Metaphors of Darkness in Joseph Conrad's Novella HEART OF DARKNESS

 

Metaphors of Darkness in Joseph Conrad's Novella Heart of Darkness

Ipatia Apostolides

Sept. 2, 2020 

     Joseph Conrad’s 1899 novella “Heart of Darkness” is a story of horror, greed, and lack of morality. The main character, Marlow, goes into the Congo with his steamboat searching for Kurtz who has lived there a long time and is involved in procuring ivory from the natives. Conrad uses metaphors to depict darkness in his story. During this journey down the Congo river, the word “darkness” is often repeated in varying nuances; darkness is seen in the dark forest; the darkness observed in the black savages; darkness as in the decaying machinery; darkness as in Marlow’s observing the death of his helmsman and the fear of dying; and darkness representing evil, as in the oppression of the savages by the white imperialists. In addition, darkness can be felt in isolation and silence. This is seen in the passage: “the silence of the land went home to one’s heart…the amazing reality of its concealed life” (Conrad 41). This darkness is not only observed externally, but internally. It is all encompassing.

     The more Marlow travelled, the deeper he entered this darkness, witnessing a continuum, like the ongoing river, of death, black savages, decay, and absence of civilization. He observed the black helpers that became diseased, “some of the helpers had withdrawn to die…nothing but black shadows of disease and starvation (Conrad 32). This inhuman treatment or indifference to the helpers and their lives evokes a feeling of moral decay and would cause an outcry in Europe. The cannibals that came along on the trip, after eating their hippo-meat, may have also provided a darkness or foreboding death to him and his crew. The only time that darkness seemed to disappear momentarily is when Marlow witnessed all the ivory that Kurtz had collected. Ivory is not black. It is almost white. Yet it too, was tainted by the greed of the imperialists who collected it to trade internationally. Finally, another metaphor for darkness was seen in the following passage: “There is a taint of death, a flavour of deathlike indifference of unhappy savages” (Conrad 42). This “deathlike” indifference of unhappy savages suggests an absence of feeling or emotion, a hopelessness, or lack of joy.

 

     Kurtz, an ivory trader, had become a madman by the time Marlow found him. He had heard about him from others; Kurtz collected ivory and had been wandering alone in the woods, and the young Russian man helped nurse him twice. According to the Russian, the tribe followed Kurtz because he had shot game for them. When Marlow discovered the shrunken heads on the posts, he was disgusted. This was Kurtz’s doing and the Russian explained that they were “rebels.” Then the Russian confided that Kurtz also told him he would shoot him for his ivory, “and there was nothing on earth to prevent him killing whom he jolly well pleased” (Conrad  72). Another example of his madness, in the 17-page pamphlet about imperialism that he handed to Marlow, Kurtz had also written “Exterminate all these brutes!” which showed his real feelings about the savages. His evil spirit revealed itself through his killing the savages or threatening to kill the Russian. Marlow described Kurtz as having “the barren darkness of his heart” (85). This metaphor can actually apply to Marlow's heart.

     When Marlow returns to the “sepulchral city” (Conrad 88), and he realizes how petty the people’s lives are, going to and from their jobs, and their insignificant actions, he is bothered, and he shudders. They are clueless as to what is happening in their world, which is also a sort of jungle, comparable to the Congo. There is darkness there too, but it is concealed. The sepulcher is a tomb, and in the Bible represents a whitewashed tomb that is pure and white on the outside but filthy on the inside. A sepulcher represents death and darkness. What secrets are held in this "sepulchral city?” Conrad uses metaphors to depict darkness here also. 

     Joseph Conrad’s 1899 novella “Heart of Darkness” is a story of horror, greed, and lack of morality. The main character, Marlow, goes into the Congo with his steamboat searching for Kurtz who has lived there a long time and is involved in procuring ivory from the natives. Conrad uses metaphors to depict darkness in his story. Even after Marlow thinks he has left the darkness of the Congo, this darkness follows him into the city. He cannot shake it off because the darkness has become embedded in his heart.

 

 

 

Work Cited

 

Conrad, J. (1996). Heart of Darkness. New York, NY: St Martin’s Press. (Originally published 1899) https://archive.org/details/heartofdarkness00conr/page/n3/mode/2up

 

My poem in Pen in Hand - "Turn Time Around" July 2020

My poem "Turn Time Around" was published in the July 2020 edition of Pen in Hand.

See link below to read the poem:
https://marylandwriters.starchapter.com/images/downloads/PIH/PIHJuly2020.pdf

A Study of W.B. Yeats’s Poem “Words”

Ipatia Apostolides

May 10, 2020

The Irish poet Yeats and his poem “Words” will be addressed in this paper. First, I will briefly cover Yeats’s biography, including his formative years, Ireland’s influence, his friends, and his primary love interest, Maud Gonne. This will be followed by a study of Yeats’s poem “Words” that was published in The Green Helmet and Other Poems in 1910 (Finneran, 2002). The poem relates to his personal life, particularly his love for Maud Gonne, and it gives us a glimpse of his use of the mask of change, rhythm, and symbolism. I will also touch briefly upon the societal influence in his work.

Biography

William Butler Yeats was born in Sandymount, Dublin in 1865 to John Butler Yeats and Susan Pollexfen (Duane, 1997; Brown, 1999). His father, a barrister, abandoned his profession and moved his family to London to become an artist but had difficulty providing for the expanding family. Yeats spent his youth between London and Sligo, his mother’s country home. Yeats met the poet George Russell at the Metropolitan School of Art where they became friends and had a mutual respect for the occult. During that time, Yeats decided that he preferred poetry over art. Yeats also joined the Dublin Hermetic Society and the Contemporary Club made up of intellectuals who studied magic and the esoteric. There he met John O’Leary who appreciated his genius. That is when Yeats began to study Irish history in earnest. Several of his poems were published in the Dublin University Review (Archibald, 1983).

Yeats’s interaction with the sexes was a source of energy to his writing (Hynes, 1977). This became evident when Yeats wrote the following in a letter late in his life: “We poets would die of loneliness but for women, and we choose our men friends that we may have somebody to talk about women with.” Yeats was to have several relationships with women, but the woman that affected him the most was Maud Gonne.

Yeats met Maud Gonne in 1889 when she visited his family; he accepted an invitation to dine with her the next day, and he did this nearly every evening until she left for Paris (Bradford, 1962). An actress, Maud Gonne was tall and beautiful, and fiercely intent on Ireland being free from Britain. Yeats proposed to her several times, but she turned him down each time. She confessed at one point about her past, where she had been a mistress to a French man and had two children by him (Bradford, 1962; Brown, 1999). He also proposed to her daughter but was turned down.

Another important woman in his life was Lady Gregory of Coole Park. A widow of two years, she met Yeats in London in 1894; she became like a surrogate mother to him, tending to him and giving him access to her rural home at Coole (Bradford, 1962). He visited the estate during the summers to work on his writing. He also wrote plays, and they collaborated in forming a theater together (Brown, 1999). 

With Maud Gonne, however, Yeats was obsessed by her, and she showed up in many of his poems (Bradford, 1962). She refused to say “yes” to his marriage proposals; she told him that she could never marry him due to her “horror and terror of physical love” (Bradford, 1962). Yet, somehow this fear did not fit with her actual life; she had been a mistress before she met Yeats and had two children, and in 1903 she had married John MacBride and had a son, but with Yeats, she could only have a spiritual relationship where they met on an astral plane. Even after she became widowed in 1916, she refused to marry him (Brown, 1999). Eventually, Yeats married Georgina Hyde Lees in 1917; she was much younger than him, and they had two children together. In 1923, he won the Nobel Prize in Literature, and he also became a Senator in the Irish Free State.

“Words” Poem

Yeats’ poem “Words” was first published in The Green Helmet and Other Poems, (1910; as cited in Finneran, 2002):

WORDS

I had this thought a while ago,

‘My darling cannot understand

What have I done, or what would do

In this blind bitter land.’

And I grew weary of the sun

Until my thoughts cleared up again,

Remembering that the best I have done

Was done to make it plain;

That every year I have cried, ‘At length

My darling understands it all,

Because I have come into my strength,

And words obey my call’;

That had she done so who can say

What would have shaken from the sieve?

I might have thrown poor words away 

And been content to live (p. 36).

This traditional rhyming poem is iambic tetrameter for the first three lines of each stanza with eight syllables, while the last line of each stanza ends with an iambic trimeter of six syllables. In order to maintain the rhythmic eight syllables per line, some of his words, as in stanza 2, line 3, had to be tightened. For example, “Remembering that the best I have done” is 10 syllables, and it has to be crammed into eight syllables. So the word “remembering” could be tightened to “rememb’ring,” and “the best I have done” could be tightened to “the best I’ve done.” This way it phonetically complied with the traditional iambic meter. 

In this passage in 1900, he explained the role of rhythm in his writing (Finneran, 2002):

The purpose of rhythm, it has always seemed to me, is to prolong the moment of contemplation, the moment when we are both asleep and awake, which is the one moment of creation, by hushing us with an alluring monotony, while it holds us waking by variety, to keep us in the state of perhaps real trance, in which the mind liberated from the pressure of the will is unfolded in symbols (p. 378).

Personal Implications 

In Yeats’s poem “Words,” he used a first-person point of view which gives it a personal touch. The poet was inviting us into his private world by beginning with “I had this thought a while ago.” It’s as if he were treating us like a friend. According to Harper (2007), “Yeats’s work is intensely interested in someone we can call Yeats.” It is obviously the case in this poem.

Morrall (1956) believed that the art and personality of Yeats was combined intimately as one, and this made a “more lasting appeal to the human heart.” In addition, Yeats took his personal relationship with Maud Gonne, one filled with private thoughts, and made it public in this poem. How does one know it was Maud Gonne? Although he didn’t mention her name in this poem, the “My darling” in the second line of the poem is revealed in the following diary entry by Yeats in 1909, where PIAL was the code for Maud Gonne (Brown, 1999):

Today the thought came to me that PIAL never really understood my plans, or nature, or ideas. Then came the thought, what matter? How much of the best I have done and still do is but the attempt to explain myself to her? If she understood, I should lack a reason for writing, and one never can have too many reasons for doing what is so laborious (p.176).

In this diary entry, Yeats made it clear that Maud Gonne did not understand him. By this time in his life, she had been separated by her husband for four years and was raising her son. Although he had had other love relationships, he repeatedly returned to Gonne, asking her to marry him, but she spurned him each time (Brown, 1999). 

In the first stanza of his poem “Words,” he stated: “My darling cannot understand/What have I done, or what would do” (Finneran, 2002). But what was it that she needed to understand? The title “Words” gives a hint. She did not understand his writing. Yeats’s writing was important to him, and he had attained recognition for his poetry and plays by this time in his life. He strived to “make it plain” to her in the second stanza. By the third stanza of the poem, he had cried every year “At length/ My darling understands it all” believing the reason being that “I have come into my strength/And words obey my call.” Then retracting these thoughts in the last stanza, “That had she done so who can say/What would have shaken from the sieve?” he wondered again if she had actually understood him, thus by asking this question, he exposed an insecurity toward her. 

At the same time, he revealed his own awareness of wanting to impress her with his writing. If Maude would have given Yeats what he wanted in the poem, which was not only her love, but her whole being and her recognition for his talent and writing, then things would have changed for him. In “I might have thrown poor words away,” Yeats showed how her actions would have influenced him (Finneran, 2002). But that was not the case in real life.

I believe that in this poem, Yeats also revealed the de-selfing of the self where he “constructs the self and then deserts it” (Harper, 2007). He came into his strength where “words obey my call” which appeared to be the construction of the self, and then he deserted it in the last stanza (if she had understood him) with “And been content to live.” Another revelation into his personal life is from his “Per Amica Silentia Lunae (1918), where Yeats wrote: “We make out of the quarrel with others, rhetoric, but of the quarrel with ourselves, poetry” (as cited in Finneran, 2002). The two juxtapositions in his poem – his wanting her to understand, and what would have happened if she did understand - reveal his angst at her not understanding him, and at the same time the “quarrel” with himself.

Societal Framework

According to the Poets.org website (W.B. Yeats, n.d.) Yeats was born into the Anglo-Irish landowning class. He became involved with the Celtic Revival, resisting the cultural influences of English rule in Ireland, and promoting Ireland’s heritage through his writing. Yeats’s writing was influenced by Irish mythology, faeries, and folklore. He liked to use symbolism and rhythm. He also dabbled in the occult. (Finneran, 2002).

During the writing of the poem, there was a feeling of unrest in Ireland, as depicted in the Irish revolutionary Maud Gonne’s nationalistic stance in wanting Ireland to be freed from Britain. In addition to what was happening politically around him and Ireland, poetry during this time, had been moving from romanticism and naturalism toward modernism, but Yeats was resisting that change in his poetry (Barsky, 2015). He continued to churn out traditional poems like “Words” that rhymed and had very little concrete images except for “land, “sun,” and “sieve.” However, after 1910, his work began to reflect the influence of Ezra Pound, and it became more modern, concise, and filled with imagery (Finneran, 2002). Yet a part of him resisted; Yeats continued to use traditional rhyming verse in his poems. 

In the “Words” poem, Yeats mentioned how his darling could not understand what he would do in “this blind, bitter land” which I’m assuming referred to Ireland. That was the only reference to his society, or Ireland, in this poem. He would go on to write other poems, like “Easter in 1916” which depicted Ireland’s historical uprising in 1916. He later became Senator of the free state of Ireland and also won a Nobel Prize in Literature. These two achievements were attained late in his life and reflected his success in reaching a high societal status through his works. And the poem “Words,” like all his other poems, was a rung in society’s ladder that helped him achieve such heights.

REFERENCES

Archibald, D. (1983). Yeats. Syracuse University Press.

Barsky, R. (2016, March 31). William Butler Yeats and the meaning of poetry in the modern world - 3.31.16. [Video]. YouTube. https://www.youtube.com/watch?v=-aujcOweqHY

Bradford, C. (1962). Yeats and Maud Gonne. Texas Studies in Literature and Language, 3(4), 452-474. https://www.jstor.org/stable/40753563

Brown, T. (1999). The life of W.B. Yeats. Blackwell. https://archive.org/details/lifeofwbyeatscri00brow_0/page/116/mode/2up

Duane, O.B. (1997). W.B. Yeats: Romantic Visionary. Brockhampton Press. https://archive.org/details/yeats00will/page/6/mode/2up

Finneran, R.J. (Ed.). (2002). The Yeats Reader. Revised Edition. Scribner.

Harper, M.M. (2007). ‘How else could the God have come to us?’: Yeatsian masks, modernity, and the sacred. Nordic Irish Studies, 6, 57-72. https://www.jstor.org/stable/30001564

Hynes, S. (1977). All the wild witches: The women in Yeats’s poems. The Sewanee Review, 85(4), 565-582. https://www.jstor.org/stable/27543298

Morrall, J. (1956). Personal themes in the public and private writings of W.B. Yeats. University Review, 1(9), 28-36. https://jstor.org/stable/25504396

W.B. Yeats (n.d.). Poets.org website. https://poets.org/poet/w-b-yeats

The Influcence of Visionary Leadership on Change Management and Implementation - COVID-19 Literature Review

The Influence of Visionary Leadership on Change Management and Implementation

Ipatia Apostolides

April 16, 2020

Chapter 2: Literature Review

Introduction

            The purpose of this literature review was to conduct a meta-analysis of the literature on the new coronavirus (COVID-19) with a focus on the leadership of the US and Chinese governments during the period from December 22, 2019, to March 22, 2020. This quantitative study tries to answer the research question of whether or not timing and transparency by government officials, two independent variables, impact the cases and deaths of COVID-19. The topics covered in this literature review are: the leadership theories in disease outbreak, the risk communication used in the past for the SARS virus, the World Health Organization’s response to the COVID-19 outbreak (WHO, 2005), as well as data from SARS which is the precursor to the COVID-19 virus, followed by both China and the US on the COVID-19 disease and the governments’ response to the outbreak, and the issues that have arisen during this outbreak. A summary will be presented at the end of this literature review.

Documentation

Table 1

Research Databases Used for Review of Literature

_________________________________________________________

Search Engine                                     Number of Resources Obtained

__________________________________________________________

Ebsco Host                                                                              3

Google Scholar                                                                       9

Researchgate                                                                           1

UC MegaSearch                                                                     3

World Health Organization                                                    1

____________________________________________________________

Leadership Theories

In a disease outbreak, leadership is crucial in its management, and according to Arifah et al. (2018), three leadership theories have been proven to be effective: participative, contingency, and transformational. An article by Wu, Yang, and Wu (2004) showed that in a Taiwan hospital stricken by SARS, about 128 medical staff resigned. The hospital's CEO brought in experts from headquarters to help, thus encouraging the staff and exercising the participative leadership approach (as cited in Arifah et al., 2018, p.7). 

The second leadership theory in disease outbreak is the Contingency Theory, and it focuses on the dynamics between the leader and the followers, and uses positional power, leader-member relations, and task structure (Arifah et al., 2018, p. 9). In order for this Contingency Theory to work in a disease outbreak, the successful working relationship between the leader and followers motivates the followers to execute well-defined tasks (p. 10). The ability of organizations and employees to work together in response to change, where employees are not only contributing expert knowledge but are accountable for their performance, explains the ‘leader-member relations’ aspect of the Contingency Theory (Gould et al., 2016, as cited in Arifah et al., 2018). 

The third leadership theory in disease outbreak is the Transformational Theory, and it relies on inspirational motivation, idealized influence, and individualized consideration (Wu et al., 2004; Koteyko & Carter, 2008; Rosewell et al., 2013; & Nyenswah, 2017, as cited in Arifah et al., 2018). The paper by Arifah et al. (2018) recommends that governments, ministries, and public health officials attend World Health Organization (WHO) courses for leadership skills in managing epidemics and pandemics to improve leadership in times of global outbreaks (WHO, 2016, as cited in Arifah et al., 2018, p. 12).

Baekkeskov & Rubin (2017) state that during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, China’s secrecy and misinformation, along with public officials playing down the risk of the disease, had exacerbated the SARS epidemic by delaying control. However, by 2009, China had learned its lesson that secrecy failed as a blame avoidance strategy in epidemics, and in the case of 2009’s swine influenza epidemic (H1N1), the Chinese official media reported immediately on the H1N1 (p.425). Several political dynamics may make the information dilemma during a crisis important for China’s authoritarian regime: authoritarian regimes often control mass media, growing information demands due to institutional reform, and regime vulnerability to information (Baekkeskov & Rubin, 2017, p. 427). 

In the US, to avoid blame for policy mistakes, democratic politicians have used ‘lightning rods’ or individuals responsible for any policy mistakes and take the fall for them (Baekkeskov & Rubin, 2017, p. 428).

World Health Organization

In an “Outbreak Communication” report by WHO (2005), disease outbreaks are urgent emergencies and require rapid decisions to bring the outbreak under control; these outbreaks have unique features, like: 

·      “urgent public health emergency

·      unpredictable

·      alarming for the public

·      socially and economically disruptive

·      strong political dimensions

·      spread has behavioral component

·      eminently newsworthy” (p.7)

Risk communication has been widely written about in over 8000 articles, and this is defined as a process of communicating honestly about the risk factors of a disease (Menon, 2006); this requires active communication by officials; including openness and transparency, and demonstrating action, as well as encouraging self-responsibility (p. 362). 

The timing of the first official communication about a disease is the most important, according to the WHO report (2005). If there is a delay, this gives the impression that officials are concealing information, because they are more concerned about loss of income from trade and preventing public anxiety than protecting public health (p. 24). However, before the government makes a disease outbreak announcement to the public, verifying it with public health officials is necessary, which usually takes two days. In contrast, significantly important events are verified in less than 24 hours (p.33).

In addition, even before a disease outbreak, trust should already be in place (p.28). If the public becomes suspicious that information about the disease is withheld from the start, the WHO (2005) report notes that this could damage a country’s leadership (p. 31). 

Severe Acute Respiratory Syndrome (SARS)

The SARS virus in 2003 was the first pandemic of the 21^st century. Singapore rose to the occasion in February 2003, in combatting the disease through quick actions, like amending the Infectious Diseases Act to allow enforcement against quarantine breakers, using electronic tags on the public, having thermal scanners for borders; purchasing mass supplies of personal protection equipment; and contact tracing (Menon, 2006).  They also used every communication tool available, with the help of grassroots leaders and religious groups, websites, advertisements, posters, booklets, and hotlines (p. 364). However, the media criticized their harsh, authoritarian, and draconian preventive measures (p. 366). 

By July 2003, the SARS global outbreak was contained (Peeri et al., 2020).

Novel Coronavirus (COVID-19) – China

The novel coronavirus (COVID-19), was first identified in Wuhan, China, in December 2019, as a genus betacoronavirus, which causes atypical pneumonia, and is similar to SARS, and Middle East Respiratory Syndrome (MERS) (Peeri et al., 2020; Li et al., 2020; Huang et al., 2020). This novel coronavirus was first identified in 4 patients as a “pneumonia of unknown etiology” (Li et al., 2020, p. 1200). Like the SARS and MERS diseases, it transmits through human-to-human transmission; however, it has surpassed SARS and MERS in the number of cases and deaths (p.2). The lack of transparency by the Chinese health ministry, along with inadequate risk assessment, has hampered efforts to contain the COVID-19 disease. It has been cited as one of the most significant contributors to the spread of the disease (p. 2). By not being transparent, the Chinese health ministry’s leadership is weakened and may contribute to trust erosion. In addition, under-reporting in the number of cases of COVID-19 in China was noted by Zhao et al. (2020). This under-reporting can impede containment and endanger other countries, because as the virus spreads to other countries, their public healthcare system might not be adequately prepared due to the lower numbers.

Li et al. (2020) looked at 425 patients in Wuhan, China with confirmed COVID-19; the test was done through an RT-PCR process, which tested for the virus’s RNA, and was repeated; if they tested positive for COVID-19 twice, then the disease was confirmed (p. 1201). The authors of this study found that the mean incubation period was 5.2 days. In its early stages, the epidemic doubled in size every 7.4 days, with human-to-human transmission since the middle of December (p. 1199). Upon graphing the number of cases, the authors concluded that the development of the epidemic follows an exponential growth; their concerns were that a delay in identification or testing and subsequent underreporting would affect the number of cases (p. 1202). Some limitations of this study were the unavailability of tests, and identifying only pneumonia cases, which left out certain patients with gastrointestinal symptoms who were later tested positive.

Chen et al. (2020) conducted a study, from Jan 1 to Jan 20, 2020, that looked at 99 (67 men and 32 women) patients in Wuhan Jinyintan Hospital with COVID-19. Out of these patients, 75% showed bilateral pneumonia, 14% showed multiple mottling and ground-glass opacity, and 1% showed pneumothorax; also, 11% worsened in a short period and died of multiple organ failure (p. 507). From this study, the authors concluded that the COVID-19 infection is more likely to affect older men with comorbidities, and could result in fatal respiratory diseases such as acute respiratory distress syndrome (ARDS); it also stressed that early identification and timely treatment of critical cases of COVID-19 are important to reduce the severity of the patient’s condition and prevent the spread of the disease (p. 508).

A study by Sun, Qiu, & Yang (2020) was conducted on 631 confirmed cases of COVID-19 in Jiangsu, China; and they established an early warning system with a sensitivity of 0.955 (95% Confidence Interval), as well as a multidisciplinary hierarchical management group to provide medical guidance for all COVID-19 patients. The authors believe that the hierarchical management strategy (Fig. 3) and early intervention (Fig. 2) provided effective medical interventions (p. 3). By March 7, 2020, 610 patients were discharged with a cure rate of 96.67%, which was better than the 4.34% mortality rate of Hubei, and it was found that critical care-dominated treatment patterns might be the core in reducing mortality (p. 1).

Novel Coronavirus (COVID-19) in US

In the “Morbidity and Mortality Weekly Report” by Jernigan (2020), who is a member of the CDC COVID-19 Response Team, he describes several steps taken by CDC in the US by February 28, 2020; posting travel notices to inform travelers about taking precautions in going to China, Hong Kong, South Korea, and Japan; the screening of 46,016 air travelers at the 11 US airports to which all flights from China had been directed; recognizing persons at risk for COVID-19; and testing for COVID-19 in the CDC laboratories. Also, since Feb. 2, 2020, a presidential proclamation was made to suspend any entry from China to the US, and allowed only US citizens and lawful permanent residents to enter the US. As of February 23, 2020, out of 11 travelers referred to hospitals, one tested positive for COVID-19 (p. 217). However, what Jernigan (2020) failed to mention were the numerous news reports (New York Times, Forbes.com, MIT Technology Review, Associated Press) about CDC’s botched COVID-19 tests and later, the requirement that all COVID-19 samples be sent to them first to be tested, which caused a bottle-neck in testing, especially with test kits that were old and not working well. This significantly delayed the testing of COVID-19.

This short report on COVID-19 cases in the US by Burke et al., (2020) is linked to the CDC website and focuses on 10 travel-related COVID-19 cases as of February 26, 2020, who had close contact with 445 persons in the US on or after the onset of the patients’ symptoms; this could be family contact, community contact, or healthcare personnel (p. 245). Symptom monitoring of the 455 close contacts for 14 days consisted of daily telephone, text, or in-person inquiries and revealed that 12% of the close contacts developed symptoms of COVID-19 (p. 246).

In another report by the CDC COVID-19 Response Team, as of March 16, 4,226 COVID-19 cases had been reported in the US (Pilishvili et al., 2020). Limitations to the findings in the report were: data were missing for 9%-53% of the cases, including hospitalizations, ICU admissions, and death; further time was needed to determine outcomes; initial approach to testing was to identify only persons with travel histories; data on underlying health conditions were unavailable at the time of this report; and finally, limited testing underscores the importance of ongoing surveillance of COVID-19 cases (p. 344-345). The report concluded that social distancing is recommended for all ages to slow the spread of the virus, protect the health system, and help protect vulnerable older patients (p. 345).

It has taken over two months for the CDC to launch studies to detect COVID-19 cases, and will include the following three studies: looking at blood samples from people never diagnosed; national survey will be conducted to sample different parts of the US; and the third study will look at the health care workers and how widely the virus has spread within them (Branswell, 2020).

Issues in Reporting COVID-19

Some issues have been raised by Kobayashi et al., (2020) in appropriately measuring the risk of death in COVID-19, and these include: delay in time from onset of illness to death; observed data of reported cases represent a portion of all infected individuals, as many are never diagnosed; using shorter virus detection windows and less sensitive diagnostic lab tests would bias the ascertainment and risk of death among all those infected. Kobayashi et al., (2020) believe that if a patient has mild symptoms and never goes to the doctor to get diagnosed, they will fall outside of the number of cases reported; in addition, the perceived severity of the COVID-19 epidemic is directly influenced by the absolute number of deaths (p. 2). Knowing when to test for the virus is important because it is not always detectable, and the accuracy of the diagnostic RT-PCR tests ranges from 44% to 80% (p. 4), sometimes giving false results. Another issue is the underreporting of COVID-19 cases (Zhao et al., 2020; Pilishvili et al., 2020). Therefore, these are issues to consider when working with data from the COVID-19 outbreak.

According to Gostin, Hoge, & Wiley (2020), more aggressive measures have been taken by other countries than the US for the COVID-19 outbreak, such as guarding areas where individuals may not enter or leave, and ordering individuals to remain in their homes at all times. In response to the COVID-19 outbreak, three national emergencies by the US federal government have occurred: on January 31, 2020, the US Secretary of Health and Human Services (HHS) issued a public health emergency, authorizing funds for diagnostic tests, antiviral drugs, and vaccines; on March 13, 2020, six weeks later, the president declared a national emergency, facilitating telemedicine and increasing hospital capacity; and the president also declared an emergency under the Stafford Disaster Relief Fund and Emergency Assistance Act, using the services of the Federal Emergency Management Agency (FEMA) (p. 1). Although Gostin, Hodge, & Wiley (2020) state that there must be a careful balance between public health and individual rights, the number of COVID-19 in the US as of April 5, 2020 has reached 332,283 cases with 9,507 deaths (Coronavirus Cases, 2020), and the numbers have not reached their apex yet. This balance between public health and individual rights might be causing more cases and deaths, and needs to be investigated further.

Summary

            Several theories abound on leadership during a disease outbreak (Arifah et al., 2018). However, it is difficult to pinpoint one exact leadership theory that can be used when different leaders act at various organizational levels. In the Chinese (CCP) government, which is authoritarian, it leads several levels of subordinate organizations in the fight of the disease. In contrast, the US government, which is democratic, relies on the Centers for Disease and Control Prevention (CDC) and emergency measures (Gostin, Hoge, & Wiley, 2020) as well as the states’ governors to lead the fight against the disease outbreak. Also, reporting the disease outbreak, if not transparent, leads to data misinformation, as seen in China’s reporting (Li et al., 2020). This makes the measurement of timing in response to the disease difficult to assess. 

In addition, not enough data has been made available of cases and deaths during this COVID-19 outbreak in the US and China to be able to get an accurate comparison between the timing and transparency of these two governments during December 22, 2019 to March 22, 2020 (Pilishvili et al., 2020; Zhao et al., 2020). More research is needed in this area.

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