Thursday, 30 April 2020

Dangerous and Deadly Cures: Paracelsus to Trump

Donald Trump’s suggestion that injecting disinfectant into the body might cure coronavirus has rightly sparked outrage and alarm within the medical community and far beyond. His promotion of the anti-malarial drug hydroxychloroquine, topped with his claim that he has been taking it himself, has made medical jaws drop. Trump deserves all the contempt and ridicule dumped on him for his medical pronouncements. When the POTUS speaks, some follow his advice, potentially deadly in this case.

Trump is a classic snake oil salesman, although snake oil would be much less dangerous than his prescriptions. He belongs to a tradition of quacks and charlatans peddling dangerous medical nonsense. That tradition, sad to say, has flourished in the USA since colonial times.


Historically, orthodox medical practitioners have offered remedies just as dangerous and useless as those of the quacks. Until the late 19th century, bleeding and purging were mainstays of their practice, and their drugs often included toxic ingredients. Critics of standard medical practice loved to claim that doctors were  more dangerous than the diseases they treated. English artist/engraver William Hogarth lumped fashionable doctors and famous quacks together and called them "The Company of Undertakers." (1736)


Another English artist Thomas Rowlandson, among others, saw little difference between the orthodox doctors and the quacks. (Below: Rowlandson, "Death and the Apothecary, or the Quack Doctor," from the English Dance of Death, 1815-1817)


Until the 19th century, medical bleeding was often moderate, with practitioners removing only a few ounces of blood. But in the late 18th century, Dr Benjamin Rush of Philadelphia promoted the removal of huge amounts of blood. He claimed to have removed hundreds of ounces from some patients with great success. One of his disciples, David Ramsay of South Carolina, declared that bleeding should in some cases be continued “until four-fifths of the blood contained in the body are drawn away.”


Along with heavy bleeding Rush recommended drastic purging with large quantities of jalap, a powerful herbal cathartic, and calomel -- mercuric chloride. Rush declared that his remedies were beneficial for all manner of diseases. He called his system “heroic" medicine. The patients who survived it surely must have been heroic. Calomel became a mainstay of 19th century medicine, especially in America.

From the 16th century into the early 20th, compounds of the heavy metal mercury were used to treat a wide variety of illnesses. The 16th century German physician Paracelsus promoted mercury as a specific in the treatment of syphilis. Mercury continued to be the medicine of choice for that disorder until the early 20th century. Its use gave rise to the saying “One night with Venus and a lifetime with Mercury.” Joking aside, the effects of ingesting mercury can be frightful. They include loss of teeth, rotting of the jaw, paralysis, and death.

Other highly toxic minerals were common in patent and proprietary remedies, especially arsenic and antimony. In the mid-18th century, Dr Robert James patented his famous fever powders, a concoction of oxide of antimony and calcium phosphate. Dr James’ Fever Powders remained a popular remedy well into the 20th century.


In the early 20th century, the German scientist Paul Ehrlich developed arsenic compounds that were widely used to treat syphilis until penicillin became available in the 1940s.

Toxic drugs were commonly found in family medicine chests. In 1814, Ann Deas of South Carolina wrote a friend that she had dosed her son with Dr James’s Powders, and hoped “by the aid of arsenic to cure him in a day or two.” We will never know how many people were unknowingly poisoned with medicines administered by their loved ones. Perhaps knowingly in some cases. Arsenic was a favourite tool of poisoners in the 19th century and was readily available at pharmacies, along with opiates and other toxic drugs.

Even young children could purchase these dangerous chemicals, as this Punch cartoon of 1849 points out. The young girl buys "lodnum" and arsenic "for the rats" on behalf of her "mother."


Godfrey’s Cordial, a favourite remedy for teething or sleepless children, was a mixture of laudanum and treacle. Laudanum is a tincture of opium, which has been used medicinally since ancient times. Treacle is a sweet sugar syrup, which made the concoction tasty to kids. They lapped it up and slept ever so well. Godfrey's Cordial and its imitators was a mainstay of the Industrial Revolution, great for mothers condemned to work 12 hours a day, 6 days a week in a factory. Not so good for the little ones, who often developed addiction and all sorts of physical and mental problems. The ad below is for a version of the cordial.


Opium in various forms was a standard ingredient in many patent and proprietary medicines from the 17th to the 20th centuries, often mixed with alcohol. It was mixed with ipecac in Dover’s Powders, which remained for sale in many places into the 1960s. When morphine, an opium derivative, was discovered in the early 19th century, it was hailed as a miracle pain killer. It is still in use for extreme pain, though carefully controlled. It was so readily available and widely used in the late 19th century that morphine addicts became a regular feature of literature.


In the 1890s, the Bayer Co. in Germany came up with a solution to the morphine problem: heroin, another opium derivative. They hailed it as another miracle drug, for many disorders. We know how that turned out.


In the early 20th century many countries began to regulate and limit the sale and use of opiates and other drugs, such as cocaine. But toxic ingredients continued to be used in some patent and proprietary medicines. And as Trump's medical pronouncements make clear, quackery in medical advice can flourish at the highest levels of society and government.

Friday, 24 April 2020

Coronavirus Lockdown Protests and Kant's Moral Philosophy

Protests against lockdowns, facemasks, social distancing, and other measures designed to slow the spread of  Covid-19 are understandable in some ways. No one should underestimate the economic hardships and mental strains of these disruptions of "normal" life. For some, the burdens can be almost unsupportable. They are especially great for poor families suffering loss of income, lacking health insurance, and cooped up in small apartments or houses.

The most vocal and visible protesters in the US do not seem to me to fit into these categories, unless they have squandered their income on large, expensive, gas guzzling vehicles and the pricey arms and ammo they flaunt at every opportunity. I doubt what I have to say would have much influence with such protestors, but here goes.





In the late 18th century, the German philosopher Immanuel Kant provided a yardstick for our behavior that seems to fit the current situation. As part of what he called the "categorical imperative" Kant argues we should "act only according to that maxim whereby you can at the same time will that it should become a universal law."

To put it another way, we should consider what the effects of our action would be if everybody acted in the same way. Say we are tempted to steal. We should ask ourselves, "what if everybody did that?" Kant argues that would make stealing a universal law. It would destroy the concept of private, individual property. (Groundwork to the Metaphysics of Morals, 1785)


Universal stealing, or even an approximation of it, would destroy far more than property rights. The same applies to the actions of the protestors. If their behavior was universal or even common, it could lead to severe illness or death for millions. 

Unfortunately, Donald Trump and many political and religious leaders seem perfectly content with the protestors' inability to grasp this basic fact, celebrating their "defense of freedom," a mantra blasted out by FOX news and other media moral morons.

Monday, 20 April 2020

Freedom, Coronavirus, and J. S. Mill's Harm Principle

The coronavirus pandemic has spawned a new cry for freedom: in this case freedom from wearing masks, social distancing, lockdown, and other measures designed to stop the spread of the disease.

The cry of "freedom from tyranny!" is heard in many places, but perhaps loudest in the USA, where it is usually accompanied by a show of semi-automatic weapons. "Live Free or Die" they chant, apparently unaware that in this case, "Live Free and Die" would be more accurate. Stop nannying us, they say. Let us live "normally" and take our chances. They have often gotten their wish, especially in "red" states. "Red." How ironic.




That might be acceptable, though tragic, if they were just doing something that would harm only themselves. For example, drinking disinfectant or shooting heroin. But it is glaringly obvious that they can do and have done enormous harm to others. Those among the "freedom for me and screw you" crowd who can read should have a close look at John Stuart Mill's On Liberty (1859). And not just the cover or the blurb on the back.



On Liberty has long been a bible for literate libertarians. Mill's aim was to define the extent of liberty, and he defined it quite broadly. "Over himself, over his own body and mind, the individual is sovereign." 

Mill argued that individuals have a right to do or say anything, even if it harmed them. Society has no right to limit or restrain individual liberty with one exception: to prevent harm to others. But that is a big exception.

The Harm Principle, as it has become known, is open to interpretation in specific cases, but it provides a rough guide to human liberty and its limits. 

Would Mill argue that society has a right to prevent individual actions that would spread a deadly infection like Covid-19? I believe he would. He would not have been a covidiot. Unfortunately, many inhabitants of Planet Doomed are.


Thursday, 16 April 2020

Comparing Pandemics: Coronavirus and the Great Influenza of 1918-19: Updated


The coronavirus pandemic is often compared to the so-called Spanish Flu of 1918-20. There are good reasons for this. The Great Influenza of 1918-19, as it is now usually called, killed between 50-100 million worldwide. No disease outbreak since then has had such catastrophic effects in terms of numbers of people and countries affected. The similarities are much greater than the differences.

Similarities


·   Both diseases spread around the globe with incredible speed. In 1918, World War helped the spread, especially with millions of soldiers being crowded together on troop ships, trains, barracks, and trenches. The flu infected about ½ of the world’s population in about a year. So far, Covid-19 has not infected so many, but it may be early days yet.

·    Both appear to have similar case mortality rates, between 1-3%, about ten times higher than seasonal flu. The great majority of the infected in 1918-19, about 80%, recovered after a week to 10 days, though many suffered lingering weakness for weeks or months. Those who did not recover within a week or so often developed severe pneumonia, the main cause of death.  Coronavirus seems to follow a similar pattern. 

·  In both pandemics, the official mortality statistics were/are too low. For various reasons, many flu deaths were not recorded, not recorded until much later, or never recorded. The same has been happening with coronavirus. That is partly because of technical and human problems. It is also because underreporting deaths suited some authorities and political leaders, then as now.

·  Both strained health systems to their limits and beyond. Hospitals ran out of beds and medical supplies. Other buildings were converted into temporary hospitals and tent hospitals were set up in the open air. People wore masks to prevent being infected or spreading the disease, with debatable results. 



·       Both led to the closing of many institutions and businesses: schools, large shops, churches, theatres, and dance halls. Both produced similar sorts of advice: avoid crowds, keep your distance from others, wash your hands regularly, wear masks, avoid touching your face or mouth. In both, quarantine and other isolating measures were inconsistent and produced protests. The measures were often lifted at the worst possible time, leading to a surge in cases and deaths. 

·  Both expanded opportunities for charlatans peddling useless or dangerous remedies. (Think Trump) Familiar products were proclaimed to protect one against the disease, like disinfectants.

Both had severe effects on economies. This is a bit tricky for the Great Influenza because the First World War was nearing its close and it had already produced catastrophic effects on world trade. The influenza made things worse by closing down many businesses for weeks or months. The US recovered fairly quickly. Many other countries did not. The economic effects of Covid-19 may be even worse, but we won’t know for some time..

·  Both produced wacky explanations for the outbreaks: In 1918-19, the flu was blamed on cosmic influences, strange weather, electricity, German U-boats spreading the germs, and dirty pajamas.  In 2020, the 5G network is one of the wackier explanations, along with Bill Gates and Dr. Fauci. And, of course "God's Wrath."

Differences

·       Unlike coronavirus, the 1918-19 flu killed younger people at a much higher rate than the old. The highest death rates were among people aged 15-44. About half the deaths occurred within this age cohort, who generally possessed the strongest immune systems. In the case of coronavirus, people over 60 and people with compromised immune systems are more vulnerable.

·  The virus causing Covid-19 was quickly identified, within weeks of the outbreak. The virus causing the Great Influenza was not identified until decades later. Some scientists speculated that the culprit might be a virus, but at that time, no one had ever seen a virus. No one would until much more powerful electron microscopes were developed around 1930. Most experts believed the cause was bacterial. Several vaccines were developed but all were useless.

·  One of the most tragic consequences of the Great Flu was the extremely high mortality among some isolated ethnic groups. In Samoa, about 25% of the population died, a proportion similar to that of the Black Death of the mid-14th century. Some Inuit and Eskimo communities in Canada and Alaska were wiped out or lost all their adult members. In 2020, there are fears that isolated populations may experience the same kind of losses. That has not happened so far, perhaps because the world contains fewer isolated populations. 





Further Reading: 

John M. Barry, The Great Influenza (Penguin Books, 2004)

Alfred W. Crosby, America's Forgotten Pandemic: The Influenza of 1918 (Cambridge, 2003)

















Thursday, 9 April 2020

Finding a Scapegoat for Pandemics: Black Death to Trump Virus: Updated with New Scapegoats


Ever since Donald Trump stopped calling Covid-19/coronavirus a hoax, he has been engaged in an age-old response to disease epidemics and pandemics: finding a scapegoat. Rather than accept his own incompetent response to the pandemic (impossible), he has engaged in blaming a host of nefarious villains. 

Trump's scapegoats have included everyone who "failed to warn him" or "created the virus." The list is long and grows longer by the day: Democrats, immigrants, the "Lamestream" Media, the Chinese, Obama, Hilary, and the World Health Organization (WHO), and Dr. Fauci. Trump, of course, is not alone in scapegoating. Some of his supporters blame all of the above, plus Bill Gates, libruls, commies, gays, single sex marriage, and Jews.

The word "scapegoat" derives from a practice described in the Bible (Leviticus 16). The original scapegoats were actual goats. A rabbi would symbolically load up a goat with all the sins of the community and send it into the wilderness. Goodbye sins.

In more modern times, a scapegoat is usually a person or group of persons blamed for a disaster. The disaster might be a famine, an earthquake, floods, or as in the current case, a deadly disease. Throughout history, people have tended to blame "others" for mysterious deaths, especially on a large scale. The scapegoats have included people of different religions and cultures, minorities, "witches," heretics, women, and the poor.

European Christians often blamed Jews for epidemics, notably during the Black Death of the 14th century. Then and in later outbreaks, Christians claimed the Jews had poisoned the wells. Mobs killed thousands of Jews. Yet the plague was never called the Jewish Disease. 

Nor was it called the Chinese Disease. The plague probably originated in China, but few Europeans were aware of that in the 14th century. In more recent times, Westerners have accused the Chinese (and Asians more generally) for epidemics and pandemics. The 1890s cartoon below, from a San Francisco newspaper, condemns the city's Chinatown and Chinese immigrants as the source of malaria, smallpox, and leprosy. 



  
In 1900, whites in Honolulu and San Francisco blamed the Chinese community for an outbreak of plague in their cities, the first ever in the United States. The entire Chinese population of the two cities was quarantined and demonized. In Honolulu, an attempt to use fires to purify the air and burn out the plague resulted in wildfires and the destruction of 7000 homes in Chinatown. (Below: Quarantine line around Chinatown, Honolulu and fire there, Jan. 1, 1900)



In the USA, many people blamed Jews for the 1892 cholera epidemic, which coincided with the arrival of a large Jewish migration from Russia. Americans also blamed Irish immigrants arriving in the 1830s and 1840s for cholera and other diseases.

In the 1980s, many people blamed gays for the AIDS epidemic. The original name for the disease, GRID (Gay Related Immune Deficiency) did not help. Later, many Americans accused Haitians as the source.

The disease for which blame has been most shared is syphilis, which first broke out in Europe around 1500. The Spanish, who appear to have been the first to experience it, blamed Native Americans, and that remains a common view. Tahitians called it the British disease after Captain Cook's visit in 1769.

The English called it the French Disease, the French called it the Italian Disease, and the Italians reciprocated. The Dutch called it the Spanish Disease, For the Russians, syphilis was the Polish Disease.Turks called it the Christian Disease, the Japanese the Portuguese Disease. 

After the Civil War and emancipation of the enslaved, many Americans viewed syphilis as a black disease. Nearly everybody blamed "loose women" but rarely did anyone blame loose men. Everybody knew that most human troubles originated with Eve and Pandora.

Scientists (especially the mad kind) are another favorite scapegoat for diseases. They have often been accused of producing killer microbes in their labs, then releasing them on the world either intentionally or because they are careless. Americans have accused Chinese scientists of cooking up the Covid-19 virus. The Chinese government have accused American scientists of the same thing. 

A popular explanation among conspiracy theorists, mainly in the US, is that the Chinese 5G network is the culprit. Another is that Bill Gates created it.


Sunday, 5 April 2020

The Boy Who Cried Wolf; Or, A Pandemic of Lies




The people of the village of Great Cockup were afraid of wolves. In order to protect the village against wolves, they hired a new Chief Wolf-watcher. The last one, they decided, was not tough enough for the job, which was to keep an eye out for wolves and warn the village if any were nearby. This despite the fact the last one had gotten rid of one of largest wolves they had ever seen. The villagers called the new Chief Wolf-watcher "The Boy." That may seem odd because he was nearing his dotage. Truth be told, he did often act like a twelve year old. He was also rather overweight. An unusual choice for such a job, one might think. But when he applied for the position, he convinced the villagers with his supreme confidence in himself. "I'm not afraid of wolves," he said. "I just look at them hard and poof, they're gone, tails between their legs. You can't hire a better Chief Wolf-watcher than me. I'm the best you'll ever have." Days went by and no wolves appeared. The Boy grew bored. One day he jumped up and cried "Eureka! I have an idea," he said. "The best idea." He ran into the village green, shouting "Wolf! European Wolf!" The villagers came out, holding pitchforks, clubs, and other weapons. "Where's the wolf?" they asked. The Boy laughed. "There is no wolf. I was just checking to see if you were ready. Go home." The Boy was highly pleased with himself. "What fun. I must do that again." And he did. His false warnings became routine. Sometimes he said the wolf was from France or Germany, other times that they were migrants from far away countries. The villagers always came out to chase off the wolves, and the Boy laughed and told them to go home. Meanwhile, reports came from other villages that a plague of wolves had descended on them. It was spreading fast, killing lots of sheep and people, which often amounted to much the same thing. Some villagers told the Boy of their concern. He laughed it off. "They're exaggerating," he said. "If there are any wolves coming, they're few and weak. I can handle them easily." One day, when he cried "Wolf" for fun, the villagers did not respond. They had grown tired of his false warnings. The Boy turned to go back to his post. As he walked away from the green, he was confronted by a huge, powerful wolf. The Boy looked at the wolf and said, "You are not real. You're a hoax." The wolf moved closer and growled. "OK, maybe you're real, but I can handle you. There's only one of you." The Boy made his most menacing face. Truly a marvel to behold. The wolf showed no fear. He moved closer, growling and snarling.
Meanwhile, other wolves were gathering around the edge of the village. When the Boy spied them, he cursed. "Why didn't someone warn me about this plague of wolves? The boy ran onto the village green and cried "Wolf!" But on this occasion, no one came out of their houses. The Boy ran away to his country mansion, Little Penistone. From news reports he learned that many of the villagers and sheep had been eaten by the wolves. In response, he bragged about his brilliant handling of the wolf plague. How he had never underestimated it. How his warnings had saved many lives. One day he wandered back to Great Cockup. It was eerily quiet. One by one the villagers who had survived came out. They were holding pitchforks, clubs, and axes. The Boy ran, but he was too slow....

Wednesday, 1 April 2020

The Orange Piper of Shamelin: A Pandemic Fairy Tale



Shamelin was the richest, most powerful, most envied country on the planet Zed. Yet, somehow many of the Shamelians were discontented. The grossly rich, because they never felt rich enough. The poor, because they were poor. For some odd reason, many of the poor did not blame the grossly rich. They blamed immigrants, foreigners, "libruls," "lefties,"and other rats. "We are temporarily embarrassed millionaires, and we are patriots," they said with pride. "We just need to get rid of the infestation of rats in this country, and all will be well."

"We need new leadership," the malcontents said, urged on by Uncle Rush,  Aunt Laura, and Fux News. "Someone who will make Shamelin great again. The last Leader wasn't even a Shamelian. He sure didn't look like one of us." 

The cry went up from the voices of millions of Shamelians "Make Shamelin Great Again!" Hardly had they spoken, when a voice boomed out to them from the sky, or so it seemed. It actually came from their TVs. 

"I am a famous TV star. You know me as The Boss. I'm also the world's greatest real estate developer. I'm so good at what I do I've gone bankrupt a bunch of times. How many people can say that? I will save Shamelin from its enemies within and without. I will get rid of the rats plaguing this country. Make it great again. There will be bigly changes. The best bigly changes. I will build a wall! A bigly wall. The best wall. To keep out the bad people. Bad people. Rapists, drug dealers, killers. Sad. The best things will happen to the economy. It will be so yuge you can dress in dollars."

The unhappy Shamelians cheered. They felt a sudden surge of pride in his words, even though his face had a weird orange glow. No one had spoken to them with such brilliance in decades, if ever. The Boss is our man, they thought, and we have made him possible. Because we love our country. They cried out as one: "How can we help you, Boss?"

"Vote for me in the next election for The Leader. The Dumbocrats think they have it locked up. But I have a secret weapon. Friends in very high places. Bigly places. The bigliest places." 

"Who are those friends?" asked one slightly skeptical Shamelian. The people around him grabbed and beat him, and told him to shut up.

"I can't tell you that. It's a secret. But they love you and want to help you defeat the Dumbocrats. Now, if you want me to save you, you must love me. I can't stand to be unloved. Sad! See you at the polls!"

Voting day came, and the results were close. The Dumbocrat candidate for Leader got more votes. But Shamelin had an odd clause in its constitution, which allowed the loser to win. Forgive me for not explaining it. Only three people have ever understood it. One is dead, the second went mad. I'm the third, and I forgot. 

This is how T
he Boss became The Leader, along with help from the people in high places. He started off his Leadership by engaging in his favorite task: firing people. Not only people from previous Leaders' administrations. He even fired his own people after a while, people he said were the best people when he hired them. He said they did not love him enough, did not appreciate his genius. He hired replacements who, he said, were also the best people, even better. 

He soon made it clear who was Boss on Zed. He told other countries that Shamelin was number one and should get all the best stuff. Other countries had some good points, if they were trying to be like Shamelin, but they were sad places compared to number one. A lot of them, he said, were shithole countries. His supporters cheered these statesmanlike words.

He insulted Shamelin's allies and refused to cooperate with them to protect the Zedian environment. To show who was Boss, he got rid of environmental protections. "We have lots of bottled water for sale. And a little polluted water won't hurt you," he said. "And smoke is good for the lungs. Makes you tough, like me." He told the leaders of certain countries that he would destroy them if they didn't do exactly what he said. When they didn't do as he said, he said he loved them and wanted to be best pals.

His supporters loved this kind of talk. They loved everything he said, because he said it. He could say one thing one day and the opposite the next. They would cheer it all. They would deny he ever lied or made an incorrect statement. He was the most honest Leader Shamelin had ever had. And he knew more than anybody, on any subject. He was, as he so often said, a stable genius. 

He was so brilliant, so perfect in every way, that some of his most enthusiastic supporters claimed he had been sent by God to save Shamelin, God's favorite country. The Boss agreed and began to do something new: he prayed, or made others pray for him. One day he proclaimed that he had done more for the true faith than God himself.

Things went along swimmingly like this for about three years. About that time, Orientia, a very large country in the Far East, reported the outbreak of a new epidemic disease. It was killing many people, mostly old. The major symptom was laughing, which ranged from a mild Ha! Ha! to a ceaseless, hysterical guffawing. When a patient cried out, "I'm going to die laughing," the doctors knew it was all over.

The Boss' medical advisors told him about the new disease. "It's so far away. It'll never get here." They told him it was caused by a virus. "What's a virus?" he asked. When they told him, he laughed. "Nothing that small could hurt a person, unless they were small, too. Like the Orientans. Nothing to worry about."

Unfortunately, the virus did not heed the Boss's words. It spread to many countries on Zed. Within a few weeks, it had arrived in Shamelin. The Boss laughed it off. "It's a hoax. Just a common garden variety bug. We might have a handful of cases, all mild, and then poof, it will be gone. It might kill a few old, useless persons, but nobody will miss them. Leeches. Sad! I know more about this virus than anyone. The doctors are amazed by my knowledge."

Once again, the brainless virus outwitted the genius. The number of cases mounted, slowly at first, then more rapidly. They included people of all ages, not only the old. The Boss blamed his political opponents. He blamed other countries, especially the Orientans. He blamed the media. "Bad reporters," he said. He blamed his medical advisors. "They're Chicken Littles. Always crying about the sky falling."

Things got worse. "No one warned me about this," he said. "It caught me by surprise." He said the whole virus thing was an underground plot to make him look bad. "They want to spoil my chances to get reelected and become Leader for Life."

As the virus spread, Shamelin's lack of preparation quickly became obvious. Those fighting the epidemic lacked the protective equipment, the testing kits, and the technology to do their job. The Leader insisted that these things could be had in plenty if health care workers weren't stealing them.

When the governors of Shamelin's hardest hit provinces asked The Leader for help, he told them they didn't love him enough to deserve it. They needed to applaud his genius. He told them to help themselves. "I have absolute authority. But the responsibility is yours.  

One day, The Leader told an astounded country, "This virus is really dangerous. It could kill a lot of people. If we can keep the number of dead under 200 million that would be a victory. And that victory will be my doing!" 

Hearing this, the Shamelians -- well, about half of them -- cheered wildly. The rest put their hands to their faces in disbelief, even though they knew that could spread the virus.

Things, as you can imagine, got worse. 

[I invite my readers to guess how this story will end.]