Mediated through the video chat screen, my smiling partner-in-crime lifts his glass of wine in a toast from far across the Atlantic Ocean. This fleeting moment of loving happiness, however, is indicative of anything but an ordinary transnational video call. I write this as my husband, a senior medical practitioner, and surgical ward director in the red zone, quarantined city of Milan, continues to work over-time for weeks on end in the midst of one of the largest global COVID-19 outbreaks outside of China. Italy is home to world-class doctors and specialists, and it has documented more than 2900 deaths in a single month, with a spike of nearly 500 fatalities in a single 24 hour period this week. The last four weeks have been agonizing for my family: for all that remains unsaid of the grief and loss that mounts daily, for worry over a nation I call my second home, for our mutual health, and for fear that we don’t know when we might see each other again given the latest travel bans and strict social and physical quarantines in place, including armed blockades in Italy. Our conversations are intended as light-hearted to keep our spirits high—we play guitar or piano, we sing, dance, cook, tell jokes, debate and argue, and sometimes, for a brief moment, we catch ourselves laughing together as we once did, bellies full, heads thrown back, eyes squinting with mirth and a cautious hope that all could be well again someday, somehow. But the losses are always there at our backs, lurking quietly in the darkest corners, waiting to resurface. Inevitably, these moments are also time to find out how many more have died in the ward overnight, how many new staff have been infected, how many respirators might have opened up for a fleeting moment before going back to use again on a new patient. Today our conversations circle to Bergamo—a breathtaking mountain town just outside of Milan. Yet, we speak not of its spectacular views, shops or restaurants, but of its rising death counts. Coffins line the morgues and church. Dozens and dozens of military trucks have been called in to transport the endless waves of cadavers for cremation or burial elsewhere as hospitals and funeral services are overwhelmed with the sudden death spikes. Now is the time for grief and loss to be our guides here in the United States.
In translating and naming the unspeakable, I call on those not yet effected by COVID-19 to act in mutual aid and care for our community members. Your responsibility to do so immediately and posthaste outweighs any rogue acts of individualism we see on the news or spiraling across social media. There is no need to panic purchase and hoard. The grocery stores will stay stocked, just as they have in even the worst hit cities in Italy. There is no need to purchase guns to protect your stockpiled resource stash. Your duty is to care enough for others that you stay in place; that you treat this as the unprecedented pandemic that it is; that you reconsider short-sighted interpretations of social distancing. Bergamo teaches us that lives, in fact, depend upon it. Now is the time, and long overdue, to listen carefully to our brothers, sisters, comrades, loved ones and global partners in Italy.
I want to use this dual access I find personally available to me—access to the epidemiological front lines of Northern Italy; to some of Europe’s most talented immunologists and virologists; and to daily increases in cases here in the US—to raise two key points of reflection on the current state of emergency and shut down in my own resident city of Los Angeles; and with regard to the frequent irresponsibility of basic interpretations of social distancing as simply personalized measures of physically distancing oneself in public and increased hand-washing. While these two acts of distance and cleanliness are absolutely necessary, and are not epidemiologically incorrect or irrelevant to the known data, these interpretations alone of social distancing fall far below the bar that must be set for the well-being of all community members, especially those most at risk. This is because they are frequently practiced while still maintaining a host of other irresponsible daily tendencies and activities, including: play-dates and face-to-face hang-out time; crowd and small group proximities or participation; one-on-one close proximities with others you are uncertain have been exposed; going out while symptomatic even if minor; small athletic group gatherings, etc. These individualized tendencies, paired with slow federal policy-level responses to the dire public health and economic straits we find ourselves in will fail to make the robust, necessary changes needed to stop the rapid-fire transmission of this highly infectious, viral form of pneumonia. We in the United States are a mere 10-11 days behind Italy. These two factors: lack of serious, sustained and consequential social distancing; and a lack of swift and meaningful policy initiatives for the protection and provisioning of all people, especially the uninsured, precarious workers and homeless folks, will be the US’s downfall in this global pandemic if we do not systemically and systematically heed the grief and loss our global partners in Italy are currently warning us about.
In their recent article in The Atlantic senior fellow Thomas Wright and former assistant secretary of State for Asia and the Pacific Kurt Cambell reflected on the profound public health effects of the rise of Trump-era Populism. They specifically lamented that amidst increasing global outbreak, “this moment cries out for a cooperative international response,” one in which leaders, and Trump in particular, heed the advice of scientific experts and work to collaborate in the best interests of international public health. To this end, we need take our cues from community initiatives that move beyond able-bodied and individualistic focus—just because you wash your hands and do not present symptoms does not mean you have not contracted the virus or that you could not transmit it to others. Children can definitely transmit the virus even while asymptomatic (and there have been cases of babies and small children effected as well); and younger adults are not immune to its respiratory effects. In fact, the first two patients with severe respirator needs in Milan my husband reported to me some two weeks ago were able-bodied patients aged 25 and 36. So please, now is the time to enact an “essentials only” attitude and a very high stakes standard about the necessity for quarantine and social distancing. Do it to protect other community members. Do it to safe-guard and to make space for those laborers who do not have the option to stay home—and where would we all be without those brave doctors, nurses, emergency resource staff, amazon delivery folks, postal, grocery and garbage workers? Listen to health officials and to the spirits of Milan and Bergamo, Lodi and Cremona, Wuhan and Daegu, Seattle, Tehran and Qom. This can and will affect us here in the United States just as drastically as it effected other parts of the world, if not more so given the exclusionary nature of our healthcare system, an overall lack of worker protections, and given the gendered, racialized and classed nature of care work among other forms of labor that are hardest hit by closures. This is not happening to Italy or China, Iran, or elsewhere because of race or ethnicity, or simply because it’s “dirtier over there.” This profoundly affects all of us, and does not discriminate, so stay home if you can. Do not just ‘run a few quick errands’ while even mildly symptomatic. No, you should not just step out to get that teeth cleaning, haircut, dress fitting or other random things I see and hear people discussing lately that puts them in close physical proximity to others. Cancel the group kids’ play dates. Limit your outside time to purposeful and brief necessity runs for food or medicine. What could a few weeks or a month of discomfort be compared to mass suffering or deaths caused by the high transmissibility of this virus? The most frequent interpretations of social distancing for purposes of interrupting viral transmission of COVID-19 include: directives to hand wash; to stand at least 6 feet apart; to avoid sharing food or drink; to stay at home should any signs of illness present. These are fundamental. I do not suggest these proposals are inaccurate. I argue that without increased, responsible social quarantine that looks outwards to care for others first and foremost, they promote a highly individualistic interpretation of social distancing that will not spare transmission of this mutated virus. I am saying stay home. I am saying assume you have it and work from there. This evening, my husband reports their hospital has reached maximum capacity. Of the 18 available respirators, all are in use. Two of his staff have tested positive. He admits to me that he has completed nearly 20 life-saving emergency surgeries in which the patient ultimately tested positive. Stop stockpiling toilet paper or guns, and start acting like your life will depend on how well you care for others ahead of yourself. After days of hearing of 40, even 50 deaths per day in one hospital alone, and the knowledge that reaching “infrastructural capacity” translates to turning people away for care, means death for many, I for one am ready to listen and act in mutual aid and care for the health and wellness of others. Are you?
Los Angeles (USA), March 27th, 2020
Rachel Vaughn
UCLA Institute for Society and Genetics
Rachel Vaughn is Lecturer in the UCLA Institute for Society and Genetics, and former visiting fellow in the Center for Study of Women. Her research addresses food precarity, waste and sanitation. She teaches courses on biotechnology, food, sanitation and public health.
UCLA Institute for Society and Genetics
Rachel Vaughn is Lecturer in the UCLA Institute for Society and Genetics, and former visiting fellow in the Center for Study of Women. Her research addresses food precarity, waste and sanitation. She teaches courses on biotechnology, food, sanitation and public health.
This blog is managed by the work group of the World Anthropology Day - Public Anthropology in Milan of the University of Milan-Bicocca. It welcomes short (self)ethnography, theoretical reflections, reading and studying suggestions.