Tagged Shutdowns (Institutional)

What My Father’s Covid Survival Taught Me About Security

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What My Father’s Covid Survival Taught Me About Security

He’s a security guard. I work in nuclear security. The pandemic swept away my sense that we can really protect the ones we love from anything.

Credit…Lucy Jones

  • Feb. 19, 2021, 5:00 a.m. ET

My father protects for a living, but he is invisible by design. For more than two decades, he watched the halls of a shopping plaza in Koreatown in Los Angeles as a security guard. Three stories of salmon-colored walls with a signature glass skylight, the plaza is a community landmark for Korean immigrants who weathered financial uncertainty, language barriers and other trials that come with forging new ground in a foreign place. In 1997, my father went there looking for a job. Our family had just arrived from the Philippines, and he needed to anchor our landing with steady income. An electrician with no history of security work, he was hired on the spot. Over time, he found meaning in keeping his new life, his family and his shopping plaza secure.

As a child, I enjoyed walks around the plaza to look at foreign goods that gave me a sense of home: copper bowls that can hold an ocean of stew, K-pop tunes on imported speakers, red bean pastries plump as clouds. Most of all, I loved watching my father during his patrols. It was a rare glimpse into his full expression of self, temporarily untethered from fatherhood. He chased shoplifters a few times a year. Once, he rescued a store owner who suffered a concussion after a faulty metal grate dropped on him while closing his stall. My father played peacemaker, moderating business rivalries he barely understood. But as he grew into his job, it made him small. He hardly made minimum wage. Shoppers walked past him, unaffected by his presence. As I grew older, it pained me to see him treated as a silhouette of himself, faceless.

Like him, I took on a profession preoccupied with security, but a vast gulf divided his work and mine. I researched one of the most violent forms of destruction invented by human hands: nuclear weapons. I armed myself with the power of speech and text — books, policy memos, and conferences to persuade governments to secure nuclear facilities and pursue arms control. I imagined my work helping prevent a hypothetical terrorist from building a dirty bomb or an erratic politician threatening nuclear war. Security became an intricate patchwork of policies and diplomatic agreements that, theoretically, would save everybody from nuclear annihilation. “Everybody” is vaguely defined, but it sounds impressive.

I sensed my father’s pride in my career, but we lacked the language to express the depth of our working lives. Through the years we stayed silent, convinced that if we spoke, we would talk past each other. It did not occur to me to connect what I do with my father’s work, or him to mine.

Then, the pandemic wiped away how to protect anyone from anything. The map of Covid cases in Koreatown bloomed like spilled ink on paper. The virus attacked households with family members working in the service industry, the lifeblood of the neighborhood. My father and his fellow guards, cleaners and shopkeepers tasked to keep essential services open in the plaza were given reduced hours as the city settled into quarantine. He counted himself lucky for receiving full-time pay even with a shortened shift. But in April 2020 — just a few days into this new schedule and four months shy of his 70th birthday — he was lying on his stomach with wires crisscrossed over his body that plugged into a ventilator.

In my head, I traced the different paths this illness would drag my family through, all leading to dead-ends that have played out in hospitals all over the world. I jumped to the worst-case scenario because this is what thinking about nuclear war trained me to do. But as much as I know about catastrophes, I was ill-prepared for this. With Covid, death didn’t barrel through like a radioactive fireball, but crept stealthily under the folds of daily life.

This virus threw social roles into disarray. Now, the new battlefront runs along the supply chain; its footsoldiers take the form of farmers in agricultural zones or grocery store owners unprepared to confront an ill-tempered customer who refuses to wear a mask. Workers like my father became celebrated heroes and called “essential,” while citizens grew wary of “intellectual elites” like me and governing bodies that could not protect them from a real, immediate threat. In this new world, my father and I swapped places. Yet this version of living does not feel any more just or secure.

Security can take the form of fortress, bunker, asylum — spaces that separate the vulnerable from harm’s way. Nuclear weapons offer a different kind of security by doubling down on the danger, a willingness to destroy and be destroyed, to prevent an enemy attack. The military calls this “mutually assured destruction,” or MAD for short. Under MAD, there is no shelter; everyone is vulnerable, protected only by an assumption that no one will dare launch their missiles first. As my father’s health declined, I thought about how MAD the world is now; behind all the well-meaning gestures to honor frontline workers like him, there is the willingness to endanger their lives to keep commerce flowing. A willingness to destroy and be destroyed for a sense of normalcy.

My father survived. He returned home with sagging shoulders and a withered face but functioning lungs, every heave of his breath an act of defiance. He now awaits his second vaccine dose and talks openly about resuming work once the virus is “controlled,” although no one knows what control looks like. The virus seems to recede in Koreatown, but it stalks the trail of inequity that encircles the city, finding more low-income communities to destroy. Time folds and begins again.

For now, my father patrols the family garden and tends a makeshift pumpkin patch, its yellow blossoms draping over the backyard fence. He cooks Filipino dishes, pulling recipes from childhood memories, relying on taste and intuition to get it right. He takes my mother for morning walks around the neighborhood block, on guard after seeing reports of strangers attacking Asian-American elders. He shares these vignettes during our daily video call, always careful to say that life goes on, and he is doing fine. But I can tell he is not the same. I sometimes catch grief on his face, an unfocused gaze to a place I cannot see. He is a foreigner in his new life at home.

I am also not the same. As I try to re-establish the rhythm of work in this new year under a new administration, I hold my father’s survival close to heart. To be in the business of protecting the world demands appreciation of every single life. The word “everybody” is empty unless it is filled with human value, like the work-hardened faces of Black and brown people who remind me of my father. Or the essential workers performing the gloss of normal routine to survive this perilous time.

But as more people regain confidence and dare cross the line of security to venture outdoors, I worry that the glory of essential work will fade until the people carrying the heaviest burdens become what they were before: invisible.

In a strange way, Covid brought my family closer together. For most of my life I did not spend time with my father, but now I see him everyday making funny faces at me through our video calls. He declares his daily oximeter readings as normal, although a dull tiredness still sits inside him. Then, we daydream about all the Korean foods our family have come to love because of the shopping plaza my father guarded for decades: glass noodles, fish cakes, yuja tea. My mother’s face appears on the screen as she leans against my father’s shoulder. They ask me how work is going, and try to talk about the latest nuclear-related headline they saw in the news.

As I listen, I also daydream about a different world, where the invisible survive everything. A world worthy of building and protecting.

Lovely Umayam is a writer, creative producer and nuclear nonproliferation expert based in Los Angeles.

Coronavirus Variant Is Indeed More Transmissible, New Study Suggests

Coronavirus Variant Is Indeed More Transmissible, New Study Suggests

Researchers warn that the British variant is so contagious that new control measures, including closing down schools and universities, may be necessary.

A gazebo outside a bar in the West End of London on Dec. 15. The city entered Tier 3 restrictions the next day.
A gazebo outside a bar in the West End of London on Dec. 15. The city entered Tier 3 restrictions the next day.Credit…Andrew Testa for The New York Times
  • Dec. 23, 2020, 10:22 p.m. ET

A team of British scientists released a worrying study on Wednesday of the new coronavirus variant sweeping the United Kingdom. They warned that the variant is so contagious that new control measures, including closing down schools and universities, might be necessary. Even that may not be enough, they noted, saying, “It may be necessary to greatly accelerate vaccine rollout.”

The study, released by the Center for Mathematical Modeling of Infectious Diseases at the London School of Hygiene and Tropical Medicine, has not yet undergone review by a scientific journal. The study compares a series of models as predictors of data on infections, hospitalizations and other variables; other researchers are studying the variant in laboratory experiments to determine if it is biologically distinct.

The study found no evidence that the variant was more deadly than others. But the researchers estimated that it was 56 percent more contagious. On Monday, the British government released an initial estimate of 70 percent.

Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health who was not involved in the study, said that it presented a compelling explanation of the past and potential future of the variant.

“The overall message of it is solid and consistent with what we’ve been seeing from other sources of information,” he said in an interview. “Does this matter? Yes. Is there evidence for increased transmission? Yes. Is that going to impact the next few months? Yes. Those are all, I think, pretty solid.”

A New Variant

A series of tiny mutations found in many British samples of the coronavirus may help the virus spread more easily. The coronavirus variant is known as B.1.1.7.

Spikes used to latch onto and enter human cells

Spike

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ORF1a

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ORF1b

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E

M

N

Change in

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MUTATIONS

that led to the

B.1.1.7 variant

X

(deletion)

X

Change in

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CORONAVIRUS

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M protein

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By Jonathan Corum | Source: Andrew Rambaut et al., Covid-19 Genomics Consortium U.K.

The variant, which came to the attention of British researchers earlier this month, has been rapidly spreading in London and eastern England. It carries a set of 23 mutations, some of which may make it more contagious.

The authors of the study found more evidence that the variant does indeed spread more rapidly than others. For example, they ruled out the possibility that it was becoming more common because outbreaks had started in places where people were more likely to come into contact with each other. Data recorded by Google, indicating the movements of individual cellphone users over time, showed no such difference.

The researchers built different mathematical models and tested each one as an explanation for the variant’s spread. They analyzed which model of the spread best predicted the number of new cases that actually were confirmed, as well as hospitalization and deaths.

The team then projected what the new variant would do over the next six months and built models that factored in different levels of restrictions. Without a more substantial vaccine rollout, they warned, “cases, hospitalizations, I.C.U. admissions and deaths in 2021 may exceed those in 2020.”

Closing schools until February could buy Britain some time, the researchers found, but lifting those extra restrictions would then cause a major rebound of cases.

Because of the higher transmission rate, the country will need a much higher percentage of the population to get vaccinated to reach herd immunity. To reduce the peak burden on I.C.U.s, the researchers found, vaccination would need to jump to two million people per week from the current pace of 200,000.

“You need to be able to get whatever barriers to transmission you can out there as soon as possible,” Dr. Hanage said.

The researchers warned that their model was based, like any model, on a set of assumptions, some of which may turn out to be wrong. For instance, the rate at which infected people die from Covid-19 may continue to drop as doctors improve at caring for hospitalized patients. Uncertainties remain as to whether the new variant is more contagious in children, and if so, by how much.

Still, they wrote, “there is an urgent need to consider what new approaches may be required to sufficiently reduce the ongoing transmission of SARS-CoV-2.”

Alessandro Vespignani, director of the Network Science Institute at Northeastern University in Boston, who was not involved in the study, said of the new estimates, “Unfortunately, this is another twist in the plot.”

“While we were all rejoicing for the vaccine,” he added, “here is the possibility of a change of epidemiological context that makes our next few months much more complex and more perilous to navigate. Evidence is accumulating that the variant is more transmissible, and this implies that it will likely require an even greater effort to keep spreading under control.”

Dr. Hanage cautioned that the model had some shortcomings. The researchers assumed that all people younger than 20 had a 50 percent chance of spreading the disease. Although that might be true for younger children, Dr. Hanage said, it is not for teenagers. “That’s the weakest part of their model,” he said.

Nonetheless, he said, the study provided an important glimpse into the country’s possible futures. “It’s not a forecast, it’s not a prediction, it’s not saying this will happen,” he said. “It is saying that if you don’t take it seriously, this is the kind of thing that could very easily happen.”

Benjamin Mueller contributed reporting.

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Despite Pandemic Shutdowns, Cancer Doesn’t Take a Break

While a raging pandemic continues to force shutdowns and slowdowns throughout the country, another major risk to human health is not taking a sabbatical: cancer.

In the early months of the pandemic, millions of people heeded warnings and fears about contracting the coronavirus and avoided, or couldn’t even get, in-person medical visits and cancer screenings, allowing newly developed cancers to escape detection and perhaps progress unimpeded.

During this time, there was a steep decline in screenings for cancer, as well as a reluctance of patients with cancer to participate in clinical trials for cancer treatments. Many mammography centers, dermatology offices and other venues for cancer screenings remained closed for months, and routine colonoscopies, which should be done in hospitals or surgical centers, were actively discouraged to minimize strain on medical personnel and equipment and reduce the risk of contagion.

Still, Dr. Norman E. Sharpless, director of the National Cancer Institute, warned in June that missed routine screenings could lead to 10,000 or more excess deaths from breast and colorectal cancers within the next decade.

Cancers cannot be treated unless they’re detected, and a review of 34 studies published in October in the BMJ reported that for every four-week delay in cancer detection and treatment, the risk of death from cancer rises nearly 10 percent, on average. The study found increased mortality following delays in treatment for 13 of 17 cancer types. Following a four-week delay in surgery for breast cancer, the death rate increased by 8 percent; for colorectal cancer, it rose 6 percent.

The hazard of delayed screenings is greatest for people with known risk factors for cancer: a family or personal history of the disease, a previous abnormal Pap smear, prior findings of polyps in the colon or rectum, or, in the case of breast and certain other cancers, having genetic mutations that seriously increase cancer risk.

Most screening facilities have since put safety procedures in place that greatly reduce the chance of contracting the coronavirus, both for staff and patients. Although I had postponed my annual mammogram for four months, when I did go in September I was impressed with how well the facility was run — no one else in the waiting room, everyone masked and hand sanitizer everywhere.

Dr. Barry P. Sleckman, director of the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, said in an interview, “When it comes to screening for cancer, people should balance the possibility of contracting the virus with their potential cancer risk. People should do everything possible to keep up with cancer screenings.”

However, Dr. Sleckman added, “If a woman is young and has no family history of breast cancer, she can probably wait six months for her next screening mammogram.” He also suggested discussing the matter with one’s personal physician, who probably also knows the safest facilities for screening.

If someone is found to have cancer, he emphasized, “There’s no reason to delay treatment. If a woman has cancer in a breast, it needs to be removed, and she should go to a hospital where she can be treated safely.”

Dr. David E. Cohn, chief medical officer at The Ohio State University Comprehensive Cancer Center, said that in the early months of the pandemic “we experienced a significant decline in new patients. Even some patients with symptoms were afraid to come in or couldn’t even see their doctors because the offices were closed. This could result in a delayed diagnosis, more complex care and potentially a worse outcome.”

But he said his center has since returned to baseline, suggesting that, despite the fall’s surge in Covid-19 cases, few cancer patients now remain undiagnosed and untreated.

“We made creative adaptations to Covid” to maximize patient safety, Dr. Cohn said in an interview. “For certain cancers, instead of doing surgery upfront, we treated patients with radiation and chemotherapy first, then did surgery later” when there was less stress on hospital facilities and personnel and patients could be better protected against the virus.

Dr. Cohn said that certain kinds of supportive care can be delivered remotely to cancer patients and their families — even genetic counseling, if a DNA sample is sent in. However, he added, “the majority of cancer treatment has to be administered in person, and surveillance of cancer patients is best done in face-to-face visits.”

Now with the virus surging around the country, many medical centers may be forced to again limit elective procedures, those not deemed urgent. But, Dr. Sleckman said, “Cancer treatment is not elective — it’s urgent and should not be delayed.”

Learning that one has cancer, even when it is early and potentially highly curable, is likely to strain a person’s ability to cope with adversity, all the more so when the diagnosis occurs in the midst of an already highly stressful and frightening pandemic.

Kristen Carpenter, a psychologist at the Ohio cancer center, said the constraints of the pandemic are “using up a lot of people’s reserve for dealing with adversity.” Adding a cancer diagnosis on top of that may initially cause people to fear they can’t deal with it, she said in an interview.

But it is nearly always possible to make more room in a person’s “bucket of reserve,” she said, for example, by identifying things that bring joy or a sense of accomplishment. Even though the pandemic may preclude great joys, Dr. Carpenter said, “people can create a constellation of smaller joys, for example, by reading a book, taking a walk or even a long shower. A little goes a long way to relieve the stresses of the day and build up the reserve needed to help you deal with the cancer.”

Noting that many people have found new ways to interact with others during the pandemic, “this is all the more important to do in the face of cancer,” Dr. Carpenter said. “Remember, you’re not just your cancer. You’re a whole person experiencing something. Take time to identify your needs and tell people what they are — don’t wait for them to ask.”

This advice is especially critical to cancer patients whose disease or treatment has compromised their immunity, leaving them especially vulnerable to infection by the coronavirus. A friend with chronic lymphoma who must avoid in-person contact with her five young grandchildren visits them through a glass door and observes their delight in retrieving the little treats she leaves for them on her porch.

Think, too, of how you’ve faced difficulties in the past, “how you’ve adapted to things you previously believed to be unimaginably difficult,” Dr. Carpenter suggested. Resiliency in the face of cancer during Covid need not have a limit, she said.