disaster

Coronavirus and Quarantine

Health education poster, Hong Kong. Photo by Shawn Smallman

As I write these words nurses in Hong Kong are on strike to protest the fact that the Chief Executive, Carrie Lam, will not close the border to China. To be clear, the executive has sharply restricted entry to Hong Kong, closed most crossings, and forbidden entry from the most affected Chinese state, Hubei.  But there are still strong calls for a complete border closure coming from within Hong Kong’s medical community.  Similarly, the United States has restricted flights from China to U.S. citizens only; some U.S. airlines had already canceled service to China. All such quarantine measures are controversial.

On social media, such as Twitter, and in the press, a number of experts have denounced all quarantines as being not only ineffective but also in violation of WHO guidelines. These authors worried about panic overcoming good judgement, the economic costs of restricting travel, the stigma imposed on those from affected areas (Chinese in particular, but also all Asia), and the importance of upholding International Health Regulations. These are valid and important points. Some authors have also pointed to studies based on computer models showing that quarantines are ineffective with highly contagious respiratory diseases.

Recently the tone has shifted in the discussion, as it has become clear that some cases of the virus are being spread asymptomatically. The number of cases has grown quickly. Some apparent facts (such as no human to human transmission) that seemed true in mid-January are no longer true. So the stridency of the debate about quarantine has declined, but the debate continues.

So is there any role for quarantines to manage such a pandemic? And is there some other way to make a judgement that relies less on computer models? I would suggest that looking at the past history of respiratory pandemics, such as the 1918 influenza pandemic, might be useful. Can history suggest particular circumstances in which quarantines may work? …

Fault Lines

A photograph of the 2004 tsunami in Ao Nang, Krabi Province, Thailand. By David Rydevik (email: david.rydevikgmail.com), Stockholm, Sweden. (Originally at Bild:Davidsvågfoto.JPG.) [Public domain], via Wikimedia Commons
Living in the Pacific Northwest, we all know that a major quake is imminent. Oregon Public Broadcasting has had a great series, Unprepared, about the pending quake in Oregon. There are also a wealth of books on the topic. I particularly recommend John Clague, Chris Yorath, Richard Franklin and Bob Turner’s, At Risk: Earthquakes and Tsunamis on the West Coast. This well written book is filled with images and maps, to detail the potential risks of an earthquakes in different sections of the Northwest. If you live in Western Washington you’ll want to check out the map on page 117; Portland or Vancouver? See the map on page 118. And if you live on Vancouver Island or the Gulf Islands, you’ll want to look at the map of tsunami run-up potential on page 138. Then you’ll want to check out the photo of what a piece of 2 by 4 lumber did to a tire during a tsunami during the 1964 Alaska earthquake. The book conveys complex scientific information in clear and readable prose. The chapters on diverse topics also have a clear flow. If only all science writing was as approachable as in this book.

Still, I love podcasts, so my favorite resource is probably the five part CBC series Fault Lines. The series is organized by time, so that the first episode discusses different forms of quake that may strike Vancouver, while the second episode describes the quake itself. What makes the podcast particularly insightful, however, is that the majority of the episodes focus on the period of time after the quake. This compels the listener to imagine what that experience will be like for survivors, and how well prepared they themselves may be. Surviving the earthquake is only the first step on a long journey. The podcast is an unsettling and insightful exploration of the topic, which will leave you musing about the danger for days. Curious? You can hear the teaser here.

Shawn Smallman, 2018

Canadian wildfires and planning

Many years ago, I visited Fort McMurray to tour the Canadian Oil Sands. The community is in northern Alberta, perhaps a five and a half hour drive from Edmonton. A few days ago a horrific wildfire began, which has been made worse by the fact that Tuesday this week the temperature was nearly double what is normal at this time of year. The sheer scale of the blaze is hard to comprehend without viewing the videos. This slideshow by NBC gives some sense of the size of what is happening. Citizens have been videotaping their dramatic experiences escaping from the town. Many people have been traumatized trying to flee on the one main highway that connects Fort McMurray to the rest of Alberta. I have read a figure that perhaps 1,600 structures have gone up in flames, but I think that it will be a long time before anyone can know the actual figure. It is heart-breaking to hear people lamenting the loss of their homes as they drive out through a highway with a wall of flames on one side. …

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