COVID Orthodox Church closures part III – An interview from the front

When starting this series, we fully expected to find really strong arguments supporting the position taken by most Orthodox Christian Church jurisdictions – that the parish temples be closed to laity during the period of quarantine imposed on most of us in the “First World” (Europe, the Americas, China, Australia, the Far East) by the coronavirus and COVID-19 mitigation efforts. Indeed, I made it a point to try to approach this topic in a manner that worked against my own gut instinct – that this closure or restriction is the wrong way to go for us to meet the crisis. It may indeed by logical to do this to prevent transmission of the disease through crowds, but it is not what Christian believers advocated in times past with far worse plagues than this one.

Up to now, however, we failed. What we did find was a strong and compelling body of evidence that suggests that the only church closures that took place during plagues were probably because the clergy serving in them died from the plague or other complications. To date we have not located any information supporting as an historical precedent, the present-day actions. Perhaps other people more clever than I will be successful, and I sincerely hope that those people will either relay what they found to me or submit their own pieces to The Duran, to give as much balance as possible to this topic.

However, an interview with an American registered nurse, currently on the front lines of this pandemic, does give perhaps the clearest body of information to at least explain the highly unusual nature of the action to close places of worship, even those of the historically conservative Orthodox Christian jurisdictions, not only in the US, but in many places around the world.

It is important to prefact the interview. As an American, as well as an American who is not living in the United States presently, but in Russia, my “outside the fishbowl” perspective allows me to make a few assertions about the US and its capabilities which are quite likely to be correct, despite the immeasurable political churn that is present in both politicians themselves and the news media in that country, most of whom are resolutely determined that the only real problem in the United States is the present occupant of the White House. Yes, even now, as the US leads the world by far in COVID-19 cases and deaths soon to follow. However, having developed a rather practiced eye for these things, it appears possible to lay out a few overall points to best frame our perspective:

1. The United States coronavirus numbers are likely the most accurate counts in the world, with the possible contender being South Korea.
2. This is because the US has a massive capability for travel and distribution of testing equipment and facilities throughout the nation.
3. The very free nature of private and public communication gives us a lot of chaos, but it also does deliver accurate information when properly used, without government control. In other words, President Trump’s course of using the Federal Government as something like a coordination center rather than a top-level base is extremely apt and is the best method possible for the gathering and dissemination of both information and assistance.
4. While the Trump-opposing “peanut gallery” doesn’t stop throwing rocks at the president, the reality is that not one of them could actually have handled this situation any better. In fact, the most successful solutions would have involved doing precisely what the President did, for, knowing that he himself is not the “supreme know-it-all” about the virus, the President is the “prime coordinator”, the one to find the best possible resources and people who do know. Further, the President is a pragmatist in terms of his political ideology. For him, solving the problem is the most important matter. This was manifested in his recent phone call with candidate Joe Biden, who is waging a sleepy but contentious campaign for the Presidency, and who, in his campaign, generally has nothing good to say about the President, as is appropriate for party and tradition.

The US has a way of “broadcasting” its internal affairs very publicly, and what we see is what such actions would look like from most any country. Centralized government control is much simpler in appearance, but it is also significantly more difficult to trust. Example: China.

We may seem to be departing from the theme of this series with is about the Orthodox Church response to the virus, but all of this information has turned up as necessary in order to properly frame this crisis. While it may be more “convenient” and certainly more attractive for views and hits to deliver some punchy piece that is not balanced, the nature of the crisis itself mandates careful, sober evaluation and not snark. In order to properly characterize our assessment (opinion, only!) of how the Church is handling it, we need one more piece of information.

In the few days that have passed since my Part II of this series was published, I conducted an interview with a registered nurse in the United States who is, logically, quite privy to the current situtation with the coronavirus pandemic in the United States. This person (who we are naming “Julie”), gave me a real “conditions on the ground” take, and it reflects the state of that person’s understanding and knowledge of the virus at this time (ranging from April 6-10, 2020). We present that information here. To make it a little more simple to follow, I have taken the liberty of creating “questions” before the significant points so that it makes the information a little more bite-size. The information is given exactly as stated, with the only corrections being punctuation or spelling if needed. In other words, the only refinement to the raw data are my attempts to step-by-step take the reader through it.

The Duran (TD): I am … investigating the closures of churches and places of worship because of Covid-19. I see several problems, but one of them is probably related to not clearly understanding what it is exactly about coronavirus that makes it such a severe threat that basically all of the civilized world is shut down. The last major pandemic, the Spanish Flu, took a huge number of people – enough to make a significant dent in the world population at that time. But this one seems far less lethal, though it is scary to see the images of people on ventilators and doctors in biohazard suits and so on. Can you tell me in your own words what you understand the threat of this to be – and how it might actually justify the closures?

Nurse Julie (NJ): You ask some very good questions. The first problem is that this virus is new to the human population, so there is not one person on the planet with any immunity whatsoever. This means the disease progresses much farther before the body even realizes there is an invader to fight, so the person gets much sicker overall.

When Columbus landed in America, he brought smallpox with him. None of the populations here had ever encountered this illness, and it is estimated that 50 million Native Americans died from it. Again, the flu pandemic of 1918 jumped from animals to humans and no one had immunity to it, it took 50 million lives.

If this one proves less lethal, it will be because of modern medical care… they didn’t have ventilators in 1918 so anyone in respiratory failure just died. They also didn’t have a strong grasp on epidemiology or disease transmission, so they didn’t attempt to mitigate the spread at the community level.

Because this virus has been known to science for less than 6 months, we are still learning what it does to the body and HOW it does it. Instead, we are looking at the symptoms presented and treating them. Until we understand the disease process within the body on a cellular level, we cannot predict how it will make patients sick, to what extent, how to best treat it, and who will be most sick.

There is a lot of talk about the need for ventilators, but this is not representative of what the disease is doing to people. They estimate 10% will need a ventilator to survive, but half of those put on one still can’t be saved… they go into multiple organ failure, when the kidneys fail they resort to dialysis to keep them alive and find their blood is so coagulated it clogs up the dialysis machine.

TD: What is actually happening at medical facilities in the US?

NJ: Many COVID positive (Covid+ hereafter) people are showing up at the ER with heart attacks and strokes, because their blood is so coagulated it caused a secondary medical crisis. This is a seriously nasty disease, and presents a way that NO ONE wants to die.

TD: What information do you have about how COVID-19 is transmitted? We have heard all sorts of claims, ranging from not-communicable person to person to highly so. What do you see now?

NJ: Another major problem we are facing is lack of consensus on how this is transmitted.

Originally it was believed to be airborne, meaning if someone exhales the virus can stay aloft in the air for 3-6 hours and travel up to 27 feet (about 9 meters). Anyone who walks through the area in that 3-6 hours is susceptible to inhaling it. All the countries affected by the virus prior to the US treated it as an airborne illness, and the US initially did also.

But it didn’t take us long to figure out we were not prepared for airborne illness and do not have adequate personal protective equipment (PPE) supplies. So the CDC downgraded its classification to droplet, which is a different ballgame. I believe this was done because they feared acknowledging both that it is highly contagious and the proper measures of protection are unavailable would make healthcare workers disinclined to continue reporting to work, only to risk the lives of themselves and their families.

I recently came across evidence that [President] George W. Bush realized this situation was inevitable and began preparation during his time in office, but the effort fell to the wayside after he left office. So, lack of valid information and lack of appropriate PPE are two major problems faced here in the US, and they are intertwined.

The Spanish Flu circled the globe with alarming speed, and they are trying to prevent that happening now. If everyone takes sick all at once it will be over quickly, but the death toll would be quite high because the healthcare system would be unable to address the sheer number of people needing care all at once. This is happening in NYC as we speak. (Interestingly, city officials instructed people there to not worry about the virus, encouraged them to continue going to restaurants and attending major public events.)

It’s likely that social isolation won’t impact the final total of people who contract the illness over time, but it will prevent them from all showing up in the ER in the next month. This gives those gravely ill a greater chance of survival, as they are more likely to receive adequate medical attention.

TD: We understand that there are fears in the US of a permanent loss of personal liberty because of this crisis. 

NJ: [Yes], meanwhile, the powers that be seem to be grappling with temptation to use this crisis as justification for a power grab. [Jared Polis], the governor of Colorado admitted on TV that they are using cell phones to track people’s movements. This creates a conflict between public safety and preservation of individual liberty.

The genuine concern for public health has brought a situation where church and state are clashing. (I don’t know if you heard, but the pastor of a megachurch in Texas was arrested for continuing services against governmental orders.)

TD: But all of this seems to come back to the ability or inability to render needed care.

Trump seems to be trying to preserve the tradition of states rights and the autonomy that goes with that concept, but the end result is individual states vying for crucial PPE in the marketplace.

Meanwhile my hospital is building negative pressure rooms for covid+ patients, but we have neither the PPE or the experience to care for critically ill patients. We are about to run out of hand sanitizer, and are trying to learn how to make our own. We are running low on gloves, and are almost completely out of medium gloves. All basic supplies are on nationwide backorder.

Meanwhile the clowns at the CDC are advising that we cover our faces with a scarf or bandana, and wear the same gloves room to room without changing them. This would have gotten me fired and likely cost me my license six months ago. Sorry this response is so long, I’ve been following the development of this very closely for about a month now and am attempting to simply hit on the major problems… but they are myriad…

While this might seem like a long, rambling response covering diverse topics, they are all truly interconnected. As such, one impacts the other and creating change with one causes changes in the other factors.

The greatest argument for social distancing is preservation of the greater population over time. Going forward in my research I will be alert of anything that might prove useful to you and send it your way. I encourage you to read the article on airborne vs droplet transmission by JAMA that I shared to my timeline. This one uncertainty stands to define the outcome of the situation and the toll on the population.

TD: What else can you tell us about coronavirus itself?

NJ: [The coronavirus] requires two genes to do what it is currently doing. One allows it to infect humans, the other allows it to pass human to human. There was no evidence SARS acquired this second gene, as the reported cases were animal-to-human. This helped curb the outbreak of SARS. (At least the one in China, I’ve not researched the one in the Middle East.)

TD: [updated for current numbers as of April 10, 2020, 18:03 UTC] Russia has 11,917 cases confirmed, 94 fatalities, 795 recoveries. Moscow has 7,822 cases. We are locked down hard but churches are still running in certain places.

NJ: I am concerned by the numbers, but it might be that you are testing better than the US, which has been laughable so far. For context, we had 8 cases in Colorado on March 8th. One month later on April 5th, we have 4950. That’s for the entire state. I read that moscow reported 700+ cases in a day early last week, which is about twice the CO state average of daily increase. If these numbers are accelerated because of adequate testing, that’s in your favor. If the numbers are such because the cases are genuinely accelerating at that rate, then I fear Moscow is in danger of seeing something comparable to Italy and New York. This is my reason for repeatedly asking you to be cautious. I think one of the hardest parts is working about those far away, including my parents.

TD: But I am also trying to find evidence for Church closures in other plagues. So far, I have not found this – I HAVE found that Christians were historically the fearless people who went into the sick houses and treated and cared for people, even if they lost their own lives in the process. I am uncomfortable with the closure orders, but I cannot say I do not understand them, especially in light of what you [shared with] me.

NJ: There has been a huge outcry amongst Orthodox in the US over the closures, with much conversation.. someone reported that services were last cancelled during one of the plague outbreaks. I don’t remember the year tho, it was several hundred years ago if I recall correctly.

Also of interest, we hear over and over its mostly older adults that are impacted but the numbers don’t represent this. Also, deaths are 60%/40% male to female ratio… not sure why.

For your own personal knowledge, one of the aspects of the disease that is proving fatal is a cytokine storm. These are chemicals that the body makes to combat illness, but the response is disproportionate.. so many cytokines are created that they poison the body. This is a factor in the coagulation issues I spoke of, and also plays a definite role in multiple organ failure. It is currently unknown how many of the perished had this happen in their bodies. The lab test to detect this response is elevated ferritin levels, and the drug Tocilizumab has shown definite promise in treating the storm. I pray that you never need this info, but if someone close to you takes ill please keep this in mind.

TD: Are there any other thoughts you have about this, maybe any unusual things you have seen or heard about?

NJ: Yes, we Americans love our individual liberty. There is a growing conspiracy theory that this is all a hoax, [that] there is no virus.

…I keep thinking of the Passover story.. the blood on the doorposts and God’s faithful sheltering in place while it all went down. Part of that is the time of year, and part is my sincere desire to hide in my house and not face this nightmare daily at work (laughs).