Trouble breathing: 'We all breathe the same air, but we don't breathe equally'
The medical term is acute respiratory distress syndrome. On an X-ray, the black space of a healthy lung fills with a cloud of white. Under a microscope, the delicate walls of the alveoli thicken. Oxygen from the breath must pass through these walls and into the capillaries to enter the blood. In a patient with severe Covid-19, oxygen intake is drastically limited. Hypoxia rapidly develops into systemic harm, and, in around half the cases that require intubation, death. It is traumatic, both for the person dying and for anyone watching as they gasp for air.
Nurses, doctors, cleaners and other staff in Italy’s hospitals took great risks, working long hours in crisis conditions with limited personal protective equipment. As Covid-19 overwhelmed some regions’ intensive-care capacities, momentous decisions about life support had to be made. For those on the front line, the virus was sometimes a direct question of who should get the help they needed to breathe.
The breath is an autonomic function of a healthy body; you don’t have to think about doing it. In distress – a smoke-filled environment, a panic attack, or choking – you suddenly become aware of the body’s dependence on air. You can survive for a few weeks without food, a few days without water. Without oxygen, you have a few minutes.
In the early days of the pandemic here in Turin, I started to visualise the breath in a new way. As I stepped into the middle of the road to keep my distance from someone, or stood a metre away from a person I was in conversation with, I realised that I saw my own breath, and the breaths of others, as clouds of vapour. I imagined airborne droplets around us, filled with some of the microbial life forms – bacteria, viruses – that lived in, and formed, our bodies. We were all in flux, in constant exchange with each other and with the atmosphere. I’d known this before, but now I felt it: the human body was not an integral unit, but part of a system.
We were not just individual actors, but habitats, hosts; bit players in a complex ecology.
Unlike other autonomic functions, the breath can be consciously controlled. I found that I was breathing more shallowly in public. I flinched at other people’s coughs, and repressed my own. I wasn’t too concerned for my own health, but I had begun to see myself as a vector of illness, a potential