The view from inside

By March 24, 2020Other

An article in one of our local newspapers refers to ‘vulnerable oldies’. That’s us. The article in question was built around the views of my wife’s geriatrician, and they are exactly what the official advice is: keep isolated, wash our hands, stay out of trouble. Of course, we need some food (I make a lot of my breakfasts) and either I go out to a supermarket or my daughter does, or (as at the moment I’m using an online supermarket). There are about a hundred of us in this aged-care facility, and like Macbeth some of us are showing some of the signs of being  ‘cabined, cribbed, confined’. It’s now impossible for visitors to come, and there’s tons of parking. A son and another daughter came to visit me the other day, and we sat outside at the regulation distance away from each other. It was not the most satisfactory encounter we have ever had, but at least my rellies came. That was then. Now we are in total lockdown.

It was not the rellies’ fault. The facility made it hard. You had to go through tests (not the Covid-19 test) and have your temperature taken, and you had to be a close family member. It was not the facility’s fault. It was only doing what it was told to do. The ACT Minister had issued new restrictions. That was just a day or so ago. Covid-19 is a fast-moving event.

“Visitors will be restricted to care and support visits that are limited to one visit per day of no longer than two hours made to the resident by one person, or two persons together,” she said.

People under the age of 16 will not be able to visit, according to Minister Stephen-Smith, who said they can only visit for compassionate reasons for the purposes of anyone who is at end of life.

The traffic past our place has shrunk a great deal, and it is a major road. I can feel the growing isolation. Indeed, I can see it: no one comes at mealtimes, though they used to. My wife and I have each other, and that is a huge plus for us. Two other married couples in the place have the same benefit. The rest are singles, mostly widows, and all of them, all of us, carry some life-threatening disease that requires high care. Otherwise we couldn’t be here.

And we’re just at the beginning of what the Prime Minister says could be a six-month endurance test. Why mightn’t we succeed? I’ve thought a bit about this, because for a variety of reasons I do rather more for the facility than most other residents can (I’m mobile and sentient, and used to doing things that need doing), and I’m a tad worried. To start with, some of the residents, lacking visits and interaction, will retreat into themselves, and thereby reduce their quality of life. The facility is doing its best, by keeping activity going. But my guess is that it is the intimate contacts that will become increasingly important as the six months roll on. Somehow we have to be able provide them. Mind you, there are people here who have no friends or family in Australia, let alone in Canberra, so none of this is new to them.

The second worry is interaction between residents. Not everyone is universally popular! From time to time there are spats, and the common politeness we acquire quickly once we’re here (if we didn’t have it before) can become quickly abraded. Aged-care facilities are highly democratic places: it doesn’t matter who you were or what you’ve done. Once you’re here, you’re like everyone else. Dementia is common, and presents in all sorts of ways. What was once funny can become irritating, and lead to words, and even to physicality. I think I can see signs of that already.

A third worry, and it follows naturally from the second, is harmful interaction between the residents and the carers. Our place is divided into four ‘communities’, and each of them has about 24 residents and a set of carers and a registered nurse. I cannot speak highly enough of the devotion and assistance given by the carers and the nurses. But as nerves become ragged, I can see carers being assaulted by residents. What are they to do? An angry resident, especially one without much control anyway, can assault a carer, scratch and punch. I’ve seen it happen, and I worry that the incidence will increase. You hear about carers assaulting residents. I’ve seen the other side. Usually the carers are quick to avoid contact, but it doesn’t always work. In any case, that is not what they are there for.

Three worries are enough. I’ll say it again. This facility I live in is a great place, and senior management and everyone connected with ageing sick residents are doing their best. Yet I worry about six months of this endurance test. What will it be like elsewhere? I had wanted to say that if you know someone who is in such a facility, see if you can pay them a visit, or ring them up. But now we are in total lockdown. For the foreseeable future it will increasingly be like prison, and from time to time I already feel a bit stir-crazy. I want to go out and lead a normal life, at least for half an hour. But unless I’m shopping my drive, though important to me, would be regarded as non-essential unless I’ve got that wrong. My wife needs a drive every other day so she can see the world. It is good for her dementia. We used to do a lot of that kind of driving. It’s going to be a tough half-year.

I jump to another thought about ‘culture’. Many years ago I welcomed our first Bangladeshi students. They were all dressed to the nines, the girls especially so. I shook hands with the young men, and began to do so to the girls, who retreated. The diplomat attending them said to me, ‘They do not shake hands with men. It is not part of their culture.’ Of course, I felt like a complete ning-nong, but afterwards I thought again. They’re coming in to our culture, and in our culture we shake hands. It is a sign of agreement, of welcome, of equality in some respect. Why should they bring their culture and expect us to honour it? Of course, I’ve had to wrestle with that one for the last twenty-five or so years.

The other day one of our carers did something for me, something important she did well. I was unable to do it. When it was done, and I saw the result I was pleased indeed, and as she came toward me I gave her a kiss on the cheek. ‘Wonderful! Thank you,’ I said. One of the other carers said to me, observing my lapse, ‘You do not kiss in her culture!’ It was a gentle reproof, not a severe one.

   ‘Ah,’ I said, the Bangladeshi incident still in my head, ‘aren’t you lucky you’re in Australia, where we do kiss!’

   ‘Yes,’ she said, grinning.

Join the discussion 40 Comments

  • Peter S says:

    Don,
    There is a video conferencing app called “Zoom” which is available for Windows and Mac devices. You can connect for 40 minutes for free. I use it frequently when conferencing with my contacts at UNE. IT is a thin client and works well at moderate connection speeds. Have a look at it. Maybe you can tackle your isolation by engaging with friends at family on-line

  • Mike Dinn says:

    Fascinating Don. I have second hand knowledge of this, with a partner in aged care. I also have concerns about long term implications. Paraphrasing Trump (which I never thought I would!) I hope the cure is not worse than the ailment.

  • Peter E says:

    Thanks, Don, for this insight. I hope that you do all right.

    • spangled drongo says:

      You’re doin’ a good job, Don.

      I’ll be happy if I can do half as well as I’m headed in the same direction.

      An old friend who is at a similar facility at Ormiston turned 99 today and I could only ring and talk to her. Still very bright. She used to take the minutes of our environmental group meetings in shorthand many years ago.

  • beththeserf says:

    Thank you , Don, for such an insightful post, as we would expect from you, re the human plight of people in Care facilities. So many impacts…
    Government cut backs on human freedoms, economic consequences… been reading Hans Zinsser, ‘Rats, Lice and History, published in 1935.

    Meanwhile, herewith ,Don, memories of past gatherings in the city square. )
    https://www.youtube.com/watch?v=ceX5jJ5fggs

  • spangled drongo says:

    A bit of inside info:

    This is advice given to hospital staff. Explains the virus and how to prevent the virus. Please share with family , friends and work colleagues.
    Internal email for RBH (Royal Brisbane Hospital) staff:
    Virus Detection:
    The simplest way to distinguish Coronavirus from a Common Cold is that the COVID-19 infection does not cause a cold nose or cough with cold, but it does create a dry and rough cough.
    The virus is typically first installed in the throat causing inflammation and a feeling of dryness. This symptom can last between 3 and 4 days.
    The virus typically then travels through the moisture present in the airways, goes down to the trachea and installs in the lungs, causing pneumonia that lasts about 5 or 6 days.
    Pneumonia manifests with a high fever and difficulty breathing. The Common Cold is not accompanied, but there may be a choking sensation. In this case, the doctor should be called immediately.
    Experts suggest doing this simple verification every morning: Breathe in deeply and hold your breath for 10 seconds. If this can be done without coughing, without difficulty, this shows that there is no fibrosis in the lungs, indicating the absence of infection. It is recommended to do this control every morning to help detect infection.
    Prevention:
    The virus hates heat and dies if it is exposed to temperatures greater than 80°F (27°C). Therefore hot drinks such as infusions, broths or simply hot water should be consumed abundantly during the day. These hot liquids kill the virus and are easy to ingest.
    Avoid drinking ice water or drinks with ice cubes.
    Ensure that your mouth and throat are always wet, never DRY. You should drink a sip of water at least every 15 minutes. WHY? Even when the virus enters water or other liquids through the mouth, it will get flushed through the oesophagus directly into the stomach where gastric acids destroy the virus. If there is not enough water, the virus can pass into the trachea and from there to the lungs, where it is very dangerous.
    For those who can, sunbathe. The Sun’s UV rays kill the virus and the vitamin D is good for you.
    The Coronavirus has a large size (diameter of 400-500 nanometers) so face masks can stop it, no special face masks are needed in daily life.
    If an infected person sneezes near us, stay 10 feet (3.3 meters) away to allow the virus fall to the ground and prevent it from falling on you.
    When the virus is on hard surfaces, it survives about 12 hours, therefore when hard surfaces such as doors, appliances, railings, etc. are touched, hands should be washed thoroughly and/or disinfected with alcoholic gel The virus can live nested in clothes and tissues between 6 and 12 hours. Common detergents can kill it. Things that cannot be washed should be exposed to the Sun and the virus will die.
    The transmission of the virus usually occurs by direct infection, touching fabrics, tissues or materials on which the virus is present.
    Washing your hands is essential.
    The virus survives on our hands for only about 10 minutes. In that time many things can happen, rubbing the eyes, touching the nose or lips. This allows the virus to enter your throat. Therefore, for your good and the good of all, wash your hands very often and disinfect them.
    You can gargle with disinfectant solutions (i.e. Listerine or Hydrogen Peroxide) that eliminate or minimize the amount of virus that can enter the throat. Doing so removes the virus before it goes down to the trachea and then to the lungs.
    Disinfect things touched often: cellphone, keyboard, mouse, car steering wheel, door handles, etc Jos Sent to us just now + we wanted to share this knowledge & advice with you all. Pls do the same.

    • Boambee John says:

      SD

      That has been floating around for a while, but I am not sure of its provenance.

      The first time I saw it it was credited to Stanford Uni, recently I saw it supposedly from the UK NHS via “Princess (sic) of Wales” hospital. There are a couple of words in it (meters, cellphone) that suggest a US origin.

      There might be sometning in it, but I think it should be checked first.

      • Jeffrey Dun says:

        This advice has also been posted on Dr Malcolm Kendrick’s medical blog. It was claimed to be from the NHS.

        Dr Kendrick replied:

        “This is complete and utter non-scientific nonsense. I have only approved this comment in order to dismiss this advice out of hand. For starters the average temperature of a human is 37oC. At this temperature the virus lives completely happily and reproduces itself. The idea that you can flush the virus down into the stomach is also completely ridiculous…. Enough. I assume that this comment has been put in good faith, but I can only advise everyone to completely ignore it.”

  • spangled drongo says:

    A flash of potential good news from the front lines of the coronavirus pandemic: A treatment is showing promise. Doctors in France, South Korea and the U.S. are using an antimalarial drug known as hydroxychloroquine with success. “We are physicians treating patients with COVID-19, and the therapy appears to be making a difference. It isn’t a silver bullet, but if deployed quickly and strategically the drug could potentially help bend the pandemic’s “hockey stick” curve.

    Hydroxychloroquine is a common generic drug used to treat lupus, arthritis and malaria. The medication, whose brand name is Plaquenil, is relatively safe, with the main side effect being stomach irritation, though it can cause echocardiogram and vision changes. In 2005, a Centers for Disease Control and Prevention study showed that chloroquine, an analog, could block a virus from penetrating a cell if administered before exposure. If tissue had already been infected, the drug inhibited the virus.”

    Dr. Colyer is a practising physician and chairman of the National Advisory Commission on Rural Health. He served as governor of Kansas, 2018-19. Dr. Hinthorn is director of the Division of Infectious Disease at the University of Kansas Medical Center.

    Wall Street Journal

  • dlb says:

    Chloroquine seems to be all the rage at right leaning websites. There seems to be much antagonism at these sites to the way Governments are handling the pandemic and the Keynesian methods they are using to keep the economy going. The attitude seems to be, bugger the lockdowns, just take a course of Chloroquine and get back to work!

    It’s a wonder the ABC or the Con haven’t yet done a takedown of Chloroquine. After all Trump is in favour of it.

    So if the ABC won’t do it I will

    https://www.msn.com/en-au/news/world/man-dies-after-ingesting-chloroquine-in-an-attempt-to-prevent-coronavirus/ar-BB11BNRn?ocid=spartandhp

    • Boambee John says:

      dlb

      What he ingested was fish bowl cleaner containing chloroquinine phosphate, a different compound, not a pharmaceutical product.

      Perhaps the ABC was right to ignore this furphy?

  • Hasbeen says:

    I really can’t see why anyone should be stopped from going for a drive, particularly if they have no desire to stop. Surely you are keeping your distance from others in your car. I drove into the chemist today, & thoroughly enjoyed my 50 kilometer round trip. It was while at the chemist i was in some danger, not in the car.

    The chemist staff are acting fairly paranoid. I don’t blame them as they are often the first call for sick people, & their response was making me nervous.

    I regularly communicate with people all over the country, & over seas on a couple of web sites, one a classic car site & the other a remote control aircraft site. After 18 years on the car site I have a number of friends I will never meet, but they are warm friendships.

    I have never used the social web sites, but some of them probably offer such contact, & perhaps should be encouraged during this time.

  • Neville says:

    Don thanks for your report on your daily experiences during these trying times. I wish you and your wife all the best for the coming months or until we start to emerge from this trial.
    BTW I think the Worldometer Corona Virus site is still the best site to try and understand the daily spread of the C Virus.
    As at this morning OZ is still doing better than most wealthy countries with 0.3 per million cases and Canada 0.7 per M and USA 2 per mil. Most OZ deaths are from NSW 5 and 1 Vic, 1 Qld and 1 WA , that’s a total of 8 people out of a pop of about 25.5 mil.
    Also OZ present critical cases are only 11 people out of 25.5 million or very low indeed. See the different columns to try and understand the data.
    African countries are very low, but I wouldn’t entirely trust their reporting either. And ditto China, Iran etc.
    And dlb I think chloroquine is still something that we should consider for elderly patients and a number of doctors/ researchers seem to hold that opinion as well. Here’s the link and is updated daily from the WHO.

    https://www.worldometers.info/coronavirus/

    • BB says:

      I prefer https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers#in-australia because it is more local to Australia. For instance there are 44 people currently in the ACT that are infected out of a population of 400,000. On that data it now appears the rate of new infections is declining dramatically in Australia as a whole the data I have so far though is not a lot.

      • Chris Warren says:

        BB

        This comment is at your usual standard. “…it now appears the rate of new infections is declining dramatically in Australia.”

        The facts are exactly opposite – the rate of new infections is rising exponentially as shown here:

        https://www.worldometers.info/coronavirus/country/australia/

        The chart of “Daily New Infections” does NOT show a dramatic decline.

        • Peter S says:

          For heavens sake Chris, which graph are you looking at! There has been a significant decline over the past two days. Whether this will be sustained is a different question. Nevertheless it takes a number of such days to flatten the cumulative growth curves. Do you simply not understand data?

          • Boambee John says:

            Peter S

            Alarmists gotta alarm.

            There is definetely cause for concern, particularly among the elderly and health compromised, but no real evidence that collective doom is upon us.

          • Chris Warren says:

            There is only one graph that is relevant. It shows a clear rising trend with various episodes of short-run declines but only so far as each later temporary decline is higher than precious declines.

          • Chris Warren says:

            “c” => “v”

          • Peter S says:

            Clearly Chris does not understand data. The number of reported cases has declined for 3 days in a row. If this will continue we don’t know, but if it does the cumulative curve will begin to flatten.

          • Chris Warren says:

            Clearly Peter S does not understand data. If he made the slightest effort he would see that the number of new cases for March 25 was 359. On March 26 the number of new cases was 374.

            Now normal people will call a move from 359 to 374 an increase. But Peter S says there was a decrease.

            Everyone should have a look at the data themselves – scroll down below the charts, here:

            http://archive.is/gSKye

            Maybe Peter S was reading the numbers back-to-front?

          • Peter S says:

            As usual Chris you are confusing your data. The Worldometer data is lagging the Australian data and so is its graph. I suggest if you want to be up to date then you should look at the Australian Government site. But you will also notice the graphs on both sites lag the published statistics.

            Of course in retrospect we should both have referenced the data we are using. I assumed you would be looking as I do at the most up to date information. For example as I write Worldometer says there are 3050 confirmed cases in Australia. If you look at the Australian Government site there are 3378.

            https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers#current-status

            You will also note my comments were also qualified, but yours weren’t. It may well be that when the latest data is published, the downward trend in reported case will reverse. That will be unfortunate. As of yesterday (27th) at 3:00 pm there have been 212 new cases

  • Neville says:

    Willis Eschenbach checks the data for Italy and some other countries and comes to a disturbing conclusion.
    Most deaths from the C virus in Italy are the elderly and perhaps there may have been an introduction to their health system before anyone had heard of the C virus.
    Nth Italy had a steady influx of Chinese workers for a longer period or so it seems.
    But if he is correct it seems that already sick elderly people could have been infected during routine visits to hospitals or clinics etc before they were even aware of the c virus in Italy. Who knows?

    https://wattsupwiththat.com/2020/03/24/the-italian-connection/

  • Pete S says:

    Thanks Don – a delightful read like a sonnet with the two themes beautifully interwoven – I reckon you should submit it to The Spectator.

    And, Spangled Drongo, great info from the hospital staff.

  • Aert Driessen says:

    Don, you and Bev seem to be coping in somewhat trying circumstances, and that is heartening. I have only one comment and it is political. I agree with you 100% on the way you feel about ‘honouring’ other cultures. Of course I respect the cultures of other people/groups but I baulk at the prospect of having to compromise my Australian culture, in Australia, for the sake of accommodating a foreign one. I detest identity politics and I see this as one of the ingredients of that. Australian culture is all about respect and good will, blended with humour.

  • Alex Martin says:

    Hi Don,

    You are doing more great work on the “inside” of a much under represented group. It’s important to hear from you as much as possible on this aspect of your life. We need your insight to that world especially now. I’m sure you will use this time to continue writing and to keep those directly around in good spirits. I hope so. Keep well. Alex

  • spangled drongo says:

    Good read from an immunologist at Johns Hopkins University

    “Not really feeling sick and do not want to be… but if you are feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand…

    It has to do with RNA sequencing…. i.e. genetics.

    Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year… you get immunity two ways…through exposure to a virus, or by getting a flu shot.

    Novel viruses, come from animals…. the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans… then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.

    Now…. sometimes, the mutation only allows transfer from animal to human, for years it’s only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human… once that happens..we have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly it’s gonna be..

    H1N1 was deadly….but it did not mutate in a way that was as deadly as the Spanish flu. It’s RNA was slower to mutate and it attacked its host differently, too.

    Fast forward.

    Now, here comes this Coronavirus… it existed in animals only, for nobody knows how long…but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person… But here is the scary part…. in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, “slippery”

    This Coronavirus, not being in any form a “human” virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunity…doctors have no known medicines for it.

    And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungs..

    That’s why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza…. this one is slippery AF. And it’s a lung eater…And, it’s already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain L….which makes it twice as hard to develop a vaccine.

    We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.

    Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passed…(honestly…I understand him so much better now). Just like us, he had no tools in his shed, except social isolation…

    And let me end by saying….right now it’s hitting older folks harder… but this genome is so slippery…if it mutates again (and it will). Who is to say, what it will do next.

    Be smart folks… acting like you’re unafraid is so not needed right now.

    #flattenthecurve. Stay home folks… and share this to those that just are not catching on.

  • Neville says:

    Here’s some really good news via the Bolter from the Walter and Eliza Hall Institute in Vic.
    A new trial is about to begin on the latest malarial drug to see whether this will be helpful in the fight against the CV -19 virus. If the trial goes well we could be able to use the drug during this flu season.
    Let’s hope for the best.

    https://www.heraldsun.com.au/blogs/andrew-bolt/no-panic-heres-hope-instead-for-a-coronavirus-vaccine/news-story/92f8db1ca2d4e5c4667daa7167a83d1b

  • Bryan Roberts says:

    I had thought better of the immunologists at Johns Hopkins.

  • Don Aitkin says:

    Thanks, Beth. It was pleasantly familiar!

  • Neville says:

    An interesting interview by Bolt with a young bloke+ wife who has just arrived back from Taiwan and the different way they’ve tackled the CV-19 crisis.
    Very little shutdown of industry or jobs but Taiwan has been very strict on any arrivals and the care etc of the elderly, vulnerable people has been amazing. And sanitation, disinfecting etc has been extremely thorough and immediate.
    Very small country, just a little over half the size of Tassie but the pop is very close to our 25.5 m people. Here’s the link.
    And to be fair Bolt has been very critical of our handling and neglect of those returning from overseas since the start of this emergency, so he has runs on the board from the very start.

    https://www.heraldsun.com.au/blogs/andrew-bolt/tonight-all-travellers-to-be-locked-up-in-quarantine-but-has-the-scare-gone-too-far/news-story/a0bbaf6c17fa1a0afeb8091af7fc0ea7

  • Neville says:

    Sorry but the above link doesn’t include Bolt’s interview, but I’ll link to it when it’s available.
    BTW so far OZ has 13 deaths from the CV-19, about 0.5 deaths per mil and now 23 serious or critical.
    Taiwan so far has 2 deaths, about 0.1 deaths per mil and now none serious or critical. See Worldometer CV.

    • Chris Warren says:

      Usual Neville’s cherry-picking

      Zimbabwe, Kazakhstan and India (and others) have done a much better job so far, than Taiwan.

      • Boambee John says:

        Chris isn’t even good at sarcasm.

      • Peter S says:

        Chris you are cherry picking. One needs to be careful when comparing data from different countries. The lag times for advising infections differs from country to country. Also it is affected by how far the virus has progressed, and also on population demographics, the degree of development of each country and upon their ability to test and confirm. It is complex.

    • Peter S says:

      Interestingly Neville the mortality rate has been fairly constant at 0.5% despite the rising number of infections. It is one of the lowest in the world. That may change of course if the infection escapes more widely into the general community, which it will do if people don’t modify their behaviour.

  • Neville says:

    Here’s that Bolt interview at long last. And OZ has certainly done very well compared to most of the wealthier EU countries, but Taiwan and Singapore have done very well and not had our heavy lock down.
    But they have been very strong in strategic areas and gone in very hard. See the video.

    https://www.heraldsun.com.au/blogs/andrew-bolt/learn-from-taiwan-beat-this-virus-without-closing-shops/news-story/9363114830d35580bf2ab027375e3d21

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