01 Answering a message from the USA

Times of Coronavirus:

Life in Spain

April 1: A letter in answer to a friend in the USA, who asked me how the “flu season” was going in Spain and whether I was all right.

Dear XXX,

I hardly know how to answer the question in your e-mail. I guess that the answer is no. No, I am not all right. Spain is about the size of Texas, and right now there are over 100,000 cases of coronavirus....and counting. Unless one has a death wish, everybody who goes outside wears a surgical mask and plastic gloves. In any case, no one goes out very much because it is only possible to leave one's house or apartment to buy groceries or medicine, and then, only to the store or pharmacy nearest your house. If people do not leave their house for a good reason, they receive a fine of at least 600 euros. All businesses and educational institutions are closed down except for pharmacies, drugstores, and stores where food is sold. Everyone who can, works from home. Those who can't work on the computer screen do not work. Even with such a strict lockdown, the contagion still continues.

The hospitals all over the country are filled to overflowing with coronavirus patients. The military has set up field hospitals in tents, gymnasiums, and conference centers in cities everywhere. There are currently a total of about 8,600 deaths, and everyday sets a new record. My oldest son, who is a psychiatrist, has been recruited to work in intensive care in Madrid. His hospital of 500 beds has stopped receiving any emergency cases except for coronavirus patients. Four hundred beds are for intensive care; the other 100 are for those in recovery. People who get better are sent off to medicalized hotels to get better. All treatments and operations have been postponed sine die. If you have a heart attack, stroke or cancer, you are toast.

It is a miracle that my oldest son has not fallen ill because there is no protection equipment for the doctors or drugs and ventilators for the patients. The doctors are thus obliged to choose which patients will live and which will die. Once people are taken off ventilators, they asphyxiate. Given the unpleasant nature of this type of death, some doctors have opted for giving patients morphine (of which there is no shortage) so that they can at least die in peace. Danny returns home in the evening, utterly exhausted, and there is no end to the nightmare.

My youngest son, who is a policeman, has been off work because he was put on quarantine. His partner was diagnosed with coronavirus but fortunately, Lucas did not get it. On Friday, he goes out to work again....also without protection. My daughter, the forensic doctor,, fortunately, can work from home except the days that she is on call. However, because of the lockdown, no one dies on the street any more. Everyone dies in the hospital. In fact, the hospital has become THE place to die. My son told me not to even go near a hospital unless I had a raging fever and could not breathe.

Our government leaders have been incredibly stupid and still do not have a clue about what to do. A lot of them have even fallen ill to the less deadly version of the illness, which is a great pity. I had thought that the mistakes of Italy and Spain would teach the USA about the folly of taking decaffeinated measures, but apparently not. Each state makes its own rules. So, the USA seems to be going in the same direction as Spain and Italy. Since the country is bigger, it may take a little longer, but the coronavirus will eventually trickle down to South Dakota, West Virginia, and Wyoming, where no one cares because their state has not been severely affected yet. In Texas, My second son, who is a pilot living in Texas, has only noticed coronavirus because schools are closed and meetings of more than ten people are discouraged. He is more worried about the economy. Unfortunately, I think that in a few months, things will get very bad there, and people will stop living in La-La Land. Since the country is bigger, there will eventually be even more deaths than there are here. I have stopped chatting with people from the USA who say that this is like the flu. It is not.

It is true that the deadly version of the coronavirus mostly affects those over 60, who are presumably expendable and can be sacrificed to the economy. In the past, ancient civilizations used to sacrifice virgins. I guess in modern times the elderly are now the new human sacrifice. However, as the disease spreads, it also hits younger people. I now know various people who have had coronavirus, two of whom are dead. One of the deaths was a man in his 50s, who used to live in my building.

So, no, I am not all right. And yes, I hate the coronavirus too. The only hope is for someone to find a magic bullet, but I am not optimistic about this possibility. Lately, I am optimistic about very little.

02 Journal of the Plague Year

Times of Coronavirus: Life in Spain

“And here I must observe again, that this necessity of going out of our houses to buy provisions was in a great measure the ruin of the whole city; for the people catched the distemper, on these occasions, one of another” (Daniel Defoe, History of the Plague in London).

Things have changed little since the 1700s. Even though the whole country is shut down and even more stringent measures were implemented on Monday that annihilate all economic activity, people still wish to go outside. Therefore they must derive what little pleasure they can by going out to buy groceries. The government has warned that it is against the law to go to any store not within walking distance of one’s house or apartment. So the corner grocery stores are booming.

In my neighborhood in Granada, everyone lives in apartment buildings, which is typical of most of Spain. Shopping for groceries means visiting the butcher’s and/or fishmonger’s and then going to another small store for fruit and vegetables. The next stop is to the bakery for a loaf of bread, and finally to the grocery store (two aisles) to buy whatever is left. Since the shops are so small, only one person can enter at a time in each place, except for the grocery store, where there is a quota of five people.

This means that it is necessary to wait in a line outside. People stand one meter apart while they wait their turn to enter. This is the only face-to-face social event of the day. It is when people share their stories of how they are coping. Yesterday a lady lamented that her roots were progressively more evident and that the drug store would not sell her hair dye (or any cosmetics) since they were regarded as“frivolous” items. I told her about my son in Texas, who complains to me because he cannot go to the mall, and can only go on walks to the park with his daughters. This story generated a collective “eye roll” from everyone in the line, and gave them their first and perhaps only laugh of the day. No one wishes to mention the mounting death toll.

The numbers here change and are published at noon. This is followed by a press conference in which different members of the government usually appear. Their faces reveal that they had thought that winning the elections would be more fun and that they would rather be anywhere else. I can imagine them flipping a coin to see who will go in front of the cameras to tell the bad news. Their discourse is divided into two parts. In the first part, they mention the “peak” of the exponential curve. We are always getting nearer to it or are approaching it or about to view it in the distance. It is an exercise in trying to say exactly the same thing, but using different words. Things are always on the point of changing, but invariably remain the same. The second part of the press conference is devoted to telling us how complicated/complex/challenging the next week will be, and that we must prepare ourselves for even greater sacrifices.

At the end, the Minister of Health (who usually draws the short straw) must answer questions from the press. Since he lacks the panache to blatantly refuse to answer “smarmy” questions, he achieves the same objective in a more subtle way. All questions from the press are previously censored, and only “non-smarmy” ones are permitted.

Although he usually tries to end the press conference by saying something optimistic, like the figures are “stabilizing”, no one believes him anymore. The truth is that people keep dying, and now it is no longer just the old. The new way to improve the number of dead people is simply to ignore them. The government refuses to count the people who have died at home or in an elderly-care facility, even those with clear symptoms. If you have died without being diagnosed (and this is easy since there is a severe shortage of tests), then you did not have coronavirus. In certain regions of Spain, forensic doctors have been told not to waste their time on doing autopsies of those people. Dead is dead.

Cataluña is one of the regions in Spain that has been particularly hard-hit. Hospitals in Barcelona are overflowing. The regional government there has told the doctors who go to pick up the sick and take them to the hospital that the critically ill with a poor prognosis should be persuaded to remain at home, where they can die surrounded by their family (and thus not occupy a bed or use a ventilator).

It is hardly surprising that death has become a big business. Funeral parlors are working 24 hours a day. Because of the number of bodies, Madrid is storing corpses at the ice-skating rink (I read that New York is now using refrigerator trucks). This has led to a new euphemism. “Poor Juan! He went skating.” In fact, the government finally had to regulate funeral prices because certain establishments were charging abusive quantities for wakes, mass, coffins and other paraphernalia even though wakes are prohibited and funerals of more than three people are against the law. A priest does say prayers, but he can only spend seven minutes on each corpse.

However, amid all of the death and tragedy, there are moments and gestures of great meaning and transcendence. Every evening at 8:00 since the beginning of the lockdown, everyone goes out on their balconies and spontaneously claps for ten minutes to thank all of the healthcare workers, policeman, firefighters, and military personnel, who are keeping people safe, often despite themselves. The clapping is heard throughout the city and is often accompanied by music. “Resistiré” [I will Survive], an oldie by the Duo Dinámico, has now become the national hymn that people play from their balconies.

Finally, there is hope. Medical protection is being manufactured in rural populations, where people of both sexes have dusted off their sewing machines to make reusable facemasks. A dressmaker’s shop that formerly specialized in flamenco dresses has recycled and is now making protection suits for doctors. People with 3-D printers are creating parts that help to adapt Decathlon scuba diving masks and to convert them into ventilators. It is evident that if we wait for help to come from China or anywhere else, we will all be dead before the material arrives. The only way to obtain material is to make it ourselves. In the end, we are like the Little Red Hen, who had to make the cake by herself.

03 The Peak

Times of Coronavirus: Life in Spain

Yesterday was an important day. The Minister of Health appeared on the television with the habitual deer-in-the-headlights look on his face, and announced that we had (at long last) reached the PEAK of the exponential curve. This statement, of course, was couched in phrases like “it is still early…”, “with due caution”, and “better to be prudent”, in an effort not to sound unduly optimistic. It is no wonder that about half of the population no longer watches the news. And the other half, who continues to watch in a kind of masochistic bedazzlement, is convinced that the government (and the media) are lying.

In this case, however, the government is not lying, at least not consciously. The situation is even worse. They simply do not know because they lack sufficient data or interpretive power to distinguish between truth and falsehood. Each region in Spain submits their data about hospitalizations, intensive-care occupancy, and deaths when convenient, and often these data do not even refer to exactly the same time period. The central government has to collate it as best they can, which evidently is not very well.

Based on their abysmal logistics and ineffective distribution of surgical masks and protective equipment, the government could learn a thing or two from my eight-year-old grandson, who organizes all of the tiny pieces of his multiple Lego constructions with mathematical precision, and has perfect control over which piece belongs to which set. In contrast, the Spanish government, though generally well-meaning, has little or no control over anything.

This morning, when I went downstairs to buy milk, yoghourt, and, of course, wine, I announced the good news about the PEAK to my grocery-line social group. Most of them were not aware that we had reached the PEAK, and their faces eloquently reflected their disbelief. Since they know that I work in the university (and thus am supposed to be knowledgeable), they asked me what “reaching the PEAK” meant and how it would affect them. I said that I was hardly the Oracle of Delphi, but even if the government were telling the truth, I doubted that it would make a great deal of difference to us, at least in the short-term. I could only tell them what “reaching the PEAK” yesterday had meant for my son, who works in one of the coronavirus hospitals in Madrid.

Yesterday, “the peak” meant that hospitalizations continued at the same rate, but at least did not spike. It also meant that even more patients than usual died. A few more protection suits and masks trickled in for the lucky few. My son, who is a psychiatrist, was briefly called out of intensive care to treat an 89-year-old man, who had unsuccessfully tried to commit suicide. Since the man is now hospitalized in one of the few beds reserved for non-coronavirus patients, his death wish might be satisfied because the hospital is the best place to catch the disease and die.

Back in the coronavirus ward, my son has volunteered for the unenviable task of calling the families of the patients who have died to tell them the sad news…and often to grieve with them. As a psychiatrist, it is something that he does well. When patients are near death, he tries to communicate with them in some meaningful way so that he can tell the family about one small personal detail …. their last words, a name uttered, someone that they loved…. one last memory for the family to hold onto. He wants them to know that their family member was not just a body in a numbered bed. He wants them to know that their loved one did not die alone…. and that someone cared.

Yesterday a husband and wife (in their 60s) were hospitalized, both with coronavirus. The husband was near death but the wife had a fair chance of recovery. They were in different wings of the hospital. My son bribed someone to give him a protection suit, went running to the wing where the wife was hospitalized, and rolled her bed to the ward where her husband was. They were able to hold hands for about seven minutes….and say good-bye to each other. Six hours later he died. They had been married for 43 years.

This is what reaching the PEAK meant yesterday in Spain….a sad trail of personal tragedy triggered by a conspiracy of dunces.