It’s one of my earliest memories, although I’m not sure why. I have no idea how old I was or what it was about the dime-size scar on my mom’s upper left arm that captured my gaze. My fingers traced and retraced the indentation in her otherwise unblemished skin. I remember asking her what it was. She explained to me, in the way parents do when they’re trying to tell the truth without scaring their children, that when she was a little girl there was an illness that everyone had to get a shot for so they didn’t get sick. A look of dread must’ve registered in my eyes, because she said, “Don’t worry. You won’t have to get one. That sickness is gone now.”
The smallpox virus was indeed eradicated worldwide in 1980, about a year after I was born. My parents didn’t have to tote me down to a National Guard armory to receive that vaccine—as my mom’s parents did for her sometime in the late 1950s or early 1960s—to protect me from that disfiguring and often deadly infection. Polio, too, was death-rattling in this country as I came into the world. However, my pediatrician still stuck a needle in my leg, an additional fail-safe nail in that disease’s proverbial coffin.
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Although I can’t fault her for being imprecise with a toddler, my mom probably should’ve said I wouldn’t have to get that vaccine in particular. Because the truth was that I was inoculated against lots of nasty diseases as a child, including diphtheria, tetanus, measles, mumps, and rubella. Like most American Gen Xers, I had little concept of the savage nature of viruses, save for a short-lived scuffle with a Jackson Pollock–like smattering of chickenpox. That is, of course, until AIDS began killing tens of thousands of Americans in the late ’80s and permeated the national consciousness well into the late ’90s. Even then, I, like many others, experienced the virus that causes AIDS in a sanitized, through-the-evening-newscast manner. I never feared it because I was not high risk and the virus was not easily transmittable. And because antiretroviral medications have made HIV a manageable chronic condition over the past 25 years, most Americans probably worry more about getting diabetes than they do HIV.
That sense of security is one of the blessings and curses of modern medicine in an industrialized nation. With the exception of the seasonal flu, the United States doesn’t often experience widespread outbreaks of fatal infectious diseases, viruses or otherwise. Americans—because of readily available antibiotics, semi-compulsory vaccination policies, and fortunate geography (tropical regions, with their rich biodiversity, offer ample opportunity for pathogens to leap from wild animals to humans, to devastating effect)—have mostly been able to think of hemorrhagic fevers, severe diarrheal illnesses, and acute respiratory syndromes as things that happen over there.
At least, that was the case until a novel coronavirus arrived stateside sometime in late 2019 or early 2020.
In 1999, I was a 20-year-old college kid lucky enough to be on a multicountry study abroad program. Cramped in the far back row of a passenger van with roughly 10 other students, I was reading Richard Preston’s The Hot Zone. As a budding writer, I’d heard that the basis of the 1994 nonfiction thriller about the emergence of the Ebola virus had been an article in the New Yorker—but I hadn’t so much as read the dust jacket until I was on a plane between Mombasa and Nairobi in Kenya. As the van bumped along what counted as a freeway leading out of Kenya’s capital city, I battled car sickness to continue paging through what was the scariest book I’d ever read.
One passage, especially, gave me pause: Preston explained that HIV had most likely emerged from Central Africa, spurred by human intrusion into the rainforests and spread unremittingly along a newly built east-west highway between Mombasa, Kenya, and Kinshasa, Zaire (now Congo). “Excuse me,” I called out to the driver of our van. “Can you tell me what road we’re on right now?” In a beautiful British English accent, our native Kenyan driver responded that we were on the Mombasa-Lagos Highway, or Trans-African Highway 8. Preston had a different term for the same exact ribbon of pavement: the Kinshasa Highway, a metaphor of sorts for the proliferation of AIDS in Africa.
Reading The Hot Zone while traveling along the Mombasa-Lagos Highway, I remember thinking, was akin to getting on a Mississippi River boat cruise and opening The Adventures of Huckleberry Finn for the first time. Horrors leap off the pages of both books. And, it turns out, viruses are not unlike racism: insidious, debilitating, and everywhere. In fact, as I kept reading I learned that roughly 150 miles from where I would stay that night, in a rustic cabin resort near Lake Nakuru, was a breeding ground for an entirely different contagion. Although no one knows from what natural source Marburg virus originates, several transmissions of the highly fatal hemorrhagic fever have been traced back to Mount Elgon National Park. I had not planned to explore Mt. Elgon’s caves, which anecdotal evidence suggests could be harboring the virus, but my 100 days abroad would allow me further encounters with other microbe-caused maladies I’ve never seen in any of the five U.S. cities in which I’ve lived, Denver included.
Before I’d left on my travels, I’d had no fewer than seven needles shoved into my shoulder muscles, protection against illnesses like yellow fever, hepatitis A and B, polio, and tetanus. I’d also had to down pills to combat typhoid (a bacteria) and malaria (a parasite). But the necessity for prophylactic medications and vaccinations, administered in a sterile travel clinic by a nurse, felt theoretical at best. I imagine it’s that abstractness, in part, that allows some Americans—and far too many Coloradans—to forgo immunizations. A trip through the developing world made the need very concrete for me.
In Havana, Cuba, raw sewage burbled up through the floorboards of an artist’s studio we visited—a not uncommon occurrence, he said, embarrassed—making me grateful for the sting from the hepatitis A shots I got. In Bahia, Brazil, we slathered Deet on our skin to dodge mosquito-borne dengue, a hemorrhagic fever (with a limited-availability vaccine) that rose by 672 percent between 2018 and 2019, 20 years after I visited. In Varanasi, India, where polio has only recently been eradicated, I saw what the virus does to the human body: its attack on the central nervous system weakening the spinal cord and causing paralysis and horrific muscular contractures that disfigure the limbs. When I bent down to talk to a young man on the street—his legs contorted, he’d learned to walk with his hands—I understood one thing very clearly, even as a 20-year-old. This human being was just like me: flesh, blood, needs, desires, feelings. The difference was one of geography. He’d been born in a developing country where political corruption, an archaic caste system, and poverty were (and are) pervasive—and where health care lagged desperately behind. By chance, I had been born in the United States, where there was certainly graft and inequality and destitution and haphazard access to health care, but where there was also, at the very least, comparatively ready access to a potentially lifesaving polio vaccine.
As I trekked through other countries, including Vietnam, Malaysia, and China, I didn’t see infectious disease firsthand—but I did wander the so-called wet markets endemic to Asia. There, a menagerie of both live and dead animals, some of which could be designated “wild,” are on display and for sale for human consumption—or as pets. But wet markets are also simply markets where people visit the butcher or the produce stand or the fishmonger. For many Asians, wet markets are not so different from, say, Costco. To a tourist, wet markets are a circus of sights, smells, sounds, tastes, and textures. For an epidemiologist, though, they are petri dishes of possible pathogens ripe for transmission from animals to humans. Several viral infections with pandemic potential have been traced to wet markets in China over the past two decades.
It was only natural, then, that virologists and epidemiologists became highly suspicious of the microbes that may have been looking for new hosts at Wuhan’s Huanan Seafood Wholesale Market located in Hubei Province, where SARS-CoV-2 is thought to have first infected humans. Although researchers have yet to make a definitive connection between the novel coronavirus and the seafood market, some experts say it could be ground zero for the illness that, as of May 13, had infected 4,170,424 and killed 287,399 globally, including more than 20,000 cases and 1,009 deaths in Colorado.
From my fourth-floor apartment in Platt Park, I can see the busy intersection at East Mississippi Avenue and South Broadway. Typically, I can also hear it. But as Denver’s stay-at-home order went into effect in late March—followed by a similar statewide directive—the sounds of angry horns and squeaky breaks and poorly muffled engines have gone mostly silent. The preponderance of ambulance sirens, however, has increased noticeably, I think. The dog that lives in the apartment above me howls his agreement each time an ambulance or fire engine screams past our building.
Sitting in this 730-square-foot apartment—the walls closing in tighter the longer I am alone in quarantine—I ruminate on all the ways in which I have encountered the remnants of disease or the possibility of disease, without actually being in true peril of contracting disease. Until now, here, in the United States.
As I write this, the tragedies continue to mount. Thirty thousand dead in Italy. Cases are rising again in China. More than 21,000 have succumbed in New York. Here in Colorado, we passed 1,000 deaths as we went to press. But there is another calamity—a much less noticeable yet maybe equally profound one—that Americans may have to acknowledge before this virus will abate. Our collective lack of compassion and empathy has not only been laid bare by the pandemic, but it has also likely fueled it.
As this virus felled thousands in China, we failed to see our grandfathers in their grandfathers’ faces. As health care professionals in Northern Italy became infected at catastrophic rates, we refused to envision that fate for our own doctors and nurses and medical professionals. As physicians the world over began noticing that those who were immunosuppressed were more susceptible to the disease, some Americans suggested that they could be sacrificial offerings. As New York City morphed from one of the world’s great cities to the epicenter of the disease, we shrugged our shoulders when some, including the president, suggested the area should simply be sealed off. When bodies began to pile up in vacant hospital rooms in Detroit, we didn’t shudder at the thought or wonder if those people’s loved ones knew where they were.
Much of this uniquely American response wasn’t surprising, considering our historical tendency to give a half-hearted, that’s-so-sad headshake and then wave things off as problems that happen over there. HIV and Ebola have been Africa’s dilemmas. When bird flu hit, we ignored it as Asia’s plague du jour. Polio was India’s trouble to fix. It wasn’t, therefore, much of a shock when our apathy toward each other here at home unmasked itself as the novel coronavirus disregarded our borders and seeped into our cells. For spring breakers and some churchgoers, stemming the spread of a deadly virus on American soil was not priority number one. For right-wingers in Denver who were protesting the state’s stay-at-home order, shouting manically at stoic, scrubs-bedecked people who were counter-protesting was somehow not out of line. For politicos—on both sides of the aisle—COVID-19 was a weaponizable disaster in an already contentious election year. For opportunists, the fear and the chaos made it easy to engage in price gouging for hand sanitizer or conveniently declare abortions nonessential surgeries.
What all of this has revealed is that the viruses among us—the new coronavirus and Ebola and Marburg and SARS and MERS and all the scary bugs we don’t know about yet—aren’t the real problem. We are. If we’d been paying attention at all to how we’ve become desensitized to the plights of others—be they fellow Coloradans or fellow Americans or simply fellow human beings—we would’ve recognized that the danger really comes from us.
Still, it would be unfair and, more important, inaccurate to say that Americans have entirely lost their ability to show grace. Just here in Colorado, I know doctors and nurses who volunteered to man drive-thru testing lines—because they care. I know journalists who worked overtime to bring critical information to Coloradans—because they care. I’ve talked with people who have given blood and sewn masks—because they care. I know there are researchers in Fort Collins working on a vaccine, doctors in Denver formulating new treatments, and local businesses building rapid test kits. I have heard the 8 p.m. howling and seen grocery store employees go out of their ways to be kind to shoppers and watched one of my neighbors give her postal worker a plate of cookies and smiled at the handiwork of children who have scrawled “Wash Your Hands” in chalk on the sidewalks in my neighborhood. People do all of these things because they care.
But these are individual acts, and as heroic and important as they are, we have to agree, collectively, that there is no longer such a place as over there. Any perceived notion of America’s superior ability to respond to a crisis-level outbreak within its borders disappeared as quickly as our stockpiles of N95 masks, which means we are all here now together in this surreal reality—and although there must be social distance between us physically, we can no longer be emotionally distant. American individualism isn’t mutually exclusive with empathy and sympathy. We just have to remind ourselves what compassion really looks like.
For me, compassion looks like a faded mental photograph of the expression on my mom’s face when she realized I was afraid. More than 35 years later, I can still see what I now know was protective instinct, that maternal desire to soothe, assure, and shield me from any possible hurt, no matter how small. It’s unrealistic to expect people to feel for strangers the way a parent cares for a child; however, kindness for others can be taught. In four or five or six years, I hope parents have to talk with their preschoolers about why they need to get an immunization for something called COVID-19. I know they’ll have to explain that a few years earlier, so many people got sick—and they’ll probably leave out the fact that so many people died. Because that’s what parents do. But I also hope they explain that getting the vaccine is itself an act of compassion; that not only could it save their lives, but also potentially many other lives. And I can only hope that one day, not too long from now, maybe another mom can tell her little girl that she doesn’t ever have to get that shot because that sickness has gone away for good.