As nCoV fear grows, daily routines become extraordinary

MANILA — The most visible sign of growing concern over the deadly novel coronavirus (nCoV), now confirmed to be in the Philippines, are the facial masks.

At a hospital east of Manila, it would have been ordinary for people to wear masks but to see nearly nine out of every 10 persons walking through the door to be wearing masks was telling—these are not ordinary times.

“It’s a hospital so it won’t be unusual to see staff, visitors or patients wearing masks,” said a nurse at the hospital’s outpatient section who gave her name only as Amy.

“But now, the corridors, even lobby and driveways are filled with people in masks,” she said. “It just shows people are being cautious,” she added.

“Especially now that there’s already a confirmed case of coronavirus,” she said, referring to the Department of Health (DOH) confirmation on Thursday (Jan. 30) of the Philippines’ first nCoV case.

At a drug store outside just across the hospital, Jim, a family driver, withdrew from a queue that he guessed was already half-a-kilometer long.

“They were all there to buy masks,” Jim said.

His boss, a bank executive, had asked him to buy 10 boxes of masks. Some would be donated, said Jim.

Unending queue

He was willing to wait in line but his boss’ schedule forced him to quit the queue. “I estimated that it would take me a minimum four hours to be at the counter,” Jim said. “I had only 30 minutes to spare,” he said.

Jim greets a fellow driver also waiting for his boss at the hospital lobby. “Hey, were you able to buy?” Jim shouted across the lobby to his fellow driver whom he called Noy, referring to masks.

“Yes,” replied Noy, his voice also raised for Jimmy to hear. “I got them.” Noy pulled down his mask and gave out a smile that seemed to tell Jim “I got one over you.”

“I was outside the store as early as 6 a.m.,” Noy told Jim. “You should have done it, too,” he added.

“I got 20 boxes,” proudly declared Noy. Jim throws a quick question at his fellow driver: “What the hell are you going to do with 20 boxes of masks?”

At 50 masks per box, the supply that Noy bought translates to 1,000 masks. At an average of P40 per mask, it meant his boss spent P40,000.

“Don’t know, maybe one for each day,” replied Noy, bearing a grin. “Or maybe to keep for doomsday,” he said, letting out a laugh.

“Wait til you see how many masks the others there are buying,” said Noy, referring to the queue of people waiting to buy masks at the drugstore just across the street from the hospital.

“I saw some, they look like househelps, carrying notes with the number 100,” Noy said. “Some were even 200, 300,” he said. The numbers were the number of boxes of masks that the bosses of what Noy described as domestic helpers had told their workers to buy.

“They should limit the purchase,” Noy said, referring to the drug store policy. “But no, they just keep on handing them out,” he said. “Bahala na (To each his own),” he said.

“If you fell in line for eternity and reach the counter and they say there’s no more masks, it’s tough luck,” said Noy.

Panic-buying

He recalled one buyer, a driver, too, filling the cargo hold of his boss’ car, a luxury SUV, with “boxes and boxes of masks you won’t see the rear window anymore from the driver’s seat.”

Jim grinned and shook his head listening to Noy’s account on buying masks. “It’s a good thing my boss is not bad,” he said. “He only wanted 10 boxes because some he wanted to give to our neighbors,” Jim said.

“But I wasn’t able to get any,” Jim added. “The queue would take a lifetime to move,” he said.

At the hospital’s waiting area for outpatients, Rey sat in one of the spotless plastic chairs in a row of chairs in bright colors. He was waiting for his wife who had a checkup for myoma.

Just an arms’ length from where Rey sat, hospital workers in blue uniforms, apparently outsourced employees, seemed to be on a ritual—spray, wipe and dry.

They spray what was presumably disinfectant on the empty chairs, the rail guards, the top of tables, door handles, the gleaming walls. Then they wipe it off, repeating a circular motion until they see the liquid disinfectant spread out thinly. They then wipe it with clean, dry cloths.

It was a ritual that Rey said he found amusing. He has been watching for more than half-an-hour as he waited for his wife.

“The other time I remember seeing cleaners as meticulous as these was when we went to Hong Kong and saw these elderly women at the airport performing like endless tasks cleaning chairs and floors,” said Rey. Hong Kong is now one of several areas with confirmed nCoV cases.

Live entertainment

Instead of tinkering with his mobile phone, as others sitting in the waiting area were preoccupied with, Rey stared at the cleaners. “This is entertaining,” said Rey, who had a mask resting on his lap.

He’s been to the hospital several times before but Rey said it was the first time he saw the cleaning crew nearly double in manpower and stay on duty for longer hours.

“It’s reassuring, though,” said Rey, who said he works for an IT company based in BGC.

He said it was his wife’s schedule to have a checkup for myoma. “It’s not getting smaller,” he said, shaking his head, referring to what he said were polyps found in his wife’s uterus.

“Then add this new virus,” he said, referring to nCoV.

Asked what kind of preparations he and his family have been up to, he takes a few seconds to reply.

“Come to think of it, all we did was get these masks,” he said, pointing to the blue mask resting on his lap.

He said he’s read that people with a strong immune system have high survival rates against nCoV. “I’d like to believe we’ve got that,” he said of him, his wife and two children.

He said the information about nCoV that he has came from watching the news on TV and “sometimes browsing the internet, but there’s so much false information online.”

“One or two websites, I can believe in,” said Rey. Asked what he learned about nCoV from reading reports on the internet, Rey said “many, but some are somewhat common knowledge na.”

“It doesn’t scare me,” he said. “Neither does my wife. But we’re going to get the children vaccinated.” His eldest is 10 years old and his youngest is six. Both are girls.

Told that there were no vaccines yet for nCoV, Rey said he knew but was thinking about vaccines against pneumonia in general. “If  you’ve got protection against pneumonia I think you’re half immune,” he said. He added quickly, though, that “we will still consult the experts.”

Going crazy

“We were able to buy 10 pieces of masks,” he said. He gave two each to his children’s nanny and their main househelp.

Told about the driver Noy’s account about one buyer filling the cargo hold of his boss’ SUV with masks, Rey laughs. “It’s crazy,” he said.

There’s nothing crazy about nCoV judging from conversations in a restaurant inside the hospital that sells Filipino food at an average of P300 per order.

One woman, wearing a shiny gold necklace shaped like rubber bands tied together and a pair of Chanel slippers, was talking loudly about the virus with what appeared to be her friends, all in designer clothes.

“Oh my God,” said the gold necklace-adorned woman. “It’s good we always consult our doctors,” she said aloud while twisting in her fork what appeared to be noodles for a dish called luglug.

“That’s why it’s good to have regular checkups even if you don’t feel anything,” replied one of her friends, a woman probably in her 50s wearing a diamond-studded bracelet.

“Can this be prevented by stem cells?” asked another woman, probably in her 50s, too, and wearing jade earrings encrusted in gold that were nearly as big as the head of the teaspoon she was using to stir what looked like coffee in a white cup.

The question drew loud laughter from the women who looked like they may have just come from a visit to their dermatologist.

Then from about four tables away from the group, an elderly man wearing a mask and sitting in a wheelchair coughed repeatedly. A caregiver was rubbing his back as he struggled to breathe.

One of the affluent-looking women gestured with her fingers to call for the bill. “Better safe,” one of them was overheard as saying as they put their masks back on and prepared to leave.

Extraordinary day

A busboy, who later gave his name only as Nel, said the group of women was a regular at the restaurant. He doesn’t know which clinic at the hospital they visit but surmised it would be one offering dermatology services.

“Didn’t you notice?” said Nel, laughing after the women, whom he described as “socialites,” got out.

“I always see them but this is the first time they’re so sensitive about someone coughing or even blowing his nose,” said Nel, who was wearing a mask, too. “Maybe because there’s now corona in the Philippines,” he added, referring erroneously to nCoV as “corona.”

Amy, the nurse, said the hospital “is always filled with people.”

The difference this time, she said, was “you can see they would hardly touch the door handles when they come in.”

“Some push the doors with their elbows,” she said.

“You know that they’re being extra cautious,” Amy added. “It’s obvious isn’t it?”

“Plus the masks,” she said. “I haven’t seen almost everyone wearing masks,” she added, herself wearing a mask with dot designs.

Outside, where a members-only shopping club sits across the hospital’s emergency entrance, people wearing masks appeared to outnumber those who aren’t. It looked like everyone did on the streets.

“No wonder face masks are now out of stock,” Amy said.

She said, however, that although face masks “offer some kind of protection,” people wearing these should not be lulled into believing they won’t contract nCoV because they’re wearing masks.

“There are actually several ways you can get infected without the virus landing on your eyes or mouth from the sneeze or cough of someone infected,” she said.

Like touching a handrail or a door handle that’s been touched by a carrier who had just wiped off cough or cold residue from his mouth or nose.

“It’s not naman to cause panic, but this virus is fearsome more because of the speed with which it could spread,” said Amy. “More than its lethality,” she added.

Nurse Amy was not making a guess.

What the experts say

According to a report in the Financial Times of London, nCoV is now spreading faster than SARS (Severe Acute Respiratory Syndrome), another coronavirus that emanated from China, which took more than eight months to infect 8,000 people at the height of an outbreak between 2001 to 2003.

The number of nCoV cases in China alone has breached 7,000 but in just one month, the Times said in its report. “Epidemiologists fear that nCoV has already infected tens of thousands more people,” the London-based newspaper wrote.

In an update, the Washington Post reported on Feb. 1 that there are now 11,000 people infected by nCoV in China alone just 24 hours after the count was more than 9,000 cases there.

In its report, the Financial Times quoted Bill Keevil, professor of envrironmental health care at Southampton University, as saying this: “Wearing face masks may give a false sense of security.”

“Tests in his laboratory have shown the coronavirus can survive for four days on common materials such as plastics, glass and stainless steel,” the Times report said.

“That’s why what they’re doing is good,” Amy said, gesturing toward the cleaners who are in the middle of their spray, wipe, dry ritual around the hospital.

A caregiver who gave her name as Lisa sat in the lobby of a wellness section which looked more like a hotel’s than a hospital’s with its cushy couches.

Her ward, an 80-year-old retired insurance executive, was with his doctor being checked for signs of fever or flu, but “not for coronavirus.”

“He’s just really sickly because of his age,” Lisa said, lowering her mask to speak clearer.

“But the new disease really scares us,” she said. She recalled her ward’s grandchildren joking that their grandfather already has nCoV each time he coughs.

“I tell them it’s not funny,” Lisa said of the children’s joke.

“What if they get sick, too?” she said. “What if I get sick, too?”

She said she worried after hearing from radio news that people with an already weak immune system are the most vulnerable to the severest effects of nCoV—pneumonia and death.

Multiple reports about the first nCoV fatality in China said the patient, a woman, died six days after contracting the virus.

Vulnerability

“Lolo is not strong,” said Lisa, referring to her 80-year-old ward. “I don’t know if his immune system would withstand the virus but it’s just a fear of mine. I would listen to his doctors.”

She said this was the reason the family of her ward had taken extra precautions at home, where Lisa also stays to keep watch over her patient.

“It’s like every minute, they tell the maids to wipe the floor and surfaces with Domex,” said Lisa, referring to a brand of disinfectant solution.

“There’s lots of bottles of alcohol at every corner,” she added.

“And the masks,” she said. “I guess we have dozens of boxes of them” mainly because her ward has to be protected from the minutest of excretions or invisible virus particles.

According to the Centers for Disease Control (CDC) of the US government and the World Health Organization (WHO) websites, no cure is available for nCoV.

Antibiotics, the two international health agencies said in their sites, won’t work because nCoV is virus, not bacteria.

“The new coronavirus is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment,” CDC said. “However, if you are hospitalized for the nCoV, you may receive antibiotics because bacterial co-infection is possible,” it said.

The only remedy available for patients is for the symptoms of nCoV like high fever, shortness in breathing, coughing if these get worse.

Little is known about how nCoV developed except that it was first detected in Wuhan, a highly developed city in the Chinese province of Hubei, which is now on a lockdown. Reports point to a market that sold animals, including porcupines, snakes and bats, as origin of nCoV.

That the virus came from China had added to what could be considered as racial bias against the Chinese in the Philippines which, while muffled most of the time, shows its ugly head when China is thrown in the middle of controversies that have effects on Filipinos’ lives.

Scare

Jon, a security guard at the hospital, is on roaming duty at night. Just hours before the DOH confirmed the first nCoV case in the Philippines, Jon recalled a group of up to four Chinese entering the hospital’s glass doors and wearing no masks.

As the Chinese group made its way into the lobby, Jon likened the scene to the famous parting of the Red Sea in the movie “Ten Commandments.”

People gathered at the lobby stepped aside or moved away as the Chinese walked inside, said Jon. “Like something scary came in,” he said.

“It’s understandable,” the guard said. Jon said he himself doesn’t look kindly on Chinese nationals coming from the mainland as his personal judgment of them is influenced by what he said was China taking land away from the Philippines. He might be actually referring to the territorial dispute in the West Philippine Sea between China and the Philippines.

The reaction to the Chinese nationals walking into the hospital without masks could be an exaggerated response to perceived nCoV threats but one that is not surprising at a time when alarming, mostly fake reports, are spread on social media.

In Legazpi City, according to an INQUIRER.net report, false reports allowed by Facebook to be posted prompted a clinic inside a mall to issue a denial about a Chinese woman getting checked at the clinic when she was already positive of nCoV.

The proliferation of false reports on social media prompted Philippine government officials to appeal for restraint in spreading unverified information on nCoV. In Malaysia, several reports said a man was sent to jail for spreading false information about the virus.

According to the CDC, while nCoV likely came from an animal source, it “now seems to be spreading from person-to-person.”

The first time that the world saw how the virus looked like was Jan. 10 when Chinese scientists were able to genetically map it and showed its face to the world—a spherical microscopic creature with tiny seemingly sawed off spikes dotting its surface, leading to the term “corona” or crown.

“It’s important to note that person-to-person spread can happen on a continuum,” the CDC said using the term for continuous sequence.

Since there is no vaccine yet for nCoV, CDC said the best way to avoid getting infected “is to avoid being exposed to this virus.”

“People of all ages can be infected by the new coronavirus,” WHO said. “Older people and people with pre-existing medical conditions appear to be more vulnerable to becoming severely ill with the virus,” it said. Some pre-existing conditions which WHO said make a person weaker in fighting nCoV were asthma, diabetes or heart disease.

The CDC said there is “no specific” treatment yet for nCoV. “People infected with nCoV should receive supportive care to help relieve symptoms,” CDC said. “For severe cases, treatment should include care to support vital organ functions,” it added.

Both CDC and WHO list precautions against nCoV which included washing hands often with soap and water for at least 20 seconds; using alcohol if soap and water are not available; avoiding touching eyes, nose and mouth with unwashed hands; avoiding close contact with people who are sick; staying at home if you’re sick; covering coughs or sneeze with tissue and throwing the tissue in trash bins; and cleaning and disinfecting objects and surfaces that are frequently touched.

In WHO’s list of precautions, two pieces of advice were added—if going to markets in areas with confirmed nCoV cases, “avoid direct unprotected contact with live animals and surfaces in contact with animals” and avoid eating raw or undercooked animal products.

A little knowledge…

According to the Financial Times report, computer modeling at two institutions—Imperial College London and Lancaster University—“suggest that each new coronavirus case is infecting an average of 2.5 other people.”

The drivers gathered at the hospital lobby waiting for their bosses continued to engage in banter, their masks pumping from the laughter these hid.

One driver looked at Jim to start a debate on whether such communicable diseases, like the one carried by nCoV, should stop people from going about their daily routine.

“How come when AIDs was spreading, people didn’t stop having sex?” the driver said. “You mean if this virus is in the air that we should stop breathing?” he continued.

Jim and Noy looked at the driver who posed the argument, taking a long pause for a rebuttal.

“The problem with us is we don’t know everything but we pretend to,” answered Jim.

As more arguments were being put forth, the driver who started it reached into his pants pocket to pull out his mobile phone to answer a call.

“Yes boss,” the driver was overheard saying to the person at the other end of the line. “200 boss,” he said, in apparent reply to a query about how many boxes of masks he was able to buy.

After around 15 minutes, the driver disappeared to reappear at the hospital driveway on the wheels of a luxury SUV, the one that Noy said he had seen brimming with boxes of masks in its cargo hold.