life Travel

Planning and Uncertainty

February 26, 2020

There is always uncertainty in life. It’s just that I — and many others, I’m sure — tend to assume the best in most circumstances.

I have my $ in the stock market (not individual stocks, but still).

I have planned a TON of travel this year, both personally and for our family (most of it domestic; one trip to Germany for a podcast-related event! I am now starting to doubt how realistic this is). Some of it can be cancelled without penalty, but certainly not all of it. And honestly, I was getting a lot of joy out of my anticipatory experience.

And then things happen. Things like a pandemic. (Or a hurricane. Or a dangerous political situation. Or Or OR OR).

It’s hard to keep going forward in life when the entire future is called into question. It’s hard to keep focusing on thing like kids’ homework and long term work projects. It’s easy to get sucked into reading news websites and clicking link after link, huddled in a corner in a cold sweat and distracted for the day’s activities.

But it is striking to me how little I can actually do personally about the current happenings. Unlike hurricane prep (shutters! water! evacuation!), it is quite hard to know what to do to ‘prepare’. In fact, if most of us are going to get it (as one well-known and well-decorated epidemiologist suggests), isn’t the best thing to do NOTHING? Keep calm and carry on? NOT drain the country of emergency supplies (have you seen the prices of masks on amazon!?!) and waste every day freaking out about what might be?

Keep Calm and Plan On?

Well, I’m trying not to. I am trying to just focus on each day (hour, minute). I will admit that it’s hard, though. How about everyone else?


  • Reply Sarah February 26, 2020 at 6:20 am

    So timely as I’ve been awake thinking about pandemic prep. Where I think I’ve landed – I don’t need to buy masks (not that I could if I wanted to!) because if it’s going to happen it’s going to happen, and honestly thinking about keeping masks on is laughable in my household. That said, I do feel like I need to put some serious thought (more serious than even yesterday) for preparing for quarantine. It feels somewhat likely that daycare will close, it feels likely that my husband will have to stay at the hospital (he is a hospitalist), and then any scenario to get routine supplies (toilet paper! diapers! formula! motrin!) involves me taking 3 kids under 5 somewhere. Which, even if there is no actual infection, is not something that I love to routinely do, especially if I’ve been with them for 2 weeks alone (eeeeeeeeeeeeeeeek). So I feel like buying some extra formula and diapers, and extra bubbles and chalk to send them to the backyard with seems reasonable.

    I FEEL you on the travel woes. We put many more thousands than I want to think about into a cruise in April and did not get any travel insurance sigh. Hopefully we can still go!

  • Reply Jennifer Killelea February 26, 2020 at 6:43 am

    Thank you for this post! Finding this balance has all been on my mind. My general outlook is to prepare, not panic, and to stay informed by credible sources as much as possible (loving the Johns Hopkins coronavirus infographic!). Travel is one of our family’s core values, so we’re always weighing risks – whether it’s in the face of a pandemic or terrorist threat (we live in Europe, where there have been a lot of local, catastrophic incidents, so I think about it) It’s even harder to find this balance as a parent though. Risks that I would have taken 11 years ago (albeit calculated, informed risks!) seem to carry more weight now. I do NOT want to parent from a place of fear or cultivate that fear in my kids, so outwardly I’m keeping calm and planning on (while keeping an open mind about the potential to reschedule or cancel things, keeping both local global authority warnings in mind). I’m also trying to teach my kids how to research these things instead of them relying on snippets of info they here on the radio, or what their friends have said. Keeping fingers crossed for our upcoming trip to Scotland, but trying to stay zen about the universe sometimes having other plans. Not buying masks, but encouraging lots of hand washing!

  • Reply Carolyn February 26, 2020 at 7:57 am

    It is a little scary. I work at a children’s health system and we have pulled all our precautionary masks that are out at our urgent cares and primary care practices in the waiting rooms so the hospital can have enough because of a shortage.

    I can’t imagine what my family’s scenario might be. I work in health care but in training and development so not a clinical or critical role (in this instance…not making a case for being laid off…lol). I suppose there are scenarios where my presence could be needed if they just need people for some reason. My husband is a police officer so I think we can all imagine when his presence might be needed which, if it’s bad enough for that, would mean school would be closed and I’d need to be home with our son.

    We don’t have any major travel planned this year, but are paying our house off this year so we can travel next year. For SO many reasons I hope this is all cleared up by then.

  • Reply Canuck February 26, 2020 at 8:22 am

    This is timely for me as well. My husband and I have a trip planned for Japan in April (our first time!) and we are in “wait and see” mode. I have, for the most part, been adopting your mentality. I literally cannot control an outbreak on the other side of the world! It is quite possibly the thing that I have the least amount of control over in my whole life right now. But it still sucks and I think it’s OK to acknowledge that. A few years ago, we had to postpone a scheduled trip to China (for health reasons – doc wouldn’t approve international travel which voided my travel health insurance). At the time, it seemed like the most awful thing that ever happened. It cost us some money to move our plans around but we did end up going and now, several years later, all I remember about going to China was what an amazing time we had, not that we had to reschedule or had to spend a bit of money to shift around our plans. I’m trying to keep that in mind as I watch the window of possibility for my trip close. I also keep reminding myself that people are dying and my desire to keep my travel plans to Japan is inconsequential compared to other issues happening globally! I am currently healthy, live in a country with a good healthcare system and we currently have very few cases; I should be grateful for that.

    • Reply Julia February 26, 2020 at 10:22 am

      I’m also supposed to go to Japan mid-March. I am thinking we will cancel, which is very upsetting. My fear is not that I would get the virus, but that i would somehow be stuck in quarantine for two weeks when trying to get back to the US.

      • Reply Amy February 26, 2020 at 3:49 pm

        My coworker just got back from a 2 week stay in Japan this past Saturday. He said they only checked people who had been to China or were from China when he came back to the US, but it’s definitely good to check on things if you decide to go. Also… it’s a little unsettling that no one was screened on his plane.

  • Reply Jordan February 26, 2020 at 8:24 am

    Times like these I wish I had deactivated Facebook. Just feels like fear-mongering and sensationalism. It’s a good reminder to be prepared and to start having supplies on hand for an emergency (which I should have anyway!) But I agree that it’s unsettling and I wish I could look away.

  • Reply Jjiraffe February 26, 2020 at 8:52 am

    As someone who has to keep close to news for my job, this story and the headlines associated with it (especially yesterday’s CDC statements!) have been very unnerving. Maybe the most of any recent news event I can remember. I’ve tried to focus on preparing in whatever small ways I can for any emergency (supplies, food, etc). And washing hands is key! Everyone needs to step up their hygiene habits. Unfortunately, I do think we are in for a bumpy ride, so we should plan for the worst but hope for the best.

  • Reply Kaye February 26, 2020 at 9:04 am

    We have a family trip to France planned in 2 weeks and I am getting myself sick with worry!! I have spent so much time and energy planning this trip and we have all been so looking forward to it. Now I just feel so nervous that everything will be disrupted, not to mention concerns that if we DO go and someone in our family got sick, that would also be horrible.

  • Reply Natalie February 26, 2020 at 9:20 am

    Epidemiologist mom here– I’m old enough to remember similar public health panicky situations after 9/11 and in 2009 when H1N1 made its debut. The things that keeps me calm with this current outbreak are: 1) the morbidity associated with novel coronavirus is likely much lower than 2% since many of the less virulent cases haven’t been identified. So, just like with influenza virus, it’s quite contagious but for most healthy people, the outcome is likely to be just fine; 2) thanks to groups like CEPI (the Atlantic article does a great job highlighting their efforts!) within the next 12 months we will likely have a vaccine to provide additional protection and help those most likely to have negative outcomes with exposure; and 3) thankfully the virus doesn’t appear to be hitting kids particularly hard. As a mom, this is my biggest concern, and although our understanding of the virus is still evolving, kids seem to be spared the most severe complications. This is definitely a different situation than with H1N1.

    My personal hero is Eleanor Roosevelt, who did things like fly commercially at a time when many were too fearful to even consider attempting. Go live your life– it’s a great example for your kids to be brave!

    • Reply SHU February 26, 2020 at 9:32 am

      ahh, 2009! I was a gen peds resident back then, and my memories of H1N1 are doing nasal washes (MESSY!!!) on many a crying child and, as a result, getting inevitably sprayed with the virus about 5 times per day in continuity clinic. It was . . . not fun.

      • Reply Ana February 26, 2020 at 11:47 am

        I was pregnant with my first during the H1N1 scare, and I definitely felt like people were asking me to more afraid than I initially was, by freaking out all around me.

    • Reply Lou February 27, 2020 at 7:57 am

      Good response here Natalie thanks – ER doc Mum from UK here. 2009 i was in a paeds ED and it was all a bit nuts. Had no kids of my own then. I looked at the chinese data from healthcare workers – it’s a bit best guess’ with positive swab results and then deaths gleaned from Chinese media – but I figured healthcare workers are more likely to represent the whole iceberg than any other group, as they’ll get swabbed with any symptoms (hopefully)! It’s also the mostly young and healthy. Mortality rate seems to be about 0.5%. Which is probably higher than flu in the same group, but not frighteningly high.

      The fact that it seems not to affect kids dramatically is heartening – I was envisioning having to stay away at work while this ran its course but maybe – hopefully – not.
      Viruses generally lose pathogenicity as they gain virulence – ie the more it infects, the less disease burden it causes. It’s not in a viruses interest to kill it’s host unless it has a long incubation time when host is shedding virus of course – possibly the case.

      I’ve also read some interesting and slightly alarming stuff about how it might be a biphasic infection – like anthrax – it causes mild illness, then recedes, then might return as a pneumonia/ARDS picture. This is all speculative – based on one case in Japan ( i think) where a woman had cleared the infection, screened negative, then screened positive again.

      Who knows. Life is for living. There’s a lot of luck involved in medicine and illness. The weather is likely to affect this, for e.g. I think having a reasonable (ie few days worth) or food in the house is sensible at the moment, and it’s as always worth washing hands etc, but I’m not buying masks as all the evidence is they work for such a short time that they’re only really of value for healthcare workers changing them between treating individual patients.

  • Reply jjiraffe February 26, 2020 at 9:48 am

    Hi Natalie – Yay, an epidemiologist! It is really good that this virus doesn’t seem to be targeting kids. Question: WHO’s Dr Bruce Aylward just gave a speech today (he went to China and investigated what’s going on) and it seems like he doesn’t think there is a significant “iceberg” of mild cases that we aren’t seeing in China. Do you agree? Here’s the link to a story:

    • Reply Natalie February 26, 2020 at 2:11 pm

      That is really interesting, thanks for sharing the link! I just don’t buy it though– like Dr. Kobinger says further down in the article, without good serology data how can you confidently say that? The asymptomatic or mild cases are the ones hopping on airplanes and going to Italy, making this much harder to control than say, MERS, where most people who got infected were seriously ill and unable to manage international travel.

      • Reply jjiraffe February 26, 2020 at 4:58 pm

        That’s a good point. Thanks for responding!

  • Reply Anu February 26, 2020 at 9:54 am

    While I’m generally not one to panic about infections and pandemics, coronovirus has already had one knock-on impact on our family. My MIL is currently planning to visit us in the US in April/May. She’s a citizen of Belarus and a permanent resident in Italy and generally splits her time between the two places. Well, while she was in Belarus the outbreak in Italy happened and now she’s (understandably) not wanting to go back. This makes it a bit more difficult for her to get her US tourist visa to come visit us, because Italy and the US have much friendlier relations than Belarus and the US. This is now jeopardizing her trip to come visit us and spend time with her beloved grandson. All this stuff is so complicated and I’m trying not to worry too much because stuff just happens, and ultimately we’re all healthy and doing well. But it’s hard not to start worrying about what-ifs.

    • Reply Sarah Hart-Unger February 26, 2020 at 10:33 am

      Oh man – that is so hard!!!

  • Reply Mommy Attorney February 26, 2020 at 10:02 am

    On March 22, 2016, I happened to be at the Brussels airport, ready to fly home. Instead I narrowly avoided two terrorist bombs and helped my friend (who is a doctor) triage wounded people.

    I went to therapy. Since then, I’ve traveled to Vienna with my children and flown more times than I can count. Terrible things can and will happen anywhere and at any time. The only choice is to keep calm and carry on.

    • Reply Sarah Hart-Unger February 26, 2020 at 10:33 am

      It got stuck in moderation sorry about that! Certain phrases trigger an auto mod 🙂

    • Reply Sarah Hart-Unger February 26, 2020 at 10:36 am

      and oh my gosh – what an experience. Thank you for sharing and definitely a great example of carrying on. Wow.

  • Reply omdg February 26, 2020 at 10:09 am

    My husband’s family lives in Northern Italy, and they report that everything is closed. I think it’s interesting that the first case in Brazil was a 61 year old man who came back from Italy 3 weeks ago, at which point I don’t believe Italy had even announced their first case. Clearly the virus is more widespread than advertised. Anyway. What honestly frightens me more is hearing on social media from people who are stockpiling food, water, and guns. WHAT?????? Then there are the people talking about how they don’t plan to pay their nannies if there is a quarantine. I need to stop reading this stuff.

    • Reply Sarah Hart-Unger February 26, 2020 at 10:34 am

      What?!?!? That is terrible!!

  • Reply Mommy Attorney February 26, 2020 at 10:09 am

    I hope this isn’t a duplicate comment, but it seemed my first disappeared. On March 22, 2016, I happened to be flying home from Brussels. Except instead I narrowly avoided two terrorist bombs and helped my friend (who is a doctor) triage the wounded.

    I went to therapy for PTSD. Since then I’ve flown more times than I can count, and traveled to Vienna with my kids. Terrible things can and do happen anywhere and at any time. The only choice is to keep calm and carry on.

  • Reply Elisabeth February 26, 2020 at 11:10 am

    It is incredible how quickly things can change…on a global scale!

    Did anyone else notice how the Pandemic show launched on Netflix right when this outbreak started (at least here in Canada; not sure when it came up in the US)?! As so many health professionals have been preaching for years, it is a matter of “when” not “if.” There is a historical precedent for this sort of thing (epidemics have been circulating for generations, some extremely serious), and with modern travel, it can spread so quickly now, too.

    It is so hard to maintain a balance of being disappointed over cancelled/altered plans, and recognizing that we just can’t control everything (most things, anything?!) in life…

    Such a timely post. Hope

  • Reply NT February 26, 2020 at 11:23 am

    Some of the concern I feel is stemming from all the conflicting information coming from the federal government — the CDC is saying prepare, other people are saying everything’s fine/ under control! It’s hard to trust some voices that have been very recently caught in lies about super trivial things.

    We have a trip planned to Italy and Spain in April and for now, we’re going to hold to it. We can always reroute if there are specific cities that are under quarantine/ experiencing an outbreak. But we are very fortunate to be healthy adults who aren’t immunocompromised, and who knows what will be going on by then. It’s also likely our last big trip before we start trying to have a kid, so we want to live it up!

    Oddly, I went to Italy back in 2009 during the H1N1 outbreak and on the way HOME they gave us all a pamphlet about the dangers of entering the US due to the flu risk. It’s all relative! We already have 2 cases in our city here, and they haven’t affected life as we know it at all (apart from 1 woman I saw in a mask at the movies, but that was almost 6 weeks ago).

  • Reply CNM February 26, 2020 at 11:28 am

    In my state, there are zero confirmed cases of coronavirus, so at least for now, the threat seems pretty minimal. But if someone in my family/immediate family is going to get it, there is little I can do to stop it other than try to keep in good health otherwise.

  • Reply Ana February 26, 2020 at 11:53 am

    Yes, planning the day to day is sort of my “security blanket” when things start to feel out of control on a more global/existential level (politics, climate change, etc…)…I focus on what I CAN control when things feel so out of control. We don’t have any international travel planned, but the first person to person transmission of coronavirus in the US occurred not too far away, so I suspect we’ll be seeing it soon here. Its good to know its not hitting kids as hard, as a mother and pediatrician, that is my biggest fear. Being off social media (except for select blogs) is VERY HELPFUL, I haven’t seen any sensationalist news about it, so I can put it out of my mind unless I need to be reminded for some reason.

  • Reply Brooke February 26, 2020 at 2:51 pm

    My book club picked Station 11 as our read many months ago for last months book choice. I decided I couldn’t read it after a few chapters if I wanted to be able to sleep at night given the current outbreak. I’ve decided I’m not going to worry too much about it (right now I’m far more concerned about the stomach bug that seems to be making the rounds in the office), but it is definitely frustrating to see all the news about stocking up for a quarantine.

  • Reply Amy February 26, 2020 at 3:51 pm

    I’m a librarian so I’m around a lot of people every day – some who often come to the library to get entertainment when they are sick. I’m a little concerned about possible exposure, but I have been a lot calmer than many around me. I guess I’ll just deal with it if it happens, but hope that it won’t.

  • Reply Erica Saltzman February 26, 2020 at 4:17 pm

    I also feel really torn between worry about coronavirus and more everyday concerns. I’m knee-deep in preparing for the arrival of my second child, and there is lots to do and I’m very excited! But, also… what will the situation be like in the hospital when she is born? And, even though I know the virus is supposed to be less dangerous for children, having a two-year-old (i.e. a walking disease vector) and a newborn seems like a vulnerable position.

    And, yes, it’s hard to know what the proper level of preparation is. We live in Manhattan, which is a crowded island with lots of people going in and out and no food source of its own. Having provisions for 7-10 days – and diapers and formula for a couple weeks – doesn’t seem like an overreaction at all.

    • Reply Sarah Hart-Unger February 26, 2020 at 4:20 pm

      That seems very reasonable!!

  • Reply Kat February 26, 2020 at 8:52 pm

    I am usually a huge supporter of this blog, but I think you are doing a disservice to your audience by taking about it like this. As a doctor, the burden to provide information that is not fear driven is much higher.

    Linking to some WHO information, giving some perspective, and talking about your worries with more context would be a better approach. For example, as 2 physicians, that’s one factor. But thinking about travel to Germany months from now, and talking about your fears, as a physician, you might want to be more careful.

    • Reply Sarah Hart-Unger February 27, 2020 at 5:05 am

      I guess I have to differ with you on the “as a doctor” comment. This has never been (AND WILL NEVER BE) a general medical advice blog, and I give my readers more credit than that. I have been looking at CDC (not WHO yet, but good idea!) just like everyone else and don’t have any insider information.

      I think — as many others — that there is a not insignificant chance that people everywhere will be impacted in unpredictable ways over the coming months (see comment from the reader from Hong Kong). And that uncertainty is hard for everyone. I was sharing my thoughts about that.

      If the planes are running and non-essential travel is still happening I would go on my trip! I just feel like there’s now a big question mark over things we had previously considered fairly certain. NOTHING ever is certain though. I guess that is something we all have to accept.

    • Reply Sarah Hart-Unger February 27, 2020 at 5:07 am

      Also, I actually don’t think I was fear mongering. My personal conclusion is there’s not really much to do right now and I am trying to just focus on each day and NOT dwell on future plans and uncertainty. My nature makes that hard, and that has nothing to do with having a medical degree.

  • Reply Greta February 26, 2020 at 10:46 pm

    I live in Hong Kong so we have been living this situation for the last month – and on top of it I gave birth 10 days ago to our third child. Fear is real, especially here where so many people died because of SARS. We watched the panic buying, toilet paper disappear and no visitors to the hospital except my husband and the kids schools have been canceled now for a month and we have two more months of it. Things are slowly normalizing a little, but trust me – this was not how I anticipated my maternity leave or birth story for this little one! We need to be smart and realize it will get better eventually.

    • Reply Sarah Hart-Unger February 27, 2020 at 6:29 am

      Great link! Thank you!!

  • Reply Christen February 27, 2020 at 10:53 am

    Hello! Long-time reader but first time commenter here. I frequently feel after reading one of your posts that I want to thank you for sharing your perspective and various aspects life, but today I’m finally actually commenting, because I wanted to thank you specifically for sharing your feelings of uncertainty surrounding the current virus outbreak. I know you’re not at all aiming to speak as a physician specifically, but knowing that someone in the medical field (and therefore someone in a good position to understand the potential scientific backing – or lack thereof – in the news) still feels quite a bit of uncertainty about the situation makes me feel not alone in my current state of “I wonder what on Earth will happen next and what I can possibly do about it!”

    (My current personal uncertainty is that I live in northern Italy – not the so-called “red zone”, but nearish – but am American and also have family in France, including an elderly grandmother… and am scheduled to go and visit her this weekend. Currently feeling extremely hesitant about doing so because what if I am unknowingly infected already and I bring her the virus?! Then again, what if it all gets much worse before it gets better and this is my last chance to go and see her for a long time?! Who knows! Potentially no one does… and so all of this to say thank you for sharing your feelings in this post – reading both the post and the various comments gave me a very well-timed “we’re all in this big question mark situation together” kind of feeling, even if geographically all in different places.) And so thank you again for sharing this post.. and every post!

  • Reply A. February 27, 2020 at 12:38 pm

    It is EXACTLY the article that I found the most relevant. I am happy to see a doctor who have the same source as me, non-doctor. I have a friend, Microbiology/Immunology Ivy league prof, she told me, that yes, to just keep calm, do the standard hygiene measures and avoid travelling in places that could close borders or restrict movements once you are there…

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