The Rest of My Life Under a Mask
After the pandemic raged for more than four months, the medical community's understanding of COVID-19 has become increasingly clear, and this novel pathogenic microorganism, the novel coronavirus, has firmly established itself among humans. Some asymptomatic carriers exhibit the characteristics of "Typhoid Mary"—carrying the virus long-term without ever developing symptoms. Chinese media use the term "persistently positive patient" for such individuals; dozens of such cases are known in Wuhan.
In the early twentieth century, some typhoid patients of unknown source appeared in the United States. Epidemiological follow-up traced the infections to an Irish-American woman named Mary (September 23, 1869 – November 11, 1938), who worked as a maid and cook. She carried Salmonella typhi but never fell ill herself. The families of the employers she served successively were infected one after another, and some died.
Later, the health and epidemic prevention department discovered that Mary was the source of infection and isolated her for many years, only lifting the isolation when doctors believed she was no longer contagious. After her release, Mary worked in a maternity hospital, and soon a large number of typhoid patients appeared there. The source of infection finally traced back to was still Mary, and everyone realized that Mary was still contagious. Mary was isolated again until her death.
During Mary's lifetime, doctors exhausted every drug available to treat typhoid, but the Salmonella typhi she carried stubbornly survived. At first, when she was isolated on a small island, Mary was furious, but after she was released and returned to work and once again infected many people, Mary understood and accepted reality.
Soumya Swaminathan, chief scientist of the World Health Organization, said the day before yesterday at the Financial Times Global Boardroom Online that he believes humanity may have to live with controlling the COVID-19 pandemic for the next four to five years. These past few days the WHO has also stated publicly that COVID-19 will be with us for the long term.
In human history, no infectious disease that has reached the scale of COVID-19 has ever died out on its own. The role vaccines can play is limited. Take tuberculosis as an example: humanity already has a vaccine against tuberculosis—the BCG vaccine—yet globally about three million people still die of tuberculosis every year. Only the general public do not care about these data; only epidemiologists pay attention.
Before long, ordinary people will no longer care about COVID-19 either; after all, everyone has to make a living. People are good at forgetting. Infectious diseases with large numbers of patients today, such as tuberculosis and AIDS, once made humanity very nervous, but people today have long since become indifferent to them.
The novel coronavirus will ultimately be like HIV and the tubercle bacillus, noticed only by certain special groups. I am not sure how long it will take our world to forget COVID-19, but it is certain that most of us will forget it.
Last night I walked the streets of Beijing and saw seven or eight young people fighting in a gang. Several were not wearing masks, and a police officer was questioning them. More and more people on the streets are not wearing masks; the barbecue stalls along the roadside are already packed. Some vegetable vendors in Beijing's food markets have stopped wearing masks. My own family, when picking up express deliveries, had a close conversation with the delivery driver without either of them wearing a mask—this terrified me, and I immediately took isolation measures at home.
I am this cautious because my son takes the high school entrance examination this year and cannot afford the slightest oversight. In addition, I myself am a COPD patient who has studied medicine and understands medical common sense, belonging to the high-risk group likely to die from COVID-19. So I am more vigilant than the average person.
Shulan City in Jilin Province, which had reported no new epidemic cases for 73 consecutive days, recently began to see clustered outbreaks, leading to another lockdown of the city; ninth-grade and twelfth-grade students went home in tears. This is an extremely unusual year; for these graduating-class students, the slightest oversight is enough to ruin their future.
Back in March I wrote an article arguing that March and April would not be scary, but that a partial rebound would begin in May. My reasoning at the time was that I believed domestic people would lower their guard in April and that some regions would stop wearing masks, which would inevitably lead to a rebound. Now it is May, and even in Beijing large numbers of people are not wearing masks. The movement of "asymptomatic patients" will surely cause others to be infected. So in the days ahead, scattered rebounds are unavoidable.
We cannot eradicate the novel coronavirus. To what extent humanity can ultimately reduce its impact remains to be seen over time. But the first peak may end this summer, after which continued transmission among the population is unavoidable. Most people will weather the COVID-19 crisis, but for those of us with underlying diseases, the days ahead may have to be lived cautiously.
I do not think any government or nation will have the patience to lockdown cities and countries round after round to fight COVID-19, because that would cause more deaths. Economic recession will cause many patients with other diseases to die because they cannot afford treatment. So society will eventually, one day, adapt to and accept the existence of COVID-19, just as everyone has already adapted to and accepted the existence of AIDS. People like me with underlying diseases can only protect ourselves.
After the AIDS epidemic, condoms were vigorously promoted; wearing condoms during high-risk sexual behavior can greatly reduce the probability of HIV infection. After the COVID-19 pandemic, masks will be vigorously promoted, and high-risk groups may have to wear masks for the rest of their lives.
But this practice is hard to unify across society and within families. Just as we can never guarantee that our sexual partners will not engage in high-risk sex, we cannot guarantee that our family members will take our lives seriously. They will be careless for one reason or another, and ultimately their carelessness will send us to the gates of hell.
Scientists advocate wearing condoms throughout every sexual encounter to prevent AIDS, but in practice not many people can actually do this. So the spread of AIDS continues, with over a million people dying of AIDS every year. Most people, after the initial panic, no longer panic about AIDS.
Once a vaccine is developed (regardless of its efficacy), preventing COVID-19 will ultimately become the responsibility of each individual and each family, rather than the government organizing a nationwide battle. A vaccine is the government's way of giving the public an account. But as Dr. Fauci of the U.S. CDC has said, leaving aside whether humanity can ultimately develop a truly effective vaccine, even if one is developed, the vaccine may cause the virus to evolve into something even harder to deal with—which would be a greater disaster for vulnerable groups.
Viruses, though microorganisms, are nonetheless living things with the ability to evolve, and their evolutionary ability is far greater than that of humans, at a far faster pace. Forty years have passed, and no AIDS vaccine has yet been successfully developed (at the beginning, humanity was also ambitious, believing that an HIV vaccine would soon be developed). This is related to the frequent mutation of HIV (human immunodeficiency virus). We do not know whether the novel coronavirus will be the next HIV.
Humanity has survived in nature, tormented by many kinds of viruses. We have been tormented by smallpox, by plague and cholera, by tuberculosis and AIDS. In recent years, newly discovered viruses such as Ebola have also threatened us. The novel coronavirus is merely a new member of humanity's pathogen library. We have never been safe; viruses have been continuously helping humanity evolve while also eliminating all manner of people with weak constitutions or weak awareness of protection. In a certain sense, humanity should thank viruses for applying the survival of the fittest to our species; it is with the help of viruses that humanity's survival capacity has been continuously enhanced.
Survival is each person's own business. Our lives have nothing to do even with our families; the last line of defense is in our own hands. If we are unfortunate enough to be born with low natural immunity, we must protect ourselves. The ill have their own survival strategies; many people beset by illness live far longer than ordinary people, precisely because those who have lost health cherish it more and live more carefully.
Let go of the wishful thinking that COVID-19 will eventually go away; do not be lulled by hymns that violate scientific common sense. Adapt to the rest of your life accompanied by a mask! If, like me, you belong to the high-risk group with underlying diseases, then for the rest of your life, when interacting with others, never take off your mask again.
Condoms, promoted because of the AIDS epidemic, not only reduced the spread of AIDS but also reduced the spread of other sexually transmitted diseases. I believe that people who develop the habit of wearing masks from now on will not only reduce their risk of contracting COVID-19 but also reduce their risk of contracting other respiratory-borne diseases.
Our behavioral habits also evolve continuously in the struggle for survival. Many of humanity's customs and traditions are not water without a source; it is precisely every bloody lesson that has taught us to survive with increasing wisdom.