Every crisis brings us brand-new lingo. Today, we toss around acronyms like “PPE,” short for personal protective equipment, as if we’d been saying it all our lives. We now knowingly discuss the latest hiccup in the “supply chain” — for such mundane life-saving devices as N-95 face masks — as if we’d ever heard that term before. My favorite new words? Alveoli and cytokine storm.
First, they’re fun to say. They sound cool. But, of course, they’re way more than that.
Among the millions of ingenious design miracles hiding in plain sight throughout the human body, alveoli might be the most quietly astonishing. Imagine the walls of your lungs lined with plastic bubble wrap, with each set of lungs wrapped with about 600 million bubbles. If all these bubbles were stretched out, we are told, there’d be enough to cover the surface of a tennis court. They are frequently described as looking like clusters of grapes.
Now imagine the skin of these grapes being porous and permeable, the same way, perhaps, a nylon stocking is. Lining the outer side of this grape skin are tiny little blood-carrying vessels known as capillaries. The oxygen we inhale through our lungs is sucked through the filter of these mesh-stockinged grapes and into capillaries on the other side. From there, the oxygen gets transported throughout the body, and we don’t die.
Going the other way — from the blood to the lungs and out the mouth — is all the carbon dioxide your body created that needs to be off-gassed. This exchange happens something like 25,000 times a day. It works so well because we don’t think about it. If it didn’t work, we’d all be fish flopping around, gasping for breath. Kind of where we are now.
COVID-19 doesn’t pop these bubbles, per se. Rather it fills them up with blood, pus, and mucous as the body figures out how to fight something it’s never seen throughout the six million years human have been swarming the planet. The body is to be forgiven for not anticipating that a bat-born virus could somehow be transmitted to humans through the scales of a Chinese creature that’s one-part armadillo, two-parts anteater.
As our air bubbles fill up, the nylon stocking hardens. What was once supple and diaphanous becomes stiff, hard, and impermeable. Imagine cardboard or tree bark. Either way, oxygen can’t get through. Carbon dioxide backs up. The body freaks. It goes nuclear and unleashes everything it has in its arsenal against the virus. This process, known as a cytokine storm, is like all the plagues of the Old Testament rolled into one. Caught in the crossfire, of course, is the body itself. Under this withering self-inflicted onslaught, the basic infrastructure of your body shuts down. Organ failure. Game over. To save itself, the body kills itself.
Kind of where we are now. Except we had choices.
After four weeks of mandatory shutdown, some people are now insisting the time has come to turn the lights back on and get the economy going again. The cure, they claim, was far worse than the disease. Some argue the threat was exaggerated from the start as a pretext for deep-staters to conduct a coup d’état or otherwise discredit Donald Trump.
Two Santa Maria councilmembers, for example, dismissed the virus as a hoax from the council dais. (One has since recanted.) Others privately argue nature should have been allowed to run its course; the frail and elderly would be culled from the herd — regrettable, perhaps — but as the infection spread, the survivors would develop herd immunity. Or as one high-ranking county official put it sardonically, “Not all wildebeests get to make it to the other side of the river.”
The “good news” is that there are not as many wildebeest carcasses in Santa Barbara as initially projected. The county coroner, for example, was told to ramp up capacity to handle a peak of 335 corpses. To date, Santa Barbara has had only two deaths officially attributed to COVID. Some skeptics cite such numbers as proof that the war has been won, others that the war was always a fraud.
To the extent California’s hospitals have not been awash in patients is the result of the cytokinetic action Governor Gavin Newsom was forced to take March 19, when he brought the world’s fifth-largest economy to a screeching halt. The withering, blithering incompetence of the emergency non-response of the federal government gave him little choice. Everyone recognizes our self-inflicted blackout is not economically sustainable. But the front-line medical professionals I talk to — people who spend 10 minutes just “gowning up” before seeing their patients — say more time is needed. In the 1918 flu pandemic that killed 50 million worldwide, more people died in the “second wave” than in the first. So when the lights do go back on, it’ll have to be with a dimmer switch.
Two years ago, during the Thomas Fire, protective N-95 face masks were like confetti throughout Santa Barbara County; public health officials passed them out on every street corner. Today, they’re all but rationed. The million masks the county received two weeks ago, it turns out, are not usable.
At the time of the Thomas Fire, Trump famously argued immigrants from what he termed “shithole countries” should not be allowed into the United States.
Who’s the shithole now?
Normally, FEMA is the federal agency assigned to national catastrophes; it’s what they do. But strikingly, they’re not in charge of this one. As early as July 2019 — the news source Energy & Environment reported — FEMA was circulating a major global-alert report to every department of the administration, warning that a novel flu virus for which no immunity or cure existed could erupt into a global pandemic and quickly overwhelm the capacity of nation’s health-care infrastructure.
In the total absence of competent federal leadership, states have been forced to compete with states, counties with counties.
Which brings me back to the beginning: alveoli and cytokine storms.
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