Sunday Morning ~ Warnings
Tinkanena anatsira m’si izi. ~ The river “We told you” goes over into the river called “Now you see.”.
~ Chewa proverb
March 29, 2020
I just watched Bill Gates’s 2015 TED talk describing the danger of a novo virus and predicting the world’s current situation. It’s eerily accurate, almost as if he planned it. He wasn’t the only one. In 2015 we were beginning to prepare. I don’t know if his talk has anything to do with that. We were warned by smart people. People who care about humanity. Was it Nassim Taleb who said, “You don’t put on a seatbelt in the middle of a crash”? When asked what scared him most as president, President Obama said, “A pandemic.” He thought that was scarier than a world war. A pandemic could kill more people and we were less prepared. Starting the Global Health Security unit in 2015, responsible for pandemic preparedness, was a way to address the possibility (inevitability?). The unit was disbanded in 2018 by the current administration. What dystopia. I thought we were in crisis before this virus appeared on the stage; this is straight out of a medical nightmare.
In women’s health we deal with problems or deviations from normal on a regular basis. This includes communicable disease. For instance, we screen every pregnant woman for immunity to Rubella, a virus that can cause severe birth defects. There is a very effective vaccine for this virus, and if she is non immune, pregnant women get immunized right after delivery because that’s a time when we know she is NOT pregnant. It’s standard of care. There is no controversy about this. We know what the Rubella virus does to a fetus. We can prevent it. We know what to do. When there is a postpartum hemorrhage, we have steps we take to address the problem; it’s ingrained in our brains and we automatically flip into crisis mode and follow the learned responses. But now, for coronavirus, we don’t know what to do or how to keep women safest. This is so incredibly unnerving. I believe one day there will be a vaccine to prevent the disease caused by coronavirus but until then it is terrifying for a medical professional to not know what to do. The only thing we can say for sure is to stay home and keep your distance. Information is coming at us daily, hourly, but nothing consistent. There is no clarity and there won’t be for some time, so when people seek medical advice, they get vague answers and that is frustrating and frightening. We can recommend what we know won’t hurt. Stay home. Keep your distance. But what about women about to deliver a baby?
I’ve been meeting with midwives in the state once a week to share information, frustration, and support. Recommendations are inconsistent from institution to institution and none of us know which is best. There is a shocking lack of supplies and protective equipment. This is not reassuring. Is it safer for women to deliver at home or risk being exposed in the hospital? We don’t have those answers. Home birth is safe if we have a good back-up plan: good transportation to the hospital if needed, a low risk pregnancy, and reassurance that the midwife coming to help isn’t going to infect the family with a deadly disease, or vice versa. We just don’t know which is safer right now. Do no harm, weigh risks and benefits, consider all options. What if we are doing harm with all good intentions? That’s the scary thing.
Yesterday I caught my breath when I read the news that some states can’t receive the equipment they need without being extorted. Holy hell. Every time I think this can’t get worse.
My grandchildren have gone back home and though I miss them, it’s best for them to be together as a family. I’ve got plenty of home projects to work on, and I’m chipping away at those. I’m sewing face masks, as bizarre as the necessity for that cottage industry seems. I’m assessing where my skills will be best utilized. Go to NYC? Stay and wait for the shit to hit the fan here? Probably more sensible to stay as I’d be able to come home and be isolated. This useless feeling is wearing me down.
I feel better when my feet land on spongy earth covered with pine needles. I can feel the ground melting every day. I spend part of each day in the woods and come home feeling a little less anxious. Crocuses are popping up and I’m trying to focus on something positive every day. Laughing feels good and I appreciate the creativity shared by isolated bored funny people. I think about silver linings: This might finally jolt our health care system into something more just. Might even make for a more just economy when it eventually rebounds. Could make for significant environmental changes… if we heed the warnings.
Love to all,