Health

Balcony View of a National Health Crisis

| GS INSIGHTS

Co-Authored by: Sid Davis

Evenings here in the Basque-Spanish resort city of Donostia-San Sebastián are when the streets used to come to life. But during the ongoing nationwide estado de alarma—the confinement of Spanish citizens necessitated by the spread of COVID-19—there's barely a soul to be seen. Above the streets, though, there's still life on the balconies. At 8 pm sharp, people gather on their balconies to solemnly applaud health workers stretched to the limit trying to treat cases of the virus. Whether any are around to hear the applause isn't the point. They know it's happening, and that it's for them, wherever they are.

We're lucky to have a balcony. We're two weeks into quarantine, but we can bask in sunlight, look at trees, watch seagulls dip and glide, and observe the few people authorized to be outside—the aforementioned health workers, police, and personnel employed in essential infrastructure. There are also other exempted people, among them professional drivers such as cabbies, delivery drivers, and bus drivers assigned to the few routes in operation. Anyone walking their dogs, buying food, or seeking medical care may venture out as well.

Social life distilled from an entire city down to a balcony is confining, but still has its pleasures. Neighbors converse with each other if they're close enough. At greater distances people sing, sometimes in groups, and some people play music, with residents of different balconies playing different instruments. A few days ago, an anonymous neighbor even gave a piano recital. We're fortunate to be dealing with this emergency in San Sebastián. In many cities around the world, there's far less comfort to be found.

You would think that if strangers can pull together from assorted balconies, acquaintances would do as well or better, but not everybody is cooperative. Within our building one set of tenants, whom we've greeted on the stairs many times, seem heedless of the gravity of the situation. People are constantly in and out of their apartment, and they make tremendous amounts of noise, oblivious to the fact that everyone is stuck at home and more courtesy is required.

Getting everyone to take the problem seriously is a challenge everywhere. In Italy, tens of thousands have been fined for disobeying quarantine. In Australia, a heatwave drove hundreds to the beaches in defiance of stay-at-home orders. Consistent leadership can make a difference, but governments send mixed messages. For the sake of public health, they repeat how potentially deadly the virus is, yet for the sake of public order caution against “panic buying.” But you can't raise the specter of death, then suggest risking multiple exposures to it. Any smart person will stock up on supplies to avoid repeated trips to stores. That isn't panic. That's just good sense.

Contraction and expansion

While our physical world has shrunk, our digital world has grown, and online there's no tension between health and order. Some would say that's because it's always been unhealthy and disordered. We disagree. We're the type who see plenty of good in digital life—even more so at a time like this. Thanks to technology we can compare experiences with friends, participate in virtual gatherings, and see what's happening elsewhere in town.

WhatsApp has become an indispensable tool for staying connected. On day one of the confinement, we were chatting with a friend from a nearby village when we heard music emanating from the street. “Strange…” we pecked, while peering out the window, “but it sounds like there is a marching band outside.” Twenty minutes later she beamed over a video, “Here is your marching band.” On the block behind us, neighbors were assembled on their balconies playing San Sebastián's emblematic theme song, usually reserved for its biggest holiday.

By day two, our phones were buzzing with activity. Videos shot from people’s balconies around town depicted the police stopping joggers or patrolling now vacant streets. “Day 2 of the Confinement” videos started circulating—a small girl shooting a plastic dart into her forehead, a young man bleating like a sheep on his balcony. Since then, links have been circulating and friends have been sharing even the most trivial of news. “Meat is ridiculously cheap right now. Just bought a kilo of lamb for six euros.”

Our phones have also become a crucial point of contact with the medical community, especially with doctors in Madrid, who are at ground zero of this developing crisis. Early on, a friend forwarded a voice recording. “This is much more serious than the media is making it out to be. Our intensive care units are almost at their limit. Soon there will be no more space. Even young people are becoming critically ill.” Another doctor in Madrid, acknowledging the limits of testing, disseminated an online health survey to try to determine the full extent of the outbreak across Spain. The local health department, Osakidetza, sent out a link to its COVID-19 symptom checker.

Social media has also been key to keeping in touch with friends outside of Spain. “Watch parties” have enabled us to view news broadcasts from abroad in real time. Local friends who escaped to the French countryside to wait out the pandemic have uploaded bucolic images from their new abode. Stateside friends have posted updates as their localities have gone on lockdown, one by one. And a friend in El Salvador, who works as an Intensive Care Unit (ICU) nurse, used Facebook’s phone feature to share her concerns, lamenting the dearth of protective equipment for medical personnel and estimating that there were fewer than 100 ICU beds available in a country of over six million people.

Online newspapers have provided yet another window to the outside world. The local paper, El Diario Vasco, reported that neighborhood groups had sprung up around San Sebastián to help vulnerable seniors with deliveries of food and medicine, or simply to chat by phone. In the surfer neighborhood of Gros, where Thursdays ordinarily kick off the weekend with crowded streets and discounts at local pintxos bars, DJs played sets for homebound revelers from their balconies in the main square. The paper also posts daily updates from the hospitals and on the numbers of people infected locally, broken down by specific areas.

Meanwhile the national paper, El País, focused on the Spanish government’s response to the crisis. The estado de alarma has been in effect since March 15. It gave the government rights to limit the movement of people, but bestows several other extraordinary powers. For example, it allows the temporary requisitioning of private enterprises. The armed forces have been deployed to assist in the conversion of facilities in Madrid, where hospitals have been overwhelmed with COVID-19 patients. A major convention center in Madrid, IFEMA, is being outfitted both as a homeless shelter and a 5,500 bed hospital. Hotels have also been converted into hospital space for less severe COVID-19 cases. As the crisis expands, the military will assist in transporting patients by land and by air.

Another power bestowed by the estado de alarma is the option for the government to ration basic necessities. San Sebastián is a global cuisine hub, internationally famous for its food. Locals love eating, and stores have long catered to that desire. In most of the city it's a challenge to walk more than two blocks without coming across either a large market or a corner shop. Many of these remain open, though with radically reduced hours. Because of the unusual prevalence of stores, there have been no problems with food or basic goods. But the estado de alarma will extend into at least mid-April, so we'll see what happens.

Day by day, the medical data is increasingly bleak. In the last 24 hours, 769 people across Spain lost their lives. A new record. Meanwhile, the virus is reaching new areas of the country. When information like this from the digital world overwhelms us, we find ourselves needing to scale back to our apartment to cope. We bake cakes in the kitchen, draw in our sketch pads in the living room, and fine tune manuscripts in the office. Then the phone buzzes. A friend writes, “Good news! After nine days of suffering at home in Madrid, my cousin’s fever finally broke!”

The unknown future

At this stage, victories are immediately counterbalanced by defeats. It will go on like this for a while, until quarantine succeeds in flattening the curve (a phrase mostly unheard of by the public a mere two months ago, but which is now destined to be a permanent part of the popular lexicon). In China, some restrictions are being lifted, and we hope we're weeks away from the same happening here. But we're aware, as well, that there's plenty of struggle to come, especially in countries where testing and preparation lagged—including the United States.

People's beliefs tend to be dictated by their personal circumstances. This crisis has reminded us of that truth. We have a friend who lives around the corner. She shops for food every few days. We consider her forays risky, but we live in a three bedroom flat with plenty of light, two balconies, and a mirador—or Spanish style window alcove that you can stand in. Our friend's flat is small and has no direct sun because it faces an interior light well. She can barely keep plants alive there. In our sunny comfort, we believe wholeheartedly in quarantine as an effective strategy, while her cave-like existence makes her dubious, at best.

Setting personal experiences aside and viewing the world through others' eyes often seems like the widest chasm humanity has to bridge. Asian countries already had experience with epidemics and immediately took the threat seriously. In the West we sat idle, unwilling to enact preventive measures because they would have disrupted the status quo. And yet here we are, once again reminded that borders are just imaginary lines, as nature rudely treats humanity like an interconnected whole. If history is marked by shocks, and the changes that subsequently come about, it will be interesting to see how we respond moving forward. Everyone wants to get back to normal. But should we?

We know on the most basic level that we'll recover. Humanity has been through far worse in the past. Everyone understands that. The question we ponder is whether everyone understands that we'll go through far worse in the future. Will we be better prepared then? Will we cooperate and coordinate better? But maybe now isn't the time to worry about it, when we're stuck at home going on two weeks. Because we work remotely we're lucky to still be earning money, so today we'll do our jobs, and tonight after dinner we may bake another cake. Cake always makes life better. Afterward, maybe we’ll step onto our balcony, take deep breaths, watch seagulls glide weightlessly above the empty street, and feel lucky to be healthy another day.