Toilet Paper

Imagine a movie pitch made in 1995.  

OK- so- Donald Trump becomes president... and then there's a pandemic that started in China (ok- so- the part about a pandemic starting in China has since been done) and then- it sweeps the world... and- there's no toilet paper. Anywhere.  None.  Nobody can find toilet paper. People are yelling at each other in grocery stores- fighting over the stuff.  

The hospitals tell doctors and staff that they are not permitted to wear masks to avoid spreading panic.  So- ok, there's no toilet paper, there's a pandemic, Trump is president, and hospital staff is not allowed to wear masks.  So THEN we all HAVE to wear masks except there aren't enough so we have to reuse the same single use mask over and over and over again- but- so- get this- the masks are kept completely sanitized because they are stored in paper bags.  So- each hospital staff member gets one mask and one paper bag- and- the hospital says that the masks are appropriately sanitized- as long as the the back of the mask is pointed towards the front of the paper bag and the front of the mask is pointed towards the back of the paper bags.  So the bags are magic- right?  So- then- people get sick because the magic paper bags aren't working.  

So- the hospitals are all full and there's no PPE, no toilet paper, everyone's dying, the magic bags aren't working, hospital staff is sick, hospitals are packed to the gills... but- a twist.  A whole bunch of people insist that this is not happening!  Get this- they say- there's no virus it is all caused by this guy Fauci.  Yeah yeah the AIDS guy - so- in the movie- he's still practicing.  

So then- somehow we get through this pandemic- lots of people die yada yada yada... then- there's a presidential election but- Donald Trump refuses to acknowledge the fact that he lost so- a bunch of people storm the capitol! But- he's not the president- it is a kindly old man with a vicious dog The kindly old guy is president for 4 years- despite the fact that Donald Trump has managed to convince people that nobody tried to overthrow the government and that he won the election. 

So- the old guy doesn't run for a second term but... get this... Donald Trump gets to be president again- and- he said that there is no resurrection and nobody stormed the capitol and that everyone who did this is being pardoned.  Yeah yeah- I know- that's confusing we'll work it out in the script.  So- then.... there's this guy who gets access to a whole bunch of Medicaid/ Medicare data.  Oh, who's the guy?  He was born in South Africa and says he invented electric cars!  

Wait- what do you mean not realistic?

The Beginning

The patient had been in China. And- she had respiratory failure. This basically meant that she required a tube to help with breathing. The intensivist wanted to send for COVID 19 testing but- his efforts were blocked by the county health department. Only certain patients could be tested- there were specific symptoms listed (the patient checked that box) but- also- the patient needed to be exposed to a patient with a known, proven case of COVID. Commercial testing was not available- so- we were all at the mercy of the county health department. Three doctors- 2 intensivists and an infectious disease specialist- had all tried to get the patient tested. But- this was to no avail. The patient did not have documented exposure to a documented case. 

Furthermore- the county health department was dictating that we remove the patient from isolation. (She was in an isolation room.)   In order to get to the patient I had to pass through one door- close it- then- pass through a second door. Negative pressure. There was a closet sized room in between the first and second door. Inside there was a sink and boxes of masks. N95 masks, specifically. The family came to visit frequently. And- each family member dutifully donned one of the masks prior to seeing the patient. One family member's mask was tilted slightly- providing no real protection. Open at the top, open at the bottom. The nurse was wearing a CAPR (Controlled Air Purifying Respirator)- one of very few in the hospital.  This looked like a helmet with a facemask attached.  

"I think I'm going to cry," the nurse said, emerging from the room. She was trying to get the family to stop poking at the patient. The trash can in the small in-between room was overflowing with used N95 masks.  

I'd read a post on my Facebook group November 2019.  Someone's husband was an epidemiologist and he had issued dire warnings. "He said it's going to be like the movie Outbreak."  I could see that this was happening in China- far away.  I recalled Severe Acute Respiratory 

I'd been sick that January- I medicated my 102.1 degree fever, I'd put on a mask, and I'd dutifully gone to work. My eyes were red- like I'd been crying. "A bad cold," I thought. Nurses gave me a wide berth. Nobody sat near me when I stopped to pound out my notes at one computer terminal or another. This was par for the course- doctors didn't take sick days. My "bad cold" had resolved when I saw the aforementioned patient. My husband had proudly shown me the dining room table- in early February of 2020. There were paper towel rolls, toilet paper rolls, hand sanitizer, bottles of sanitizing spray. A giant, shapeless mound of cleaning products. I'd walked past- thinking that we were set for the next decade. 

My "bad cold," the mystery patient, the pile of cleaning products, the Facebook post- looking back- this was The Beginning