Different Ships, Same Storm

There is a meme going around the internet these days that I love. The meme goes like this: We may be in the same storm, but we are in different boats. The meme is framed as a quote and is often attributed to Dr. King. However, I could not find a single instance of him or anyone else saying or writing it, meaning if I had the resources and time, I might find the real author.

Still, according to one Martin Luther King scholar, while he might have said it, the phrase cannot be attributed to him. But for purposes of this paper, I will maintain that the author is unknown. If you know the origins of the quote, please share it with me in the comments!

Decision-making based on COVID-19 and personal needs

Regardless of who initially said or wrote it, the phrase has special meaning in the context of the COVID-19 pandemic. As COVID-19 spread across the country, we have found ourselves in quite different boats, even while we are in the same storm of a virus. Most of us in this community would agree that RA puts us in a very different boat then the average American. 

Considering my RA and surgery recovery

At my house, Sheryl and I went immediately to lockdown mode. We decided we could not risk being in public. My suppressed immune system plus the fact that I am still recovering from extensive back surgery in March meant we had no choice. It was apparent to us that if I were to be exposed and contracted the ill effects of the virus, it could be awful.

Others made a different calculation, and over time that difference has become more apparent as the gulf between going back to normal has become expansive.  If you are like me, you may be feeling more isolated even as the rest of the world is becoming more connected.

Others make decisions on different factors

Look at that in comparison to television commentators, who were saying that developing herd immunity was the only way to combat the virus.  Oh, and by the way, sure, we would lose a few thousand people. Still, it was worth it to restart the economy, usually without restriction or accommodation for the immunocompromised. The clear message to me at least is that society has judged me to be not important enough to join the mainstream.  I am clearly on a vastly different ship than others in America.

Herd immunity and COVID-19

However, not all agree that herd immunity will be so easy to obtain.  In a well-reasoned piece in the MIT Technology Review, Gideon Lichfield makes a compelling argument for why herd immunity will not likely work.1

Herd immunity by vaccine or infection

His point is that herd immunity will be achieved only when one of the two factors are present. First, a vaccine is developed and used by a majority of the population. Or second, roughly 50 to 75 percent of the population has been infected to achieve herd immunity.1 That number only works if having the virus creates immunity, something which is not known at present and can only be known given time.

The unknowns of herd immunity with COVID-19

Further, given the lack of widespread testing both for current infection and, far more critical, a valid and widely available antibody test, it is impossible to know when we will achieve or even get close to herd immunity.

We also do not know how many people might die as a result of the virus on our way to herd immunity. Let's suppose that 1 in 1,000 people who contract the virus are desperately ill; we simply do not have the hospital facilities to care for them. But let's suppose that 1,000 out of 1 million people get desperately ill, then there would be the need for far fewer hospital beds.

The problem is that until we know roughly how many have been infected, we have no way of knowing what these percentages are. We do not even know for sure there is a reason for concern for the long term or if we are in significant danger of causing mass illness and death.

Living with RA in the presence of COVID-19

As I write this in early May 2020, it seems probable that the United States is careening headlong into reopening and removing enforced social distancing. I imagine many of you feel, as I am namely marginalized by the current debate. I do know that people with RA are careful. And that is what scares me the most. I do not feel like we are entering into a carefully thought out future as we try to live with the presence of this virus. 

Until there is an effective vaccine, it is doubtful that herd immunity can be achieved. Past epidemics have proven one thing is abundantly clear; whatever we think is going to happen likely will not.  For the sake of those of us with compromised immune systems, I hope we guess correctly.  However, I fear we are guessing without the immuno-compromised at the table where the decision is being made.  That is the scariest part of all.

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