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The viral load of COVID-19

A contribution by Samantha Gallivan, BSc MBBS FRCS (Tr & Orth), Imperial College London

Before now, perhaps at the beginning of the SARS crisis of 2002, I would only have a glimpse of something sinister-but-far-away at the end of a news bulletin. Maybe I’d be a little tired and turn off the sound on the TV and only see the reporter voicelessly shivering in a pool of butchers blood and feathers. Cutaway to the inside of the market, she waves an arm to blurred figures that bob and weave through plastic sheeting, gumboot footed and heaving tubs of unmentionables that slosh over the sides to mix with the market-guts on the floor. Containment, she mouths. Isolated cases. Sporadic. Concern. Over there and back to the studio.

But not this time: tales of COVID-19 went viral as fast as the disease itself and skittered up my timeline dragging a smear of racist misinformation, fear and gossip. Fingers were pointed at the Other, those people who eat bat soup and guzzle live animals spreading ‘yellow fever’. The virus then made a species jump from anonymous digital trolls to the real-world herd of commuters flicking to refresh their screens the minute they get a whisper of wi-fi on a boring train journey. Londoners of East Asian heritage discovered with sorrow that they could clear a halo of empty seats on the Underground, hearing the word ‘coronavirus’ hissed behind their backs in earshot.

The speed at which online reports are updated plays on our worst habits of mind. Each headline is optimised to arouse an emotion that guarantees a click, even if the story behind it is no more than a couple of lines of vague unhelpful text or an old recycled photo. We are constantly refreshing and updating our feed to try and get more information about COVID-19, but as every story is distorted to stand out from the others, the overall effect is to obscure not offer clarity. The continuous twists of opinion on social media in response to evolving news adds to this feeling of uncertainty, but this immediacy can also help in bringing us closer to people most affected far away as we can see and hear their stories almost in real time. We heard the voices of the citizens of Wuhan shouting to each other in high rise quarantine and saw images of the wronged like Dr Li Wenliang, whose name has almost been forgotten in the twitter churn of news.

At the end of December, Dr Li posted a private message online to some old medical school friends warning of cases of SARS coronavirus in Wuhan. This message caused his first viral injury – the text could not be contained and then leaked and spread widely to end in his arrest and public admonishment under the threat of prosecution. He returned to work as an ophthalmologist and saw an unwell young patient with acute angle glaucoma ‘Sit right there, lean a little closer… that’s right, rest your chin here and look up… left… down… that’s good, now look up into the corner of the room’. Perhaps he felt his patient’s warm rapid breaths graze his cheek as he worked, leaning in closer to get a better look at the fundus. If you have ever sat close enough to someone to examine the back of their eye, you will be familiar with the solemn intimacy of the act, sharing the same space, looking past each other, breathing the same sour air. His patient was infected with COVID-19 and so soon was Dr Li. In his last self image- selfie seems too sweet a term for a man’s final portrait- he has almost tipped the oxygen mask off his nose exposing tight folds of sweat where the elastic of the mask had pinched his face. He is not the man stood comfortably holding his camera in both hands at chest height in earlier pictures. He is now underneath the camera framed by tubing and wires, trapped between the lens and his sickbed, staring straight up at us. Take a moment and search his name again and find his picture. Meet his gaze and know that although we might not know what comes next, one of us leant in, cheek to cheek- ‘That’s good, now let’s see the other eye’ -not knowing what his future held either.

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