Twenty months home from the war
Twenty months ago, I ended my 18-month tour of duty as a reconnaissance specialist in the fight against COVID-19. The 53 reports written, the interviews given, the presentations, the meetings, the inferences, the decisions the decisions over and over again, all in the service of public health, are my flights over Berlin. I’ve been home now for longer than I was gone. And yet, the war rages on, my side lost, and I now live in occupied territory. Everywhere is occupied territory.
I’ve been lucky so far–I’ve only personally known one person who died and we’d only just met a few weeks earlier.
But there’s a unique trauma of first watching the bodies stack up in your mind and then watching them stack up in your data, without ever seeing a body directly. From data out of Wuhan, I knew that around 1% of people who got infected would die and that it took around 21 days to do so. I remember driving home from work one day early on, seeing thousands of cars, and wondering who inside was already dead and they just didn’t know it yet. Around the same time, we started testing the thousands of samples we had despite FDA regulations to the contrary, and we knew we had community transmission in my backyard a few days before the first documented COVID death in the US. Shortly thereafter, I wrote that, without doing something to change the tranmission dynamics, “we expect that roughly 80 deaths will have occurred by April 7 and that roughly 400 total deaths will have been destined but not yet occurred” [1].
Then something amazing happened: people with power listened. And people without power listened too. And our field hospitals went unused.
For the next year, this cycle of seeing what was coming and helping people to understand how to prevent bad outcomes and steer towards good one gave me some control over our destinies. I think the body of work my colleagues and I put out, and the record in Washington state that we helped achieve, says I used that power better than most.
But then the political economy changed. An enormous amount of bipartisan and public-private coordinated effort went into forcing upon us a set of beliefs that there was no longer a virus problem, but a vaccines problem, or a red-blue problem, or a business problem. But it’s none of those. It’s still a virus problem. It will always be a virus problem as long as we let the virus run free.
I know viruses. Some are my mortal enemies, but I respect them all. But that doesn’t matter anymore. Our leaders gave up, so my mission was over, and, in July 2021, I metaphorically went home.
Twenty months later, I’m watching everything I knew and did be forgotten. I was able to help because we built the country’s first end-to-end, community-based, many-pathogen, infectious disease surveillance and response sytem in 2018. There is still no national equivalent today. Books get written that talk about what happened in New York or California or compare countries, but none are being written about what happened in Washington state, where enough went more right than not that we’re 46th per capita in COVID-19 deaths despite having the first outbreak in the country. No one is asking how what still went wrong here interacted with what went right, so that perhaps we could learn about the interactions of complex systems and how to manage them better, and not just doing post-mortems of failure and starting from scratch.
And while I keep saying I’m home now, that’s only mostly true. It hurts that no one is listening now. Like I was one of a small, disconnected group of people around the world who understood everything that was to come by the end of January 2020, I’m also part of the small, disconnected group, that understands that preventing respiratory infections is an engineering problem–one of removing pathogens from the air before they can infect anyone anew–and that we know how to clean the air, and get incrementally better at it. In 2020, we learned how to eliminate human influenza, eliminate RSV, drive COVID burden to levels low enough that it was actually less bad than a typical flu season, and we know the few places that did it best had the most social freedom.
Back in March 2020, I used to explain to people that “whatever problems that’ll come with fighting the virus, they’re gonna be about the same size no matter how long you wait, but the problem with the virus is doubling every week, so you should act now.”. The timescales have changed, but preventable death, disability, suffering, social and economic disruption, and the ongoing collective trauma of living with all that while being pressured not to see it, is still accumulating every day. And the same lesson holds–every week that goes by, the virus problem gets worse while the costs of stopping it don’t. So act now.
A different person could’ve stayed and joined the long fight. But I’m not a lifer. My 18 months cost me and my family too much. Cost me still. And yet, there’s no VFW for people like me. And so the part of me that is home but doesn’t know how to be home just hurts all the time, alone. I miss having some say in our destinies. I miss having some say in my own. I miss the unity. I miss the camaraderie.
This must be in a small way what losing the war and suffering under an exploitative enemy occupation feels like. I can wear the partisan symbol on my face, in our local island of relative autonomy against the occupying force, and I can still clean the air to fight the virus in my home. My immediate family hasn’t had so much as a cold in more than three years, while living well. But I have a child coming soon, and one day, she’ll have to go out into a world I can’t abide, but also one I can’t control. And so we’ll face the occupiers anew.
I suppose I’ve come full circle. Once again, I feel the trauma of seeing what’s coming and then still having to watch it happen. But this time, it’s clear no one with power is gonna surprise me by listening. I want to forget they ever did.
I still have hope. I know that in my child’s lifetime, in every place with stable infrastructure, we will engineer away COVID, flu, RSV, and the dozens of things like it, just as we’ve engineered away cholera and typhoid and the plague. I now understand that I have to grieve for our loss of freedom, my loss of power, and my crushed hopes for change today, so that I can be present with my family until tomorrow someday comes. My daughter won’t know the world that was and must live in the world that is. My job is to help her live in this world as well as we can, protecting her to the best of my ability, balancing the harms of exposure to the occupiers and to the fight, until the liberation comes.
For the partisans who are still fighting, know that I see you and I love you.
For attribution, please cite this work as:
Famulare (2023, April 29). Twenty months home from the war. Retrieved from https://famulare.github.io/2023/04/29/Twenty-months-home-from-the-war.html.