When I flew to China at the beginning of January to teach a three-week college class, the Wuhan coronavirus was barely on anyone’s radar. By the time I got back to New York last Friday, it was front page news around the world, with more than 800 cases in China and 26 deaths; by Monday, the total was at least 80 deaths.
My students and I had all arrived a few days after China had reported the first cases of pneumonia in Wuhan to the World Health Organization, and shut down the seafood market that was thought to have been the origin of the epidemic.
I was teaching students from a wide variety of countries, who were in China for their first time. When they first brought up the question of the virus in Wuhan, I have to admit that my reaction was basically to reassure them, in line with all the official reassurances, and then to ask how many of them had gotten their annual flu shots. Wuhan was more than 500 miles away, and none of them would be going there.
The virus had been identified as a new coronavirus on the first day of our class. By the end of the first week, the first death was reported, followed by the first overseas case. So sometime in the second week, the students, who had presumably been hearing from their anxious faraway parents, started to ask whether there was anything here to worry about. I gave stock answers: the situation is being monitored, no one here has been anywhere near Wuhan — but then again, I acknowledged, you have to take it seriously; you never know what a virus is going to do.
[Read the Centers for Disease Control and Prevention’s update on the coronavirus.]
As a pediatrician who has done a fair amount of traveling and worked in clinics in the United States through a variety of outbreaks (H1N1, SARS, Ebola, measles), I made the usual suggestions, which people find so unsatisfying when they’re scared: Stay as healthy as you can, get lots of sleep, drink lots of water. Wash your hands, wash your hands, wash your hands. That will help keep you safe from all kinds of infections, I said, remembering that students often come down with the standard winter colds and other viral infections during the intense three weeks of the January term.
And yes, I asked them how many had gotten the annual flu shots that I knew all student health services are anxious to give — and sure enough, many of them had not. So I allowed myself to give a pompous little lecture about all the thousands of people dying of influenza — and the thousands more who will die before the flu season is over. Why didn’t that scare them, I wanted to know — at least enough to get their flu shots? Why were some cases of pneumonia in Wuhan — and some deaths, but fewer than 10 at that point — so much more terrifying?
If I had held up a syringe full of some unknown mixture and announced that it was an untested compound that might protect against the Wuhan virus, would people have knocked one another over in the race to get injected?
Well, things moved fast, and they only got scarier. The students got updates from the university, and more worried messages from their parents, and the news out of Wuhan got worse. I had seen Wuhan as far away, but the parents, much farther away, saw it as very close — and in some ways, they were right. And cases were beginning to be reported from other countries in Asia.
Halfway through the three-week course, I checked and confirmed that no human-to-human transmission had been reported at that point, and explained to the students why that was reassuring — but also, given the history of viruses that have jumped from animals to humans, like SARS, why it needed to be monitored, and might change. And sure enough, at the beginning of the third and last week of classes, human-to-human transmission was confirmed.
The students who did get sick with the usual January respiratory illnesses were frightened. They got checked out, they got treated, and they had to sit through another lecture from me about getting that flu shot — not because it would protect them against this new infection, but because anyone who came down with influenza would now be terrified it might be the new coronavirus. And because influenza is also a serious illness, and there will continue to be a lot of it around.
The day before the course ended, as everyone was packing up to leave, the city of Wuhan was closed to air travel and other forms of transport, essentially locked down. What had seemed kind of unimaginable a week before suddenly seemed very close. Was it possible the travel ban would extend to all of China? And was the Wuhan quarantine an extreme measure, or was it too little too late?
The story was changing every day — new information, new anxieties. Chinese New Year celebrations were being scaled down or canceled in many parts of China. New cases were being reported from France, Canada, Australia, the United States. Scientific inquiry was proceeding fast, seemingly with good cooperation.
We were all told to be sure to get to the airport four hours early, since there would be extra screening measures. In fact, since we were traveling on the eve of the lunar New Year, the airport was pretty empty when we got there, as were the roads on the way — the vacation had begun, no one was working, and most people had already done their traveling and were in place for the holiday. There was a sign at the airport informing us that we were walking through a temperature scanner, but the lines moved quickly.
Everyone was wearing masks, from basic surgical masks, which were being handed out in hotels and offices, to much more elaborate closefitting masks with respirators in them. There are reports that the masks don’t help, but it’s probably fair to say that they decrease, but don’t eliminate, the chance of infection. And there was a very definite getting-out-of-Dodge feeling as we boarded the airplane (never mind that airplanes — with their recycled air — are actually very effective settings for the spread of respiratory infections) and took off. Some people took their masks off, others kept them on for the whole 14 hours. No one was coughing on the flight.
When I left Shanghai on Friday, no deaths from the virus had been reported there. By Sunday, the city’s first death had been reported. On the way to the airport, I read the notice from the hospital in New York where I see pediatric patients, giving us the city guidelines for screening patients, checking travel histories, isolating people with fever and lower respiratory symptoms, along with a history of travel from Wuhan, or contact with a person who may have the virus.
There was something ironic, of course, about the idea of coming back from China to what might be a higher exposure risk (lots of sick people in a hospital). Everyone who works in a health care setting has seen some version of this over and over (we still have the signs up about screening for Ebola). New viruses do appear, and you never know what a virus is going to do, but you have to take the information you have and do your best. (And at least, at the clinic, everyone gets a flu shot.)
So there was also something very comforting in the matter-of-fact directions. And oddly, maybe especially in the very matter-of-fact statement, “Please note, all guidance is subject to change as additional information becomes available.”