An early morning text message
It is 3 am local time in Penang, Malaysia, Thursday, 19th March 2020. I am sitting here with my elderly mother, who is having another acute episode of paranoia and delusion. She has Alzheimer's. My phone ping and I open up to read a text from John, a good friend, and colleague in New Zealand. He advises me to get back to New Zealand quickly while I still can. The New Zealand government has just announced the closing of its border. I replied to John’s text to say I will stay rather than make a hasty return to New Zealand. I thought I share why I have made this decision.
My mother's Alzheimer's journey
My mother’s Alzheimer's journey is rapidly progressing. Each day brings increasing uncertainty, anxiety, and challenge for her. My father passed away seventeen years ago. All her siblings have passed away. Her few remaining friends are also elderly with severe cognitive, mobility, and health issues.
My siblings and I, in recent months, have been working through her care and support options. Striking the fine balance between her health, safety, independence, and dignity has not been straight forward for us. With the help of a full-time live-in maid, she still lives in my parent's family home. The maid has only agreed to stay provided one of the family members remain in the house as well. My siblings and I have decided to share this filial responsibility between us.
Decision to stay
I had less than a 24 hours window to try and book a ticket back to New Zealand after receiving John's text. If I leave and make a hasty retreat back to New Zealand, this filial responsibility will fall solely to my two younger sisters who live in Malaysia with the one living in the same town as my mother shouldering the lion share of this responsibility. I cannot abandon and abdicate my responsibility to my mother and siblings. I am staying for now, and I am so fortunate and bless that my wife is supporting my decision. She is here with me.
Government escalating intervention measures
When my mother was diagnosed with Alzheimer's at the beginning of 2020, COVID 19 was quietly evolving in China’s Hubei province. Now it is a full-blown global pandemic with rising infections in many countries and deaths in most countries. Governments around the world are escalating their responses in their fight against this deadly, fluid, and still evolving virus. Part of these escalated responses includes closing down their borders and restrict the internal movement of its citizens.
In the absence of a vaccine and effective drug treatments, the World Health Organisation is strongly recommending governments take early and comprehensive steps to combat the impact of this pandemic. On 16th March 2020, the Imperial College London COVID Response Team published a report that recommends a preferred non-pharmaceutical interventions (NPIs) strategy to combat this pandemic. This preferred “suppression” strategy is to interrupt, reduce, or eliminate transmission by:
- Introducing social distancing measures for the entire population
- Closing schools and universities
- Home isolation for symptomatic cases
- Household quarantine for family members of symptomatic cases
Closing of borders, travel restrictions, banning mass gatherings, and shutting all public and private services (except for essential services) are examples of social distancing measures.
Within days after this report was published, numerous governments started closing their borders, restricting population movements, banning mass gatherings, and shutting down public and private services. These measures took many by surprise, and one of the consequences was airlines around the world started canceling their flights for the next few months, including ours.
Marathon not a sprint
This COVID 19 pandemic will not be over in the next few months and will run through 2020 and into 2021. There are now statements coming out from governments to prepare their citizens on this looming reality. Despite unprecedented collaboration globally to develop an effective vaccine for this coronavirus, experts say it is still twelve to eighteen months away. Likewise, the race to find effective drugs (new or repurposed) to treat those severely ill from COVID 19 is also moving at an unprecedented pace. In the meantime, governments are trying to buy time, slow down COVID 19 infections and death, and prevent their health system from being overwhelmed.
The recent drastic “suppression” measures by many governments are a highly disruptive, sweeping, wide, deep, and lasting impact on people's daily lives. Citizens are asked to cooperate in the interest of a common fight against COVID 19. Governments are introducing seemingly eye-watering “stimulus” packages running into tens and hundreds of billions and in the case of the USA in the trillions. The reality is many of these stimuli are stop-gap measures at best. When this pandemic runs through 2020 and into 2021, many businesses (big and small) will fail and result in significant job losses. Recession is inevitable, and the possibility of depression lurks around the corner. Governments are starting to make statements to give early warning for recession ahead. The social costs will be high, and the wider societal repercussions will reverberate for many years to come.
Living with COVID 19
We currently already live with cousins of COVID 19 like the common cold and influenza. We have vaccines that are effective in protecting many, but not all. New therapeutic drugs are constantly being developed to treat and help many who are infected but not all recover.
Many brilliant scientific minds and organizations are collaborating to develop a vaccine and new therapeutic drugs for COVID 19. Vaccine for COVID 19 is still twelve to eighteen months away. New and repurposed drugs are likely to be available sooner for treatment for severe COVID 19 cases. The new vaccines and treatment drugs will all be part of our world that needs to adapt and adjust to living with COVID 19 and other viruses that follows.
On a personal level, I have had to explain daily to my mother why she cannot go downtown. The Malaysian government on 18th March put the whole country on a fortnight "movement control order." Apart from essential services and food outlets, everything else has to close. Public gatherings are not allowed, people have to stay home, and police are out enforcing these social distancing measures.
My mother needs to exercise, and for now, we take an early morning walk around the neighborhood. Without this morning walk, her overall physical and mental well-being will deteriorate very quickly. She does not understand why she cannot go downtown and becomes increasingly agitated. Thankfully despite her agitation, she agrees to go for the early morning short neighborhood walk. We are making the most of it while we still can.
Final word
The current drastic measures have a sweeping, wide, deep, and lasting impact on countries and their citizens. As we brace ourselves for disruptions to all our lives, we are starting to see the worst and best of human behaviors in places like public transport, local supermarkets, and workplaces.
One of the critical factors that will determine how well each country gets through and recovers from this pandemic is the strength of its social resilience and cohesion. Such resilience and cohesion will require more of us to stand on the side of the best of humanity. I was in the queue at the local supermarket a few days ago. I could hear altercations happening somewhere in the supermarket. Everyone in the queue was very tense. I notice an older gentleman behind me, holding a tin of milk, and he was very nervous. I said, "you go ahead. You have only one item." He thanked me, and we started chatting. He told me he was living alone with his wife, and they were here earlier but forgot about the milk. As he was leaving, he turned around and said, "My name is Jimmy. Thank you for talking to me. Everyone is so afraid to talk to anyone in case they catch the virus." As he walked away, I thought, "COVID 19 did not take away our humanity for that brief moment".
As a New Zealand citizen, I can still return to New Zealand, but with all airlines canceling their flights, I might not be able to return to New Zealand for some time. I am confident that flights will resume, and countries will reopen their borders again because the alternative is unthinkable. When it does, I would happily go back and do my 14 days of isolation. In the meantime, WhatsApp and emails connect me to my families in New Zealand and other parts of the world. Of course, the most obvious bonus is getting extra time with my elderly mother as she makes her way through the final stage of her life. Kia Kaha