I do not personally know anyone who is sick from the coronavirus.

The last few days were basically in a free-fall collapse. Almost every item on my schedule was canceled or postponed. The major effects of the coronavirus included the closing down of Brigham Young University and, of course, the Family History Library where my wife and I volunteer as missionaries and the suspension of Sunday church meetings of The Church of Jesus Christ of Latter-day Saints. for all 16 million-plus members around the world. In addition, the Church's temples were also closed to all but certain approved activities. The impact on our family was dramatic and personal. Where possible, these activities (not including the temples) will be conducted online. In fact, the General Conference of the Church in April will be held entirely online with no one except the direct participants actually attending the meeting in person. See "Updates on How COVID-19 Is Impacting Saints Worldwide" for the entire list of closures and changes.

Another change involved one of my granddaughters who is leaving on a mission for the Church. Normally, she would spend a few weeks at the Missionary Training Center in Provo, Utah but because of the virus, she will have all her training online and go directly to her mission. The changes the past two days or so also impacted all of my grandchildren who are students at the University because all of the classes are going to be taught online and the students are all being sent home. See https://www.churchofjesuschrist.org/?lang=eng.

The complications kept us going for two days almost non-stop and then it started to snow. Well, an interesting week. I started this journal because of my interest in history. Today, one of the prominent historians of the Church, Ardis E. Parshall, published an article about the cancellation of the Church's General Conference back in October of 1957 because of the flu. My wife's sister died from complications due to the flu's impact on an unsuspected heart condition. You can read the article and the striking similarities to the current pandemic here: “It Will Be the Wise Thing to Do”: Behind the Cancellation of the October 1957 General Conference."

From my personal perspective, I have spent the last 16 years as a Church Service Missionary, first at the Mesa FamilySearch Library in Mesa, Arizona and then at the Brigham Young University, Family History Library in Provo, Utah with a year off to serve as a Church Service Missionary in Annapolis, Maryland digitizing records at the Maryland State Archives for FamilySearch.org. Not having an assignment at the Library is a major change for me. Like the rest of the world right now, I am practically holding my breath about the rest of the challenges that might occur if and when the virus gains a foothold in Utah. Both my wife and I have weathered the flu, Type B, so we know first-hand what killed off so many people this year and in the past, but the novel Coronavirus COVID-19 is a whole new challenge.

Of course, the organizational consequences of a pandemic are not as serious as the disease and deaths. We live in a community with a significant number of people over 60 who are in the risk category for the coronavirus. We hope to rally as a community to take care of those around us as much as possible and as consistent with good pandemic practices.

Journal of the Virus Year: My experiences with the virus: March 11, 2020

Thomas Gainsborough, English, born Sudbury, England 1727-died London, England 1788 Public Domain

As the worldwide number of confirmed infections of the Coronavirus COVID-19 passes 120,000, the big issue in the United States is whether or not the reporting system is functioning at all. The question is not the number of people who have been diagnosed with the coronavirus but the number of tests and testing kits that have been taken. There is no doubt that the coronavirus has been circulating in the United States for weeks but political blundering and denial have resulted in only a relatively few actual medical tests being administered. Obtaining those numbers is complicated by the fact that private test results are not reported and according to some news accounts, the results from tests by Center for Disease Control (CDC) are no longer publishing negative results for the coronavirus. Quoting from the CDC website,

CDC is no longer reporting the number of persons under investigation (PUIs) that have been tested, as well as PUIs that have tested negative. Now that states are testing and reporting their own results, CDC’s numbers are not representative of all testing being done nationwide. 

Here is the infographic of the number of states reporting cases of COVID-19 to the CDC from the CDE website for March 10, 2020.

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

A running total of all the worldwide cases is being maintained by the Center for Systems Science and Engineering (CSSE) of the Johns Hopkins Whiting School of Engineering. Further reliable information about the coronavirus can be obtained from the Johns Hopkins Coronavirus Resource Center. The COVID-19 Interactive Map is the best resource for seeing the progress of the disease across the world.

https://coronavirus.jhu.edu/map.html

It is important to remember that the numbers on this map are only the instances of the coronavirus that are reported and counted. Countries such as North Korea that are refusing to report are not included.

Obviously, the coronavirus is a major topic of conversation. However, I have already heard a significant amount of misinformation from conversations about the coronavirus and from news outlets that are quoting inaccurate numbers. The CDC is obviously not an accurate source because they are reporting only reporting "confirmed and presumptive positive cases of COVID-19 reported to CDC or tested at CDC since January 21, 2020." On March 10, that number for the total cases was 647 while the CSSE number for the morning of March 11 for the United States was at 1,040. However, both numbers are most likely lower than the actual incidence.

As an attorney, I automatically examine the evidence. I also discount any evidence that appears to originate from politically influenced sources. However, it is evident that if the information I receive is wrong (i.e. my client is lying to me) my conclusions might also be wrong. But from all I read, the numbers of actual infections here in the U.S. is much higher than either of these two reporting sources.

Well, that is all for today. I will be writing more about our efforts to evaluate and react to the disease as time goes on. We did make our "run" to the stores and had no trouble ultimately finding what we needed despite some of the bare shelves in Costco. Since we always keep a sufficient supply of essentials on hand to last us many months, we do not have to resort to panic buying every time there is something that comes up to cause the rest of the world to go berserk.

Journal of the Virus Year: My experiences with the virus: March 9, 2020

Walter Clark, American, 1848–1917 Public Domain https://www.si.edu/object/landscape:chndm_1929-13-27-b

In the midst of an international hysteria about the novel coronavirus COVID-19, it is interesting to review the current statistics for seasonal flu in the United States. Here is the summary.

https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

Reminder, this is just the United States. Now, the novel coronavirus COVID-19 is currently, as of the date of this post, at the following statistics:

• 111,397 total confirmed cases in the world
• 3,892 total deaths in the world
• 600 confirmed cases in the United States

See Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE or https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Hmm. No one is buying toilet paper or water worrying about the flu. No one is quarantining millions of people over the flu.  No one is shutting down museums, parks, and other destinations over the flu. No one is telling the elderly to stay inside and to avoid crowds because of the flu. Hardly anyone is buying or wearing a facemask because of the flu. I had the flu, the real flu, about three years ago and no one interviewed me for the news or avoided me and told me to go home. The stock market did not collapse over the flu. No politician made comments about the flu except in passing. 

What is the difference?

I really don't have an answer to that question. 

My grandson got home from South Korea and apparently, my daughter and her husband have worked out the two-week quarantine. We have decided to carry on our activities as usual unless and until someone in authority tells us otherwise. 

There is a reason for writing about the virus simply because it is causing such a huge reaction. I am guessing that the U.S. number of cases is vastly under-reported.

Stay tuned as I watch. 

Journal of the Virus Year: My experiences with the virus beginning March 7, 2020

Cooper Hewitt, Smithsonian Design Museum, Public Domain, Walter Clark, American, 1848–1917

As a genealogist, I have been interested in the impact that wars, disasters, pandemics, and other natural phenomena have had on history and particularly the history of my extensive family. As a result of my interest, I have read extensively about events such as the 1918/19 Flu Epidemic. You can watch a video about some of my thoughts from this video on the Brigham Young University Family History Library YouTube Channel.

Wars, Plagues, and Catastrophes and Genealogy

I never really believed that I would be caught up experiencing a global pandemic. We always have a tendency to think that this type of catastrophe occurred in the past as a result of a lack of knowledge about medicine and hygiene. As I began a renewed interest due to the beginnings of what is now being called the novel coronavirus epidemic, I discovered that I have already lived through a number of pandemics. See Wikipedia: List of epidemics. One of these, the ongoing HIV/AIDS pandemic from 1960 to the present, has killed over 32,000,000 people. Two other pandemics during my lifetime, the Asian flu of 1957/58 and the Hong Kong flu of 1968/69 killed about 2 million and 1 million respectively.

As of the date of this post, the Coronavirus COVID-19 (the official name of the disease) has claimed the lives of 3,555 worldwide putting it into the low category for diseases. So what is the big deal? From all that I have read so far, this Coronavirus has two or three things that make it more disconcerting; it spreads while people show no symptoms, it is relatively more contagious and lethal, and it got a huge head start in China before coming to the United States (where I live).

So why did I start to write today (March 7, 2020)? Today, the Coronavirus made our lives even more complicated than they have been recently. No, I am not sick. No, no one in my family is sick. A least not yet. However, the complications came from the disease. One event this week did give me a preview of what was coming. I greeted a patron in the Brigham Young University Family History Library, where my wife and I volunteer, and she shook my hand and then dashed to the hand sanitizer dispenser to disinfect her hand. Not a usual reaction to me or my handshake. That got me thinking.

One of my grandsons was serving as a missionary for The Church of Jesus Christ of Latter-day Saints in South Korea. As the Coronavirus began spreading to countries other than China, the Church began to close down its temples and transfer missionaries out of the impacted countries. My grandson was, at first, isolated and then sent home where he will have to spend two weeks in isolation before being transferred to a different mission here in the United States. See "LDS missionaries removed from South Korea due to virus." Suddenly, the virus was affecting my immediate family.

I have been regularly checking the number of infections and reading some of the recommendations. Here is one I read today: "New CDC guidance says older adults should ‘stay at home as much as possible’ due to coronavirus." Here is a quote from this article:

The CDC guidance comes as two top infectious disease experts with ties to the federal government have advised people over 60 and those with underlying health problems to strongly consider avoiding activities that involve large crowds, such as traveling by airplane, going to movie theaters or concerts, attending family events, shopping at crowded malls, and going to religious services. 

Dr. William Schaffner, a Vanderbilt University professor and longtime adviser to the CDC, said these two groups should strongly consider avoiding activities that involve large crowds, such as traveling by airplane, going to movie theaters, attending family events, shopping at crowded malls, and going to religious services.

Now, it looks like we might be impacted even further, especially since the first known case of COVID-19 in Utah has been confirmed. My reaction to almost everything is to write, hence, this post and the ones to follow.

Stay tuned for updates as various events occur. I don't think I will write every day but only as events drive my writing.

Outbreak vs. Epidemic vs. Pandemic: All three words politically charged

Crystal skull at the Musée du quai Branly, Paris. Eugène Boban, a controversal antique dealer, sold this piece to Alphonse Pinart, a young explorer. Pinart donated it to the Museum of Ethnography at Trocadéro, Paris.

An outbreak is a term that refers to the initial, sudden appearance of a particular disease. The disease does not have to be new or unusual. The term is usually applied to the first detection of the disease in a limited population. If the disease spreads to a larger population in a short period of time, the terminology changes to refer to the disease outbreak as an epidemic. 

The word "epidemic" is defined as a widespread occurrence of an infectious disease in a community at a particular time. An epidemic usually involves a relatively short period of time and a large number of people in a defined population. Once the occurrences of the disease increase across larger populations, at some point, the terminology shifts to refer to the disease as a pandemic. The World Health Organization (WHO) has the following list of Pandemic, epidemic diseases on its website as of the date of this blog post. See https://www.who.int/emergencies/diseases/en/

• Chikungunya
• Cholera
• Crimean-Congo hemorrhagic fever
• Ebola virus disease
• Hendra virus infection
• Influenza (pandemic, seasonal, zoonotic)
• Lassa fever
• Marburg virus disease
• Meningitis
• MERS-CoV
• Monkeypox
• Nipah virus infection
• Novel coronavirus (2019-nCoV)
• Plague
• Rift Valley fever
• SARS
• Smallpox
• Tularaemia
• Yellow fever
• Zika virus disease

Because of my interest in history and particularly in genealogy, I have been interested in historic pandemics. These occurrences usually result in blank spaces on a pedigree chart with few records that help to fill the gaps. The most recent historical pandemic occurred in 1918 and 1919 and resulted in the death of an estimated 1/3 of the world's population. See the following:

Taubenberger, Jeffery K., and David M. Morens. “1918 Influenza: The Mother of All Pandemics - Volume 12, Number 1—January 2006 - Emerging Infectious Diseases Journal - CDC.” Accessed March 4, 2020. https://doi.org/10.3201/eid1201.050979.

Here is a quote from the above article about the 1918 pandemic:

An estimated one third of the world's population (or ≈500 million persons) were infected and had clinically apparent illnesses (1,2) during the 1918–1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were >2.5%, compared to <0 .1="" 100="" and="" arguably="" as="" at="" blockquote="" deaths="" estimated="" high="" in="" influenza="" million="" other="" pandemics="" total="" were=""> If you were to review a list of what are considered to be the worst pandemics in history, you might be surprised to realize that you lived through some of them without buying a surgical mask and/or rushing to the stores to buy toilet paper. Here is a link to one such list: https://www.mphonline.org/worst-pandemics-in-history/

 While doing genealogical research, it is not unusual to find multiple deaths in the same family at the same time. These deaths can sometimes be connected to a local epidemic or a larger pandemic. If you look at the list above, you will see some diseases that are still prevalent in the world today and one or two that have disappeared from most of the countries of the world.

When we think of a major pandemic in history, we often think about the "Black Death" or Bubonic Plague of the Middle Ages from 1347 to 1351 that killed from 75 to 200 million people. See "Black Death." You might also be surprised to find out that the Plague is still endemic in the Southwestern United States. See the following:

Eisen, Rebecca J., Russell E. Enscore, Brad J. Biggerstaff, Pamela J. Reynolds, Paul Ettestad, Ted Brown, John Pape, et al. “Human Plague in the Southwestern United States, 1957–2004: Spatial Models of Elevated Risk of Human Exposure to Yersinia Pestis.” Journal of Medical Entomology 44, no. 3 (May 1, 2007): 530–37. https://doi.org/10.1093/jmedent/44.3.530.

There are several diseases on the list that are still lurking out there waiting for the right conditions to reappear in the general population. For example, smallpox has been eradicated in most of the world but currently few people have has the vaccination and a smallpox epidemic today would affect a large population before it was controlled.

It is certain that epidemics and even pandemics will continue to occur. The Novel coronavirus is only one of a number of possible pandemic diseases.