Sunday, March 29, 2020

Canary in a Coal Mine? Hardly.

A letter of gratitude arrived from a friend today, who works as an EMT in Norther New England. She wrote, "Most of the patients [I visit] can stay home but people are freaking out. I would be too if not for your educational efforts. Honestly I can't thank you enough. Our govt did shit but there you were educating for all who would listen. Our govt totally sucks." While I will take the compliment, I think it is important to distinguish between different levels of government and different levels of response. (By most accounts, America's Governor, as I have started to call Andrew Cuomo, is doing a great job.)

While the US was better prepared than almost every other country, according to both WHO and Johns Hopkins, we were not prepared in some very important ways. Ed Yong says it better than I could in The Atlantic:

Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.

When some of you read the pieces in the Concord Monitor, the Boston Globe, or the Charleston Post and Courier, your response was disgust that I would be so public about what I was doing and about my private life. One friend's spouse said to me that my efforts were little more than an effort to garner attention for myself and hold myself out as an expert. She went further to say that I was being over-sensitive for defending myself against her charges of corrupt purposes. The host of my AirBNB, who was one of the wonderful humans I have ever met, was so angry that I had taken a picture with his woodstove, unbeknownst to him, for The Globe that he wrote me, "This might be an interesting publicity stunt for you, but it's how I pay my bills." (At that point, I was for the duration of my two-week stay, the only one in his county in quarantine or isolation because of the novel coronavirus. I understand his concerns.) Another spouse of a dear friend wrote some of the most hurtful words that I have ever read, "I hope you are well. I also contacted the Boston Globe and Concord, NH paper to let them know how you played them! Publicity on top of your cowardice actions. Sure you made the Lee legacy proud." (I can forgive and excuse this comment, because he is not well, but, people, please be not cruel to those in quarantine or isolation. This is not an easy time for anybody.)

Little did you all know, that in less than a month, you would be unable to read or listen to any news that was not related to COVID-19. Little did you know that alcoholism and domestic violence, not to mention anxiety, would skyrocket, as your friends and neighbors are trapped at home in a society that relies on trappings for its sanity. Since I had been locked down since January 23, I knew what was coming and it broke my heart. My heart still breaks everyday as I watch what is happening. 

It is hard to admit that the country to which I returned, China, whose government so many of my friends and family despise, has done a much better job than our own. It is an existential crisis for me, who agrees with so many of you that the doctor in Wuhan who blew the whistle is a martyr. However, the Rep. Seth Moulton approach was wrong and I am glad that he saw the errors of his ways. (Softball interview with Moulton about his experience with the disease begins at 2 minutes in video below. The part where he talks about the resolution starts at 12 minutes and 50 seconds. Sympathy to him and his wife as they recover from what they have to guess is "the disease"; he takes VA health benefits instead of Congressional benefits...and VA won't test a virile middle-aged man. There are not enough tests, as Science Friday explains, and the results sometimes take a long time.)


Here in Guangzhou, in my second fortnight long quarantine, this is what I am doing. I am reaching out to groups that are working to deliver quality supplies of test kits, PPE, and other equipment to the United States. It is hard to figure out who is a "carpetbagger" and who is really involved in this effort because they want to save lives. Luckily, my partner is an extremely well-connected businesswoman and we have been able to identify reputable factories that make test kits and personal protective equipment (PPE). We will be working over the next weeks to send out as much as we can, but, sadly, Trump's tariffs, his "Wuhan virus" rhetoric, and stories of bad test kits from China in Europe and elsewhere in Asia are making it hard to send these supplies to the United States, where we both most want to send them. Chinese testing kit exports have soared as COVID-19 spreads, but the cancellation of most China Airlines flights and the failure of American airlines to resume cargo flights to China are additional challenges.

The NMPA will clamp down on the bad products and I would guess eventually people will go to jail.  Yesterday, NMPA gave emergency approvals to COVID-19 test kits. Sadly, the bigger problem, which we have known for over a month, is that there are not enough US FDA workers here to do their job. Claims that the FDA is taking further steps to help mitigate supply interruptions of food and medical products should be taken with a grain of salt. This is an agency that answers to a protectionist President who would, in the words of one of my friends, "rather die than be conciliatory with China." This press release does offer hopeful words:
The [FDA] is taking steps to facilitate importation of PPE into the U.S. and we are ready and available to engage with importers to minimize disruptions during the importing process. This means that when products come in from overseas, their authorization via our EUA authority allows them to quickly enter the country. These products aren’t hindered from entry and we’ve already determined, among other criteria, that the known and potential benefits of these products being used in health care settings outweigh the known and potential risks.

Will keep you posted as things develop.

I have had my second free COVID-19 test and when the results come back, I may be free to go outside. Rumor has it that we may return to physical school in April, but as Dr. Anthony Fauci says, "You don't make the timeline, the virus makes the timeline."  There will be a knock at the door and they will remove the camera monitor from the outer door when I am done with quarantine. I am excited to see 丫丫 and the kids, as well as take a hike. I am feeling very healthy, having lost about 10 kg from my plant-based diet. Have even watched a few movies during this second quarantine--notably, "Dirty Money"!

Back to the trenches...and first breakfast. Eat well, sleep well, wash your hands, and take care of each other. May God bless America!

Alexander Lee
Guangzhou, China

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