I just had an hour-long conversation with my brother Suleman, a doctor on the front lines of the fight against COVID-19 at Valley Hospital in Ridgewood, New Jersey. Ridgewood is located in Bergen County, the epicenter of the COVID-19 pandemic in New Jersey. Bergen County is also where my university happens to be located.
The ostensible point of our conversation was child-care. Both my brother and his wife are physicians at Valley, and both are needed on the front lines of the fight against the pandemic. They also have two young sons, Marco and Leo. For reasons that are completely understandable, two of the three babysitters they normally employ have decided that they can’t risk babysitting the kids any longer: Suleman and Jessica are, after all, venturing into COVID-19-laden environments every day, and even with personal protective equipment (“PPE”), they risk bringing COVID-19 into their home, infecting their kids, and infecting anyone who comes into contact with their kids.
The two of them now have elaborate protocols for entering the house after work, for touching anything that’s been at work, and so on. That includes their clothes, their skin, their belongings, the interior of their car, a wall, a doorknob–anything. They enter the house through the garage, where they take off the clothes they wore to work, and store them in laundry bags that can’t be opened in the house, except right at the mouth of the washing machine. They walk through the house without touching anything with their hands. They wash their hands thoroughly. They then put on clean clothes that’s never to come into contact with anything that’s been at work (clothes, wallets, watches, etc.)
Only then do they come within proximity of their kids. But of course, after that initial contact, one of them has to go out and disinfect the car (or both cars). That person then has to repeat the process. When they leave for work the next day, they take off their home clothes before entering the garage, taking that day’s work clothes with them, and putting them on in the garage.
There is also, obviously, a separate, even more complicated protocol involved when they get to work about put on their PPEs, but let me regale you with that story another time.
All this to explain the child-care conversation. I am, to be sure, at least nominally an uncle, but substantively speaking, I suck at it. I know I was a kid once, but not having had any of my own, I don’t really get kids any more. They don’t seem to have jobs, so you can’t talk shop with them. Certain topics like sex, that I take for granted as part of the furniture of the universe, oddly have to be treated as non-existent around them. Same with the morbid sorts of topics I tend to like–war, liars, dragon’s fire, etc. Profanity, which I regard as second-nature, can’t be indulged around them.
Bottom line is, kids are wholesome and innocent, so I feel like I can’t really be myself around them. When I deal with them, as I sometimes have to, I have to act. But I suck at acting, too. The lamentable result is that I really, completely, totally suck at the uncle thing, and haven’t done five minutes’ worth of babysitting of my nephews since the first of them came into existence a decade ago (plus or minus; I forget). Child care is just not my thing. Children aren’t my thing. Actually, most things aren’t my thing. The only thing that’s really my thing is whatever I want to be my thing at any given moment.
Well, that shit’s about to change. I know it sounds pretty narcissistic; I’m just trying to be honest here. Of all the reasons for resentment against a deadly virus, the desire for all-encompassing self-centered whim-worship may rank fairly low for most people. But it ranks pretty high for me. I’ve done a lot of jobs in my life–from hospital janitor to copy-editor to adjunct to working on a loading dock–so I’m not averse to work per se. Nor am I a snob about jobs; I’m enough of a workaholic to do most things as long as they need doing and pay. But there are jobs I won’t do, and until now, babysitting was one of them. Until now. I guess adversity requires all of us to reach deep inside.
The scenario that Suleman and I war-gamed was this: what if either Suleman or Jessica tested positive for COVID-19, and/or was actively struck by the illness itself? Either scenario would require quarantine; a debilitating illness might require a long quarantine or hospitalization.
If Suleman succumbed, Jessica would have to work longer hours, and vice versa. But then the kids would be home alone almost all of the time. And in any case, where would Suleman or Jessica (or in the worst-case of the non-lethal scenarios, both of them) go? The quarantine period is two weeks long. For reasons I explain below, hotels are basically out of the question.
One plan was to have my family–me, Alison (my wife), and Hugo (our cat)–vacate our home for two weeks, and live at my brother’s place for that time (taking care of his kids), while he self-quarantined at our house. Then, having spent the duration of the quarantine here, he’d get our place professionally cleaned, and we’d then exchange homes again. It works, at least in theory. We’ve saved other, less palatable war games for a future conversation. So far, we’ve covered, “What if one or both of them test positive, or get ill?” We have yet to cover, “What if one or both of them die?” One thing at a time.
My brother told me in passing that he was surprised at how many “little things” get overlooked in the attempt to tell the big-picture story about COVID-19, and how many such “little things” we currently lack the infrastructure for (or in some cases, even awareness of the need for one). He hit me over the head with a long list that would take several posts to describe, but the most obvious one was the lack of infrastructure for self-quarantined medical personnel. “I thought they’d have some place for us to go, but I haven’t heard a thing on that subject.”
As he mentioned that, it occurred to me that one obvious place to house self-quarantined medical personnel would be all the college dorms left vacant by colleges’ (wise) decision to go online for classes a week or two ago. Could those dorms be re-purposed as housing for self-quarantined medical personnel? The idea has something of an indirect precedent: the one full-scale COVID-19 testing facility in New Jersey is located on the campus of Bergen County Community College in Paramus.
I ran the idea past Suleman, who liked it. “Not that I’m any kind of authority on this specifically, ” he said, but
as a potentially infected person I individually would be ill-advised to privately rent a hotel room for myself on a one-off basis as a means of self-quarantine.
A hotel might serve as an adequate location for institutional quarantine if health authorities took control of the entire building, evicted the current residents, ensured that it adhered to infection control standards, and altered the environmental services and systems accordingly (HVAC, etc.). Hotels have forced air heating and ventilation systems that may promote the spread of infection. Hotel conditions may also promote spread to housekeeping staff.
Granted, dorms face some of the same problems but have the advantages of having fewer problematic surfaces (e.g., wall-to-wall carpet, fabric drapes and wallpaper) and of already being empty as of this time.
Also because colleges have several separate dormitory buildings, you could safely house (a) international students [or any others still there], (b) low-risk patients who are pending rest results (i.e., lower likelihood of having disease), (c) higher-risk patients who are pending results (i.e., higher likelihood of having disease), and (d) confirmed test-positive cases. Unlike a single hotel building, you could put each category of patient in a different building to avoid cross-contamination.
The CDC website does actually suggest as an infection control measure that communities develop non-hospital alternative dwellings for patients who need them to quarantine. I don’t have the link to the exact page right now, but it’s there.
Suleman and I are in the middle of inquiries to make this work. If you happen to be reading this, and have any kind of access to decision-makers wherever you happen to be, you might consider running the idea by them as well.
There’s a huge irony here. I got this “dorm re-purposing” idea by reflecting on an event I witnessed in the West Bank. During the summer of 2016, while teaching a summer term at Al Quds University in Abu Dis, I was staying at Al Abraj, a largely vacant university dorm about a kilometer from campus. Near the end of the summer, the Palestinian Authority came to occupy our building (so to speak), in order to stage a large-scale police operation from there,* housing what seemed to be about 100 paramilitary forces in “our” building. If you can quarter paramilitary forces in a university dorm, I thought to myself, why not self-quarantined medical personnel and others during a pandemic?
I mean, anything to avoid babysitting.
*Having witnessed the PA operation at close range, I don’t happen to share Amira Haas’s breathlessly positive verdict on this operation, but that’s another story.