2020-03-17

Reflection: A Week of Downward-Spiraling Public Health News Culminating in Unexpected Adjustments

Please note: this is about the current widespread disease outbreak that is dominating the news. I will not mention the name of this disease or other common words used to describe its spread, because for good reason, popular search engines are cracking down on articles and videos other than those from official public health agencies and related well-established organizations to stop the spread of misinformation. I have no background in epidemiology or public health. This post is merely my musings about the last week, and the implications for my near-future plans. Please consult public health agencies and other governmental agencies for guidance regarding responses to this crisis.

This post is the first in a series of three posts about the end of my time as a PhD student in Princeton University (in this post henceforth referred to simply as "the university"). As a write this, I am still technically a PhD student enrolled full-time in the university. The second and third posts will be somewhat more traditional reflections for the end of my time, but this first one has been precipitated by the current public health crisis. Follow the jump to see more; it is effectively a chronological history of the developments of this crisis from my very narrow perspective, and my own (in hindsight, arguably delusional) reactions to these developments.

The current disease that has become widespread through the world was to many in the US, as far as I could see, not a huge deal by 2020 February 10. It seemed to be mainly confined to Asia, primarily China. With my graduation coming in June and a new job in an unfamiliar place (which will be the subject of the second post in this series) waiting for me to start in September, I had figured up to that point that I'd have 3 months in the summer to enjoy a life of minimal responsibilities, so I could travel to places that require a fair amount of time to set aside for that purpose. With relatives in India and friends in Singapore & Thailand that I hadn't seen in a long time, I wanted to travel to each of those places to spend time with them especially before moving to a new place; though my disability does make travel, especially international travel, rather challenging, I had taken time to reach out to these relatives & friends to plan for the smoothest possible visit & experience. I had asked my friends in Singapore and Thailand about the situation, and they advised that while cases were growing in each of those places, the situation still seemed relatively safe, though I might be screened more thoroughly upon returning to the US. Thus, in my mind, all of my plans were still essentially set, though I hadn't bought any tickets by this point. Plus, I had also planned for domestic trips within the Northeast to see family & friends during the month of May, between my defense and graduation.

On February 17, the university sent an email advising its members about what to do regarding travel to or from China, which was still the country that was affected most by this disease, particularly specifying quarantine procedures while simultaneously condemning bigotry against those of East Asian origin/descent (particularly those who may generally choose to wear medical face masks to prevent the contraction or spread of general infectious diseases). I thought the situation might peak soon both in China and in other countries, so I didn't think much more of it at that time. On February 23 and again on February 26, I messaged these friends abroad again, who said the situation was worsening in Singapore as well as Thailand at that point. Given this, I decided to wait and see rather than booking flights immediately.

On February 28, the university sent an email advising of further restrictions on travel to or from China and South Korea, and recommendations with respect to Iran, Italy, Japan, and Mongolia. The 2020 APS March Meeting, which I was not planning to attend, though I had attended the past 3 years, but which many of my friends at the university were planning to attend, was at that point still scheduled to go on as planned, though there were many emails cautioning attendees to take extra precautions with respect to hygiene and proximity to others (which even then was evidently ridiculous for such a large conference in confined quarters); thus, many of my friends were concerned about their health and safety there.

From my perspective, February 29 seemed to be the first turning point, as that was the day of the first death on US soil due to this disease, though there had been several cases reported in the US prior to that. Moreover, at night, less than 24 hours before the first events were scheduled to start, the 2020 APS March Meeting was canceled. I was grateful that this didn't affect me, but sad for my friends and others who had spent so much time preparing their talks, organizing travel & accommodation details, and looking forward to meeting their friends & colleagues coming from afar. This was in the middle of a few days of a spate of other large high-profile events being canceled too, so this was to some degree a sign of things to come, though I certainly can't claim to have known the extent to which things would change after that; if nothing else, I still felt comfortable taking a day trip to a nearby city to hang out with friends, even taking public transit to get around as needed.

A series of emails came from the university during the week of March 1. On March 3, the university president sent an email cautioning people to practice good hygiene and take care of themselves & each other. On March 4, there was another email about new restrictions for international travel over spring break (which is this week that this post has been published), along with admonitions that international travel in the summer may be advised against too, though I took hope that the situation would improve in the coming weeks, and that domestic travel wouldn't be so affected.

By March 6, it was clear that companies were starting to panic about the spread of this disease, as the stock market started to noticeably slide. A day prior, there were multiple confirmed cases in Maryland (my home state) as well as Massachusetts (where I went to college, so it feels like a second home), so this started to metaphorically hit home for me. That day, during our department's weekly cookie time, rumors swirled about our department canceling its Visit Days for prospective PhD students, and these were confirmed later. Meanwhile, some of my relatives who were planning to come from India to visit the US in the spring canceled their trips. By this point, I was coming to the conclusion that with so many cancelations of trips and large events, many of my planned trips and celebrations of my graduation may be canceled, and while I held out hope that things would improve soon enough, I also recognized that it was only a matter of time before someone in the university or the town of Princeton would test positive for this disease, so it felt like the metaphorical walls were closing in. For these reasons, I also started to become more diligent in checking in with family & friends near & far, and have continued this since then.

On March 8, I saw messages implying that some prospective students were still planning to visit, even from affected areas in the US, while other current students might be visiting affected areas. This suggested that as a vulnerable person, I may be safer by working from home that week. That proved to be a prescient decision, because on March 9, the university sent an email about social distancing, canceling large events, canceling all university-sponsored international travel, discouraging all university-sponsored domestic travel & all personal travel, moving all lecture-based instruction online to start in 2 weeks (as the following week would be spring break), and encouraging all students traveling for spring break to stay away for at least another week thereafter. On March 10, our department sent a follow-up email with details to conduct the Visit Days remotely through online panel discussions, and discouraging prospective PhD students from visiting in person. Plus, the university sent information that two staff members had been tested for this disease, though there were no results available by that point. In any case, the deteriorating situation seemed to make clear that the hope that my friends & I had just a few days ago, that we might still be able to go out to dinners even without the prospective students, in lieu of the full Visit Day experience, would remain nothing more than a dream.

On March 11, at night, the university sent a message saying that all instructional activities must be moved online for the remainder of the semester, that all undergraduate students (with exceptions for international students from affected countries, or domestic or international students who otherwise face danger) must move off-campus to their permanent residences, and that all student life events on campus would be canceled. A follow-up email seemed to send mixed messages for graduate students: it seemed like graduate students could basically continue living as normal even on campus (modulo better hygiene & social distancing) because on-campus apartments are not as risky as dormitories for spreading disease, and because so many more graduate students come from abroad, yet graduate student events were canceled (but even then only until the end of April), and those who had other residences to move to were "encouraged" to do so, with students particularly living on campus being allowed to end their contracts early without penalty. I also saw the news that the US had instituted a partial travel ban on Europe, and India had instituted a ban on foreign nationals from entering, both (at that time) until the middle of April. That day and the following day, it gradually became clearer that I may in fact have to leave campus far sooner than I had hoped, even as I held onto the remote hope that I may still be able to work on campus again the following week, and that all of my travel and other plans following my defense would be completely mooted by this situation, though I held onto the remote hope for those things too. In any case, I told my family that I didn't see the circumstances as being so compelling as to move back with them in Maryland immediately; part of this was also apprehension that the university might not come up with a coherent & consistent plan for students like me, who would be defending, to perform those procedures as well as thesis submission remotely. I still had it in my head that I'd remain on campus for a significant length of time, though I was starting to see that if I did remain, I would see no one in person as I'd be in my own apartment by myself the entire time.

Much of the stress that week was because I didn't want to believe that I would have to leave campus so early, without even being able to say goodbye to friends in the university, let alone the issue of plans after my defense being canceled. All of those things would have helped to nurture meaningful relationships that could sustain me after moving to a new place in September, and I couldn't have that opportunity anymore. It also didn't help that in the process of trying to stay abreast of developments in the university with respect to the spread of this disease, I ended up consuming a lot of other news and analyses about this disease and its spread: many of the analyses started from similar or the same sets of data but reached diametrically opposite conclusions about how best to stay safe at a societal level, while others had some faulty assumptions that led to questionable conclusions. As someone who has no expertise in the relevant fields (though some of the questionable analyses were done by people who are experts in their own fields but may have misapplied such expertise to these relevant fields), it was hard to really know what to do; it didn't help that even official guidance from the US government, as well as from the university, was often unclear, and allowed people to draw overly optimistic or overly pessimistic conclusions that could be quite far apart from each other.

On March 13, I talked with various friends in the university as well as outside, who were seriously considering moving in with their respective families. I also thought more about my own situation as a vulnerable person, and realized that I would be safer with my family, because if I were to get sick, they could much more easily get me medical care than I could get for myself living alone. In the afternoon, I even saw people in my apartment complex on campus moving out immediately. Plus, the university announced that one of the aforementioned staff members' test results came back positive, and there would be new restrictions on building access. Given this, I realized it may be my time, so I informed my family, prepared myself for a long-term move through the end of my PhD by doing things like setting up the university VPN software, and confirmed that procedures were in place to submit & defend my thesis remotely. Initially, I thought of staying for another 2 weeks and then fully moving out, only moving a good chunk of my stuff out initially, but my family convinced me to move immediately, leaving behind only a handful of things that we could make another trip to move later. This also coincided with other family members who might be coming for my defense sending messages that their trips & other travel were canceled. With this, I had to scramble to finish up a lot of other personal things that I would have done for others in May or June, as I would be leaving the following day. I did get to meet a few friends in person to exchange some items, practicing proper hygiene & social distancing in the process, and then packed up & left with my family the following day (getting to Maryland later that day).

To leave in this way was an emotionally wrenching decision. For having put nearly 6 years into my PhD, I admit that even many months before this, I envisioned being able to defend my thesis in front of several friends & family members, being able to spend the last few months of my time in the university with friends there, and generally being able to relax before being able to properly say goodbye to all of them; then, I would be able to spend time with other relatives & friends elsewhere, nurturing my relationships with them before moving to a new place. The mood I was expecting was of joyful triumph after a long and hard slog, yet the mood I got was of being sadly rent from my friends too soon, without even being able to properly say goodbye, leaving almost in the dead of the night with my metaphorical tail between my legs, and having to live with all of the uncertainty and fear stimulated by the spread of this disease for an indefinite period of time. These are friends who have so greatly enriched my life as a PhD student, and I can trust (and have in some instances trusted) my life to many of them. I felt truly terrible that we'd have to be separated from each other so abruptly under such circumstances; there will be more along these lines in the planned third post in this series, as well as in my thesis acknowledgments, but for now, for whatever little it may be worth, this post is truly dedicated to them.

I did feel like I could better accept the situation, particularly the need for me to be closer to my family where I would be safe & have my health needs taken care of much more efficiently, as well as the fact that even those who remained on or near campus wouldn't be seeing each other anyway either, after I could return to the familiar setting of my family's home, seeing it as my home too for the foreseeable future. It also helped that I was able to catch up with many relatives from here and abroad, as well as family friends from this area, along with friends from the university as well as from college, as that reminded me of the social network supporting me wherever I go. Now, three days after having moved back, the situation has gotten even worse; the university is canceling more events even farther in the future, closing several buildings on campus, and more strongly requesting that graduate students move off-campus and not come to campus to the greatest extent possible, so even more of my friends there may have to make similar decisions. Plus, now that I'm in the safety of my family's home, as the procedures for the remainder of my PhD are set, and as none of us are stepping out of the house except for a walk outside or to do grocery shopping (separated from others to the extent possible) for the foreseeable future, I no longer have to worry about this situation on a day-to-day basis, whether at the university level or more broadly, provided that I continue to practice more careful hygiene & social distancing protocols; these changes remove a lot of stress & anxiety from my life on a day-to-day basis, and that removal in turn allows me to more mindfully engage with my work, accept this new reality with greater mental clarity than I could muster before moving, and commit to diligently checking in with friends & family elsewhere.

There are, of course, many greater questions for the societal response to this crisis, and some of the ones I'm thinking about are in the context of the US in particular.
Will this spur a greater push for truly universal single-payer health care, and better preparedness for fast-spreading diseases causing such public health crises?
Will this spur a greater push for housing-first policies, so that homeless or housing-insecure people aren't at disproportionately more risk in these sorts of crises?
How will retail and factory work adapt to mandates for employees to stay at home, and how will building owners adapt to mandates waiving rents or late fees for marginalized tenants who are more vulnerable to such crises?
Alternatively, will the nature of employment change entirely for poorer people, and how will an economy still dependent on the production, distribution, and consumption of goods from raw materials adapt to mandates to work from home (applicable mostly to white-collar work that doesn't directly yield physical tangible economic goods)?
Will working from home become more normalized for white-collar jobs, and if so, how will this affect overall housing development patterns (currently geared toward more dense communities with urban amenities to attract rich working millennials) and travel demand for commuting if commuting is no longer as highly valued?
Will companies be able to maintain productivity, or at least ensure that its decrease is less in magnitude compared to the decrease in costs from not having to maintain such large office spaces?
How will agglomeration benefits for white-collar work, which typically arise because of spontaneous in-person interactions between people from similar or somewhat connected roles within an organization or between organizations, change if in-person meetings become much more rare?
How will the disproportionate benefits to marginalized communities from less air pollution & fewer instances of drivers colliding with pedestrians or other drivers compare to the costs due to these huge economic shifts?
How will middle-class and rich lifestyles, thus far currently stereotypically built around frequent socialization, enjoying urban amenities as desired, and traveling a lot at low cost, adapt to this new reality of social distancing and greatly depressed travel demand?
It is clear that the spread of this disease has been far more geographically widespread, and far more socioeconomically widespread, than usual: rich and poor people alike across the world have to deal with overwhelmed health care systems if they contract this disease, so in that sense, it is more "egalitarian"/it is a greater "leveler". These are all questions that will be more relevant for the second post in this series.

Overall, last week in particular was a whirlwind of developments and consequent reactions, and I'm still reeling a bit from how quickly it all happened and how my decision-making process had to accelerate to essentially go hour-by-hour from one decision to essentially its exact opposite. I'm certainly still a bit sad about being separated from friends at the university so soon and not being able to experience the joys of finishing the PhD and doing other things in the usual way, but since making this move, I have accepted the circumstances as they are and don't regret my decision; to better reflect this progression of raw emotional reactions, this post hasn't been edited much, and I didn't start this long before finishing this. Plus, this is a great reminder that the combination of a natural disease and accumulated years of political & economic decisions that have been different around the world have wrought a global phenomenon that has no concern for individuals' egos and plans, and that could have a nontrivial likelihood of fundamentally remaking society. For now, I intend to adjust to this new reality, and adjust the means with which I interact with others, while still maintaining an overall cautiously optimistic attitude in general.

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