Can't have a Chicken Pox Party, so let's have a Pity Party with your favorite pariah

Coming into Concord on Thursday evening and want to see people on Friday evening in a group setting. Have a message into my friend at the Department of Health to ask where I should lodge, because there are cases of asymptomatic infection, possibly, that extend beyond the 14-day quarantine period. (One friend reminded me that I have actually been cooped up since January 23, with scarcely any possible exposure beyond the buttons in the elevator of my building, but the trip to the airport in a taxi and being on a plane for three hours and then another plane from Beijing to New York resets the Exposure Clock.) I was going to stay in the home of an old, dear friend who has passed away, but I decided that since her child won't be there, it is best not to touch his fridge door or his spare key.  I might obsessively need to wipe everything I touched out of a mixture of politeness and genuine concern. Frankly, as each day wears on, the chances of me being an asymptomatic carrier continue to wane.

Anyway, I thought it would be fun, to have a party with friends since I could get called back to work in China within a week (unlikely, but possible--imagine that level of uncertainty in your life?). Furthermore, I plan to re-quarantine myself for another couple weeks, because as I said to the bickering CDC women at passport control, who could not agree if the professional who was helping me told me that my quarantine was optional, not mandatory, "Don't worry. I am going to quarantine myself anyway, because I do not want to be a part of the spread of a disease or the cause of a pandemic. My friends would never forgive me."

Over the last two weeks, so busy that I have watched the first boring episode of Ken Burns' The West (I am a huge fan of his opus so maybe it is me and not the actual documentary), I have had so many conversations about public health and medicine with a variety of clued-in folks that have left me feeling fairly confident that I know the status of the current knowledge (what we know and what we think we know versus rumors, speculation, and prognostication) and the best way to communicate about what is happening. My old friend, an immunologist, may vehemently disagree with me, but instead of engaging publicly or privately, he has chosen to cut-me-loose, as is the style of Americans on the Internet these days. All I can say is, "Bring it." I love you, but I cannot stand by as people scaremonger about this disease. Scaremonger about Mike Pence and the disaster that our federal government has become, underfunded as it is (blame that on both parties, please, and call your damn Congressman) and run by an Administration that could not find itself out of a paper bag unless there was a tiki torch rally happening at the orifice; indeed, then they would show up with feigned law-and-order to snuff out the torches with a blink and a wink.)

It is good that we can are finally learning more about this. One of the valuable people who has been most helpful to me both in counseling me through this hard time and in providing valid information is a first cousin. She is a former USN doctor, who has served in Guam, but her glibness got us both labeled as insensitive jerks, when she wrote on Facebook, "."

Now she has, in response to my posting an article about how COVID-19 is like the flu, with the comment that the next thing we need is an article about how COVID-19 is like the "common cold," shared this, in the category of what we think we know:

[Eighty percent] of cases thus far are mild, and coronavirus IS one of the ‘common cold’ viruses along with rhinovirus, adenovirus and others while flu -
Orthomyxoviridae - definitely is not. 

In the ‘non-mild’ cases, the pneumonia is the issue with some distinctive findings on chest CT. The literature I’m reading suggests some promise on certain antivirals’ ability to prevent that complication, which seems to show up around day 9-12 of illness (if it’s going to happen).

My physician*, the former head of the NH Medical Society, has also been helpful. One of the bundle of things that repatriating or returning from abroad citizens need to do is sign up for healthcare coverage, if their work coverage is not portable across national borders, as mine was not. He and my cousin were both able coaches for the experience of signing up with a for-profit health exchange. The policy starts today; tomorrow, I am liberated and get a rental car. Good timing. Thank the Lord nothing happened to me in Scranton, where I stopped for dinner on the five hour drive to my lazaretto. You never know when some stranger is going to sneeze on you and give you the flu or a common cold!

Anyway, back to the idea of holding a party. I am worried that I will continue to self-quarantine in an abundance of caution and then get called back to China, seeing neither of my sisters or my favorite people before I need to leave again. My summer vacation is probably getting eaten up by an official March 2 (tomorrow!) restart date so I won't see them until I pop back on a climate-irresponsible junket to attend my sister's wedding in September. Alternatively, I will find a way to get my partner and her kids here and then we will be like one-armed paper hangers in Versailles (or whatever the expression is), as we seek to acculturate and enroll the kids in school--a privilege that my well-heeled Chinese-American friend, a lawyer in Shanghai has availed himself of in Manhattan with his Chinese-American wife and their Chinese-American kids. "I chose Chinatown over Marin for this precise reason. Didn't want to be a scourge...There are three families that here due to the lock out [sic]."

I emailed a few folks about the party idea. Wanted to call it a "chicken pox party" and wear a hazmat suit from an EMT friend who used to visit Superfund sites (a job that I had in 2004). She now mostly visits clothes dryer fires and bonfires (think 5th of November) that have gotten out of control. There will be no party with me in a Hazmat suit and her in a Guy Fawkes mask, though, because somebody I respect blew the whistle on this idea as irresponsible and suggested instead, "Maybe you can have a party to play the game Pandemic, and people can learn and engage around the issues? Bring examples of appropriate behaviors and PPE [personal protective equipment] for flu and droplet-born disease. A hazmat suit may [my emphasis] mis-represent the risks, unless you’re in a medical setting." I think a Hazmat suit would not only protect everybody, but be hilarious. There is no doubt about it, though, it completely misrepresents the risk, just as the picture in this Scientific American article might leave people thinking that there is a basis for aerosol spraying in the streets. Yet, the picture got people to look at the article, just as a person in a Hazmat suit would draw attention, too. In the zeitgeist of the moment, everybody would instantly know what the article was about.


So, I can think of nothing more awkward than sitting around with a bunch of people who do not know each other playing a board game, but I am down with the hand-washing demo and sniffing some pepper so we can sneeze into our elbows (but what if I am sick? Someone else will have to do that.) If you want to join me on Friday evening, please RSVP send me a message. Not sure where I will be staying because NH Dept of Health does not seem to have a COVOD-19 hotline on the weekends that could tell me which public accommodations have agreed to act as quarantine facilities, but, oh yeah, that does not pertain to me any longer.



*A fellow 2004 Boston Democratic National Convention delegate for HoHo "Choo choo" Dean, M.D.--now a pharmaceutical lobbyist since Obama, sadly, gave up on the fifty state strategy and booted him from the position now held by the all-powerful and so-popular Perez, compared, at least, to Debbie Wasserman-Schultz, right?

Day Ten: Open Letter for Enemies of Civil Discourse

Day Nine: Letter from Congressman Welch's Office

UPDATE: Phyrrhic victory!!! They have clarified that people should come home and get sick instead of stay and get sick, but all I was seeking was clarity. Come home, friends!


Hello Mr. Lee,

I certainly understand your frustration. I reached out to the State Department with your question, and received the following response:

“Those currently in China should attempt to depart by commercial means. U.S. citizens remaining in China should follow the U.S. Centers for Disease Control and Prevention (CDC) and Chinese health authorities’ guidance for prevention, signs and symptoms, and treatment. We strongly urge U.S. citizens remaining in China to stay home as much as possible and limit contact with others, including large gatherings.”

Please don’t hesitate to let me know if you have any additional questions.

Thank you,

Shannon Furnari
Deputy State Director
Office of Congressman Peter Welch (VT-AL)

Day Eight: How You Can Help This Effort

In Memory of Dr. Li Wenliang (1986-2020)

Lessons and Scripture for the Day

There are three kinds of information:

• what we know
• what we think we know
• rumors and speculation

This morning, I spoke to someone that I have known a long time who had very good information on coronavirus. He works in public health on the environmental side for a state government. They are knee deep in responding to the pending, possible pandemic. He asked me, a little too politely and diplomatically as he has been trained, to remove an irresponsible article from my Facebook feed that I had posted mostly to make the point that the rumors are rampant. I don't want to be in the company of Rush Limbaugh, who continues spreading this vile bile even as his bearded countenance withers into even greater (mental) illness that will eventually consume him. So, I did as I was told asked.

In fact, the most irresponsible article that I have shared was in WeChat Moments, on the other side of the Great Firewall of China. If I was still inside China, I would not have posted it, because I am more cautious there--given the strict punishment for rumor mongering. The article was viral and claimed that America had started the spread of the virus (think smallpox blankets and Indians), as well as kept secret the presence of 10,000 infected people--a possibility that most doctors and American journalists find preposterous. Just almost no way that could happen in this social media rich nation with a free press.

The topic of the untoward repercussions of censorship and Dr. Li Wenliang (the opthamologist who died of COVID-19 on February 6 and whom I referred to as a martyr in last night's post) is beyond the scope of today's discussion, but my old friend from Changchun--with whom I sometimes think that I have only a christened name (Alexander), our Catholic faith, and a penchant for argumentation in common--has published a powerful essay on the subject.

My acquaintance shared a Scientific American article that every responsible blogger, journalist, and poster to social media should read. Obviously, the rumors while we searched for the cause of HIV burned a painful memory in the generations that lived through the 1980s. More recently, the SARS epidemic in 2003 gave rise to horrible rumors. Yet even this very article that I am recommending, which was written as an antidote to misinformation, features a picture that is irresponsible from a public health awareness perspective.

South Korean health officials spray disinfectant in Daegu on February 21, 2020. Credit: Jung Yeon-Je Getty Images

While this is happening in South Korea now and it happened near my home in Panyu District of Guangzhou City, this aerosol spraying is mostly a placebo to reassure the public, peering out from their windows, that the government is doing something to protect you. It is an effective propaganda tool, albeit an expensive use of public resources. 

Before I conclude this post, I want to summarize the main recommendations of my friends in public health and the CDC fliers that I have been handed since coming back:

• get the flu shot. 
• wash your hands all the time
• do not touch your face
• avoid sick people (but if you have one in your home assign one person to tend her/him)

When I leave this place where I am staying, I will need to wash the grime in the sink, bathroom, and anywhere else its built up. Using a disinfectant is not necessary, but helps. 

Finally, I discussed with him that I think there needs to be a "Guide for Returners" that helps us to find the hotels which have agreed to host people who might be hosting COVID-19, helps us to figure out the financial resources to get a phone, find and pay for safe transportation to our lodgings, etc. The three day delay between landing and my visit from the Seneca County Health Department was enough time for me--who had called CDC and the New York Health Department prior to leaving China--to spread the disease to hundreds of people, if I had not been responsible and if I had not come to a rural county. Luckily, as I keep mentioning I am very healthy, but that does not mean that I don't have it because of the long incubation period. If I did and had gone to rent a car, eat at a restaurant on the drive north because the one that I had thought I would go to was closed, and visited the healthy food store in Ithaca to do a couple weeks of food shopping many people could be sick because of me. Yet, I probably had less contact than most people would, as I had meticulously planned to rent a car, do all my shopping at once, and only stop for gas and a meal.

Thanks for reading and please help to promote responsible reporting of information on COVID-19 or other diseases. 

Day Seven: Welcoming People Home from China

One more week to go of this "experience"...if I am not sick, and their is no evidence that I am. Temperature hovers around 98 degrees morning and night. I am arguing with everybody about everything. This a lot more stressful than I anticipated so get ready if you are reading this from China and planning to come home for a two-week isolated quarantine. Probably more manageable if you land with your whole family and you hole up together, but this is for the birds--even if I have the best Superhost ever, ever and his property is gorgeous. Not trying to sound ungrateful or like my situation is particularly rough. I am healthy after all! What do we have in life besides our health? Or something like that. Still and all, it is stressful.

It is increasingly clear that school, in my province of China (i.e., Guangdong), will extend beyond the expected mid-July end of the school year to the end of the first week of August, though no announcements have been made. In the education market, that may mean that there will be high attrition. Thus, next fall, if everything is back to a modicum of normality, it may be a good time to look for opportunities teaching in China. Already the various recruitment websites are noisy with places looking for new hires. If the various provincial education boards do make this decision to lengthen the school year due to the lower intensity of on-line teaching and stemming from a desire to make sure all content is covered, they need to think about what ramifications that will have on students, parents, Chinese and foreign teachers, and the economy.

It is not clear, when and if life returns to normal, what the Chinese government will do to insert a bit of juice into the economy after two or three months of its malingering workforce not making widgets. Already the biggest travel time of the year (Lunar New Year) and resultant economic activity world-wide has been devastated by the nearly national shut-in. Difficult times lie ahead for all businesses. The restaurant sector is likely to have been hit very hard as margins are thin to non-existent in good times. One friend of ours has 23 restaurants and over a thousand workers who he cannot pay. Imagine this story repeated, literally, millions of times over. If students had intended to attend a summer program in late July and early August, now they may not be able to do so.

I am starting to get to the place where I don't want to read the COVID-19 news updates any longer, even though it is germane to my family and my life as a teacher in China. I have been looking at The Guardian every day for a month now to get the best available health reporting and up-to-the-minute alerts about breaking news. Furthermore, I can hardly make sense of the world any more. The Internet and social media seem to be full of rumors and misleading propaganda, my distinction being that the latter are officially generated a type of rumor promulgated by governments or government actors. For instance, the various theories of spread based on bats, snakes, and pangolins have gotten a lot more play than they merit, maybe. Yesterday, I thought it was fecal spread because of the Chinese CDC article published a few days ago. Today a respected NH doctor, with whom I discussed this, re-sent me the US CDC stuff about how they think it is primarily spread through the air by coughing and sneezing. He agreed that it could be both. I joked that if I have this thing, I am like a perfect piece of evolutionary farm equipment--a spreader and a sprinkler. We must keep pursuing the truth and the martyrs, like the doctor in Hubei who died from this, were doing that, but there are others, like Mike Pompeo, with an axe to grind. Can we trust that this is not economic warfare?

I burst into tears today while talking to my Congressman's office about the difficulty of coming back when you cannot get straight answers from a) a chronically understaffed Department of State or b) a frighteningly understaffed US CDC about a) whether you "should return by commercial means" is still the current recommendation or if it was even ever the real recommendation and b) what will happen in terms of quarantine when you do arrive. As I believe I mentioned in an earlier post,  I had called both US CDC and the NY Dept of Health before arrival and I said please don't share my phone number unless absolutely necessary with the CDC worker in the airport. None of these parties explained that two nice RNs from the county health department would be out to see me and do an intake interview. That would have been nice to know for me and for my AirBnB Superhost before they called to announce that they would like to come out and see me.

I talked to a reporter that I have known for almost twenty years today for almost an hour relating much of what's happened and at the end, under pressure from his editor, he had to cut off my droning, detailed stories with the question that I remember from Project Laundry List days when a reporter did not think there was a story, "What do you want me to do with this info?" Let me try to answer that.

I want people to know that we cannot get straight answers from our own government about whether we are supposed to shelter in place or leave.

Aside: My friend in California, whose quarantine with wife and kids did not involve daily calls to report his temperature to public health officials or a visit from any state or county health officials, was speculating that when we return some people will resent that we were able to leave. Good Lord, there is a difference between solidarity and stupidity. 

Today's news from Italy and South Korea make me confident that I did the right thing, but I am conflicted because when will my girlfriend and the two kids we are raising together be able to leave? When will China let them leave and the US let them enter? We are lucky that they all have current visas (and Yaya and I both have a MasterCard), but I cannot imagine the Americans inside of China, who want to leave but don't have a visa or a line of credit. At current "market" rates they are facing a 12,000 RMB ($1,700) round-trip plane ticket, if they can even find an available one; two weeks in a hotel or friend's house where they should not share a toilet with other non-pariahs, etc. Some might be facing losing their job if they come home and don't go back when school's and work open.

There needs to be a support group to welcome people back from China. I would rather call it a relief committee so it does not sound so pathetic, but people need information and what is on the CDC website or what little clarity you can coax from the Department of State is not enough to help figure out where to stay, how to get groceries, etc. Then there is all the regular hassle of coming back and needing to get a working SIM card, etc. It's a lot to think through and people need checklists and guidance. Even hyper-educated, hyper-vigilant, hyper-responsible people like myself. Done tooting my horn.

That's enough stream-of-consciousness for one day. Good night.

Day Six: My Fascination with Sh*t (and its possible relationship to COVID-19)

It was two books--The Humanure Hanbook (1995, now in its 4th edition) published while I was in college and How to Shit in the Woods (1989, now in its 3rd edition), a rollicking read to which I was introduced on a 1992 NOLS course in the Brooks Range of Alaska--that got me interested in shit. By senior year in college, I had also become aware that my favorite writer, Wendell Berry (b. 1934-), had written a book called The Toilet Papers--not his best literary work, but one of the most important. He made the observation that one of the stupidest things we do (I would add, besides give each other shit) is shit in water. Bill Gates agrees and is spending part of his fortune (less than 1%, I am sure--in fact, "Overall, the Gates Foundation has invested some $200 million into projects having to do with clean waste and sanitation") to solve this problem. (Stephen Colbert interviewed Bill and Melinda about their wealth and it is a good watch!)

      

"A classic is back in print! One of the favorite books of 1970s back-to-the-landers, The Toilet Papers is an informative, inspiring, and irreverent look at how people have dealt with their wastes through the centuries." -review on EBookMall  The Humanure Handbook "is a self-published book that no respectable publisher would touch with a ten-foot shovel" available at The Humanure Store.

Gates has done the rounds with Jimmy Kimmel and Trevor Noah on the topic of poop. This is the most important thing that he is doing in our water-constrained world with his unearned billions. It is also relevant to COVID-19.



Jason Gale reports for Bloombergquint, "The finding of live virus particles in stool specimens indicates a fecal-oral route for coronavirus, which may be why it’s caused outbreaks on cruise ships with an intensity often seen with gastro-causing norovirus, which also spreads along that pathway. More than 600 Covid-19 infections were confirmed among passengers and crew aboard the Diamond Princess, the ship quarantined for two weeks in Yokohama, Japan."


It is time to take this shit very seriously.

The prevention and control recommendations in the report are:

Suggestions to strengthen the control of fecal oral transmission of 2019-nCoV include strengthening health publicity and education; maintaining environmental health and personal hygiene; drinking boiled water, avoiding raw food consumption, and implementing separate meal systems in epidemic areas; frequently washing hands and disinfecting of surfaces of objects in households, toilets, public places, and transportation vehicles; and disinfecting the excreta and environment of patients in medical facilities to prevent water and food contamination from patients’ stool samples. (China CDC Weekly)

Finally, on a personal note, I was thrilled to see, before I departed China, that my AirBnB had a Sun-Mar compost toilet solely for my use during the quarantine period (i.e., my shitty hands are the only ones touching the sawdust scoop handle) and nobody else is using it. I had suspected this mode of transmission for some time and am gratified to see it more solidly (no pun intended) confirmed; however, we still do not know enough about this coronavirus (COVID-19) and how it spreads to be conclusive.

I will post a little video introduction to the Sun-Mar toilet on my Facebook page, if you are interested in seeing what you could have in your home. Just as important as solar panels and your food compost/recycling set-up. Get with the program...

Day Five: My Lazaretto, Musings On the Chronic Insane

Willard Asylum Is One Of The Creepiest Places On Earth

A note to my host, a Briton, after yesterday's perambulation of my lazaretto:

When you are ready to do laundry, which need not be for a few more days, I wonder if you have a drying rack or clothesline, as I am historically, since college, philosophically unable to dry clothes in the dryer. I ran an organization called Project Laundry List (www.laundrylist.org) for fifteen years (founded it in 1996) and a decade ago was featured in a full-length documentary by you British chaps, called Drying for Freedom (www.dryingforfreedom.com). (How you love to make fun of Americans!) Given your amazing hospitality and generosity, of course, under the circumstances, I would be willing to accept whatever you want to do...

"New Catholic" is my plot! Unmarked graves, eh? I love cemeteries as a historian and New Englander. There is a tale in my family that I once remarked to my father, at about age ten, "There are so many dead people in New Hampshire" because of the proliferation of Civil War (and earlier and later) family plots, often adjacent to an animal pound. They litter the forests and fields of northern New England on both side of the Connecticut. [Vermont shipped off more people per capita to fight in that war than any other state, except possibly Maine.]

That said, I did not love this graveyard, but I will go back. How utterly depressing to think of all those late 19th and early 20th Century adults with various syndromes (autism and Tourettes) that caused their families to abandon them for life, because they could not cope with what many times was probably not insanity at all. They lived out their lives and then did not even merit a headstone. Are all of the NY Cavalry and Infantry headstones also for inmates or is that a separate contiguous plot? Think of the PTSD after the Civil War and WWI, chapters in our national history buried and drowned out by the PTSD victims of Vietnam and Iraq/Afghanistan.

-Your Chronic Inmate
2/21/2020 at 2:47 PM

 

Chiesa di Santa Maria di Nazareth- Venezia

lazaretto

noun, plural laz·a·ret·tos.

1.  a hospital for those affected with contagious diseases, especially leprosy [and COVID-19].

2.  a building or a ship set apart for quarantine purposes.

ORIGIN OF LAZARETTO
1540–50; < Upper Italian (Venetian) lazareto, blend of lazzaro lazar and Nazareto popular name of a hospital maintained in Venice by the Church of Santa Maria di Nazaret

 
The Willard Asylum for the Chronic Insane sits on both the National Register of Historic Places and at the end of my lane. Yesterday and again today, I wandered around the 75-acre farm to which I am legally bound for my period of (supposedly voluntary) self-quarantine. It is adjacent to a cemetery in which more than 6,000 people lie, more than 1,500 of whom were buried by one of their fellow denizens, named Mocha (like chocolate and coffee), or so claims a plaque erected by his admirers. He lived from 1878 to 1968 (90 years), outliving both MLK, Jr. and RFK.

As the video above mentions, most people spent thirty years in the place. Thirty years! I am only here for two weeks, cut off from family and friend. It will probably be long enough.

      

There are road signs in the middle of this barren field (no headstones): One says "New Catholic" (converts? Italian immigrants, Polish?), another "Old Catholic" (Irishman? Quebecois and Marylanders?). One says "New Protestant" (cremated?), another "Old  Protestant" (members of the Society of the Cincinnati? descendants of early settlers in the Colonies?). There is a plain "Jewish" sign and then a fabulous arch for "Old Jewish ✡ Cemetery."

At the far end of the field, by a precipice that goes down to the two-lane highway running along the shore of Lake Seneca is a soldier's field, where there are headstones. Mostly Civil War and Great War veterans (or KIA, perhaps), each man's stone has an American flag. Only one stone, slightly different than most of the rest has a wreath aside it.

Patrick Walsh was a seaman on the USS Wabash and USS Montauk, who fought in the Civil War, but died as America was entering World War I. Though he does not seem to be among the notable or honored crew, one wonders if he saw service with George Dewey.

There are no marked plots for atheists, agnostics, Moslems, Hindoos, or any other faiths, but in a grove of trees that bisects two fields are 107 cast iron, numbered graves with no other information.

 

+     +     +

In today's post, I want to turn, briefly and ultimately, from this description of and these musings on my surroundings to a brief reflection on the history of the lazaretto (spellcheck wants to make it amaretto). In Italian, lazar, as the etymology above indicates, means someone affected with a disease, especially the disease of Lazarus, or leprosy. Of course, as far as I know, I have neither COVID-19 nor leprosy nor chronic insanity, but I am self-quarantined near an asylum so this is not a non sequitur. Furthermore, I did say to my host, as I was proposing to stay here, "Feeling like a pariah! Haha," though my host's legitimate worries have mostly subsided as I continue to be healthy. Still, this experience, where a guest on his property overheard us talking about the impending initial visit from the Health Department nurses, makes me reflect on the experience of Lazarus, of those who survived the Black Death, of the Yellow Fever (not that "yellow fever"!) in Philadelphia, 1793. In fact, in preparation for the now largely cancelled United States Academic Decathlon in China--ironically focused on health this year with a big chunk of reading on plague--I learned a great deal about buboes and transmission of disease by rodents. I also read a wonderful book for young teens called Fever, 1793, which described how people would avoid each other on the streets of Philadelphia in the days of Dr. Benjamin Rush, though Yellow Fever is not transmitted from person-to-person. 

It is like that now in China. Masked, out for a walk in an abandoned park, you see someone coming the other way and both of you adjust or pull up your N95 masks and give a wide berth. You have no idea if the person could even give you COVID-19 if he tried, but we must behave that it is possible.

When I leave here, despite the fact that there will be virtually no chance that I arrived back in the US infected, will people still be worried to be near me? Of course there are those generous and/or foolish who would see me now, without waiting. Some may think that the God of Lazarus will protect them from being sick, perhaps because of their "good works"; others, because they perceive themselves to be healthy, young, virile. This is a disease killing smokers, as my friend Michael, who returned for a two week quarantine in China first observed. Those with already weakened lungs are succumbing at a higher rate than most, men more than women. In China, men smoke a lot.

WILLARD OFFICIALLY OPENED IN 1869 [four years after the Civil War ended). BY 1877  [the end of Reconstruction] WILLARD, AT 475 ACRES (1500 PATIENTS) WAS THE LARGEST ASYLUM IN THE UNITED STATES.  IN 1995 WILLARD PSYCHIATRIC CENTER CLOSED ITS DOORS, BUT A PORTION OF THE CAMPUS IS A NEW YORK STATE DEPARTMENT OF CORRECTIONS REHABILITATION FACILITY FOR INMATES. (MOSTLY INMATES WITH DRUG ADDICTION)
Attribution: Jerrye &amp; Roy Klotz, MD / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)

Additional Reading

Read more about the suitcase that is mentioned in this spooky video above.