ANATOMY OF AN OUTBREAK – Part I: The Staff
By JOHN HOPKINS, DR.P.H.
(All rights reserved. Names and identifying information have been changed for privacy’s sake)
Bob’s Facebook page shows him and his family in Florida in mid March 2020. Older parents, his wife and college age sons…cheerful, engaged in Floridian tourist activities, an uneventful break from an unusually mild winter in New Hampshire.
I have a Masters and Doctorate in Public Health from U. Pittsburgh, one of the leading programs in the nation. The Salk Polio vaccine was developed there. The Sabin vaccine, an oral variety, appeared about simultaneously with Salk’s. In second grade, circa 1961, I think, in a Catholic School class of 60 led by Sister Mary Margaret , we ate a single sugar cube containing a liquid dose of the Sabin Vaccine. So far so good, I guess.
I studied a lot of epidemiology between 1978 and 1984 when I came to Portsmouth to do geriatrics. As I watched Covid-19 evolve in January and re-read the cross species transmission theories, I wondered, “if not here, then where; if not now, then when?” (partial attribution to Hillel, the Rabbi)
Bob worked three shifts at Bellamy Fields after vacation in later March, then showed up on his day off, complaining of not feeling well. The administrator stopped him in the lobby and brought a nurse out from the resident care area to take his temperature. It was 101 and we sent him to his doctor.
He tested positive and at that time it took several days to get test results. He remains out of work and our HR is paying him through a special Covid-19 program.
Given the vague incubation theories of viral transmission, did he get the virus in New Hampshire then take it to Florida, or in more likelihood, did he pick it up in Florida? Was it on a table top, a hand rail, a sneeze from a barista?
He and his family quarantined at home. No one else got the virus.
Althea gave Bob a high five and a quick hug when he came back to work after vacation. Their families have been friends for two generations.
She worked a few more shifts, then felt ill and tested positive. She quarantined at home, as did her family. No one else got the virus and she was cleared to return to work under the CDC guidelines.
Althea is a vibrant college student, social activist, engaging and popular by every measure imaginable. What makes you think she got it from Bob? She worked at Bellamy all through high school and now college.
College? you ask. What’s that gonna look like?
I want their blood. Not in a vampirish way. I want to know if they now have their own antibodies.
If so, the recovery of America takes one path; if not, then another. The driveway at Watson Fields, my second community, is named “Not Taken Road.” Tests on four residents at Watson who I consider high risk are negative as of 4/18.
Which will it be? The road to immunity is a popular fantasy, a happy ending, an American Dream, a two-part House episode. The road not taken is a Darwinian nightmare.
