Journal of the Plague Year (2020)

By Hugh Cameron

The original Journal of the Plague Year was written by Daniel Defoe in 1639. Plagues have been a recurrent fact of life since humans have existed. A virus or a bacterium makes the jump either from an animal or from a tribe who have long been habituated to the organism, and this novel infection races through the newly exposed populace, and a huge die-off of the new hosts occurs.
The last major event was the Spanish influenza at the end of WWI. There have been events of concern such as SARS and Ebola, with other lesser events such as H1N1, MERS, and Hong Kong flu. While these potentially were a major problem, the Wuhan virus has turned out to be a new plague of disastrous dimensions. It remains to be seen if the catastrophic subsequent events were due to the virus itself or the hysterical overreaction to it.
As an experienced doctor, with a large active clinical practice, I found I was often being asked the same questions as many patients were totally confused by the media and the changing and contradictory pronouncement from politicians and public health. I found I was answering so many questions in the office and on Facebook that it came to me, in April of 2020, that what I was doing was in fact compiling a “Journal of a Plague Year.”
This book is a collection of sequential posts, almost all completely unedited. Also included were some questions and my answers.

• Language: English
• Publisher: Xlibris US
• Release date: Feb 10, 2021
• ISBN: 9781664157309

Hugh Cameron

Hugh Cameron, born in Scotland, is an internationally known orthopedic surgeon who lives, works, and teaches in Toronto. He was one of the developers of modern joint replacement surgery. Most patients with artificial hips are walking on the technology he was instrumental in developing. He was the lead designer of many artificial hip and knee implants, some of which are currently being implanted. For more than thirty years, he and a group of surgeons crisscrossed the world teaching and demonstrating modern joint replacement surgery. He is the lead author of more than two hundred scientific papers and continues to publish, now mostly on issues related to pain. He has published two technical books and several novels of which this book is the fourth in a series about the decline and fall of the West and its possible redemption.

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Copyright © 2021 by Hugh Cameron.

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Rev. date: 02/09/2021

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CONTENTS

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Abstract

Chapter 1 An Inauspicious Start

Chapter 2

Chapter 3 Facebook Posts

Acknowledgments

Hugh Cameron

ABSTRACT

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The original Journal of the Plague Year was written by Daniel Defoe in 1639. Plagues have been a recurrent fact of life since humans have existed. A virus or a bacterium makes the jump either from an animal or from a tribe who have long been habituated to the organism, and this novel infection races through the newly exposed populace, and a huge die-off of the new hosts occurs.

The last major event was the Spanish influenza at the end of WWI. There have been events of concern such as SARS and Ebola, with other lesser events such as H1N1, MERS, and Hong Kong flu. While these potentially were a major problem, the Wuhan virus has turned out to be a new plague of disastrous dimensions. It remains to be seen if the catastrophic subsequent events were due to the virus itself or the hysterical overreaction to it.

As an experienced doctor, with a large active clinical practice, I found I was often being asked the same questions as many patients were totally confused by the media and the changing and contradictory pronouncement from politicians and public health. I found I was answering so many questions in the office and on Facebook that it came to me, in April of 2020, that what I was doing was in fact compiling a Journal of a Plague Year.

This book is a collection of sequential posts, almost all completely unedited. Also included were some questions and my answers.

CHAPTER 1

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An Inauspicious Start

We were all sick. A great start to the year of our Lord, AD 2020. I was vaguely not well; with what exact symptoms I cannot remember. My wife was also somewhat sick. Our eighteen-year-old son was very sick. He ran a high fever for a couple of weeks and had severe aches all over. This was very unusual as we are not a sick family and seldom feel unwell, with nothing more than a very odd cold every few years. None of us was sick enough to require any specific treatment as I remember, and certainly none of us saw a doctor as a result. But the symptoms did drag on for at least a couple of weeks, and I think about a month or more before we all felt completely well.

We had gone to a resort in Cuba for Christmas. Why we picked Cuba again I don’t remember. Probably it had something to do with my son’s exams as he was in his first year in university studying engineering and business. Maybe we did not know when his examinations would be finished, and it is always possible to book a last-minute trip to Cuba as their resorts are never full.

A decade before, when he was a child, we used to go to Cuba for holidays as it was very safe. The beaches and resorts were patrolled by serious people. This was and still is, after all, a communist police state. Locals were never allowed on the beaches, so there were no annoying people trying to sell cheap knockoff junk from China. There was always the odd shady character trying to sell counterfeit cigars. Everyone was sternly warned numerous times not to buy these as unless they had the official stamp of government approval, they could not be taken out of Cuba.

I am sure that there was some unwary traveler who bought these cigars. There always is. I wonder if anyone remembers the movie Midnight Express, which told the story of a poor unwary boy being caught in the hashish scam. The terrible thing about that movie was that I knew it was true to life. I still remember watching it with pity and sorrow.

More than fifty years ago, I was on holiday from medical school and was on a train going from Athens to Istanbul. It was the end of term, and all the Greek university students were going home for the summer. There were a few students from other countries as travel then was safe, cheap, and easy. The Greek students spoke some English, and I had my high school Attic Greek that no one understood, but it was great fun, loud, boisterous, and noisy. Cans of beer and lamb kebabs were bought at every stop. On the train there was singing, dancing, laughing, and shouting.

This was so many years ago that the train pulled into a siding up in the mountains of northern Greece to let the famed Orient Express go by. Every child in Europe had heard of that train and longed to ride it. Alas, nowadays, it only runs from Paris to Vienna.

When the train left Greece and pulled into Turkey, the drug dealers boarded with their cardboard suitcases full of hash. Everyone told the foreign students not to buy it, and none of the locals touched the stuff. A few young Americans threw caution to the wind and bought it, against all advice. I still remember leaving the main train station in Istanbul, walking down the steps and seeing the ring of police waiting for these unwary American students carrying these cardboard suitcases. In some cases, the dope dealers were pointing out their prey to the police.

What I still don’t understand to this day is who benefited? Cui bono? At that time, I thought the Turkish government were reasonably honest people as they were still the remnants of Mustafa Kemal’s men, who were trying to Europeanize Turkey. They were not at all like the current leaders who seem determined to take Turkey back to the Middle Ages. So who made money? I don’t know, but these poor US students went into a Turkish jail. So why would anyone buy cigars in a communist state, which surely everyone knew had so many of its own people in jail?

The reason we used to go to Cuba was that the beaches were superb for a little child. When he stopped being a little child, we stopped going as there was never much of anything else to do in Cuba. The island was, after all, bankrupt, as is true for every socialist economy, such as today’s Venezuela and the African countries that still remain socialist. Starvation is always the outcome of socialism, so the food in Cuba always was of limited choice and poor quality.

The food, which is one reason many people go to a resort, had hardly improved in the decade since we were last there. Sadly, in spite of being a Spanish-owned resort, this was no different. In contrast, the food in numerous Caribbean resorts is now often superb.

The year before, we spent Christmas in Ocho Rios in Jamaica. As a surgeon, I have worked with nurses from Jamaica and other Caribbean islands ever since I got to Canada decades ago. I know and have always liked Jamaican food, such as jerk, salt fish, and curry, especially goat curry. The food in that resort in Ocho Rios was spectacular. The problem was weight gain from eating a couple of irresistible entrées every meal.

In the resort in Cuba, the food was very limited in variety. We were told that it used to be imported from Venezuela as being communist state, of course, very little was locally produced. The collapse of the Venezuelan economy, with widespread starvation in that country, meant that there was none for export at the former give away prices. The Spanish Manchego cheese and chorizo sausages were good, and for the last few days, that was all I bothered eating. Maybe I was getting sick by then without knowing it.

Of interest, there were numerous mainland Chinese guests holidaying in the resort. I had not seen these people in such numbers in any other place in the Caribbean. I knew they were mainland Chinese because my wife is mainland Chinese, from Shanghai. I spent most of my time at the resort writing, completing a scheduled book, so I was not terribly active, and perhaps because of that, I did not really realize that I was not well until I returned to Toronto.

In Canada, we knew nothing in December and January about this Wuhan virus, so the reason we were all sick was not clear. It was only a couple of months later I realized that that was what it was as we now know that the virus was on the loose in China sometime in the fall and, by December, was widely established and was being exported to the West.

The genesis of the plague therefore began before the year 2020.

CHAPTER 2

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I still had little knowledge or interest in the virus but had just had another book, a novel, published with my longtime friend and scrub nurse, Edna Quammie. Ominously, it dealt with two contentious issues, one being post-traumatic stress disorder in medical military personnel and the other with the difficulties of caring for inmates in nursing homes. We had no idea how prophetic that would be as nursing homes became a focal point of the disaster and were where almost all the subsequent COVID deaths occurred.

Equally prophetically, we had almost finished a new book dealing with bioweapons, in this case prions, released from China. We chose prions as they are more easily controlled than a virus. The lockdown has prevented us from completing that book as we are both in the high-risk category and thus had to isolate, especially as I continued working, seeing patients, but we hope to finish it soon. We were thinking of calling it Prion, but perhaps The Plague from Wuhan might be more apropos.

CHAPTER 3

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Facebook Posts

I really was not active in Facebook posts as I had very little to say that I thought would be of interest to anyone. I also took little notice of the virus as there had been numerous previous virus scares like H1N1, which turned out to be of little consequence. The Wuhan virus had not really affected anyone in Canada. And then it triggered, and the number of cases exploded. My first post about the virus was in March, and thereafter, I began to track the Wuhan virus epidemic and my progressive understanding of it and its curious progress.

March 13

Was in No Frills (a grocery store) tonight. Many empty shelves; meat, fish, and eggs are almost gone. Long lineups of people with stuffed shopping carts. Crowds very calm and orderly, no fuss, no fights, no pushing or shoving. I have never seen a real crisis before and am very proud of the people of Toronto. News of the virus getting worse. More whispers of the Winnipeg Wuhan virology lab connection. Conspiracy guys having a field day, but maybe, maybe, better not say more until more information is available.

March 15

Everyone should google singing in Siena. It is magical, the plague or coronavirus song. The Sienese should do this annually like the Passion Play at Oberammergau.

March 16

I wondered how many doctors would show up at the clinic today. 13 specialists are here. Very proud of my profession. Screening patients at the entrance. More than Ottawa can manage (for people) coming into our country. Our clinic manager should be in charge in Ottawa; she is doing a much better job.

Q. Where can I get a test?

A. I believe that the provincial government is going to open freestanding test facilities, but when I don’t know. Please do not go to a hospital unless it is absolutely necessary in case they are overwhelmed.

March 19

Just heard some hopeful news that maybe chloroquine will help treating COVID-19. Early days but was in the orthopedic hospital yesterday. Nurses and support staff are so brave. Stopping elective surgery but will handle surgical trauma to free up beds in Sunnybrook for the big one. (The hospital I work at is a purely elective hospital doing joint replacement surgery only. It is affiliated with the major Toronto teaching hospitals.)

Q. Have you heard anything on treatment?

A. I heard a guy in France has had good results with hydroxychloroquine in 20 cases, but the numbers are too small to tell. Some doctors in Korea are also looking at it, and it may, may, may be promising.

March 20

Clinic again today. All the staff here, all services, and 13 specialists. No no-shows. Telehealth set up for anxious patients. I can’t help much there unless it’s broken or worn out. News hopeful, chloroquine trials underway in the US, and company donated 1 million doses. Still not clear how effective, but . . .

Q. Did you hear someone died after taking chloroquine?

A. Someone just wrote to me about someone dying after taking chloroquine. It was not the medicine that he took. It was a fish tank cleaner. I definitely would not recommend that.

March 23

Clinic again today. All the doctors are here. Tight upper lips and lousy jokes, but all here, all ages. Girls at reception, x-ray, and the lab all here. They are terrified, but no one called in sick. Brave wee things. News from Cremona is terrible. Running out of coffins and priests. Was there once while lecturing in Brescia. Stradivarius’s house was closed, but the main square was stunning. Great doctors and nurses and good hospitals but overwhelmed. Reading Henry V.

We few, we happy few we band of brothers.

If we are to die we are enough to do.

But if to live the greater glory.

Heard last night all sorts of US businesses have begun production of protection gear and ventilators. Magnificent response. Hope they are up to speed before the big one hits Canada. Thinking of R. L. Stevenson,

Under the wide and starry sky

dig the grave and let me lie.

Glad did I live and gladly die,

and I laid me down with a will.

This be the verse . . .

March 24

In the orthopedic hospital. Toronto traffic is normally terrible. Almost no cars on the road. Hospital eerily quiet. Normally 50 people in x-ray. No one, clinics closed. One ward emptied waiting for the coming overflow. Trauma patients only being done. Protective gear being limited. Nurses not to change during cases and number of assistants limited. Surgeons advised to reduce the number of drapes used during surgery as the hospital might run out. Gear only to be opened when a case is definitely going ahead. Saw a report from Global Affairs Canada dated Feb 9 that 16 tons of face masks, shields, and goggles were shipped to China? Word from someone, Canada and Italy have the same number of ventilators, about 5,000. And about 3,000 ICU beds. Mary, mother of God, pray for us now and pray that the warmer weather will slow the virus.

March 25

Can’t sleep. People asking for information. I am just an orthopedic surgeon, so this is the rattle of a simple man. Coronavirus is common, just like cold or flu. No vaccine for the cold, and flu vaccine is different every year as it mutates. So sometimes good, sometimes not. Spanish flu from pigs in Kansas killed about 50 million people. War conditions responsible for so many. H1N1 from pigs in Mexico. MERS, still going, from camels in Saudi. During the Great Starvation in China (that was Mao’s Great Leap Forward), the government allowed farming of wild animals. Sold for food in special markets. Very unsanitary. SARS was from bats to civets in such a wet market.

COVID-19 is also part bat virus but with additional strange features and is also said to come from the same source. Animal rights people should get on the job there. If these markets remain open, it will happen again. Videos from Italy are frightening. All beds full, patients in hallways. 8 percent all deaths health-care workers, exhausted 12-hour days, dehydrated, emotionally worn out. How brave. Kipling wrote this about nurses:

Yet their graves are scattered and their names are all forgotten,

Earth shall not remember but the waiting angel knows.

March 26

Hospital again today. Doctors’ offices closed. Corridors empty. Nurses waiting for the coming onslaught. Sense of doom. Virus now in warm climates, so spring will not bring surcease. Devastating in Europe. My scrub nurse and I wrote a book about the problem with old-age homes. We had no good solutions. Google virus in Spain. Old-age homes being decimated. This is not the solution we suggested. Shortages of protective equipment all over. Nurse in Texas told me today that she is being told to use the same mask all day. But . . . but regular (surgical) masks are no good after a couple of hours and should not be reused. From now on, could we please make this equipment in North America? Best data still from Italy. First-class hospital system but the ranks are buckling, exhaustion physical and mental. One nurse committed suicide. Details not clear. Exhausted, just diagnosed with the virus, racked with guilt about spreading it. God rest her brave soul. Just in No Frills. Have largely restocked. Magnificent effort. Weathered the initial storm. Enforcing social distancing. Employees calm, customers calm. Everything good. All the frontline workers, health care, food stores, so stoical.

Their shoulders held the sky suspended, they stood and earth’s . . .

March 28

Clinic yesterday. Quiet and calm. Telephone interview before access. So far no staff are ill. Not so many people falling downstairs. X-rayed two people only on day shift. Fear not so palpable. I hear some government people walked off their job. Probably just a rumor. Hope it’s not true. But still anticipating the big one in Canada. US coping well. Amazing can do attitude. Modified one ventilator to handle 4 patients. Anesthetists using their machines. Still no triage. Everyone who needs a machine getting it. 2,000-bed naval hospital ship on its way to New York. Hard to believe the crew won’t get infected. Be very interesting to see containment. Some people are very cautiously going back to work in the US. See what happens. Figures reported of infection rates meaningless. No whole population tested, and some donated tests don’t work. Situation in Italy and Spain is grim. Triage required. Great people and great health care but staff physically and emotionally exhausted. Look so brave gowning up for a 12-hour day. Significant death rate among staff. Remember a poem.

Once more their anguished way

they take towards their Golgotha.

Turn hearts to those as they go by,

salute those about to die . . .

Q. I hear that docs and dental offices are still open in New York. My doc’s office is closed here in Ontario.

A. Not all docs’ offices are closed (in Ontario). The ones in the hospitals are. Some