Scientist, writer, podcast host. PhD in Molecular Microbiology. Professor, Plant Dad. www.food4thotpodcast.com and www.josephosmundson.com
The first time I went down on a guy, my mind was doing math. I knew the risk to contract HIV was 1 in 12,000. “Oh god, this is a mouthful,” I thought. I knew, too, that the virus, that virus, was poorly transmissible in any single act. Even bottoming (receptive anal sex), without a condom only had a 2% chance of seroconverting.
I was — I am — a professional biologist. I did my postdoc, in part, in biostatistics. Long before I touched another man, I’d gone to the CDC website and looked at a table of acts and percentages, calculated long ago.
I knew too well, even then, that probabilities and statistics have a wicked sense of humor. A 2% chance seems unlikely, until you end up on one side of it, the rarer side, asking how exactly is it that you arrived at this particular, unlikely destination.
“But I only did it once…” I imagined myself saying to keep myself from doing it at all.
This was in the early ’00s. I was born in the early ’80s. I have to admit that, looking back, I am ashamed of these calculations and the stigma behind them. I understood the virus as a threat. In many ways it no longer was.
Every time I got naked in proximity to another man, my mind was a calculator. Even after I started taking PrEP to prevent seroconverting, I knew that nothing was perfect, nothing erased risk entirely.
I’d spent my life afraid of HIV, and so never able to rid myself of worry or of stigma for those who had it. We know, now, that the only risk-free sex is with an HIV positive person who’s managing the virus with drugs. I’ve had sex with HIV-positive men, on PrEP, and my mind arrived only at one round number, the one I love most: 0, wide open like a mouth.
Well, it’s 2020 and we all want to know if we can safely go to the grocery store.
Late 2019, a new coronavirus passed from human to human for the first time, traveling from bats probably into pangolins before evolving the particular suite of mutations needed to bind to our human cells well enough to infect one person, and then another, and then another.
The virus doesn’t want anything. It is just a recipe for itself. And our bodies are the kitchen.
I’ve been obsessed with viruses ever since I read The Hot Zone in middle school. I wanted to be a virologist at the WHO when I grew up. This is why I’d studied French, and not Spanish, in high school. Silly, young child.
This memory only came back to me through my mother at my dissertation defense. In my PhD, I’d studied a protein from a virus that infects Staph bacteria, with the hope that we could build a drug that acted like that virus, and so killed that deadly bacteria.
“You’re doing what you always wanted to do,” she said, but I’d forgotten that particular desire over the long course of my life. I’d moved on to wanting to be a lawyer, a doctor, a professional soccer referee.
I’d managed to somehow come back to viruses.
Thanks to the coronavirus, Americans are inundated with numbers in a way that’s rare outside of political punditry. The mortality rate is 3.4%, or 5%, or 1%, or, according to Trump’s statements from early March, 0.1%, just like the flu. We thought the R0 is between two and three but now we know it’s actually between five and six meaning that each infected person will — on average — infect five to six. The doubling time for the number of infected individuals is around five or six days, which also, confusingly, happens to be Covid-19’s average incubation period. The virus can live on surfaces for 12 hours, or two days, or 17 days if on a cruise ship, apparently.
But, my god, we all just want to know: Is it safe to go outside? Can I… hook up?
Viruses don’t want anything. They’re too small for desire. Viruses are life-forms, but they’re not living. They, by definition, need a host cell to replicate. Living things can replicate themselves. Viruses are usually small, both in size and in the information they need to replicate. HIV has a genome — a collection of all its information — that is 10,000 bases (A’s, G’s, U’s, C’s) long. Coronaviruses are massive, at 30,000. You, me? We’re made of 3.3 billion letters (of T’s, not U’s), each written twice.
And yet the virus can get in us, copy itself, kill our cells, activate our immune system, target our organs, kill. This is not what the virus wants. The virus doesn’t want anything. It is just a recipe for itself. And our bodies are the kitchen.
It’s March 16, about a week before New York State will go on pause. I wait outside of Trader Joe’s on a Monday afternoon, figuring that traffic to the store will be low at that time of day. Here are some things I know.
SARS-CoV-2, the virus that causes Covid-19, is similar to other coronaviruses, including the first SARS virus, in that we think, we’re pretty sure, it’s transmitted by liquid droplets, and that it’s not (or only very rarely is) airborne. This is why standing away from people minimizes the risk of getting ill. Three feet is good. Six is better.
I stand in the Trader Joe’s line outside wondering what the store will be like inside. Crowded? Will there be lines for checkout too? There’s no tape or chalk on the ground marking six feet. But I know enough to stand six feet behind the person in front of me, and to stare at the person behind me with an intensity that keeps them six feet behind me too. I’m treating everyone like they might be infected, because they might be, and I’m treating myself like that too.
Care does not require anxiety, or punishing ourselves for what we cannot avoid. Care does not require perfection, as that’s something no human body can attain in this moment.
One thing I don’t know, because no one does, not yet, is the number of people who will be infected with SARS-CoV-2, never develop any symptoms at all, and still spread the virus.
SARS-CoV-2 is also similar to other coronaviruses in how long it can survive on surfaces. Coronaviruses are enveloped, and so wrapped in membrane just like our cells. Their genetic information is made of RNA, the less stable cousin to our cells’ DNA. And yet, these little sacks of membrane and RNA and a few proteins, too, can remain infectious on certain hard surfaces for not just hours, but up to a couple of days.
Riding down the escalator into Trader Joe’s, I’m shocked at how empty it is. Keeping the line outside, where wind can whisk viruses off surfaces, that’s smart. Suddenly I see a virus on every surface. That pile of avocados. That freezer section with only three pizzas left. The red onions I’m stocking up on. From every surface, that virus gets on my hands. But, I know enough to know: It can’t infect me from there.
I do not touch my face. I use the back of my hand to move my glasses up my sweating nose.
The basket of groceries feels sharp in my hand with its weight. It’s the liquids, I know: seltzer water, iced coffee concentrate, some beers, because nothing matters anymore at the end of the world. There’s no line to check out. I stand six feet, as best I can, from the nice woman checking running the register, number 17. She discovers that I teach at NYU, that I studied microbiology, and now she wants to talk.
“What the fuck is going to happen?” she asks.
“I don’t know, but it’s going to be like this for a while,” I answer. “How are you holding up?” I ask.
“It’s not that bad,” she says, and I look at her sideways. “Okay, fine. It is. But what else can I do?” I nod, guilty for having put my body so close to hers. I pack my groceries into my massive camping backpack. I walk up the escalator, it’s empty, no one six feet of me in any direction.
And what is the risk to me, personally? I’m almost 40 with no preexisting conditions. Reports state this virus can be nasty, if not usually deadly, for people like me. But young people in Americaare dying of Covid-19. And people of all ages can get severe diseases and require hospitalization to live. If our hospitals aren’t functional because there are simply too many cases, the mortality rate for this virus can climb, as it did in areas of Italy.
Remember statistics are darkly humorous. Risk spreads itself out across the world, to everyone.
I’d call this virus a hilarious jokester if it weren’t so deadly. Ask Rand Paul. But yes: Rare probabilities become downright likely once they’re spread across a large enough population. We all could be on the wrong side of a statistic. We all need to care for our own flesh, too.
Care does not require anxiety, or punishing ourselves for what we cannot avoid. Care does not require perfection, as that’s something no human body can attain at this moment.
I feel guilty for having gone to the store. I put myself at risk, and while that’s bad, there’s something worse. I could be carrying the virus, but not feel sick, and depositing it wherever I go. One study — done in China — put the likelihood of that at well under 1%, but certainly not zero. More recent work suggests asymptomatic infections are much, much more likely.
I feel guilty, but I have a mouth to feed. My own. I’m still human. My O-shaped mouth. As a human, I’m a walking SARS-CoV-2 incubator. If the virus wants anything, it wants me.
We’re human; we need to eat, which necessitates a world outside of our apartments. Anything out there, in that world, brings the possibility of illness. I washed my hands. I washed my veggies. I put rubbing alcohol on the bridge of my glasses, where the back of my hand always pushed them up, out there, in the world.
The risk is not, and can never be, zero. Could I order groceries, have them delivered? Sure, of course I could. And that would push some of my risk onto another person, a shopper in the store, a delivery person on a bike. That person is more likely to be a person of color and more economically at risk than I am. My risk may be lowered, but the overall risk remains, and will always remain, as long as my body has needs, which is to say as long as I live.
We have to reframe the very notion of risk, of fear. It can never be zero. The more we minimize risk, the less there is to fear.
Myrisk and yours, our personal risks, will be more than zero, always. There’s solace in this. If we’re all doing the best we can, then it’s no one’s personal fault if they happen to fall ill. We know that people are sick now, and more will get sick. This is a virus, and that’s what viruses do. This virus will be with us for weeks and months, maybe years.
The stigma of being infected, well, fuck that, because viruses aren’t malicious, they’re a mistake, and people aren’t reckless, they’re living human beings, and all living human beings are flesh, and flesh is vulnerable to this virus.
Those kids, though, at spring break, were reckless. But even they don’t deserve to get ill.
Even more than those kids, I blame the people who allowed them to come, who kept beaches open, who profited from all those drinks they drank at crowded bars. Money, so clearly, is worth more than life to some. That is violence, the opposite of care.
It is care to hold our leaders accountable, to push them to make the decisions that are right across our community. It is care to inform people, to help them stay home. And then to buffer the economic harm that’s being done to us all, especially those losing their work, and among them, especially those whose work was never worth enough to begin with, who live month to month without an ounce to spare between.
I’ve stopped running calculations. Instead, I run outside on the East River, measuring myself six feet from other bodies. Most days, I don’t even go outside, I run up and down the stairs in my apartment building, six flights to the skylight on the last. On my first trip up, I wondered why the light got brighter with each floor I ascended. I didn’t even notice until the crisis made me run stairs, pull myself up toward the heaven, protected still by glass.
Returning from the store, I wash my vegetables in water, only after I’ve soaped my hands for three singings of “Happy Birthday.” I’m not doing math. I just know, in my gut, I killed 99% of the things on me, and that’s as good as I can do. I stopped taking PrEP because I’m not hooking up. The risk of HIV is now zero, fully zero, and those pills can be saved for another day.
My anxiety isn’t driving my actions, not anymore. My care is. I picture myself a line, approaching a limit of zero. No risk. I will never arrive, a beautiful failure. The better we all do, the better we all will be. Our personal risk, small but present. Watch what we just did: New cases in our city stabilized. Now they will — god willing — fall. The goal, for now, is to get those to zero, and keep them there. Will we? What will it matter what I’ve done, if I’m still at risk? It’s not my risk that matters, but ours, together. It just matters that I’ve done the most I can and pushed those in charge to value what matters most, the thing that can’t be gotten back or bailed out: human life.