One Year Into the Pandemic: My Story So Far
On February 4, 2020, I woke up around 4 in the morning and started to get ready for what would be a very long day. The previous evening, a friend in Washington, DC, had asked if I was available for a radio interview the next morning. A local radio station in DC — a Spanish language station — wanted to talk to someone about the virus from Wuhan, China, that was causing a stir. I agreed to do the interview, which meant that I had to be in DC by no later than 5:30 in the morning.
Over the previous weeks, my colleagues and I had been talking online and in person about what was going on in China. Some of us theorized that a novel influenza strain had emerged, but the lack of laboratory evidence made that less plausible. (The lack of information from the PRC made sense; they have always been secretive with their outbreaks.) Others theorized some more deadly virus, while others correctly theorized that a coronavirus had been involved in a spillover event.
Slowly, the information from China continued to trickle out, and the World Health Organization and China started reporting what was really going on. By mid-January, cases starting popping up outside of China, but China also shared the genetic sequence of the virus. That genetic sequence would come in very handy by July when mRNA and other vaccines were designed and their clinical trials started.
After the interview on the radio, I remember thinking if I had gotten things right. I told the deejays that this would be “a very bad flu season” and that “masks are not helpful.” I was way off, but I was basing my opinion on the information I had at the time. Before this pandemic, we in public health did not recommend masks for prevention of transmission of airborne diseases, and we asked the public to not buy up masks because our healthcare providers would need it. Before this pandemic, the highest rates of death from a respiratory disease had been from influenza, certainly in the 1918 pandemic but also in the pandemics since.
By March, the incident command structure had been stood up at the county where I worked as an epidemiologist. Because of my experience with infectious diseases — flu surveillance coordinator in Maryland, Zika epidemiologist in Puerto Rico, and a short consulting gig in Colombia — my boss asked if I wanted to lead a team within the health department. That team ended up being the Outbreak Branch. A group of environmental health specialists, public health nurses, epidemiologists and support staff would respond to outbreaks in institutional settings. As we saw what was happening in other places around the world, we started to get a little worried.
Late that March, a nursing home near our home reported a cluster of cases, and my wife and the county’s health officer ended up paying the nursing home a visit. In a matter of days, the first-in-the-state epidemic ended up being one of the biggest, with dozens infected and twenty-nine dead. Worse yet, my wife had to work in an emergency department as a physician assistant while low on personal protective equipment, without a vaccine, and with a veritable wave of cases coming our way. For the first time in a long time, we ended up praying a little prayer before she went to work.
By April, the nursing homes in our area were involved in the epidemic in some way. Some had many cases among residents. Others had a few cases in residents but many in staff. Deaths had started. On Easter Sunday, the health director where I worked called us all in on an emergency basis. She directed us to implement a plan whereby every long term care facility in our jurisdiction was to fully implement the recommendations we had given them in the previous weeks, and we had to make sure they did. Our days were about to get very, very long.
In May, as the weather got better, many people started to feel safe, but the wave was in full swing. We started noticing that the bulk of the cases were in the Latino men and women who lived in overcrowded housing and worked essential jobs and service jobs. The people who could not afford to stay home if they got sick were not staying home, and they were spreading the virus with everyone with whom they rode on public transportation, everyone they worked with, and then their families. The bulk of deaths was occurring in long term care, mirroring what was happening in the rest of the country and around the world.
That same month, I was into the second month of trying hard to lose some weight. After seeing what COVID-19 was doing to overweight and obese folks with respiratory problems, I decided that I was not going to be a statistic. So I started jogging, swimming (until the gym closed down) and riding my bicycle. By the end of the year, I had lost thirty pounds and felt as healthy as ever. All that exercise also helped with the long days. The added stamina and mental health benefits of strenuous exercise saved me from blowing a fuse, from burning out and taking others with me.
Unfortunately, our daughter had to be babysat at home by a young pre-med (now med) student who was looking for some extra cash. The toddler didn’t notice much of a difference, and the babysitter could study for her MCAT exams. Kids old and young are resilient like that. Nevertheless, my wife and I worried more and more that we were ships passing at night. Even as I tried to work from home as much as I could, I found myself in the office, coordinating the outbreak branch. From time to time, I was out in the field, investigating outbreaks at nursing homes, or visiting the testing sites.
As all of that was going on, I was still teaching epidemiology and biostatistics online. I was still trying to keep up with updates to the History of Vaccines project. The latter also meant that members of the media were reaching out to me for information. It seemed like everyone wanted to compare the COVID-19 pandemic to the 1918 Spanish Flu pandemic, and they wanted some reassurance that we would come out on the other side like we did in 1918: right into the “Roarin’ Twenties” where the economy soared… Until the Stock Market Crash of 1929, of course.
Back at work, the fact that I speak fluent Spanish also meant media appearances and presentations in Spanish in an attempt to reach the people who were driving the epidemic locally. It also meant participating in a project to understand knowledge, beliefs and attitudes toward vaccination by Latinos in the United States. And it meant appearing live on Facebook with local politicians to talk about how the situation was going.
Through all that, I promised myself, my wife and my daughter that I was going to stand up for truth, justice… All that stuff. I wasn’t going to sugarcoat things, and I certainly was not going to lie. There had been enough of that from the President on down in his administration, and there had been enough of that in other places in the United States and the world. I didn’t, and it went well. The people who come to me for advice know that I’m going to explain the science to them, and that I’m going to give them as much information as they need to make the best decision for themselves.
The summer marked a lull in activity locally, though there were still plenty of cases in institutional settings and in the community. Nevertheless, I could continue to work on my fitness, doing several long bike rides on the C&O Canal trail on the weekends, including a very fun one in the pouring rain. September brought with it some very bad news, however. The husband of my dear cousin — a man who I looked up to since I was a child — caught the coronavirus and developed a severe case of COVID-19. He passed away on Labor Day.
Just a few weeks before that happened, a co-worker at the hospital where I used to work as a lab tech also passed away. It’s funny how you assume that people are always going to be around until they’re not. While some died, I also disconnected from other people who were filling my social media with conspiracy theories about the pandemic. Because they were privileged enough to not be in the demographic groups that were being affected the most, they spread just about any rumor they heard, virtually spitting on the grave of people who had died from COVID-19, including my cousin.
By the fall, the cases started picking up again, and we were fearful that an influenza-COVID-19 double wave was coming our way. However, after looking at the data from Australia, we knew that the public health measures put in place were going to be somewhat effective against influenza. I got my influenza vaccine. My daughter and wife got theirs. In the end, over 190 million vaccines were distributed. Influenza has been a slow burn in all of this, saving the healthcare system from collapse.
Of course, I couldn’t do a year-in-review without mentioning the 2020 Election and all that came before and after it. My friends and I all agreed that all President Trump had to do to be reelected was to go into the background and let the scientists guide the pandemic response, but he didn’t. He just had to stay quiet and let the scientists do the talking, but he didn’t. At the same time, the Democratic candidate, and eventual winner of the election, Joe Biden, was conducting a campaign from home.
Everyone seemed worried about the turnout for the election. Some said it would be very low because of pandemic restrictions. Others said it would be very high, because of the stakes in the election. The answer was somewhere in the middle because the high turnout was driven by absentee voting and a fear from both sides that the opposite candidate would finish the job that the pandemic had started. By January 20, we had gone through that mess — including a violent insurrection at the Capitol — and COVID-19 was still with us.
The new year came with two highly efficacious vaccines. The hope that those vaccines brought was tempered only by the logistic nightmare of vaccinating millions as soon as possible, albeit with a limited supply of vaccine. I received my first dose right before Christmas. I received the second dose two weeks later, on the 300th day of emergency operations activated at the health department. To say that I felt relief after the second dose is an understatement. The side effects of chills, muscle aches and headache that the second dose gave me for about 36 hours were a small price to pay for immunity.
Now, here we are, a year into the pandemic. My wife is still working as a clinical consultant, working in almost daily vaccination clinics and at the emergency department. The toddler is growing physically and mentally each day. As parents, we have had quite a string of successes… We potty-trained her in a pandemic! I’m still somewhat busy at work, especially now that questions about the pandemic’s effects on social determinants of health and social diseases and conditions are being asked. I still do media interviews, with most of them now asking about how the vaccine roll-out compares to previous ones. (Reporters, podcasters and bloggers are still surprised when I tell them that the 1918 pandemic ended without a vaccine.)
What the next year will bring is hard to predict with much precision. The coronavirus variants are certainly worth worrying about, especially the one that emerged in Manaus, Brazil. Then again, more and more people are getting vaccinated each day, with estimates that all qualifying adults will be vaccinated by the end of the summer. One of the best ways to prevent variants is to be immune and have less disease. How the rest of the world will do depends on how soon and how effectively vaccines can reach them. We’ll have to see what happens when it happens…
But, if the past is prologue, we’ll get through this pandemic as a species. It will be up to us individually and collectively to learn the lessons of the pandemic.
René F. Najera, MPH, DrPH, is a doctor of public health, an epidemiologist, amateur photographer, running/cycling/swimming enthusiast, father, and “all-around great guy.” You can find him working as an epidemiologist a local health department in Virginia, grabbing tacos at your local taquería, or on the campus of the best school of public health in the world where he is an associate in the Epidemiology department. All the opinions in this blog post are those of Dr. Najera and do not necessarily represent those of his employers, friends, family, or acquaintances.