Calculating the Incalculable – Scientific American Blog Network

My alarm clock sounds at 6:45 A.M. I reach over and extend my arm to the empty space beside me, feeling for the lingering heat from his body that I know will be gone. He has been awake for hours already. If I strain to listen through the walls between our bedroom and his office, I can hear the murmurs that now mark the arrival of each day. These words, and the pulse I feel around them, are about hospitals, doctors, projected cases, “the curve,” and various scenarios for tomorrow and the weeks to come.

When I married my husband, a medical doctor who works on outbreak response, I feared Ebola would resurface at some point. In less than 24 hours, he would disappear from our lives, traveling to help at the newest epicenter. Over our years together, however, I’ve slowly grown into the contours of a relationship shaped by the spread of various diseases—first Ebola, next malaria and Zika.

Whatever we plan is vulnerable to last-minute change. He can pack a carry-on bag to travel to Africa in less than 10 minutes. I have always figured that at some point, we’d need to move as a family. I’d worry about the risks for our son, wherever we were headed. But I never imagined an epidemic (now pandemic) coming to us—that I’d be trying to maintain “normalcy” for our 19-month-old boy in one part of the house, while my husband spent 18-hour days advising governments, companies and hospitals on what to do next.

Back in January, as the first COVID-19 cases appeared in China, he ramped up work from afar. I remember asking him, “At what point will you start to worry?” “When there’s community transmission near us,” was his response. Now, here we are, sheltered in place.

I slip from the covers into my sweatpants, crack open the bedroom door, stepping out into the unknown of the world knowing he will have the latest already. I wonder what he will or won’t say today, whether the look on his face is an indicator of exhaustion, or new knowledge, or more likely some mix of the two.

On this morning, like many others for months now, we fall into a simple routine with our son. These are our daily sacred moments together as a family of three. We try hard to guard them, too, from the reach of the virus through the conversations we could hold but don’t. Within minutes, our little one is snuggled between us, sipping his milk while we hold hands across his little legs.

“Doctor” is the word he first surprises us with on this day.

“You’re thinking about doctors?” I ask.

“Yeah!” he says with a sense of curiosity and excitement.

“You know, your Papa is a doctor, and Mama, too—a different kind of doctor.” His eyes widen and he smiles, looking up at us both.

As a scientist who works on understanding the impacts of climate change and helping people adapt, I deal with uncertainty in my own work all the time. I’ve written about hope and panic and faced the grief of knowing what may come in this warming world without aggressive climate action. Climate and disease: these are two wars against invisible enemies. We have been fighting them both from our home, and there is one dominating right now, yet also bringing immediacy and visibility to the other.

Before the headlines hit the newspapers, he tells me, late one night in our bathroom, that the curve is flattening in China; more recently that a day has passed without any new cases reported. “This is a good sign,” he says, rather pragmatically with perhaps a tinge of relief stirring somewhere inside. “I don’t want to get too optimistic,” he catches himself, “as it’s just one country.” He puts the toothpaste down and starts brushing his teeth. Then, through a smile and the white froth, he declares, “But it does show that it can be contained. That we can, in fact, stop it.”

But here in the United States, we are not doing what they did in China yet. In February, only weeks into the outbreak, China launched an app that let its 1.4 billion citizens check if they’d crossed paths with anyone infected. At the height of its outbreak, stores checked customers’ temperatures at the door and required them to maintain a minimum distance in line. But we’re behind. But we need to test more people. But, here, sheltering in place began with populations on two coasts and staggered efforts in between them. We have individual states, counties and cities taking action—more every day—but we need more federal leadership and international cooperation, too. But… But… But…

These are just some of my concerns, and I resist the urge to share any of them here in our bathroom together—what has become the space of daily debriefs in the final minutes of our day. I am thinking about this virus in our country, in our state, perhaps in our community. I am thinking about my mom at home alone in Connecticut, about my brother in New York City and his pregnant wife, wondering if their daughter will be born aboard a military hospital ship. But my husband, Matt, is someone who has the bandwidth and expertise to be thinking about the same—only scaled up and across the world.

He gives me a hug and a kiss. I crawl into bed, as he heads back to the office for a few last e-mails. If I let my mind wander back to the virus, or the many parallels between solving this crisis and the climate crisis, I know it will be a long time until sleep comes. So, I recall the day, centering on the sweet moments we’ve created and the rituals I embrace in our home. Reading children’s books and playing music in the morning. Writing. Moving our bodies and getting outside. Calling my mother so that she and her grandson can blow kisses to each other. And finally, I fall asleep with the sound of my son’s laughter in my head. The pitter-patter of feet across hard wooden floors. The birdsong in the trees, as he reminds me on our walk to look up at the sky.

*********

My relationship to the news is a disciplined one. I can’t let it seep into my everything. When I’m with my son, only messages from friends or family come through. When he goes to bed, I let myself go there. There, to the one media outlet and then to another; there to the e-mails for more updates in my own community, as neighbors rally to pick up groceries for one another and others circulate hotlines or information about various closures of public spaces. I still want to know what my husband thinks each day.

“We are underestimating cases in the U.S. by two- to tenfold”” Matt says to me over another dinner, when I ask about the testing delays, the rate of community transmission, and the latest projections on cases, both nationally and globally.

We bounce between topics at the dinner table, dancing around the inevitable. I recall the new words our boy spoke that afternoon and recount the games of hide-and-seek we all played before his bath, then irresistibly circle back to the fight from our home. On this evening (which is now two weeks ago), Matt says the range of plausible case numbers in the United States is anywhere from 50,000 to 50 million, and that, too, gives me pause. (The virus moves faster than we can write and publish. At least one of these numbers already looks silly by the time you read it; we have far surpassed the best case he presented that night.)  “With such a wide range, we need to talk in terms of scenarios,” Matt says.

I don’t have any experience building scenarios for a pandemic, but I’ve built them with colleagues for another purpose. We use them to consider the future consequences of climate change and help citizens and resource managers to prepare. Uncertainty, vulnerability, risk. I think about these things every day when it comes to climate change but in relation to outcomes over years or decades to come. This virus is operating on another timescale; cases in the U.S. almost doubled recently in just two days. Every minute matters, to consider new information, to evaluate and reevaluate, and to make new decisions. This is mentally and emotionally taxing even for experts trained in emergency response. Naturally, it’s exhausting and frightening for everyone else.

My colleague, Molly Cross, climate adaptation lead for the Americas at the Wildlife Conservation Society, told me earlier in the day, “All of a sudden, everyone is constantly having to calculate the incalculable.” In our world, in our nations, in our towns, and in our homes. She was talking about the day-to-day decisions of meeting basic needs. Every morning, when I pour milk from our fridge into my son’s bottle, I estimate how many bottles remain in that jug and the days we have remaining on supply.

“What I like about scenario planning,” she said, is “that you don’t have to know the one future for sure.” She has used the approach with resource managers as a tool to help make better decisions about how to manage our forests or our watersheds today, in light of anticipated climate impacts. “You just have to know the plausible futures and there are, in fact, multiple,” she adds. “Then you look for commonalities and differences to inform what you do.”

If there are far too many variables and unknowns in a given problem, scenario planning allows you to build out the many ways it could all unfold based on everything you do know at a given point in time. You consider those plausible futures, then look for the common sets of actions, and then evaluate the trade-offs for the differing sets of actions to make tough decisions. Fifty thousand to 50 million; that’s an enormous range of outcomes. Social distancing, or perhaps better termed “physical distancing,” is one of those common actions; it’s the must-do-now commonality across all the scenarios.

“We have to prepare for the worst-case scenario,” Matt says, “but work towards achieving the best one.” Shelter-in-place gives us the best chance for the best case, as it’s one tool we know works if it’s done well, really well, to flatten the curve. But it takes an enormous investment and remarkable coordination. China built an entirely new hospital in 10 days. From decision point to full operation, that is bold action. Rapid, coordinated action is what crisis requires.

“So, you think our individual actions matter?” This question has been at the center of so much of my climate work. It is the fuel that inspires my research and writing and practice. It rests at the heart of my struggle to reconcile the long-term habitability of our planet in light of future climate conditions and the portfolio of solutions needed to address the problem itself. And here I am asking my husband the same over our kitchen sink amid a pandemic.

“They definitely matter, but this is not something that grassroots efforts, alone, can solve,” he says to me. “Quarantines only work if enough people obey them and somebody needs to organize and enforce that.”

“Sooner, rather than later,” I add.

*********

“Two months,” I tell him 24 hours later after reading another wave of news. It is late. We are minutes away from sleep, a rare occasion for us both to experience at once. “At least for now,” I say, “I’m wrapping my head around doing this, everything of this new life, for at least two months.”

“That’s probably the right thing to do,” he says, knowing I like a plan, even if I need to change it.

Wrapping my head around two months doesn’t mean I’m not optimistic. I am. By the end of summer, life as we once knew it could all return to normal but more likely, some sort of new normal. The plausible future scenarios include this one, too. Where we are free to gather, free to roam, to work, to create, to dream. To let our children play together again. But for right now, during this time of so much uncertainty, I need to fall into the rhythm of creating some new semblance of a beautiful world inside our home. Where the laugh of a little boy rings louder than a parent’s fear. Where in one room we are fighting from home and in the other we are fighting for home, realizing they are one and the same.