From The Covid Safety Handbook: Staying Safe In An Unsafe World, by Violet Blue. Reprinted with permission.
Listen to an audio version of this excerpt here.
I had been shivering in a muddy tent on camera for five hours gripping a microphone and manipulating volunteers for various international aid organizations into telling me where the bodies were being kept when we finally got a break from the din of nonstop gunfire. One hour earlier, two trainees had run past us toward one of the roads, terrified, fleeing the site altogether. I kept the interview rolling.
It was 2012: my first year as a session leader for UCSF’s Complex Humanitarian Emergency Training (CHE Leadership Training). This took place in a sprawling forest campsite at Anthony Chabot Regional Park, Oakland, California (not far from the Chabot Gun Club’s outdoor shooting range). CHE Leadership Training was a fully immersive on-site simulation, an overnighter that began at dawn and was based on the Libyan‐Tunisian crisis. Trainees and session leaders represented Médecins Sans Frontières, The UN World Food Programme, The International Federation of Red Cross, and the International Medical Corps.
The CHE began with trainees entering the simulation upon arrival. They were greeted by “military” and processed, or isolated and detained, before each team was called into one of five sessions: Wilderness Medicine (wound triage), Geneva Conventions Training (mock abduction and interrogation), Water Training (refugee camp water systems), and Interacting with the Media. The fleeing pair who’d sped by my training had come from the Geneva Conventions session, and did not return. A Médecins Sans Frontières colleague remarked, “If they can’t deal with what happens to us, they can’t do this work. Better to know now.”
I was drawn to lead the CHE sessions after growing up at the end of the HIV/AIDS crisis in San Francisco’s queer Castro district and fully understanding, firsthand, how the role of media distorted public understanding of health and science, prolonged the crisis and suffering, and added to the body count. Essential to my survival and getting me off the streets was becoming part of SF’s harm reduction movement: participating in public health outreach, science and prevention education, and turning fear and misinformation about HIV into community-appropriate prevention strategies (and getting people tested). I was also drawn to be part of the CHE’s work in 2012 because I was working with colleagues in New York at CBS News, journalists who had been on the ground during 9/11 and still seethed about media coverage and mischaracterizations of first responders in the aftermath of the disaster.
My job was to portray a sensationalist reporter visiting the refugee camp, remain in character, and put volunteers on the spot to learn how to deal with misinformation traps and representation under pressure. My CHE sessions were popular and highly regarded for their accuracy in replicating what relief workers encountered in the field.
I was invited by Dr. John Zeigler to lead a media training in a summer course called “Emerging Topics in Global Health” for the UCSF Global Health Masters Program. Its focus was the public understanding of science in general, and in particular how scientists communicate effectively with the media, particularly around public health crisis communication.
This training was in a classroom: I got to forgo the CHE’s gunshots, bug bites, atmospheric drama of lurking actors, and sticky fake blood. Dr. Ziegler began with remarks about the public understanding of science and critical role of the media in health messages. Next, I explained how the media looks at health “stories” and how important it is to frame messages for a lay audience, structured around avoiding misrepresentation or distortion of facts. Then we got to the fun stuff: the hands-on bits.
The class was presented with a crisis and split into two teams. Our crisis setting was based on one that actually occurred in Ghana, where rumors, spread by the media, almost derailed a massive public health campaign.
In 2007, Ghana held a national health programme where it administered deworming tablets to schoolchildren, jointly organized by the Ghana Health Service, the Ghana Education Service, and UNICEF. Within hours of the start, rumors circulated and became unsubstantiated reports on local radio stations about childrens’ deaths and serious side effects. People panicked. Traffic was jammed, parents rushed their kids to hospitals by the hundreds, and in some instances, teachers were attacked and schools were shut. Trust in public health was broken and a safe prevention tool (in that situation, a deworming tablet) was believed to be of worse consequences than the outcome of infection. Sound familiar?
The UCSF Global Health Masters Program students came back with great plans. Their plans included unifying community-based outreach in conjunction with local leadership (like teachers). Taking parents’ concerns seriously and transparently investigating the rumors. Creating a clear messaging plan that communicated the harms and consequences of infection, and the science of prevention. And critically, for my part, communicating all of this to the media in ways that won’t get misinterpreted. This is what actually happened to turn the crisis around in Ghana; some of the students noted it was far from the many, many horrific public health decisions during the HIV/AIDS crisis. COVID-19 arrived seven years later, and I often wonder what those students have done since.
The many parallels between the HIV/AIDS crisis and ongoing COVID-19 pandemic are undeniable. The queer San Francisco neighborhood I grew up in was a ghost town from the virus’s toll when I became homeless at thirteen. I never knew the bustling, populated, joyous Castro that existed before the AIDS crisis (although police harassment and abuse of residents remained the same).
On March 5, 2020, San Francisco announced its first local cases of the novel coronavirus, then was the earliest and strictest city in the U.S. to enact a shelter in place order, and–for a brief moment–was united in community care and held the title of most lives saved in the U.S. by our actions. We knew it was because we had done this before as a city, saving each other during the AIDS crisis and abandonment to that virus by the US federal government and US CDC (Centers for Disease Control and Prevention).
Then, the city of San Francisco reversed course and began a cycle of mass COVID infection that would see my hometown continually have the highest wastewater readings and cases in the state of California since the virus evolved into Omicron. I watched my beloved Castro neighborhood sickened by COVID waves on repeat. I watched friends working retail in my local shops unable to finish sentences as they struggled with Long COVID after their second and third infections. I witnessed so many of the infected and reinfected, my friends and neighbors, some who were survivors of the AIDS crisis, just… disappear from daily life. All while the US CDC urged people to wash their hands and insisted COVID is just a “high risk” person problem, media ignored COVID-19 just as it had with HIV/AIDS, and pundits mocked prevention or branded communications about COVID’s dangers and unknowns as “hysterical.”
One thing Dr. John Zeigler said during our Ghana exercise with UCSF’s Global Health Masters’ students stayed with me from the beginning of COVID-19 and rings louder in my head every week as the pandemic continues. He said: “The pathway from evidence to sound policy often relies on the public understanding of science, and the mass media is the main messenger.” To prevent disaster, he believed, it was critical to translate science and health outcomes for a lay audience. That’s why The COVID Safety Handbook is designed for lay people as well as a book you can consult for resources, ideas, and pandemic wayfinding tips.
COVID is a global pandemic and no one nation can declare it “over.” Yet the world seems to be stuck with a US CDC-led response to COVID-19. This is despite the fact that in 2022 when the US passed one million deaths it began to “unwind” its COVID response, and America was ranked third-worst in Think Global Health’s High-Income Countries on Cumulative Reported COVID-19 Mortality. The following year, 2023, the United States held 4% of the world’s population and 16% of global COVID-19 deaths. And we know the mass disabling event of Long COVID will only amplify the scope of America’s ongoing COVID-19 disaster. Long COVID has never been a metric of the pandemic. But it must be. It’s more important than ever to understand that the US CDC represents a complete misunderstanding of public health and social contracts.
This book was begun and finished in Aotearoa New Zealand, where I am currently in Wellington researching and writing a book about New Zealand’s COVID-19 response in the pandemic’s first three years. Typically, a country’s “pandemic success” regarding COVID-19 is ranked by deaths per capita. Aotearoa is globally lauded as saving the most lives of any other country. In 2023, Aotearoa attained Bloomberg’s title of having the lowest COVID-19 deaths among wealthy nations. Bloomberg also rated New Zealand at the top of its COVID resilience ranking among 10 metrics including case counts, deaths, testing capabilities, vaccine supply agreement, health care system capacity, impact of restrictions on the economy, and citizens’ freedom of movement. That year, New Zealand counted 3,250 total lives lost to COVID.
If Aotearoa had used the same response as the United States, it would have translated to a death toll easily six times as many deaths (19,900). But we can’t hope to understand Aotearoa’s COVID successes by counting its losses–or by editing out the principal role of community, and Indigenous cultures and values, from history’s record.
When I was a homeless kid in San Francisco long after it had been abandoned by the federal government to HIV/AIDS, my neighborhood was equally a place where I watched friends die from the disease as well as a place of community care, resilience, organizing to save one another, and fighting back against anti-science steeped in stigma. The care circles that formed to sneak magazines into hospitals for AIDS patients, hand out flyers about safer sex, and deliver food to homebound patients also formed to give us street kids food, places to go on holidays, ways to form job skills, and the resilience of chosen family (our values).
Remember in the beginning of the pandemic when everyone came together to help each other stay safe, do prevention, care for one another, make too much bread for each other, and flash each other “V for victory” signs when we hit prevention milestones together? We are still here.
The COVID Safety Handbook is informed by the global, national, local, and neighborhood care circles coming together under the banner of COVID prevention to center science, accurate and non-judgemental information, inclusiveness, and equity in public health. This book draws strength from all the tireless variant hunters and wastewater trackers around the world who struggle to maintain and share the work of COVID-19 surveillance. It is inspired by the global formations of community-led mask blocs, Corsi-Rosenthal Box workshops, COVID-safe maps and meetup networks, COVID safety subreddits (and Discords, Facebook groups, and Slacks), clean air in schools organizations around the world, and those fighting to reinstate masks in healthcare everywhere.
This is a handbook shaped by the oracles of disability activism and disability justice. This book is indebted to the fight against medical racism. This book is humbled and informed by the people with Long COVID, the LC communities, and the massive global movement of Long COVID networks who refuse to give up, who keep organizing and sharing information, fighting for prevention, recognition, and help, who refuse to be silent or left behind. This book is in solidarity with the journalists out there who see all of this and know the COVID-19 pandemic is far from over.
All of these groups comprise a global phenomenon that formed only within the past few years and is growing, undeniable in its increasing strength and momentum.
This book is made possible by Kickstarter backers, patrons, everyone who answered survey questions, each person who said a kind word to someone struggling in our comments or chat, everyone who commented, messaged, and emailed; everyone who did test reads, psychology reads, and sensitivity reads. It’s the product of years of weekly Pandemic Roundups, a newsletter and community that has shared news, information, and support every single week of this ongoing pandemic. It’s comprised of voices I’m honored to feature, many of my own pandemic heroes, including Yaneer Bar-Yam, Dianna Corwin, Dr. Cat Hicks, Tithi Bhattacharya, Dr. George Taleporos, Julia Doubleday, and many more.
Stay apart, stand together, mask up, and stay strong.
Violet Blue
Wellington, Aotearoa New Zealand
2024
Link to purchase the full book: The Covid Safety Handbook: Staying Safe In An Unsafe World, by Violet Blue.
Violet Blue is a six-time award-winning author and investigative journalist on cybersecurity, COVID-19, and privacy. Her bylines include Engadget, Financial Times, CNN, CBS News, The Spinoff, San Francisco Chronicle, Popular Science, O The Oprah Magazine, and many others.
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