“…but we did everything right.”

2 September 2020

Here is a tale of three infections. This is local fiction; is it global fact?

She had been especially careful, always wearing a mask and keeping her distance as advised. She trained her children to do the same. (Why, then, was the government that insisted on this now sending children back to school without these protections?)

Then it happened, but not through the children. On a Sunday, she relaxed in her back yard, with no-one around, except a neighbor at a safe distance. The aroma drifted in from his barbecue, but there was no recognized harm in that.  He knew he was infected, but he, too, did everything right. Almost a week into his quarantine, why not a little barbequing in his own back yard?

When he coughed, the droplets fell nearby, as he knew they would. What he didn’t know was that they were accompanied by aerosols, tiny particles of the virus that didn’t fall: they could travel farther in the air. (But why should he have known that, when it took scientists at the World Health Organization several months to acknowledge it.) Across the lawn that day, she became infected, initially without symptoms (a state in which the infection could be passed on; that, again, took the WHO several months to acknowledge).

The next day she went to work downtown. She and others had long complained about the air in the ventilating system of their building, but as in so many such buildings, including schools, this was never corrected. So while going about her normal business, mask off when alone, she was breathing aerosols into that air. Days later, several people in the building “mysteriously” became infected.

But that’s not the way another guy got infected. At lunchtime, she walked to the bank, quickly, because the smog was particularly foul. She took side streets to avoid people, so as not to bother putting on her mask until she got to the bank. But she did continue to breathe, after all, sending aerosols into the polluted air.

Why should the pollution have mattered? In March, a report by a team of Italian scientists had put some potentially important handwriting on the wall: the viruses can attach to aerosols and particles of pollution in the air, possibly enabling them to travel greater distances. This finding was sporadically reported and widely ignored, despite mounting evidence since March that pollution, frequently in the form of smoke, was present at a number of prominent outbreaks (for example, in and around hog plants that smoked ham and in the American Embassy in Riyadh after a barbeque party). Pollution! Smoke! To minds fixated on opening up economies, this must have sounded like Trump’s bleach.

He was taking a walk elsewhere downtown, blanketed by the same smog. Again, being alone, he saw no need to wear a mask. These were, after all, designed to protect others, not himself. Besides, what risk was he taking in a deserted park?

Little did he realize that the risk was in the pollution, for several reasons. First, some of the aerosols that she breathed into the side streets were on their way to the park, hitched to particles of pollution in the air. Second, on a clear day, these aerosols would have been rendered inactive by the ultraviolet rays of the sun. But not on this day: the smog was blocking the sun. Third, while it might have taken a greater density of aerosols to infect most people, his immune system had been compromised by having grown up in the polluted air of the city.

Thus, it was not long before he came down with COVID-19, again without ever knowing why. And once that virus got into his lungs, also weakened by years in that air, he was unable to fight it off. Soon he was fighting for his life in the ICU of the local hospital.

Need he have ended up there if the local and global authorities had seen past their distancing, into the polluted air?
I post this, not to worry you more about the coronavirus, but to worry you about those authorities—in medicine, administration, even op ed pages—who have blocked unorthodox explanations for this pandemic, much as smog blocks the rays of the sun. A way forward, with the full story evidenced and referenced, can be accessed on Pollution and Pandemic. While dealing with the pandemic, we face an unprecedented window of opportunity to deal with climate change.

© Henry Mintzberg 2020, posted on the fifth anniversary of this blog. No rights reserved, under a Creative Commons Attribution-NonCommercial 4.0 International License. Feel free to forward, circulate, quote and post this blog and the associated link. For more questioning of the correctness, please see Managing the Myths of Health Care and other books listed on the mintzberg.org home page.

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