Tanya has encouraged me to cut the trip short, but leaving on a long haul flight seems like a high risk option. There are few realistic methods of early detection. The airport has armed screeners with instant read thermometers which may catch the most egregious cases. Hand sanitizer is readily available, sometimes with employees just walking through the crowd squirting it in your hand. At the muay Thai fights were even giving people surgical masks as they entered the arena.
Meanwhile, there are reports out of the US that baggage handlers in Los Angeles and New York have tested positive for COVID-19. Most of the cases reported in the US are near Seattle (where my feet were last on US soil), San Francisco, Los Angeles and New York, in short, the largest international terminals. In addition, there are no nonstop flights to the US out of Bangkok. The most common connectors are through China, South Korea, and Japan, all have had outbreaks. Flights through China and South Korea have been canceled. It is possible to go west and connect at Singapore or Europe, which are hardly better options as both places have experienced outbreaks. In short, travel to the US is not without risk.
As I sit in Chiang Mai on March 5, 2020 (the day Tanya was supposed to be traveling to Bangkok to meet me before her flight was canceled), there have been 95,266 cases of coronavirus (COVID-19) reported world wide, 3,285 of those have resulted in death, and 53,219 have recovered. The death toll will certainly climb upward as there are 42,074 unresolved cases in the world and these numbers are not static. New cases are found each day, people die and recover each day.
A disease, once contained to China has now gone global with cases reported in more than 70 countries. The worldwide cases are likely to match the number of cases in China in less than 10 days as growth in China has slowed to fewer than 200 new per day and other parts of the world are in the midst of an exponential growth phase.
The growth of the virus in nearly every location is very similar. First, a few cases appear, then a few more. Authorities tell people to wash their hands, use hand sanitizer, wear masks (in the east, not necessary if you’re in the west). Authorities don’t act quickly enough and after seven to 14 days, the virus hits an exponential growth where new cases are added at the rate of 25 to 50 percent per day and compound. Authorities have their “Oh Shit” moment and start closing airports, schools, canceling public events, etc. until the growth is brought under control. Of course, to this point, we’re treating each individual country as a discrete entity where cases start, they grow and the die. All this leads us to travel.
Travel is undoubtedly the worst thing you can do during a pandemic. The way diseases spread is primarily through human to human contact. If people never leave their homes, the only people they can infect are others in that home. The disease dies with the people in the home (or the people recover, they don’t have to die). The risk associated with travel are increased when travel is done by plane or cruise ship as these are transporting a large number of people in a mostly enclosed vessel with recirculating air.
So, why did I decide to travel during a pandemic? I bought my ticket to Bangkok on December 27, 2019, China started reporting cases on December 31, 2019, and Thailand reported the first international case on January 13, 2020. At the time I left on February 16, 2020, Thailand had reported a total 33 cases with no deaths and 12 recoveries. I deemed that it was safe to go as there were no large scale outbreaks outside of China. WIthin the last week, the number of reported cases in South Korea, Italy, and Iran have all run into the thousands and multiple other countries have hundreds of cases. If I had waited to buy my ticket even a week, I probably would have waited another week, and then probably another and probably would have arrived at a different result, such as South America where there is only political unrest to deal with.
Ethically, I think the thing to do is stay in one place or at least stay away from the areas where the virus is spreading rapidly. In terms of economics, I didn’t want to lose the money. I did buy travel insurance, but travel insurance doesn’t have a ‘cancel for any reason’ clause. Financially, the best move is to wait as long as possible in hopes that the airline will cancel the flight. If the airline and I differ on whether it’s safe to go to a particular destination, then I have to make the decision that is in the interest of my health and ethics. My next move is to Cambodia on March 18, 2020, a country that has only reported one case. Which of course leads to the question, can the Cambodian government be trusted? I do not know the answer to that.
This leads me to explore the positives and negatives of my next move. As Tanya has pointed out, by returning to the US, at least we would be together should something happen to either of us or a close family member (of course, with the aforementioned travel insurance, should I get sick, they will pay up to $300,000 for medical evacuation). She’s right though, should the disease spread and affect any close family members I may not be able to get back due to travel bans. It is also possible that Trump will have an ‘Oh Shit’ moment and shut down all US airports indefinitely. It would be a bold move, probably effective, and might score him points with his base who only ever fly to a cruise ship with an all you can eat buffet. So, yeah that’s possible. As I mentioned before I significantly increase my risk of contracting the disease merely by travelling back to the US and entering through one of these international airports. I am caught between a rock and a hard place.
As a veteran of countless safety training courses throughout my career, it’s been drilled into me, Question: “Who’s the most important person on the jobsite?” Answer: “You are. If you don’t take measures to protect yourself, you cannot protect others.” This philosophy is consistent across all safety training from airplane safety training where they tell you to secure your face mask before assisting others to OSHA-sanctioned training courses.
Is it safe to be in Thailand? Americans tend to believe that America has the best medical care and most resources in the world. In terms of resources, the US is a wealthy country with vast resources that tend to be distributed in a very uneven way. Americans are deeply suspicious of government, but paradoxically trust government agencies like the CDC to protect them. Thailand, though I have very little knowledge of how they allocate their resources, does seem to have very good medical care. Having the earliest known cases outside of China, they have limited the spread to just 43 cases and one death since January 13. The US reported its first cases several weeks later and now has 157 cases and 11 deaths. So, on the surface Thailand seems to be handling COVID-19 better than the US both in terms of stopping the spread and in terms of medical outcomes. There’s a lot more that goes into these numbers than just the numbers, so indicting the US medical and public health officials on this alone is not fair.
The public health campaign in both countries has been similar with both stressing hand washing, hand sanitizer, avoiding physical contact. The main difference that I can see is that Thai officials recommend the wearing of face masks in public and US officials have come out against this. As I mentioned above, I have had a number of safety training courses over the course of my career. The respirator training sections have always stressed that the equipment must be used properly for maximum benefit. This includes the right equipment, proper fit, etc. They always cite workplace safety studies completed by NIOSH or MSA. The rationale aligns very closely with what public health officials are advising publicly. I have not been able to find any studies either proving or disproving the efficacy of surgical masks or dust masks to prevent the spread of communicable disease. I assume that public health officials are basing their advice on these workplace safety studies that are looking at very different sources, contaminants, and threshold values. For workplace safety, the assumption is that the worker will be exposed to contaminants for the entirety of their shift. and possibly career For public health, the concern is an instantaneous exposure from a sneeze, a touch, etc.
Further, all officials seem to agree that the wearing of masks are effective to prevent someone who has the disease from spreading it. Officials also agree that a person can have the disease and be contagious without knowing it. If you can have the disease and not know it and the mask is effective in preventing carriers from spreading the disease, it follows that people should wear masks to stop the spread of the disease. Also, we are in the midst of a global pandemic. We all need to buy into the idea that stopping the spread of communicable disease is good. A big stick approach is in order.
Also in Thailand, hand sanitizer and masks are both somewhat available. I bought hand sanitizer last night and have seen masks for sale, but brought some with me. and haven’t bought more. Reports are that both are in short supply in the US. I would attribute this to a different mindset between the two places. Thai do not seem prone to panic buying. This may be because they don’t have the disposable income or extra space to store a six month supply of things to live on. It is the culture here to only keep a few days of food and supplies on hand at a time. The US has the peculiar ability to ignore a problem to the last possible moment, then launch into panic buying mode. This results in shortages of critical supplies in stores and disruptions in the supply chain. The last guy in the store ends up with a few cases of diet Dr. Pepper, brillo pads and dill pickle flavored corn chips. No masks, no hand sanitizer.
So, at this point the best course of action seems to be ride out the situation in Thailand and hope for the best for me and for my family in the US. If something happens, hopefully, I can make it back. Hopefully, the virus will be contained and I can execute Plan A, though some modifications appear likely. I think that’s the best decision for now. Stay tuned.