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We were primed for this

Our TV primed us for this. We binged on "Walking Dead." "Contagion," "Outbreak," "World War Z." Social media has an insatiable appetite for the next hurricane, blizzard, tornado. And now we have COVID-19. The stories are tweeted and retweeted.

History primed us, too. 95% of pre-Columbian Native Americans died of infections brought from Europe. Boccaccio’s Decameron recounts in graphic horror the death of half the population of Florence, Italy, during the plague outbreak of 1348. Plague is a horseman of the apocalypse.

China. Persia. Italy. Ancient cultures and sites of plagues past. The very word "quarantine" comes from Venice during the time of the Bubonic Plague, when between 1/3 to 1/2 of the people of the Italian peninsula were killed from the Yersinia pestis bacterium. In 1448, Venice decided to lengthen the time newcomers had to wait in containment to get into the city from 30 days (a trentina) to 40 days (a quarantina). And just as the bubonic plague started its attack on western Europe in Italy from the East, so the coronavirus is using the same beachhead.

It doesn’t take a brilliant epidemiologist to understand why the Italians are sitting ducks for a virus like COVID-19. They are close knit, family-based and often live and eat altogether. The first thing Italians do when they see you is to kiss you on both cheeks. I go to Italy, and I’m kissing uncles, aunts, cousins, distant cousins, friends of cousins. Beautiful nieces of friends of cousins, the friends of the beautiful nieces of the friends of cousins (my wife often pulls me away from all the kissing at this point). It seems that everyone greets everyone with a kiss on both cheeks. I met a bank teller once and went to kiss her on both cheeks (she had gorgeous brown eyes and olive skin), but my wife pinched me and I thought better of it.

Italian kids go to school, play soccer, go to the piazza, then come home, kiss their nonna and nonno and so share all their germs with their grandparents and great grandparents right before pasta, or as they pass the parmesan cheese.

There’s a funny “viral” video where the actors of "Gamorra" — the Neopolitan mafia series — have moved away from street drugs and are now dealing in contraband hand sanitizer — "clear gold."

In my own office, I used to have the habit of shaking people’s hands when I walked in the room. Now people look at me like I’m a murderer when I stick my hand out to shake. Instead, we touch elbows. And I use sanitizer after I touch everything.

Coronavirus is less severe to the young, typically causing only cold-like symptoms, but like the flu, it can be deadly to the elderly and to people with underlying conditions. The WHO pegged the case fatality rate at 3.4% as of March 3, but this assumes we know how many are infected. But if only those who are really sick are tested, then isn’t it possible that we aren’t testing the silent carriers who make up a larger denominator and that the fatality rate is much less? (The Chinese estimate the case fatality rate at only 0.7%). There are still a lot of kinks in the testing, surveillance, and containinment when it comes to worldwide infections.

While we know how to treat bacterial infections with antibiotics, we simply haven’t mastered the treatment of viral infections. I suspect that coronavirus will not be the next bubonic plague. Nevertheless, it should prime us to get ready for one. 


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