Saturday, April 18, 2020

The Air We Breathe - Readiness series

. . . or the air we exhale

Unclean!
I remember joking how governments must eventually devise a way to tax the very air we breathe. In fact, that day came all too soon as a response to global warming, various measures to hold industry accountable –however, not for emission of evident pollutants. This time civil authorities declared, per warnings of many scientists, that atmospheric CO2 might become toxic to our planet's future health. Next thing we know, all products are a bit more expensive, and we have an effective consumption tax on the air plants breathe and animals exhale.

Insurance contracts have managed mostly to dodge liability for pollution, whether ground, water or air. Even coverage for structural contamination is excluded or severely limited, such as mold and mildew, animal or insect infestations. Insurer legal departments would swear their policies were never intended to cover perils of radiation, chemical emission or communicable disease. So home and business owners must assume such risks while trying to plan ahead, mitigate loss and limit liability for whatever is uninsurable.

Nuclear or volcanic fallout, windblown dust laced with farming chemicals, fumes from a defunct landfill, oil field or processing plant-- experts advise a household to self-isolate indoors, caulk joints and crevices, even duct tape window and door frames; hunker down until the threat is publically cleared. Other experts warn that a thoroughly insulated structure will lock in other kinds of bad air, whether mold spores, cleaning chemicals or new carpet vapors. As respiratory ailments increased, the campaign for energy efficient homes diminished. A house and its occupants need fresh air and lots of it. Mold remediation is extremely expensive; defense against liability claims even more so.  A single claim involving foodborne illness may destroy a restaurant business, even if insurance is found to help.  Still, there is established protocol for all of the above to avoid, limit or transfer much of the risk.

But what about airborne illness?  Invisible threat of microscopic pathogens is daunting, largely indefensible and, well --invisible. People also get sick from tick bites and spores, mosquitoes and roaches and mites . . . Oh my! But lately, add to that list the air we breathe out.


Hospital administrators shudder to admit that high tech filtering A/C systems may fail to protect staff and clientele. In fact, one unintended consequence of extreme sanitation is breeding of the Super Bug, drug resistant strains of bacteria. Protocol against that threat is again unintuitive: send the patient home to recover, soon as an effective therapy is determined. No more extended hospital stay-cations. Actually increases the patient's chances for survival, and it reduces liability for complications on the part of every professional or institution involved.

Will a virus retire us?
Airborne disease is an especially hot topic this season, April 2020, as nations worldwide are besieged by a new viral pandemic. The truly novel part is public response to a yet uncertain threat. Again, consumers are not taxed directly; indeed we are expecting some rebate of federal income taxes. But as local governments assert authority, limiting our freedoms of movement, assembly and commerce: it is certainly an extraordinarily taxing experience, no definite end in sight.

Much confusion is due to a prevailing Science of Uncertainty. So far, pronouncements are based largely upon experience with other viruses, else lack of research data, therefore precautionary. Civil authorities are ordering our response to what might happen. While the most candid (and credible) experts will admit, per words of one epidemiologist, that "everything we thought we knew was wrong". For instance:
   The common cold viruses (enterovirus, such as the corona or rhino varieties) are rarely life-threatening and too varied to bother developing vaccines.
   Once expelled from the body and exposed to air, a virus isn't viable for long.  
   A face mask is effective defense against viral inhalation. 
   All but the weakest immune systems will neutralize a coronavirus infection provided only rest and fluids.
   Immunity is most effectively armed by antibodies developed to recognize the same or a very similar pathogen, whether via vaccine or prior infection. 
   Once winter shut-in living/working conditions give way to a more open-door spring and summer, a respiratory viral epidemic will subside. 
   Sunlight destroys viruses. 
   A person is contagious only when first symptomatic; not after recovery. 
   If a case goes critical and begins to threaten death, standard hospital protocol for treating acute respiratory distress syndrome (ARDS) is best.
I have saved numerous articles reporting medical expert statements covering the whole spectrum of reply to such pre-COVID-19 doctrine: some remain faithful, others won't commit, while many now disavow what was taught. To date there has been little consensus. Actual science for this class of pathogen is just too new. Where there was agreement, that has often reversed, and then reversed again.
Like many fix-it projects around my house, there is probably no single cause triggering the latest public siege strategy. Many continue to ask: Why the lockdown of homes, schools and businesses? Numbers are yet as high or higher for seasonal flu, which does not prompt such panic. Why now? What really made this coronavirus so threatening?  Again, I have collected many and varied expert statements, theories, suspicions (some readers may prefer to skip to the next heading for now):

   First, there was no vaccine anticipating this class of virus.  Medical workers could not be inoculated to defend themselves or protect hospitalized clients from potential carriers. As medical workers test positive for infection, any and all other workers having recent contact must self-quarantine.  Remaining staff is spread thin treating increased caseload, extra-stressed by overwork and scarcity of equipment. Stress heightens vulnerability to any pathogen.
   Assuming this strain originated in Wuhan, the Chinese government delayed reporting its true seriousness; and when they did divulge, numbers were undercounted. WHO and CDC had late, little and unreliable data by which to assess the threat. 
   There is no precedent in a free society for effective public response to a suspected untreatable epidemic. Medical authorities have long dreaded a viral pandemic, anticipating delayed and inadequate government directives for fear of panicking the public or disadvantaging minorities. Worse it's expected that only the most authoritarian regimes will actually enforce public compliance. This while knowing how totalitarian governments have every incentive to conceal their experience and leverage media to sow discord between leaders and populations of their rivals. Therefore, free societies who can prepare, have not; perhaps will not unless compelled or panicked.
   Researchers in truth have very little data informing the medical community what to expect of a virulent viral strain. Vaccines are developed annually to defend against an assortment of last year's Asian flu strains, those likeliest to communicate intercontinentally and threaten the weakest during succeeding winters. But travel is faster, cheaper and more common than ever, both to and from the Asian continent. A twelve month time buffer may no longer exist.
   Critical respiratory cases of older subjects appear to involve a "Trojan horse" intrusion and autoimmune over-reaction (known as ADE - antibody-dependent enhancement). Lifelong accumulation of antibodies, whether by infections or vaccines, may prove a disadvantage. Lungs and other organs begin to self-destruct.  
   It can be politically and legally punishing for medical institutions to report certain contributing causes of morbidity, such as habitual vaping, legalized marijuana use; mix of medications for privacy-protected conditions like cancer, mental disease, addiction, dysphoria, HIV/AIDS, etc.
   Employees of all industries are growing more fearful and sensitive to work environment and various workplace hazards.  Some will fish for any excuse to file a Workers Comp claim or lawsuit. Progressive companies have begun adapting employment policy, requiring that any experiencing symptoms of illness stay home. Some businesses have already equipped staff to telecommute instead. But this cultural/legal movement was already under way, holding the employer liable for exposure to communicable diseases. No limitation or indemnification of such liability is in sight.
   This is the first generation of history --Boomers through Millennials-- becoming accustomed to managing personal business digitally, from payroll deposits to banking and bill payments, to every phase of shopping, purchases and deliveries, including basic essentials of living: food, household items, medicines, entertainment, etc. Likewise for many kinds of commercial enterprises. It is entirely feasible now to "hunker down" in isolation, yet remain connected with family, friends and co-workers.

All of the above contributes to a Culture (if not science) of Uncertainty: Multiple causes which, like a perfect storm, converged upon Winter/Spring 2020 to stage this historic, worldwide reaction to . . . not actual experience and counts of cases (still largely unknown); rather a response driven by rumor that this might finally be Apocalypse. 

Back to work
Realistically, a job boss can't ignore public perception or pretend the economic crisis will go away, even after this health threat is declared over. It appears we must assume that medical and political authorities have (finally) begun to direct appropriate response to a suspected pandemic, much like a bomb threat. Even so, we can't let it become the utter end of human rights, freedom and civilization. We certainly shouldn't continue to live or work as agoraphobes. So, how must a home or business now prepare?

I am proudly holding up my award for predicting which common commodity will replace cigarettes as History's wartime currency of trade.  You guessed it:

Toilet paper

To start, look back over my previous Readiness series of articles. Then search online for your own choice references... for whichever skills you might want to survive another lockdown (think earthquake, rioting, extended power interruption, epidemic). CDC has pubished some thoughtful material for the preparedness-minded business:
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

Definitely, heads of house and workplace must equip all hands to better work from home, school from home, shop from home... all at an hour's notice. And again, there is a slew of material online to effectively self-educate for self-isolation. Employers consult changing OSHA guidelines, federal and state:
https://www.osha.gov/SLTC/covid-19/standards.html
https://www.dir.ca.gov/dosh/coronavirus/Health-Care-General-Industry.html

And remember to print the most useful how-to's on paper in case the lights go out. 

All types of business, but especially retail, must find creative solutions for an old dilemma, growing ever more complex: How best to protect employees (and public) while yet making customers feel wanted and welcome. Same businesses must update their environment to exhibit reasonable precautions against communicable disease. For some, sadly, that may require leaving the plexiglass up as a permanent barrier between worker and client. At least we can see each other smile... assuming they finally let us take off the masks.

Other shops may need wider aisles, broader doorways, lower maximum occupancies for dining rooms, elevators, halls; staggered use of escalators, spaced seating in auditoriums, on buses and planes, Try this: timesheets posted showing completed sanitations of public spaces (already common for restrooms and play areas). How about disposable menus? Someone might invent an automatic sterilizer for hands-on items, such as salon chairs, exercise equipment, shopping carts and baskets. Some industries now use special UV lamps just so. Compliance with a commonly recognized reasonable standard may prove the establishment's only defense against a claim that management "let my granny get infected and she almost died".

I think it unlikely that a standard insurance policy will address the risk of airborne disease, other than categorically excluding such, along with perils of war, volcanic eruptions, sinkholes and terrorist acts. Likewise the economic fallout (business interruption, job loss) due to a civil authority's preventive order, whether scientifically warranted or not.

In a word, be prepared to cut your losses and try to carry on.

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