Coronavirus: A story and two perspectives

March 29, 2020

After two weeks of struggle, it seems I have overcome COVID-19.

The virus infected my mind long before it penetrated my body, and I am still struggling with it mentally today. With the news media spouting real-time-all-the-time-coronavirus-right-now updates, it is hard to think of anything else.

At the risk of adding another voice to the infernal choir, I’m sharing a couple of perspectives on the virus, in an attempt to free my mind to think about something else.

In this essay I’ll describe my own history with coronavirus. Then I’ll discuss why understanding something abstract (like an exponentially growing death rate) is a completely different skill to translating that knowledge into concrete action (like washing your hands). We need an emotional response to the abstract to transmute it into a change in behaviour. Finally, I cautiously endorse public shaming, which I believe is the lesser of evils, enforcing us all to make the behavioural changes we need to get through this.

If you’re not interested in me but want the take home messages, skip to parts two and three.

See you on the other side.

Me and coronavirus, a short history

I was probably the first person in my group of friends to take coronavirus seriously.

I kept tabs on the original outbreak from the end of January, and by mid February thought it had been contained. My relief turned to dread when I saw outbreaks occurring across the world at the beginning of March. I was in Canada at the time and worried I might not be able to return home to start a new job. Unfortunately, governments around the world were much less concerned than I was.

I returned home on the 6th of March. Toronto airport’s tables are covered with iPads, which you can order food and drinks from, while being showered with a perpetual stream of advertising. I wiped my screen down with disinfectant, and chatted to an amiable Irish hydrologist who sat kitty-corner to me. We didn’t shake hands. It turned out that he was visiting Toronto for a mining conference — the same one that Justin Trudeau was exposed to COVID-19 at, I later learned.

I boarded the plane and disinfected my tray table. My neighbour looked askance at me for a while, then pulled some Purell out of his bag and self-consciously washed his hands. I had a few masks in my bag, but at the time the idea of wearing one seemed ridiculous. I had read the WHO guidance, and seen the articles debunking “the myth about masks”. I was confident I didn’t have COVID-19, and knew the mask would only stop me spreading the virus, not prevent me from contracting it.

I saw my parents the next day. They were off to the rugby, Dad’s birthday treat. I encouraged them not to go. 80,000 well-travelled upper-middleclassmen using the same toilets, Twickenham a petri dish of people. They didn’t listen. I was glad they’d had the foresight to visit my grandma before they went to the rugby, not afterwards. Both working in pharma, they were surrounded by medical advisors. My parents knew the virus would be bad — they had cancelled their trip to Italy. But they weren’t ready to disrupt their way of life just yet.

The day after, I started work. A consulting role — my first “real” job. 30 new joiners crammed inside a hotel conference room. Two weeks’ training. Return on Investment. Value Creation. Excel. Introduction speeches and pressing flesh. Most people had just returned from travelling. I made smalltalk about full moon parties and elephant sanctuaries while refreshing the Johns Hopkins Coronavirus tracker. 700 cases on the Diamond Princess. A question about the impact of coronavirus on the firm’s business. The senior partner answered: “We don’t know.”

Over the weekend I caught up with an old friend. Two weeks prior, back when everything was normal, we’d agreed to meet at the pub. It felt like a moment stuck in time. She worked in healthcare and could see the future clearly. The place was rammed, and everyone was having the same guilty conversation about being out and about while the virus lay dormant inside some of us. We knew it would be our last trip to the pub in a very long time.

The next day I terrified myself over coronavirus. I spent the afternoon reading accounts from China and South Korea, and the evening modelling possible outcomes. We were about 12 days behind Italy. Before the month was over, hundreds of Brits would be coughing themselves to death every day. I ordered £200 worth of Amazon Fresh. Working from home was strongly encouraged. As the country moved indoors, the flowers began to bloom. While the incubating virus coiled, spring sprung.

Model of total (incl. unreported cases) in the UK and daily deaths. Today = 14th March 2020. I predicted 204 deaths on March 29th, actual number at time of publishing is 209.

All work socials were cancelled. Rumours that clients couldn’t or wouldn’t pay for existing casework. As the new joiners from the Munich office were sent home, work from home began in earnest. I wondered about the firm’s cash reserves while I developed a mild fever. I started self-isolating and informed everyone who needed to know. A few days later it emerged a German colleague had tested positive.

Training completed! But we weren’t going to be doing any work just yet. The firm solicited feedback on our orientation over Zoom, while individually each new joiner was called by a partner, and surprised with furlough. 12 weeks of unpaid leave.

Like you, I’ve been stuck at home ever since.

Macro understanding, micro actions

Despite seriously understanding the scale of the pandemic, it remains enormously difficult to translate this into practical action.

The coronavirus seems tailor-made to spread uncertainty. We don’t know how long it incubates for, but carriers can be asymptomatic for up to 12 days. We don’t know what medicines can treat it, so we dose the fever with paracetamol, pop the patient on oxygen and cross our fingers. It can feel suspiciously similar to a mild cold, and days later you can have organ failure.

You can understand the aggregate consequences of the virus from looking at growth rates, R0 estimates and exponential distributions. This gives a high level understanding: if I know how many people died every day in the UK over the past two weeks, I can accurately predict the number of people who will die tomorrow. But these deaths are abstract. The thought of 800 Italians dying every day can’t stick in my head. The crowd of their bodies, the rattle of their coughs doesn’t fit. Their deaths just feel like a dark fog. An ominous cloud portending our own future.

Understanding the catastrophe in abstract doesn’t help us change our behaviour. When I went to the pub two weeks ago I was probably already carrying coronavirus. And I broadly understood how bad the situation would get — I believed lockdown was an inevitability. But I still went to the pub, and so did everyone else. I couldn’t turn my macro understanding of the pandemic into personal, micro actions.

Unless you have a visceral understanding of the shape of things to come, it is easy to talk yourself out of behaviour change. We tell ourselves that we are special, visiting a friend one more time won’t hurt. And if only one person did this it probably wouldn’t hurt. When everyone does this it’s a disaster.

Humans are notoriously stubborn creatures, and we crave homeostasis, a return to equilibrium. We can be displaced from this equilibrium by the threat of violence from authoritarian rule, or by a powerful emotional response. Either way, we don’t change unless we are forced to.

The government are now enforcing a lockdown which will help stop the spread of the virus. But as a society we are sorely lacking an emotional connection to why our little acts of cleanliness matter. I didn’t socially distance two weeks ago because I wasn’t emotionally invested in it. Instead of holding a cloud of nameless dead in my mind, I should’ve thought about the death of someone I know.

In the 50s, regular above-ground nuclear weapons testing reminded everyone of the threat of apocalypse. Today we need something similar: a regular reminder of the threat of COVID-19.

Above ground nuclear testing made everyone take the threat of nuclear war seriously. We need viscerally emotional images of the impact of COVID-19 which provoke the same response.

We need tales of nurses returning from nightmarish 12-hour shifts. We need pictures of wards like war zones, patients on ventilators in the hallway. We need videos of grieving families prevented from holding their loved ones in their final moments, of young adults coughing up blood, the angry tearless sighs of people struggling at home, unable to receive treatment.

Above all we need a story. A story that changing our behaviour — washing our hands, wearing a mask, staying inside, keeping apart — matters. As well as the stark reminders, we need the specks of light. Operatic Italians. Clapping for the NHS. 750,000 volunteers in 24 hours.

Fairytales were originally dark stories parents told to inculcate good behaviour in their children. We need a new fairytale to go viral, a narrative that makes us feel like our tiny acts of hygiene are part of a cosmic struggle, each of us a foot-soldier waging war against the shifting wraith of coronavirus.

A cautious endorsement of public shaming

I had a conversation with a friend two weeks ago. Back then we weren’t yet social distancing, and I was sounding off about how we would soon all be stuck at home for months on end, so we should prepare today. I encouraged my friend to evangelise; to inform others who also weren’t taking it seriously.

He said something along the lines of: “Who am I to tell others how to live? I’ll wait for the government or some other authority before I change my own lifestyle.”

He made an important point. To people who haven’t spent hours reading first-hand accounts from Wuhan and Lombardy, the idea that we should change our way of life because a few hundred people have flu-like symptoms doesn’t just seem absurd, it seems authoritarian. It seems like every other kind of religious moralising: when entering a building, instead of making the sign of the cross, wash your hands.

Pseudo-religious moralising is exactly what we need to beat the virus. Most people are simply not interested in digging into the epidemiology of SARS-CoV-2. Most Westerners had limited exposure to the SARS outbreak in 2002. Most of us still don’t know people who have suffered from COVID-19. And by the time we do know someone, it will already be too late.

There are only two ways to enforce social distancing and strict hygiene. The first is Big-Brother style authoritarianism, of the kind seen in China, and now Switzerland. The second is mass behaviour change, fuelled by full-on public shaming.

We need the state to prop up our tanking economy, to act as the lender of last resort, the ultimate guarantor of our financial struggles. But we should not give it the power to completely control our lives. If we give them our lives we don’t know when or if we’ll ever get them back. Public shaming seems like a relic of a stuck-up culture, something Victorians might do. But compared to a military lockdown, public shaming is liberation. It is individuals wresting control of their lives away from the government, demonstrating that we don’t need a Big Brother to protect us from ourselves.

Two weeks ago, no amount of epidemiological studies would’ve convinced my friend I was right. But if me and all our friends started carrying hand sanitiser, wearing a mask outdoors, and washing our hands when we entered the house, he would’ve started doing it too.

Mask on. These homies are my in-group.

Shame is a powerful drug. Countries which experienced the 2002 SARS outbreak like Taiwan have cultures which normalise mask-wearing, and the virus has transmitted far slower there as a result. Tapei-based Paul Millerd says as early as February if he left the house without a face mask he’d feel so self-conscious he’d go back home and get one.

Public shaming creates in-groups and out-groups. There are people who use the “correct” pronouns, and there are racist, sexist, homophobic bigots. In most cases, the differences between groups are purely cultural. But the differences between groups who socially distance and those who don’t can literally be measured by a difference in death rate. Moralising about cleanliness has ceased to be a quirk of personality, and has become a heroic gesture.

Every movement which publicly shames creates collateral damage. I am not endorsing burning at the stake those who don’t wash their hands. I am encouraging firm reminders. Ask someone you see outside why they aren’t wearing a mask. Share your hand sanitiser with people liberally, and make a point of washing your hands any time you enter someones home.

All change is uncomfortable, and lately everyone has been going through their own personal discomfort. Be kind, but be strong. Every individual behaviour change is a life saved.

When the lockdown ends we’ll all step out together, into the darkness, or else, the light.

Thanks to Ned Davies and Serena Bhandari for reading drafts of this essay.