Easter Sunday, 12/04/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic. “The sedge has wither’d from the lake, and no birds sing.”
Letters from Australia. No.5 by Prof. Roger KA ALLEN (www.sarcoidosis.com.au)
As I revel in the sunshine and cloudless blue sky of a Brisbane Easter Sunday morning, I am reminded of the saying by the Greek Stoic philosopher, Epictetus (50 AD-135 AD),
“It isn’t events themselves that disturb people, but only their judgements about them.”
I am fortunate to have a lovely garden with a frog-pond, chooks (Australian for hens), a dozen different green herbs, self-sewn cherry tomatoes, a fig tree now, unseasonally, bearing figs, two olive trees, many citrus, lavender, borage and Australian native trees like grevilleas, beloved of bees, parrots, bee-eaters and wattle birds. From by garden, it would appear, to quote the poem, Pippa Passes by Robert Browning, that,
“Gods in his heaven, all’s right with the world.”
So today, Christians around the world celebrate the incarnation of God, the Redemption of Mankind and the advent of a new spiritual dimension for our species. But is God with us and what is He doing about this? Over the ages, when plagues occurred, the gods or God were usually implicated somehow either as divine punishment on man, a call to repentance or a need for salvation. Just read about the Plague of Justinian (541-542 AD). However, I see our present predicament, not so much as religious spiritual dimension, but a more fundamental one which I shall explore in a later essay.
When the poet, John Keats wrote in 1819 this poignant love ballad, “La Belle Dame sans Merci” (the beautiful lady without mercy), he was in love with his girlfriend, Fanny while also knowing he had tuberculosis which had killed both his younger brother and mother. Two years later he would be dead. In a way, current life in this pandemic presents a similar dichotomy.
The poem describes the desolation of his situation with the looming presence of death mixed with fantasy and love. And thus I feel that now, realising that Brisbane is not New York where two of my sons with partners live, nor Tokyo where my eldest son, a pilot, works and lives part of the time. We are in contact nearly every day. No one is safe.
“And no birds sing”; Gone are visits of friends, the carefree morning coffee with “smashed” avocado and smoked salmon or an eggs benedict, or sailing with a mate on the bay, the annual cacophony of the piano-tuner, the man who washes our high windows beyond my reach, a restaurant meal with wine and friends, shopping without feeling like you are risking your life, a trip to the beach with no police, a drive with friends, a walk in the park or a visit to my 95 year old mother in a nursing home.
“The sedge has wither’d from the lake.” When will the metaphoric birds sing again and the sedges sprout forth to resound with croaking frogs and busy reed-warblers?
It is also somewhat ironic that the tuberculosis which killed Keats, Chopin and most of the Brontë family, as well as ravishing our species since long before the pyramids were built, has been re-visited as a possible remedy for Corona virus in Australia and overseas. As a child I was given BGC inoculation as TB was more prevalent then and thus there is evidence that this immunity may confer some benefit in this pandemic. Indeed when my mother was a nurse there was a whole ward at the Brisbane General Hospital devoted to medical and nursing staff with tuberculosis.
In 1900 at the Pasteur Institute in Lille, France, two French bacteriologists, Albert Calmette and Camille Guérin developed an attenuated TB bacillus which acted as a primer for the immune system to fight Mycobacterium tuberculosis and bovis and has been used for some years to treat some forms of cancer including bladder cancer. Indeed when I did my PhD thesis, I used BCG and Schistosoma to form granulomas in mice as part of my research into sarcoidosis but more about that later. The B in BCG stands for “bacille” in French, meaning a bacillus (the type of bacteria which causes TB) (i.e., le Bacille Calmette-Guerin).
Despite our initial tardiness and bungling cruise-ship fiascos and inadequate border protection, so far, Australia, has done quite well in this pandemic with a total of 56 deaths and 6,292 cases for a population of 25 million people (437,847 tested with 1.8% positive), comparing favourably to wealthy Norway with one fifth our population having 119 deaths and 6,409 cases while progressive, laissez-faire Sweden with 10 million people have had 10,151 cases and 887 deaths. Queensland which has roughly the population of New Zealand has had 974 cases with 5 deaths (NZ has had 4 deaths and 1,035 cases despite being on Stage 4 lockdown).
The issue we are all aware of is when and how to ease restrictions. This pandemic has been like my all-familiar cauldron of boiling water containing pasta. The USA and UK let it bubble up too quickly without turning down the heat let alone putting a lid on it, throwing in some salt and oil to lower the boiling point and then watching it carefully. New York with 8 million people or one third that of Australia is paying dearly with 6,367 deaths and 98,308 cases; staggering compared to our statistics. The USA with all its weapons of mass destruction, aircraft carriers and opulence has insufficient paper masks and paper “suits of armour” for its health workers while this tiny, invisible virus has incapacitated their biggest aircraft carrier.
Our Chief Health Officer announced today that there was no guarantee that the vaccine would be effective when and if it finally is made. We haven’t even made one for the common cold. Thus, it seems so far that epidemiological methods used so far are the only way out of this.
I have seen some videos by so-called eminent professors advocating the “let it rip” approach so it will all be over in a few weeks but, as a chest physician who watches the media and reads reports from countries such as the UK, USA, Sweden, France, Spain, Norway and Germany, this take the lid off, turn up the gas the let it all boil over.
However this takes little account of the ability of the health systems to cope, let alone the canon-fodder of health professionals to clean up the mess like sacrificial lambs.
“There is a tide in the affairs of men
Which taken at the flood,
Leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are we now afloat,
And we must take the
Current when it serves,
Or lose our ventures.”
From Julius Caesar Act 4, Scene 3
In other words, we must strike while the iron is hot or miss our opportunity and then be lumbered with the consequences as individuals and as a nation. We have seen what has happened overseas. The next big challenge will be how to take the lid off the cauldron in the realisation that if we get it wrong, a lot of people including doctors and nurses will die. Time and tide wait for no man while Corona virus is the potential Grim Reaper of Everyman. I think it is fair to say that governments are all on a learning curve here and on uncharted waters, very much aware of the consequences of getting it wrong on the other side of the downhill curve which is flattening but which may confront us with a second curve, a second hill or a second mountain with a precipice on the other side and even a third one as occurred in the 1919 pandemic.
As the great German writer of Faust once said (paraphrased),
“As knowledge increases, doubt increases.”
And to quote Einstein who in turn paraphrased Aristotle,
“The more I learn, the more I realise how much I don’t know.”
The more we sail on in these uncharted waters, the more we realise we still don’t have a good map of these seas and coast-line. We sail on, while “the sedge has wither’d from the lake, and no birds sing.”
“How do you mend a broken heart?
How can you stop the rain from falling down?
How can you stop the son from shining? …
And let me live again
I can still feel the breeze
That rustles through the trees
And misty memories of days gone by…
Please help me mend my broken heart
And let me live again.” A song by the Bee Gees