It's Not About Trust, Only About the Pandemic: Chronic Disease Patients Must Guard Their Own "Safe Island"

In mid-December 2020, an old friend from Zhejiang came to Beijing and invited me out to a restaurant; I politely declined — I had not eaten out in a year. He then suggested coming to my study to chat over tea, which I also politely declined. My old friend said he certainly would not catch COVID, and he believed I wouldn't either, so he felt that friends meeting for tea and chat would be no problem.

Indeed, the probability of either of us being infected was negligible, and Beijing was calm at the time, but I still was unwilling to take the risk of meeting him under these circumstances. A few days after he arrived in Beijing, a new outbreak appeared in the city. Then outbreaks appeared in Shijiazhuang and Xingtai in Hebei province.

I am an asthma patient; although I have treated myself fairly well and rarely relapse, I know my respiratory tract is more fragile than a normal person's. If I were to catch COVID-19, others might only have mild or moderate cases, but I would very likely become a severe or critically ill patient. I have studied medicine; maybe I could intercept the disease's progression at the mild stage, and maybe not. Medicine is full of uncertainty. I know that the best medicine is preventive medicine, and avoiding infection as much as possible is what matters most.

It's the end of the year, and banquet after banquet is being held in my hometown. I haven't gone back, but many relatives and friends have called to invite me. On the phone I urge them not to gather for meals or attend banquets; most relatives and friends (including my father) say, "We're all family, there's no one we can't trust, nothing will happen." This is the nature of grassroots society: people are guided not by science and reason but by personal relationships.

Scrolling through my social media feed, every day someone posts photos of various dinners and banquets; at lively gatherings, no one wears a mask because everyone is an "acquaintance" and no one wants to lose face. The biggest feature of China's new wave of pandemic transmission is transmission among relatives and friends; based on trust and affection, people assume their relatives and friends cannot be potential COVID carriers, and even if they were, it would be awkward to refuse, so at gatherings they keep no distance and wear no masks.

It is hard for us to change this situation. It is difficult to predict how long the COVID-19 pandemic will last. COVID-19 is not like smallpox — once you've had smallpox or been vaccinated and developed immunity, you never get it again; but news reports show some patients have caught COVID three times within a year, recovering only to be reinfected. So controlling COVID-19 through immunological means is very difficult, and humanity may need some time to emerge from this plague.

During a plague, those most vulnerable to harm are people with weak constitutions like us. We can maximize our chances of survival only by guarding our own "safe island." Don't trade on personal connections or sentimental feelings; the last line of defense for each person's life is ourselves. We cannot constrain society or others, but we can constrain ourselves. Don't attend gatherings; don't replace reason with sentiment. I will definitely not be visiting relatives and friends for the New Year, nor will I receive visits. Many relatives and friends have respiratory tracts stronger than mine; I envy them, and can only compensate for my respiratory deficiency with vigilance.

Also, don't stay up late, and don't get too caught up in online activities; we need to boost our immunity through exercise and sleep. In fact, from a scientific perspective, people with weak constitutions like us are targets of natural selection; many diseases try to cut our lives short. But because humans have intelligence, we often go the opposite way: many people with weak constitutions live long, while robust people die young. The reason is simple: people with weak constitutions are vigilant, while robust people are not vigilant enough.

We can meet completely unprotected only with our closest loved ones, and these loved ones must be people who are willing to look out for our health and voluntarily maintain social distance from others; otherwise, we must also keep our distance from them. Carefully examine every person who will approach our "safe island"; do not let their carelessness cause us to pay with our lives. Any frail person who values personal sentiment over precaution is not a smart patient; such a person has not suffered enough from disease.

In the early period of Europeans' invasion of the Americas, dozens or hundreds of Spaniards easily conquered thousands upon thousands of Native Americans; the most powerful weapon that helped them defeat these indigenous peoples was the smallpox virus. These Spaniards were immune to smallpox; they carried the smallpox virus in their bodies. The Americas had never had a smallpox outbreak before, so the indigenous peoples had no immunity. When the Spaniards came into contact with the indigenous peoples, they triggered a massive smallpox epidemic, and huge numbers of Native Americans died; some Indian tribes lost over 95% of their population to smallpox. This led the bewildered Native Americans to believe the Spaniards were gods, to fear them greatly, and to hand over their beautiful homelands to these invaders. If the Native Americans had possessed the wisdom of humanity today, they would not have been annihilated.

So when we fight disease, we must make good use of our innate vigilance. Everyone hopes to live a life free of pain and illness, but this goal is hard to achieve; therefore we must try our best to avoid adding new diseases to ourselves. I see many cancer patients in my social media feed who are happy to attend gatherings; I always wonder if they are tired of living. Viruses are not as big as pumpkins; no one can see pathogenic microorganisms with the naked eye. We can survive in nature's survival-of-the-fittest only by being constantly vigilant.