vox--2020-03-19--A one-page, printable guide for preparing to shelter at home

Imagine , two weeks from now , the country is functionally in quarantine .
Only groceries and pharmacies remain open , and there are limits on how many people can be inside them at once .
Other stores are closed , and many delivery services have shut down .
If this sounds dire , it ’ s a description of where Italy is , right now , in the coronavirus pandemic .
And by some measures , we look to be following Italy ’ s trajectory fairly closely , with about a two-week lag .
So now isn ‘ t @ @ @ @ @ @ @ is a time for preparation — to be ready for weeks or even months when much is shut down .
Even if you ’ re in a location where stores are staying open , many of us won ’ t want to go into the crowded public spaces we typically frequent without another thought .
“ People should be prepared to hunker down , ” Dr. Caitlin Rivers at the Center for Health Security at Johns Hopkins University told Vox .
“ I don ’ t think we have turned the corner yet.
@ @ @ @ @ @ @ How should you think about preparing ?
While store shelves are emptier than usual and lots of items are out of stock , many people still haven ’ t really thought about what the weeks and months ahead will hold — it may well be like nothing we ’ ve ever seen before .
Here ’ s a guide to the essentials ( and a version made for printing ) .
Not everyone can afford to respond by stocking up on necessities .
For many people living on the margins , the virus @ @ @ @ @ @ @ and more disruptions are coming .
But if you can afford to make some purchases now that will make the outbreak easier to weather , you will be helping to protect your fellow citizens who can ’ t .
Every additional person in a store increases the odds of coronavirus spread , and many people can unknowingly be carriers .
Staying home means that sick people ( including those who don ’ t yet realize they are sick ) spread the virus to fewer additional people .
If on average they spread it @ @ @ @ @ @ @ case numbers will shrink .
And even just delaying the growth in case numbers can save lives by buying us more time to prepare .
So preparing for the isolation yourself and your family may soon be facing isn ’ t selfish ; it ’ s one way to help protect people who don ’ t have the resources to prepare themselves .
It lets you avoid excursions that might get them sick .
It also lets you weather problems at home , instead of clogging an urgent care center or the emergency @ @ @ @ @ @ @ overwhelmed .
If you can afford to buy some things that will enable you to ride out social distancing , local supply shocks , school closings , and potentially getting sick , it ’ s a sensible thing to do .
That said , don ’ t panic-buy enormous quantities of things you won ’ t need .
Making it harder for other people to get those things actually puts you in greater danger !
Here is an expanded version of the guide above on some purchases that might make an unnerving few @ @ @ @ @ @ @ Keeping your living quarters , personal appliances , and surfaces clean is not just good general practice — it ’ s increasingly important as we learn more about how the coronavirus can spread and linger on devices like phones .
But that doesn ’ t mean you need to douse everything in Lysol ; some basic household products and good practices will help a great deal .
• Soap : You ’ ve probably seen the run on Purell and other hand sanitizers — which are sold out in many places or prohibitively @ @ @ @ @ @ @ and water is the recommended way to get clean , and is still available .
Get a soap you like using ; the most important thing is that you ’ re actually willing to use it to regularly wash your hands for a minimum of 20 seconds .
“ Wash your hands much more than you think you need to wash your hands , ” Dr. Rebecca Katz , director of the Center for Global Health Science and Security at Georgetown University , told me .
“ It ’ s not satisfactory because @ @ @ @ @ @ @ more , but at this point it ’ s the best advice we can be giving.
” Don ’ t neglect the more important basic measures that can protect your health and safety just because now much more intense precautions have been added as well .
• Towels , clean linens , anything else you might need more of if your cleaning habits change : If your family is like mine , after washing your hands , you all dry them on a bathroom towel that is laundered whenever someone remembers to get @ @ @ @ @ @ @ more bathroom towels and swapping them out more frequently .
In general , rethink your household habits now that you ’ re hopefully washing more , wiping down surfaces more , and spending more time at home — what do you need to keep up your improved habits ?
• Disinfectant wipes : Wiping down surfaces ( including your phone ) can make sure the virus doesn ’ t linger on them .
Most disinfectant wipes will work fine for this , but do check this list from the EPA to make sure @ @ @ @ @ @ @ — some natural cleaning products are not .
• Disposable gloves : Wearing gloves is great for reminding me not to touch my face ( though unless you are removing them properly and not washing or reusing them , they don ’ t make it safe to touch contaminated surfaces ) .
Anxious about the virus being transmitted by mail and packages , my family has been opening them on the front porch with gloves on .
You probably don ’ t need to be that paranoid , but if someone in your @ @ @ @ @ @ @ gloves to handle contaminated substances .
And once we had a supply around , we found that they also make diaper changes less unpleasant .
The food supply chain is not going to break down .
and hoarding can cause problems , but “ people might want to slowly start to stock up on enough nonperishable food to last their households through several weeks of social distancing at home , ” risk communications experts Jody Lanard and Peter Sandman have written .
You should be planning for interruptions and inconveniences , but needn @ @ @ @ @ @ @ at how the coronavirus has played out in other countries , it seems likely that people will need to plan for less frequent access to grocery stores , and if they get sick , they might not want to go out shopping at all .
It ’ s also possible many communities might be home for a long time , potentially months , so boredom is a real concern as many public activities are limited .
Consider buying : • Supplies of shelf-stable food if access to grocery stores is limited for a @ @ @ @ @ @ @ or county might start limiting how many people can be in the store at a time , creating long lines , as some areas of Italy have done .
The cheapest way to make sure you stay fed is probably some big bags of rice and dry beans , but keep in mind that food is important to your morale , too — snacks you actually like may make long periods of restricted movement more bearable .
My home has stocked up on chocolate and popcorn as well as flour , butter , @ @ @ @ @ @ @ or tea is good to have on hand , especially if you have a caffeine habit .
You will be much less happy stuck at home without them , and as things get worse a run out to the local coffee shop may not be a good idea ( or your city or county may close all nonessential businesses ) .
• A first aid kit : Hospitals in parts of the US are likely to be overwhelmed .
Already , many are canceling non-emergency surgeries .
That means it will be harder @ @ @ @ @ @ @ that have nothing to do with the coronavirus , former ICU nurse Miranda Dixon-Luinenburg told me .
“ Even in the moderate-bad case , ER wait times ” will be out of control , she said .
And if you don ’ t have the coronavirus yet , “ you do not want to be waiting there for many hours even if they will eventually see you , ” because you ’ d be at high risk of catching it from someone else in the waiting room .
So be prepared to treat @ @ @ @ @ @ @ rehydration fluids ?
bandages ?
Over-the-counter meds ?
Antiseptic wipes ?
Cold packs ?
Things like food poisoning or stomach flu can be safely treated at home unless you ’ re “ unable to keep down any fluids and have symptoms of dehydration , ” Dixon-Luinenburg said .
Cuts can be treated at home with gauze to stop the bleeding , polysporin , and bandages unless there are “ signs of infection ( area is warm , very tender , swollen , red , or draining pus ) , or if bleeding won @ @ @ @ @ @ @ me .
“ For injuries that might be sprains/might be broken , probably this pushes toward waiting it out and treating with ice + rest + painkillers , rather than immediately going to the ER to check .
( If you can put weight on it , it ’ s probably not broken ) .
If your arm is bent in two pieces , though , it is definitely broken and can not be dealt with at home.
” As I told my 3-year-old yesterday , doctors are very busy and it ’ @ @ @ @ @ @ @ the stairs — and a bad time to be unprepared if your 3-year-old does them anyway .
• If your doctor and insurance will approve you stocking up on 90 days of medication , the CDC recommends doing so .
Many states initially announced shutdowns for a few weeks .
But experts say we should expect things to be closed for much longer than that .
“ I think we will continue to see an expansion of the epidemic here in the US , ” Rivers told me .
“ I think we @ @ @ @ @ @ @ So you should expect that it may be months before you can return to your normal life .
Plan what you ’ ll need to keep yourself and your family entertained at home .
• Hobbies : Have you been considering taking up embroidery ?
Knitting ?
Miniature furniture making ?
Baking ?
It ’ s a good time to dive into an activity you can do at home .
Morale matters !
• Things for working-from-home : If your job is possible to do remotely , you should prepare for being encouraged @ @ @ @ @ @ @ the next few months .
Make sure you have a desk and a chair that ’ s comfortable , and consider other contingencies like a prepaid wifi hotspot for if your internet ’ s being unreliable .
• Electronics and , potentially , spare parts : If your phone or computer breaks , it ’ s an inconvenience in the best of times .
Right now , it might be more than that , if you ’ re relying on your connected devices for work or interactions with the outside world and stores @ @ @ @ @ @ @ replacement .
If you can afford a backup phone , a spare battery , or replacement parts for the devices you rely on , then you ’ re not one unfortunate spill from disaster .
• Things for quality time : Face it , you might be stuck with family , roommates , or partners for a while ( and experts do not recommend even small gatherings with other families , which can still transmit the virus ) .
So have on hand some things you can do together : board games , @ @ @ @ @ @ @ , popcorn for movie nights .
If you can ’ t afford to purchase much , keep in mind that many activities that can make the long days go by faster are basically free : My family is planning a D & D game , which can be run with free online materials and a set of dice ( if the dice are too pricy , your phone will do the trick ) .
For if you get sick According to data from China , for around 80 percent of people that contract @ @ @ @ @ @ @ “ Mild , ” though , doesn ’ t mean that it ’ ll just be a cold — it just means that you won ’ t require hospitalization .
It may still feel like the worst flu of your life .
Getting by at home , though , means that hospital beds can be reserved for those who need them .
“ If you are doing fine at home , you should stay at home , ” Rivers told me .
So stock up on things that help you get through a @ @ @ @ @ @ @ plus some other unpleasant symptoms .
That probably includes : • Medication for reducing a fever , like acetaminophen ( Tylenol ) .
There ’ s nothing like trying to figure out dosing instructions for medications , while miserable and sick , so look that information up now !
If you can ’ t manage your fever with over the counter medication , seek medical attention .
• A thermometer for monitoring your fever .
This can help you notice that you ’ re sick in the first place ( fever is the @ @ @ @ @ @ @ ) and help you notice if your fever is dangerously high or if medication is failing to manage it .
• Medication for managing a cough , including cough drops and lozenges , and cough syrups like Dayquil/Nyquil .
Stuffy/runny nose seems to be rare among Covid-19 patients , but for illnesses in general , decongestants like Sudafed can be helpful .
• A humidifier can also help a lot with a cough that makes it tough to sleep .
if you don ’ t own a humidifier , sitting in a steamy @ @ @ @ @ @ @ is running ) can help .
• Rehydration solutions .
You can buy these in the form of something like Pedialyte or Gatorade , or make one at home with a liter of drinking water , a scoop of sugar , and a pinch of salt .
Staying hydrated while you ’ re sick can help you recover faster and ensure you don ’ t need medical attention — which may only be available to the very ill .
I ordered Gatorade because I prefer the taste : The best rehydration solution is @ @ @ @ @ @ @ drink .
( But don ’ t get the sugar-free kind — sugar is what your body needs ! )
• I also purchased a finger pulse oximeter — which costs about $ 20 — the last time I had a respiratory illness .
When it feels like you ’ re having trouble breathing , it can be hard to know if it ’ s just anxiety or if you ’ re really having trouble getting enough air .
The oximeter measures whether you ’ re actually short of breath .
In healthy @ @ @ @ @ @ @ 96-100 .
“ Home ones are unreliable ( honestly , hospital ones are unreliable ! )
, ” Dixon-Luinenberg told me , “ so take a reading seriously if it ’ s more than five minutes on several different fingers while you ’ re sitting comfortably still and with warm hands .
A sustained reading under 92 percent is worrying.
” But for me , the oximeter was mostly useful for anxiety — I could slip it on my finger and be reassured that I was likely not very sick and didn ’ @ @ @ @ @ @ @ If self-care at home isn ’ t enough , you should call ahead before seeking medical attention so that precautions can be taken , experts say .
“ If you do start to get worried you ’ re not doing well at home , you can call your doctor ’ s office or call the emergency room , ” Rivers told me .
“ Call ahead so they know you ’ re coming and can make sure you ’ re not sitting in the waiting room.
” Sign up for the Future Perfect @ @ @ @ @ @ @ a roundup of ideas and solutions for tackling the world ’ s biggest challenges — and how to get better at doing good .
Future Perfect is funded in part by individual contributions , grants , and sponsorships .
Learn more here .
Clarification : An earlier version of this article recommended purchasing ibuprofen as a fever-reducing medication .
Due to some uncertainty as to whether it may exacerbate coronavirus symptoms , we have removed it from the list .
At present , however , the World Health Organization has said that it @ @ @ @ @ @ @ any negative effects of ibuprofen , beyond the usual known side effects that limit its use in certain populations .
”

Editor’s note, April 4: There have been significant developments in the coronavirus pandemic since this story was last updated, and some details may no longer apply. For our most up-to-date coverage, visit our coronavirus hub. Here’s the CDC’s current public health guidance.
Now isn’t a time for panic, but it is a time for preparation — to be ready for weeks or even months when much is shut down. Even if you’re in a location where stores are staying open, many of us won’t want to go into the crowded public spaces we typically frequent without another thought.
“People should be prepared to hunker down,” Dr. Caitlin Rivers at the Center for Health Security at Johns Hopkins University told Vox. “I don’t think we have turned the corner yet.”
So what do you need? How should you think about preparing? While store shelves are emptier than usual and lots of items are out of stock, many people still haven’t really thought about what the weeks and months ahead will hold — it may well be like nothing we’ve ever seen before. Here’s a guide to the essentials (and a version made for printing).
Not everyone can afford to respond by stocking up on necessities. For many people living on the margins, the virus has already disrupted paychecks and livelihoods, and more disruptions are coming. But if you can afford to make some purchases now that will make the outbreak easier to weather, you will be helping to protect your fellow citizens who can’t.
Every additional person in a store increases the odds of coronavirus spread, and many people can unknowingly be carriers. Staying home means that sick people (including those who don’t yet realize they are sick) spread the virus to fewer additional people. If on average they spread it to fewer than one additional person, case numbers will shrink. And even just delaying the growth in case numbers can save lives by buying us more time to prepare.
So preparing for the isolation yourself and your family may soon be facing isn’t selfish; it’s one way to help protect people who don’t have the resources to prepare themselves. It lets you avoid excursions that might get them sick. It also lets you weather problems at home, instead of clogging an urgent care center or the emergency room when both are likely to be overwhelmed.
If you can afford to buy some things that will enable you to ride out social distancing, local supply shocks, school closings, and potentially getting sick, it’s a sensible thing to do. That said, don’t panic-buy enormous quantities of things you won’t need. Making it harder for other people to get those things actually puts you in greater danger!
Here is an expanded version of the guide above on some purchases that might make an unnerving few weeks go a little more smoothly.
Cleaning products
Keeping your living quarters, personal appliances, and surfaces clean is not just good general practice — it’s increasingly important as we learn more about how the coronavirus can spread and linger on devices like phones. But that doesn’t mean you need to douse everything in Lysol; some basic household products and good practices will help a great deal.
Soap: You’ve probably seen the run on Purell and other hand sanitizers — which are sold out in many places or prohibitively priced online. But good old soap and water is the recommended way to get clean, and is still available. Get a soap you like using; the most important thing is that you’re actually willing to use it to regularly wash your hands for a minimum of 20 seconds.
“Wash your hands much more than you think you need to wash your hands,” Dr. Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University, told me. “It’s not satisfactory because people feel they should be doing much more, but at this point it’s the best advice we can be giving.” Don’t neglect the more important basic measures that can protect your health and safety just because now much more intense precautions have been added as well.
Towels, clean linens, anything else you might need more of if your cleaning habits change: If your family is like mine, after washing your hands, you all dry them on a bathroom towel that is laundered whenever someone remembers to get around to it. Consider buying some more bathroom towels and swapping them out more frequently. In general, rethink your household habits now that you’re hopefully washing more, wiping down surfaces more, and spending more time at home — what do you need to keep up your improved habits?
If your family is like mine, after washing your hands, you all dry them on a bathroom towel that is laundered whenever someone remembers to get around to it. Consider buying some more bathroom towels and swapping them out more frequently. In general, rethink your household habits now that you’re hopefully washing more, wiping down surfaces more, and spending more time at home — what do you need to keep up your improved habits? Disinfectant wipes: Wiping down surfaces (including your phone) can make sure the virus doesn’t linger on them. Most disinfectant wipes will work fine for this, but do check this list from the EPA to make sure your preferred cleaning product is actually virus-killing — some natural cleaning products are not.
Wiping down surfaces (including your phone) can make sure the virus doesn’t linger on them. Most disinfectant wipes will work fine for this, but do check this list from the EPA to make sure your preferred cleaning product is actually virus-killing — some natural cleaning products are not. Disposable gloves: Wearing gloves is great for reminding me not to touch my face (though unless you are removing them properly and not washing or reusing them, they don’t make it safe to touch contaminated surfaces). Anxious about the virus being transmitted by mail and packages, my family has been opening them on the front porch with gloves on. You probably don’t need to be that paranoid, but if someone in your house gets sick, you might want gloves to handle contaminated substances. And once we had a supply around, we found that they also make diaper changes less unpleasant.
Food, groceries, necessities
The food supply chain is not going to break down. and hoarding can cause problems, but “people might want to slowly start to stock up on enough nonperishable food to last their households through several weeks of social distancing at home,” risk communications experts Jody Lanard and Peter Sandman have written. You should be planning for interruptions and inconveniences, but needn’t fear a famine.
Looking at how the coronavirus has played out in other countries, it seems likely that people will need to plan for less frequent access to grocery stores, and if they get sick, they might not want to go out shopping at all. It’s also possible many communities might be home for a long time, potentially months, so boredom is a real concern as many public activities are limited. Consider buying:
Supplies of shelf-stable food if access to grocery stores is limited for a while. For example, your city or county might start limiting how many people can be in the store at a time, creating long lines, as some areas of Italy have done. The cheapest way to make sure you stay fed is probably some big bags of rice and dry beans, but keep in mind that food is important to your morale, too — snacks you actually like may make long periods of restricted movement more bearable. My home has stocked up on chocolate and popcorn as well as flour, butter, lentils, and rice.
if access to grocery stores is limited for a while. For example, your city or county might start limiting how many people can be in the store at a time, creating long lines, as some areas of Italy have done. The cheapest way to make sure you stay fed is probably some big bags of rice and dry beans, but keep in mind that food is important to your morale, too — snacks you actually like may make long periods of restricted movement more bearable. My home has stocked up on chocolate and popcorn as well as flour, butter, lentils, and rice. Coffee or tea is good to have on hand, especially if you have a caffeine habit. You will be much less happy stuck at home without them, and as things get worse a run out to the local coffee shop may not be a good idea (or your city or county may close all nonessential businesses).
is good to have on hand, especially if you have a caffeine habit. You will be much less happy stuck at home without them, and as things get worse a run out to the local coffee shop may not be a good idea (or your city or county may close all nonessential businesses). A first aid kit: Hospitals in parts of the US are likely to be overwhelmed. Already, many are canceling non-emergency surgeries. That means it will be harder to access hospitals for injuries and illnesses that have nothing to do with the coronavirus, former ICU nurse Miranda Dixon-Luinenburg told me. “Even in the moderate-bad case, ER wait times” will be out of control, she said. And if you don’t have the coronavirus yet, “you do not want to be waiting there for many hours even if they will eventually see you,” because you’d be at high risk of catching it from someone else in the waiting room.
So be prepared to treat everything from home: Do you have rehydration fluids? bandages? Over-the-counter meds? Antiseptic wipes? Cold packs? Things like food poisoning or stomach flu can be safely treated at home unless you’re “unable to keep down any fluids and have symptoms of dehydration,” Dixon-Luinenburg said. Cuts can be treated at home with gauze to stop the bleeding, polysporin, and bandages unless there are “signs of infection (area is warm, very tender, swollen, red, or draining pus), or if bleeding won’t stop,” she told me.
“For injuries that might be sprains/might be broken, probably this pushes toward waiting it out and treating with ice + rest + painkillers, rather than immediately going to the ER to check. (If you can put weight on it, it’s probably not broken). If your arm is bent in two pieces, though, it is definitely broken and cannot be dealt with at home.”
As I told my 3-year-old yesterday, doctors are very busy and it’s a bad time for acrobatics on the stairs — and a bad time to be unprepared if your 3-year-old does them anyway.
If your doctor and insurance will approve you stocking up on 90 days of medication, the CDC recommends doing so.
Fighting the war on boredom
Many states initially announced shutdowns for a few weeks. But experts say we should expect things to be closed for much longer than that. “I think we will continue to see an expansion of the epidemic here in the US,” Rivers told me. “I think we will also see corresponding mitigation measures.” So you should expect that it may be months before you can return to your normal life. Plan what you’ll need to keep yourself and your family entertained at home.
Hobbies: Have you been considering taking up embroidery? Knitting? Miniature furniture making? Baking? It’s a good time to dive into an activity you can do at home. Morale matters!
Have you been considering taking up embroidery? Knitting? Miniature furniture making? Baking? It’s a good time to dive into an activity you can do at home. Morale matters! Things for working-from-home: If your job is possible to do remotely, you should prepare for being encouraged or asked to work from home for the next few months. Make sure you have a desk and a chair that’s comfortable, and consider other contingencies like a prepaid wifi hotspot for if your internet’s being unreliable.
If your job is possible to do remotely, you should prepare for being encouraged or asked to work from home for the next few months. Make sure you have a desk and a chair that’s comfortable, and consider other contingencies like a prepaid wifi hotspot for if your internet’s being unreliable. Electronics and, potentially, spare parts: If your phone or computer breaks, it’s an inconvenience in the best of times. Right now, it might be more than that, if you’re relying on your connected devices for work or interactions with the outside world and stores aren’t open to get a replacement. If you can afford a backup phone, a spare battery, or replacement parts for the devices you rely on, then you’re not one unfortunate spill from disaster.
If your phone or computer breaks, it’s an inconvenience in the best of times. Right now, it might be more than that, if you’re relying on your connected devices for work or interactions with the outside world and stores aren’t open to get a replacement. If you can afford a backup phone, a spare battery, or replacement parts for the devices you rely on, then you’re not one unfortunate spill from disaster. Things for quality time: Face it, you might be stuck with family, roommates, or partners for a while (and experts do not recommend even small gatherings with other families, which can still transmit the virus). So have on hand some things you can do together: board games, video games, sheet music for sing-alongs, popcorn for movie nights. If you can’t afford to purchase much, keep in mind that many activities that can make the long days go by faster are basically free: My family is planning a D&D game, which can be run with free online materials and a set of dice (if the dice are too pricy, your phone will do the trick).
For if you get sick
According to data from China, for around 80 percent of people that contract coronavirus, the symptoms are mild. “Mild,” though, doesn’t mean that it’ll just be a cold — it just means that you won’t require hospitalization. It may still feel like the worst flu of your life.
Getting by at home, though, means that hospital beds can be reserved for those who need them. “If you are doing fine at home, you should stay at home,” Rivers told me.
So stock up on things that help you get through a bad fever and a bad cough, plus some other unpleasant symptoms. That probably includes:
Medication for reducing a fever, like acetaminophen (Tylenol). There’s nothing like trying to figure out dosing instructions for medications, while miserable and sick, so look that information up now! If you can’t manage your fever with over the counter medication, seek medical attention.
like acetaminophen (Tylenol). There’s nothing like trying to figure out dosing instructions for medications, while miserable and sick, so look that information up now! If you can’t manage your fever with over the counter medication, seek medical attention. A thermometer for monitoring your fever. This can help you notice that you’re sick in the first place (fever is the most common symptom and often the first) and help you notice if your fever is dangerously high or if medication is failing to manage it.
for monitoring your fever. This can help you notice that you’re sick in the first place (fever is the most common symptom and often the first) and help you notice if your fever is dangerously high or if medication is failing to manage it. Medication for managing a cough , including cough drops and lozenges, and cough syrups like Dayquil/Nyquil. Stuffy/runny nose seems to be rare among Covid-19 patients, but for illnesses in general, decongestants like Sudafed can be helpful.
, including cough drops and lozenges, and cough syrups like Dayquil/Nyquil. Stuffy/runny nose seems to be rare among Covid-19 patients, but for illnesses in general, decongestants like Sudafed can be helpful. A humidifier can also help a lot with a cough that makes it tough to sleep. if you don’t own a humidifier, sitting in a steamy room (like one where the shower is running) can help.
can also help a lot with a cough that makes it tough to sleep. if you don’t own a humidifier, sitting in a steamy room (like one where the shower is running) can help. Rehydration solutions. You can buy these in the form of something like Pedialyte or Gatorade, or make one at home with a liter of drinking water, a scoop of sugar, and a pinch of salt. Staying hydrated while you’re sick can help you recover faster and ensure you don’t need medical attention — which may only be available to the very ill. I ordered Gatorade because I prefer the taste: The best rehydration solution is one you’ll actually want to drink. (But don’t get the sugar-free kind — sugar is what your body needs!)
You can buy these in the form of something like Pedialyte or Gatorade, or make one at home with a liter of drinking water, a scoop of sugar, and a pinch of salt. Staying hydrated while you’re sick can help you recover faster and ensure you don’t need medical attention — which may only be available to the very ill. I ordered Gatorade because I prefer the taste: The best rehydration solution is one you’ll actually want to drink. (But don’t get the sugar-free kind — sugar is what your body needs!) I also purchased a finger pulse oximeter — which costs about $20 — the last time I had a respiratory illness. When it feels like you’re having trouble breathing, it can be hard to know if it’s just anxiety or if you’re really having trouble getting enough air. The oximeter measures whether you’re actually short of breath. In healthy people, blood oxygen levels are usually 96-100. “Home ones are unreliable (honestly, hospital ones are unreliable!),” Dixon-Luinenberg told me, “so take a reading seriously if it’s more than five minutes on several different fingers while you’re sitting comfortably still and with warm hands. A sustained reading under 92 percent is worrying.”
But for me, the oximeter was mostly useful for anxiety — I could slip it on my finger and be reassured that I was likely not very sick and didn’t need a doctor at all.
If self-care at home isn’t enough, you should call ahead before seeking medical attention so that precautions can be taken, experts say. “If you do start to get worried you’re not doing well at home, you can call your doctor’s office or call the emergency room,” Rivers told me. “Call ahead so they know you’re coming and can make sure you’re not sitting in the waiting room.”
Sign up for the Future Perfect newsletter and we’ll send you a roundup of ideas and solutions for tackling the world’s biggest challenges — and how to get better at doing good.
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Future Perfect is funded in part by individual contributions, grants, and sponsorships. Learn more here.
Clarification: An earlier version of this article recommended purchasing ibuprofen as a fever-reducing medication. Due to some uncertainty as to whether it may exacerbate coronavirus symptoms, we have removed it from the list. At present, however, the World Health Organization has said that it is “not aware of reports of any negative effects of ibuprofen, beyond the usual known side effects that limit its use in certain populations.”


vox--2020-03-19--American Truck Simulator is the perfect way to hit the great, virtual outdoors

There are few American dreams as alluring to me as that of exploring the open road .
Taking to the highways in a slick vehicle , driving well into the night , waiting for the next sleepy little town to stretch out before you — they ’ re all things I love but get to do far less often than I ’ d like , now that I have a “ job ” and have to be “ responsible ” and “ pay my bills.
” Thank goodness for the game American Truck Simulator , then .
The 2016 release @ @ @ @ @ @ @ continuously expanded by developer SCS Software — is exactly what it sounds like : a game where you are a truck driver , completing long hauls and taking cargo from city to city .
But what it really excels at is capturing the feeling of driving through the great , open expanses of the country , radio blasting some of your favorite tunes ( you can load your favorite songs right into the game ) .
You have places to be , but for now , you ’ re just killing time .
@ @ @ @ @ @ @ , and by the time you ’ ve completed a run from Los Angeles to Albuquerque , you might have entered a kind of meditative state .
That ’ s not going to sound like a great time to some folks , but for those who play video games primarily to chill out after a long day ( as I do ) , it ’ s one of the games that will best accomplish that goal .
And , hey , if the quarantine is getting you down , if the thing you @ @ @ @ @ @ @ drive to some other city entirely , well , few things are more socially distanced than the cab of a semi , except for the cab of a semi that only exists in a video game .
This could scratch that travel bug just a little bit , until the quarantine lifts , and we can all complete long-haul routes in the real world .
American Truck Simulator is the kind of game that lets you have whatever experience you ’ d like with it — so long as you ’ re driving @ @ @ @ @ @ @ driving a truck , American Truck Simulator isn ’ t bad .
I ’ ve driven a semi a handful of times ( I grew up on a farm , and my dad owned one ) , and you rarely get the sense of weight from your virtual truck that a real one would have .
But maybe that ’ s okay since even a massive collision with another car in this game only results in a fine , with the other car driving off unscathed .
That would ... not happen in @ @ @ @ @ @ @ the US , American Truck Simulator is slightly better , though it ’ s currently working its way across the country from the Pacific coast very , very slowly .
The base game allows for hauls through California , Nevada , and Arizona , and further expansion packs have added New Mexico , Oregon , Washington , and Utah , with Idaho coming sometime this year .
The simulations of those states capture their essence , with major cities looking more or less like themselves and lots of fun byways to explore ( @ @ @ @ @ @ @ clock for a delivery ) .
The spaces are big , but not impossibly so .
Taking a job in northern Washington and driving all the way to the southern tip of New Mexico will take you well over an hour of gameplay , but it would take you well over a day of real time , so the scale of the game is vast but not too vast .
( What ’ s even more impressive about the game ’ s ability to capture the feel of western America is how it @ @ @ @ @ @ @ . )
The difficulty also scales .
You can get a more realistic simulation of driving by turning it up , or you can turn it all the way down and just bomb around the American West listening to some killer tunes .
It ’ s also the kind of game that lets you play it however you want .
If you really want to just drive around and not worry about hauling goods , you can do that .
If you want to take on as many hauling jobs as possible and @ @ @ @ @ @ @ can do that , too .
And if you are more business-minded and want to use your proceeds to buy more trucks and hire drivers and start a trucking concern , there are plenty of options to do that as well .
It might sound weird to use the time when you ’ re not at your actual job starting a virtual job , but the appeal of these sorts of simulators lies in the way they offer us a window into lives that exist outside the normal portraits of pop culture .
@ @ @ @ @ @ @ many entertainment options , and the back-breaking , blue-collar work they do isn ’ t either .
American Truck Simulator won ’ t make you an expert trucker or anything like that , but it might give you an appreciation for the folks who keep American commerce going , or at least for the siren song of the open road .
Just don ’ t ask me how to back up a truck that has two trailers attached to it .
That always takes me forever .
American Truck Simulator is available to @ @ @ @

There are few American dreams as alluring to me as that of exploring the open road. Taking to the highways in a slick vehicle, driving well into the night, waiting for the next sleepy little town to stretch out before you — they’re all things I love but get to do far less often than I’d like, now that I have a “job” and have to be “responsible” and “pay my bills.”
Thank goodness for the game American Truck Simulator, then. The 2016 release on PC and Mac — which is continuously expanded by developer SCS Software — is exactly what it sounds like: a game where you are a truck driver, completing long hauls and taking cargo from city to city. But what it really excels at is capturing the feeling of driving through the great, open expanses of the country, radio blasting some of your favorite tunes (you can load your favorite songs right into the game). You have places to be, but for now, you’re just killing time.
It’s an extraordinarily relaxing experience, and by the time you’ve completed a run from Los Angeles to Albuquerque, you might have entered a kind of meditative state. That’s not going to sound like a great time to some folks, but for those who play video games primarily to chill out after a long day (as I do), it’s one of the games that will best accomplish that goal.
And, hey, if the quarantine is getting you down, if the thing you’d most like to do is drive to some other city entirely, well, few things are more socially distanced than the cab of a semi, except for the cab of a semi that only exists in a video game. This could scratch that travel bug just a little bit, until the quarantine lifts, and we can all complete long-haul routes in the real world.
American Truck Simulator is the kind of game that lets you have whatever experience you’d like with it — so long as you’re driving a truck
As a simulation of actually driving a truck, American Truck Simulator isn’t bad. I’ve driven a semi a handful of times (I grew up on a farm, and my dad owned one), and you rarely get the sense of weight from your virtual truck that a real one would have. But maybe that’s okay since even a massive collision with another car in this game only results in a fine, with the other car driving off unscathed. That would ... not happen in real life.
As a simulation of the US, American Truck Simulator is slightly better, though it’s currently working its way across the country from the Pacific coast very, very slowly. The base game allows for hauls through California, Nevada, and Arizona, and further expansion packs have added New Mexico, Oregon, Washington, and Utah, with Idaho coming sometime this year. The simulations of those states capture their essence, with major cities looking more or less like themselves and lots of fun byways to explore (if you’re not on the clock for a delivery).
The spaces are big, but not impossibly so. Taking a job in northern Washington and driving all the way to the southern tip of New Mexico will take you well over an hour of gameplay, but it would take you well over a day of real time, so the scale of the game is vast but not too vast. (What’s even more impressive about the game’s ability to capture the feel of western America is how it’s designed by a Czech company.)
The difficulty also scales. You can get a more realistic simulation of driving by turning it up, or you can turn it all the way down and just bomb around the American West listening to some killer tunes.
It’s also the kind of game that lets you play it however you want. If you really want to just drive around and not worry about hauling goods, you can do that. If you want to take on as many hauling jobs as possible and race the clock, well, you can do that, too. And if you are more business-minded and want to use your proceeds to buy more trucks and hire drivers and start a trucking concern, there are plenty of options to do that as well.
It might sound weird to use the time when you’re not at your actual job starting a virtual job, but the appeal of these sorts of simulators lies in the way they offer us a window into lives that exist outside the normal portraits of pop culture. Truckers are not precisely the center of many entertainment options, and the back-breaking, blue-collar work they do isn’t either. American Truck Simulator won’t make you an expert trucker or anything like that, but it might give you an appreciation for the folks who keep American commerce going, or at least for the siren song of the open road.
Just don’t ask me how to back up a truck that has two trailers attached to it. That always takes me forever.
American Truck Simulator is available to purchase on Steam.
One Good Thing is Vox’s recommendations feature. In each edition, find one more thing from the world of culture that we highly recommend.


vox--2020-03-20--How Spain’s coronavirus outbreak got so bad so fast — and how Spaniards are trying to cope

How Spain ’ s coronavirus outbreak got so bad so fast — and how Spaniards are trying to cope Share All sharing options for : How Spain ’ s coronavirus outbreak got so bad so fast — and how Spaniards are trying to cope Ellen Hietsch made quite a life for herself in Spain over the last three years .
She and her boyfriend would walk together in Madrid ’ s parks .
She ’ d wake up certain mornings regretting the money she spent at bars .
And when it was time to work , she enjoyed teaching English @ @ @ @ @ @ @ .
Amidst the fun , the 25-year-old Pennsylvanian expat kept an eye on the news .
Watching Italy struggle to contain its coronavirus outbreak gave her pause , she said , but she “ never thought something like that would happen over here.
” But it did .
Spain now has the world ’ s fourth-largest Covid-19 outbreak and is second only to Italy in all of Europe .
To stop the spread , the government — slow at first to respond to the crisis — imposed a country-wide lockdown last Saturday .
@ @ @ @ @ @ @ hold .
To pass the time , she meditates , does yoga , and chats with her three American roommates .
She used to run up and down the building ’ s stairs for exercise — a neighbor ’ s young daughter would sometimes cheer her on — but other tenants just put up a sign asking her to stop .
Hietsch ’ s new normal is fine for the moment .
Other than missing her boyfriend , she makes turmeric lattes for her roommates and online videos for her students .
The @ @ @ @ @ @ @ .
“ It ’ s been one of the oddest weeks of my life , ” she told me .
It ’ s similarly odd for the rest of the nearly 50 million people in Spain , where one-fifth of the population is over 65 and thus at increased risk of “ getting very sick ” from Covid-19 , according to the CDC .
Not only does everyone in Spain have to stay inside , but also they have to live with police and drones patrolling the streets to keep pedestrians at home @ @ @ @ @ @ @ an uneasy , rare silence .
And they have to watch one of Europe ’ s best health care systems struggle to treat patient after patient .
“ What makes me most angry is that we had a month and a half to get ready after our first case , and we had weeks to prepare after watching what ’ s happened in Italy , ” said Ángela Hernández Puente , a top official at a health labor union in Madrid , the country ’ s outbreak epicenter .
The problem is that @ @ @ @ @ @ @ , and historical problems are making a coherent response difficult .
The politics alone are daunting .
Prime Minister Pedro Sánchez , weak after forming a minority government , likely didn ’ t want to risk his fragile hold on power by banning large gatherings , experts say .
Instead , he allowed thousands to attend soccer games last week , as well as permitted a 120,000-strong feminist rally in Madrid to proceed .
Hietsch was at that demonstration .
“ I regret going , ” she told me , fearing it may @ @ @ @ @ @ @ ’ ve felt anxiety ever since that I could be a carrier of the disease.
” So far , though , she ’ s healthy .
The crisis has now reached even the highest levels of Spanish power .
On March 14 , Begoña Gómez — the wife of the prime minister — tested positive for coronavirus .
That news came after two government ministers also contracted the disease .
As a precaution , Sánchez does his best to keep away from others as he works and conducts press conferences over a video @ @ @ @ @ @ @ Week ) — one of the country ’ s most cherished traditions and religious ceremonies — had to be canceled for the first time since 1933 .
What ’ s especially worrying is that Spain isn ’ t an anomaly .
Like Italy , it ’ s a grim warning of what ’ s to come in countries around the world , including the United States , if their governments don ’ t act aggressively or quickly enough to confront the crisis .
In that sense , Spain is a glimpse into much @ @ @ @ @ @ @ .
“ Nobody is ready for this , ” Evangelina Martich , a health policy expert at the University of Carlos III in Madrid , told me .
How Spain ’ s outbreak got so bad so fast The Spanish government confirmed the nation ’ s first case of coronavirus on January 31 in the Canary Islands , which lie to the west of Morocco .
That same day , Spaniards evacuated from Wuhan , China — where Covid-19 first emerged — arrived in Madrid .
Nine days later , another case was @ @ @ @ @ @ @ of Mallorca .
The first positive cases of coronavirus on the Spanish mainland came on February 26 , including in both Madrid and Barcelona , the country ’ s two most important cities .
It was then that the heads of Spain ’ s largest public hospitals told the Health Ministry “ more tests had to be done , and as soon as possible.
” Ramping up testing was easier said than done .
“ The [ health care ] system was not prepared for the seriousness of what was coming , ” @ @ @ @ @ @ @ told El País newspaper this week .
“ Up until at least a week ago , we weren ’ t able to do a PCR [ a diagnostic test ] for coronavirus without asking for authorization .
I could order a PCR for the flu , but not for the coronavirus.
” Even today , large hospitals , including ones in Madrid , can ’ t process more than 400 tests a day .
“ We would like to test everyone but with the diagnostic capability and number of kits we have , @ @ @ @ @ @ @ Cantón , the microbiology chief in the city ’ s Ramón y Cajal hospital , also told El País .
Cinta Mora , a doctor in the southern city of Seville , believes the lack of foresight and planning doomed Spain from the start .
“ With tests , we would ’ ve stopped a lot of the problems we have now , ” she told me .
But it wasn ’ t just a testing failure , it was a cultural and political failure , too .
Those I spoke with noted @ @ @ @ @ @ @ complicated the public ’ s own response .
First , the country has a deeply embedded late-night culture , with everyone staying out late to hang out at bars or simply eat dinner .
Second , a paranoia stemming back to Spain ’ s decades-long dictatorship created a palpable friction between the public and law enforcement .
The result was that few in Spain felt compelled to change their ways despite signs of chaos .
“ The Spanish character is not to believe a crisis is coming , ” Mora said .
“ @ @ @ @ @ @ @ ’ s when you react — but by then it ’ s too late.
” Government inaction didn ’ t help .
As mentioned above , Prime Minister Sánchez refused to stop large gatherings like soccer matches and political rallies from proceeding .
Some experts I spoke to said that allowing so many people to congregate almost surely spurred a larger outbreak .
But Martich , the health policy expert at the University of Carlos III , cautioned that it ’ s too early to know if that ’ s truly the case @ @ @ @ @ @ @ week that the Spanish government really ramped up its response as the number of cases and deaths rose .
It shut down the soccer league , closed schools , and asked people to stay home .
But even then , people I spoke to said few took it seriously .
Many were still going to bars , walking outside , and carrying on as if not much had changed .
The central government had to take more drastic measures .
Last Friday , Spain declared a state of emergency , giving the central @ @ @ @ @ @ @ made by Spain ’ s 17 autonomous regions ( think of them as more powerful US states ) .
And the next day , Sánchez took an even bigger step , one others in Europe had already taken : imposing a 15-day complete lockdown of the entire country .
Some believe it will ultimately last for longer .
Everyone now has to stay home unless they ’ re going to the grocery store or pharmacy , getting medical treatment , caring for an older or sick person , or walking a pet .
@ @ @ @ @ @ @ drones roam the streets to reprimand and fine anyone caught wandering outside .
Authorities have also set up about 30,000 roadblocks so no one secretly drives to another location .
Now , millions are stuck inside as they wait for the government to lift the restrictions .
The hope is that the draconian measures will help stop the spike in the thousands of positive cases and hundreds dead .
While understandable , those moves angered and surprised people like Erika Tepler , a 35-year-old from Maine living in Seville .
“ It all @ @ @ @ @ @ @ me .
“ I ’ m in Spain , and it sucks.
” A feeling of “ anger and abandonment ” in Spanish hospitals Mora , the 35-year-old doctor from Seville , has a deeply personal connection to the crisis .
Her partner Sebastián , also a physician , was in contact with someone who tested positive for Covid-19 .
For at least the next week , he ’ s self-quarantining in a separate bedroom and using his own bathroom .
He finally got permission to do that after the Spanish government on @ @ @ @ @ @ @ exposed to the virus to stay home .
Before then , he ’ d been forced to keep treating patients even while possibly carrying the disease himself .
That leaves Mora alone to care for her 11-year-old daughter .
It hasn ’ t been too hard , she says , because her child doesn ’ t require as much attention as a toddler .
Were her daughter younger , the quarantine — while necessary — would ’ ve proven a greater burden on the family .
What bothers Mora most , though , @ @ @ @ @ @ @ than sit around and wait for this all to be over .
But the nation ’ s medical workers are anything but idle .
Night and day , they contend with patients flooding into their hospitals , and it doesn ’ t look like that ’ s going to end any time soon .
“ The crisis is overwhelming the system , ” said Martich , the health policy expert .
Part of the problem is that while Spain has a national health care system , each of the 17 regions actually administer @ @ @ @ @ @ @ health labor leader Hernández Puente , caused a lot of coordination issues early on , including leaving doctors ill-supplied to provide care .
The central government has now tried to address this disconnect by temporarily nationalizing all the country ’ s private hospitals .
Those physicians who receive incoming patients lack masks , gloves , and other protective gear .
And those doctors who treat patients with the most severe coronavirus symptoms are short of beds to put them in and respirators to help patients breathe , all in understaffed intensive care units @ @ @ @ @ @ @ t addressed these critical needs , Hernández Puente said .
“ The general feeling among doctors and nurses is anger and abandonment.
” To ensure there are enough workers and resources for coronavirus care , some hospitals in Madrid and elsewhere are suspending services like general family care or cancer-related surgeries .
That ’ s a tough position for health care providers to be in .
“ I wouldn ’ t want to be in that situation , ” Martich told me .
Fourth-year medical students are also being called in to help @ @ @ @ @ @ @ that can produce medical equipment must now contact the Ministry of Health for an assessment of how they might contribute to the national response .
When care fails , Mora says physicians put the dead bodies in special biodegradable bags .
They ’ re closed tightly to ensure bodily liquids don ’ t spill out and spread the virus on surfaces or onto other people .
No autopsies are performed to minimize droplets from landing on a healthy person , possibly getting them sick .
There ’ s at least a shared national @ @ @ @ @ @ @ , at 8 pm , Spaniards stand on their balconies and clap together for health care workers returning home from their day shifts .
At first , that happened at 10 pm , but the time was moved earlier so children could join in .
That includes Mora ’ s daughter .
When she needs to go to the grocery store , Tepler , the American living in Seville , is surprised by what she finds .
The streets are eerily quiet , save for the police officer asking her where she ’ @ @ @ @ @ @ @ , she finds the shelves of toilet paper stocked up while the wine aisles are empty .
“ It ’ s so demoralizing , ” she said .
But there are some signs of optimism .
A social media movement with the hashtag # YoMeQuedoEnCasa — “ I ’ m staying at home ” — has found some success convincing people not to yearn for the outdoors .
Even police who make announcements on empty roads reminding people to stay inside are now met with applause and chants of “ bravo !
” @ @ @ @ @ @ @ Spain has become something of a national folk hero for boosting the message of what needs to be done to combat the virus in the country .
With his YouTube videos , which he posts under the name Spiriman , Jesús Candel especially reprimands the country ’ s youth .
“ I ask young people to stop watching stupid shit on their phones and look up information on the coronavirus , ” he says in one of his more famous videos .
“ Young people need to fucking understand what they have to @ @ @ @ @ @ @ going to the hospital with some symptoms who ask for a coronavirus test because all they care about is themselves , ” he continues .
Medical professionals will likely tell you to go home , he explains , “ so we can attend to the severely sick people , like the woman I just attended to who was drowning alive , who had a week-long fever , and who ’ s in bad shape.
” Spaniards have also taken a cue from the Italians and have begun singing together from their apartments .
@ @ @ @ @ @ @ the country is an old Spanish hit called “ Resistiré ” ( I will resist ) .
Part of the chorus is particularly relevant to life these days : I will resist , to stay alive I ’ ll resist the blows and won ’ t give up Even though my dreams might tear me to pieces I will resist , I will resist Of course , many are still worried about what ’ s next .
Spain just barely recovered from the 2008 financial crisis and will struggle to climb out of @ @ @ @ @ @ @ lot of elderly people that will remain susceptible to the coronavirus for the coming months .
And political polarization , which has stymied Spanish politics over the years , is likely to get worse during the crisis .
“ The hardest is yet to come , ” Sánchez told a near-empty Parliament on Wednesday .
But in some ways Spain might be one of the lucky ones .
It has an advanced economy , a health care system that won ’ t entirely implode , and many of its citizens have enough resources @ @ @ @ @ @ @ disease spreads further around the globe , those living in less-prepared nations will struggle to even sing from their homes .
“ It ’ s going to be much worse in other countries that aren ’ t as advanced , ” Martich told me , referring mostly to countries in Latin America and Africa .
“ Spain is better prepared than most.
” The hope is that people who will soon face a similar reality can , like those in Spain now , resist .

How Spain’s coronavirus outbreak got so bad so fast — and how Spaniards are trying to cope
Share All sharing options for: How Spain’s coronavirus outbreak got so bad so fast — and how Spaniards are trying to cope
Ellen Hietsch made quite a life for herself in Spain over the last three years.
She and her boyfriend would walk together in Madrid’s parks. She’d wake up certain mornings regretting the money she spent at bars. And when it was time to work, she enjoyed teaching English to her young students at Colegio Madrigal.
Amidst the fun, the 25-year-old Pennsylvanian expat kept an eye on the news. Watching Italy struggle to contain its coronavirus outbreak gave her pause, she said, but she “never thought something like that would happen over here.”
But it did.
Spain now has the world’s fourth-largest Covid-19 outbreak and is second only to Italy in all of Europe. To stop the spread, the government — slow at first to respond to the crisis — imposed a country-wide lockdown last Saturday.
Now the life Hietsch built is on hold. To pass the time, she meditates, does yoga, and chats with her three American roommates. She used to run up and down the building’s stairs for exercise — a neighbor’s young daughter would sometimes cheer her on — but other tenants just put up a sign asking her to stop.
Hietsch’s new normal is fine for the moment. Other than missing her boyfriend, she makes turmeric lattes for her roommates and online videos for her students.
The sudden change, though, remains jarring. “It’s been one of the oddest weeks of my life,” she told me.
Keep your mind busy these days! Ellen started a diary about how she feels. What about you? What are you doing to... Posted by Colegio Madrigal on Tuesday, March 17, 2020
It’s similarly odd for the rest of the nearly 50 million people in Spain, where one-fifth of the population is over 65 and thus at increased risk of “getting very sick” from Covid-19, according to the CDC.
Not only does everyone in Spain have to stay inside, but also they have to live with police and drones patrolling the streets to keep pedestrians at home. They have to put up with an uneasy, rare silence. And they have to watch one of Europe’s best health care systems struggle to treat patient after patient.
“What makes me most angry is that we had a month and a half to get ready after our first case, and we had weeks to prepare after watching what’s happened in Italy,” said Ángela Hernández Puente, a top official at a health labor union in Madrid, the country’s outbreak epicenter.
The problem is that Spain’s long-standing political, economic, and historical problems are making a coherent response difficult.
The politics alone are daunting. Prime Minister Pedro Sánchez, weak after forming a minority government, likely didn’t want to risk his fragile hold on power by banning large gatherings, experts say. Instead, he allowed thousands to attend soccer games last week, as well as permitted a 120,000-strong feminist rally in Madrid to proceed.
Hietsch was at that demonstration. “I regret going,” she told me, fearing it may have accelerated the spread. “I’ve felt anxiety ever since that I could be a carrier of the disease.” So far, though, she’s healthy.
The crisis has now reached even the highest levels of Spanish power. On March 14, Begoña Gómez — the wife of the prime minister — tested positive for coronavirus. That news came after two government ministers also contracted the disease. As a precaution, Sánchez does his best to keep away from others as he works and conducts press conferences over a video link. Even Semana Santa (Holy Week) — one of the country’s most cherished traditions and religious ceremonies — had to be canceled for the first time since 1933.
What’s especially worrying is that Spain isn’t an anomaly. Like Italy, it’s a grim warning of what’s to come in countries around the world, including the United States, if their governments don’t act aggressively or quickly enough to confront the crisis. In that sense, Spain is a glimpse into much of the world’s new normal.
“Nobody is ready for this,” Evangelina Martich, a health policy expert at the University of Carlos III in Madrid, told me.
How Spain’s outbreak got so bad so fast
The Spanish government confirmed the nation’s first case of coronavirus on January 31 in the Canary Islands, which lie to the west of Morocco. That same day, Spaniards evacuated from Wuhan, China — where Covid-19 first emerged — arrived in Madrid. Nine days later, another case was reported, this time on the island of Mallorca.
The first positive cases of coronavirus on the Spanish mainland came on February 26, including in both Madrid and Barcelona, the country’s two most important cities. It was then that the heads of Spain’s largest public hospitals told the Health Ministry “more tests had to be done, and as soon as possible.”
Ramping up testing was easier said than done.
“The [health care] system was not prepared for the seriousness of what was coming,” a doctor in a southern Spanish hospital told El País newspaper this week. “Up until at least a week ago, we weren’t able to do a PCR [a diagnostic test] for coronavirus without asking for authorization. I could order a PCR for the flu, but not for the coronavirus.”
Even today, large hospitals, including ones in Madrid, can’t process more than 400 tests a day. “We would like to test everyone but with the diagnostic capability and number of kits we have, that is not possible,” Rafael Cantón, the microbiology chief in the city’s Ramón y Cajal hospital, also told El País.
Cinta Moro, a doctor in the southern city of Seville, believes the lack of foresight and planning doomed Spain from the start. “With tests, we would’ve stopped a lot of the problems we have now,” she told me.
But it wasn’t just a testing failure, it was a cultural and political failure, too.
Those I spoke with noted two aspects of the Spanish lifestyle that complicated the public’s own response. First, the country has a deeply embedded late-night culture, with everyone staying out late to hang out at bars or simply eat dinner. Second, a paranoia stemming back to Spain’s decades-long dictatorship created a palpable friction between the public and law enforcement.
The result was that few in Spain felt compelled to change their ways despite signs of chaos. “The Spanish character is not to believe a crisis is coming,” Moro said. “Once you see people die, that’s when you react — but by then it’s too late.”
Government inaction didn’t help. As mentioned above, Prime Minister Sánchez refused to stop large gatherings like soccer matches and political rallies from proceeding. Some experts I spoke to said that allowing so many people to congregate almost surely spurred a larger outbreak. But Martich, the health policy expert at the University of Carlos III, cautioned that it’s too early to know if that’s truly the case.
Still, it was only last week that the Spanish government really ramped up its response as the number of cases and deaths rose. It shut down the soccer league, closed schools, and asked people to stay home. But even then, people I spoke to said few took it seriously. Many were still going to bars, walking outside, and carrying on as if not much had changed.
The central government had to take more drastic measures. Last Friday, Spain declared a state of emergency, giving the central government the authority to override any decisions made by Spain’s 17 autonomous regions (think of them as more powerful US states). And the next day, Sánchez took an even bigger step, one others in Europe had already taken: imposing a 15-day complete lockdown of the entire country. Some believe it will ultimately last for longer.
Everyone now has to stay home unless they’re going to the grocery store or pharmacy, getting medical treatment, caring for an older or sick person, or walking a pet. To enforce these rules, police and drones roam the streets to reprimand and fine anyone caught wandering outside. Authorities have also set up about 30,000 roadblocks so no one secretly drives to another location.
Spanish Cop: “Walking around is prohibited. This is very serious. Lots of people are dying.” https://t.co/WXfxEAe7P4 — Alex Ward (@AlexWardVox) March 15, 2020
Now, millions are stuck inside as they wait for the government to lift the restrictions. The hope is that the draconian measures will help stop the spike in the thousands of positive cases and hundreds dead.
While understandable, those moves angered and surprised people like Erika Tepler, a 35-year-old from Maine living in Seville. “It all changed so fast,” she told me. “I’m in Spain, and it sucks.”
A feeling of “anger and abandonment” in Spanish hospitals
Moro, the 35-year-old doctor from Seville, has a deeply personal connection to the crisis.
Her partner Sebastián, also a physician, was in contact with someone who tested positive for Covid-19. For at least the next week, he’s self-quarantining in a separate bedroom and using his own bathroom.
He finally got permission to do that after the Spanish government on Monday authorized doctors who’d been exposed to the virus to stay home. Before then, he’d been forced to keep treating patients even while possibly carrying the disease himself.
That leaves Moro alone to care for her 11-year-old daughter. It hasn’t been too hard, she says, because her child doesn’t require as much attention as a toddler. Were her daughter younger, the quarantine — while necessary — would’ve proven a greater burden on the family. What bothers Moro most, though, is that people can do little more than sit around and wait for this all to be over.
But the nation’s medical workers are anything but idle. Night and day, they contend with patients flooding into their hospitals, and it doesn’t look like that’s going to end any time soon. “The crisis is overwhelming the system,” said Martich, the health policy expert.
Part of the problem is that while Spain has a national health care system, each of the 17 regions actually administer it separately. That, according to health labor leader Hernández Puente, caused a lot of coordination issues early on, including leaving doctors ill-supplied to provide care. The central government has now tried to address this disconnect by temporarily nationalizing all the country’s private hospitals.
Those physicians who receive incoming patients lack masks, gloves, and other protective gear. And those doctors who treat patients with the most severe coronavirus symptoms are short of beds to put them in and respirators to help patients breathe, all in understaffed intensive care units.
The central government still hasn’t addressed these critical needs, Hernández Puente said. “The general feeling among doctors and nurses is anger and abandonment.”
To ensure there are enough workers and resources for coronavirus care, some hospitals in Madrid and elsewhere are suspending services like general family care or cancer-related surgeries. That’s a tough position for health care providers to be in. “I wouldn’t want to be in that situation,” Martich told me.
Fourth-year medical students are also being called in to help address the staffing shortfall, and companies that can produce medical equipment must now contact the Ministry of Health for an assessment of how they might contribute to the national response.
When care fails, Moro says physicians put the dead bodies in special biodegradable bags. They’re closed tightly to ensure bodily liquids don’t spill out and spread the virus on surfaces or onto other people. No autopsies are performed to minimize droplets from landing on a healthy person, possibly getting them sick.
There’s at least a shared national sense of the struggle. Every day, at 8 pm, Spaniards stand on their balconies and clap together for health care workers returning home from their day shifts. At first, that happened at 10 pm, but the time was moved earlier so children could join in. That includes Moro’s daughter.
¡GRACIAS a todos los profesionales sanitarios que estos días trabajan sin descanso aquí nuestro pequeño homenaje! #QuédateEnCasa pic.twitter.com/09KODoYUJW — ConSalud.es #QuédateEnCasa (@Consalud_es) March 14, 2020
“I will resist”
When she needs to go to the grocery store, Tepler, the American living in Seville, is surprised by what she finds. The streets are eerily quiet, save for the police officer asking her where she’s going. When she finally arrives, she finds the shelves of toilet paper stocked up while the wine aisles are empty. “It’s so demoralizing,” she said.
But there are some signs of optimism.
A social media movement with the hashtag #YoMeQuedoEnCasa — “I’m staying at home” — has found some success convincing people not to yearn for the outdoors. Even police who make announcements on empty roads reminding people to stay inside are now met with applause and chants of “bravo!”
And a doctor from Granada in southern Spain has become something of a national folk hero for boosting the message of what needs to be done to combat the virus in the country. With his YouTube videos, which he posts under the name Spiriman, Jesús Candel especially reprimands the country’s youth.
“I ask young people to stop watching stupid shit on their phones and look up information on the coronavirus,” he says in one of his more famous videos. “Young people need to fucking understand what they have to do.”
“There are young people going to the hospital with some symptoms who ask for a coronavirus test because all they care about is themselves,” he continues. Medical professionals will likely tell you to go home, he explains, “so we can attend to the severely sick people, like the woman I just attended to who was drowning alive, who had a week-long fever, and who’s in bad shape.”
Spaniards have also taken a cue from the Italians and have begun singing together from their apartments. The song most often heard blaring across the country is an old Spanish hit called “Resistiré” (I will resist). Part of the chorus is particularly relevant to life these days:
I will resist, to stay alive
I’ll resist the blows and won’t give up
Even though my dreams might tear me to pieces
I will resist, I will resist
Of course, many are still worried about what’s next. Spain just barely recovered from the 2008 financial crisis and will struggle to climb out of another recession. The country has a lot of elderly people that will remain susceptible to the coronavirus for the coming months. And political polarization, which has stymied Spanish politics over the years, is likely to get worse during the crisis.
“The hardest is yet to come,” Sánchez told a near-empty Parliament on Wednesday.
But in some ways Spain might be one of the lucky ones. It has an advanced economy, a health care system that won’t entirely implode, and many of its citizens have enough resources to weather the crisis.
As the disease spreads further around the globe, those living in less-prepared nations will struggle to even sing from their homes. “It’s going to be much worse in other countries that aren’t as advanced,” Martich told me, referring mostly to countries in Latin America and Africa. “Spain is better prepared than most.”
The hope is that people who will soon face a similar reality can, like those in Spain now, resist.