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The Pandemic

How Manoj Jain became “The Dr. Fauci of Memphis”

Dr. Manoj Jain answers emails in his home workspace on Wednesday, March 3, 2021. (Mark Weber/The Daily Memphian)

On Sunday, March 8, one year ago, Dr. Manoj Jain stood at a nurse’s station at Baptist Memorial Hospital and watched his world and ours suddenly and inevitably change forever.

Jain, an earnest, friendly, soft-spoken physician, had just completed his rounds. He joined half a dozen nurses who were watching a live press conference from the Shelby County Health Department.

“We have our  opens in a new windowfirst confirmed case of the novel coronavirus in Shelby County,” said Dr. Alisa Haushalter, director of the health department. “That individual traveled out of state recently, and that’s very important because that means that from our opinion there is no risk to the public at large.

Jain, an infectious disease specialist and epidemiologist who has tracked viral and bacterial killers for the World Health Organization and the World Bank knew the news was more disturbing than that.

He knew that by the time the first case is identified, the virus likely has been in the community for weeks and infected two dozen others or more.

He knew the highly infectious and lethal coronavirus would not easily or quickly be contained.

He didn’t know how long the crisis would last, or how quickly and deeply the virus would overwhelm his life and severely test his experience and expertise.

He had spent the previous three decades studying, testing for, and treating infectious diseases such as HIV, swine flu, and tuberculosis here and around the globe.

He had spent the previous two months educating himself about the novel coronavirus, informing the public in newspaper columns, and encouraging local officials, including the health department, “to prepare for the worst and hope for the best.”

He was about to spend nearly every day of the next 12 months trying to guide his family, his practice, and his community through a pandemic.

“This is just the beginning,” Jain said to himself as he watched the press conference.

Two days later, Memphis Mayor Jim Strickland asked Jain to start advising him and his administration on the city’s response to the virus.

“I don’t want to even think about how bad things might have gotten here without Dr. Jain,” Strickland said. “He’s been our primary source of information on the science of the pandemic. He’s the Dr. Fauci of Memphis.

Jain had been preparing for the role his whole life.

From India to Boston

Manoj K. Jain, the son of immigrants and an immigrant himself, was born near Indore, a densely populated city of about 3 million people in central India.

When Jain was 2, his parents moved to Canada where his father earned a doctorate in mechanical engineering. Jain stayed with his brother in India until he was 10, then joined his parents in America.

Jain’s grandparents taught him the rituals of their faith. Jainism is an ancient religion of India. There are twice as many Jains in India as there are Episcopalians in America.

As a child, Jain (a common surname in that religious community) found the rituals and festivals entertaining. They made him feel like an adult. As an adult, he finds them reassuring.

“I can’t explain the comfort of such rituals, especially when performed with beloved family members,” Jain said. “Perhaps it is hardwired deep in my brain from early in my childhood. Performing rituals aren’t necessarily acts of logic, reason and analysis. They are acts of faith.”

Jainism teaches that the path to enlightenment is through nonviolence and reducing harm to living things.

For Jain, becoming a physician and taking the Hippocratic oath to refrain from causing harm or hurt was an act of faith and reason.

“I had my life plan all set by the time I was 20,” Jain said. “I was going to become a doctor, and then go to work for the CDC or the World Health Organization. I was going to devote my life to public health.”

In his second year of medical residency in Boston in 1990, Jain read an  opens in a new windowarticle in the New England Journal of Medicine that shifted the course of his life.

The article explained how simple, inexpensive vitamin A supplements might reduce by half the deaths of children in malnourished parts of the world.

“Malnutrition and infectious disease are a deadly combination in vulnerable preschool children,” Dr. Gerald Keusch wrote in 1990.

The article focused Jain’s attention for the first time on infectious diseases. “I was inspired by the idea that we could save millions of children’s lives by doing such a small thing,” he said.

Jain called Keusch and expressed his appreciation. When Jain’s residency was over, he started a fellowship in infectious diseases with Keusch at New England Medical Center.

The fellowship took Jain back to India, where he spent months studying the spread of HIV/AIDS and consulted for the World Bank.

“India was not the easiest place to work, especially for someone of Indian heritage who was part of the diaspora,” said Keusch. “A lot of people are suspicious of those who grew up outside of India, but Manoj is so charming and earnest, he’s able to bring people together into a common pursuit.”

By studying and tracking HIV, Jain learned how to use an “epidemic curve” to measure and predict the transmission of an infectious disease.

He also learned how vital it is to “flatten the curve” to slow and eventually stop the spread of the disease.

“Flatten the curve, flatten the curse,” said Dr. Jeff Warren, a physician and City Council member who has known Jain for 25 years. “I think that became his mantra from the beginning of the pandemic. He kept us all focused on that.”

From Boston to Memphis

Jain and his wife, Dr. Sunita K. Jain, who also was born in Indore, met in college in Boston. They were married in 1989.

Dr. Manoj Jain with his wife Dr. Sunita Jain in their home on Wednesday, March 3, 2021. (Mark Weber/The Daily Memphian)

“We have different approaches to medicine,” said Sunita, who works at Baptist Rehabilitation Hospital in Germantown.

“I love the one-on-one interaction with patients. Manoj wants to take care of his patients and also take on projects to help the larger community as well. He always has some project going.”

The couple moved to Memphis in 1995 when Sunita got a job at Baptist. Jain soon started his own practice, Mid-South Infectious Disease, the first of many new projects.

Jain was among the co-founders of a local charity, the  opens in a new windowIndian Community Fund for Greater Memphis. In the early 2000s, the fund raised money for a  opens in a new windowGandhi exhibit at the National Civil Rights Museum.

In 2003, Jain worked with the Indian Community Fund, the museum, the Mid-South Peace and Justice Center, and the M.K. Gandhi Institute for Nonviolence at CBU to organize an annual  opens in a new windowGandhi-King Conference.

“Manoj is trustworthy and has a way of bringing people together,” said Janice Vanderhaar, a founder of the Mid-South Peace and Justice Center. “He cares deeply about others.”

In college, Jain had immersed himself in the nonviolent teachings of Mohandas Gandhi, a fellow Indian, and Dr. Martin Luther King Jr., a fellow Boston University graduate.

“I am convinced that the realism of our day-to-day work has to be grounded in idealism, the kind of idealism Gandhi and King provided for us,” Jain wrote in a 2012 column in The Commercial Appeal. “We need to nourish this idealism in an ever more cynical world.”

In 2014, Jain’s idealism led him into the sometimes cynical world of politics.

He challenged Republican incumbent Steve Basar for a seat on the county commission. Jain ran as a Democrat, but during the campaign, he was a regular presence at meetings of both local parties.

“He once stifled a brewing quarrel among feuding and shouting members of the local Democratic executive committee by leading the group in a meditative chant,” the  opens in a new windowMemphis Flyer reported in 2014.

Jain lost the election soundly, receiving 39 percent of the vote in the heavily Republican East Memphis district. But his foray into politics gave him some valuable experience.

“Manoj has always had a keen interest in public health and has also been willing to participate in local politics,” said Dr. Stephen Threlkeld, medical director of infectious disease at Baptist.

“That intersection of medicine and politics can make for pretty rough sailing, and I’m grateful that he’s been willing to put himself out there to try to make a difference in this important and difficult time. Manoj was able to communicate to local leaders the potential danger of COVID-19 in our community and encouraged them to invest in a vigorous response to avoid a severe impact early on during the pandemic.”

Quality control and teamwork

In 1999, Jain found another project to satisfy his interest in public health.

He became a medical director for Tennessee’s Quality Improvement Association,  opens in a new windowQSource, a nonprofit dedicated to improving care for Medicare and Medicaid patients in Tennessee.

Jain visited nearly every hospital in Tennessee and heard story after story about the broken health care system.

He met a nurse who told him about her own one-day hospital stay and her $54,000 hospital bill.

He met an HIV patient who stopped going for treatment because his insurance dropped him from coverage.

He met a physician who assumed every patient was out to “hit the jackpot” with a malpractice claim.

Jain studied quality control measures being used by FedEx and other successful corporations.

He talked to government officials about how state and local agencies could apply those same methods.

He learned the value of incremental step-by-step improvements. He saw the importance of working with teams.

“Most doctors have a sort of God complex,” Jain said. “We believe we can do it all on our own, but that sort of attitude can be detrimental to good health care. The Jain fable of six blind men and the elephant teaches us that no single person has the complete truth. Truth only exists in our collective thinking.”

Jain teaches classes in health policy and management for the  opens in a new windowRollins School of Public Health at Emory University in Atlanta, and for UTHSC in Memphis.

He preaches the need for communication and teamwork, and tries to practice what he preaches.

Jain was an original member of the Joint city/county task force that began meeting every day last March. In recent months, it has met twice a week. Jain hasn’t missed a meeting.

He helped launch the testing committee, which met three times a week in the early months of the pandemic and now meets every Wednesday.

He also pulled together weekly meetings with other local epidemiologists, with nursing home representatives, and with lab directors.

In addition, he talks about vaccines with representatives of local hospitals and pharmacies on Mondays and Fridays.

He attends Safety Net Clinic meetings on Mondays, and joins a meeting of national COVID-19 policy leaders on Tuesdays.

He regularly updates City Council as well as county and municipal leaders on Thursdays.

Fridays are especially busy. In addition to the nursing homes meeting, he attends a regular meeting on masking and another on antibody research.

Dr. Jon McCullers is an expert on infectious diseases at UTHSC as well as pediatrician in chief at Le Bonheur. “Manoj has brought many groups together that otherwise might not have worked together,” McCullers said. “He has been absolutely indefatigable in working at this problem, responding to the pandemic.”

SARS and COVID

In 2003, during the  opens in a new windowSARS outbreak, a FedEx pilot returned from Hong Kong and landed in Baptist’s ICU with a fever, cough and shortness of breath.

Jain wore full protective gear to examine and treat the patient, who was isolated. When Jain got home, he showered, washed his clothes, and quarantined himself from his wife and children for two weeks by moving into the guest room.

Last March, when the COVID-19 pandemic hit Memphis, Jain and his wife began to maintain 6-feet of distance from each other and their kids.

She was seeing patients who might be infected. He was seeing many patients who already were infected. Her elderly parents lived with them. And their two youngest children were home, attending classes virtually.

The couple didn’t share a drink, a towel, a hug, or even a bed. At the end of March, Manoj moved into their eldest child’s empty bedroom.

The couple’s self-imposed quarantine ended in January when they both were vaccinated.

They broke protocol only once, for a few moments, last May. “The virus did not matter,” Jain said. “It was our 31st wedding anniversary.”

The pandemic interrupted Jain’s home life in other ways.

“The kids still make fun of me when they see me on TV,” Jain said. “‘Oh, Dr. Jain,’ they’ll say at dinner. ‘What can you tell us about the coronavirus?’ They’re tired of hearing me talk about it. I’m tired of hearing me talk about it.”

The pandemic turned Jain’s home into a telemedicine clinic.

When COVID-19 hit, clinics went virtual. Hospital rooms were outfitted with iPads and surveillance-type cameras.

Keeping nurses, doctors, other staff members, and patients safe was the top priority.

In a matter of weeks, the coronavirus put more physical distance between patients and the people caring for them than technology and telemedicine had in a decade.

“The physical isolation of the pandemic has drained me,” Jain said. “I cannot imagine the heartbreaking pain it is causing my patients.”

Jain treated an elderly woman from a nursing home, a former hairdresser, who was taking 40 breaths a minute and still could not get enough oxygen. Before she was intubated, she told Jain she felt like she was drowning. Her daughter and grandchildren watched on FaceTime as she died alone in the ICU.

Jain treated a physician who acquired COVID from an unmasked asymptomatic patient. Her husband acquired COVID from her. Both were admitted to the hospital. She went to the ICU, he went to a negative pressure room. Jain relayed messages for the couple and family members. They both survived.

Jain treated a young pregnant woman in her third trimester who was severely ill with COVID-19. She had an emergency C-section, then deteriorated and required a ventilator. Her lungs stiffened and she was placed on a heart-lung machine. She spent two months in the hospital, unable to be with her newborn or any family members. She survived and so did her child.

“COVID is like sepsis on steroids,” Jain said. “I’ve never seen patients deteriorate so quickly, or so sadly. Even with tuberculosis, a family member could put on a mask and be in the room. Not with COVID. So many people are dying alone.”

Tuberculosis and COVID

In 2010, Jain returned to India to start another project —eliminating tuberculosis from his hometown.

Before COVID-19, TB was the world’s third  opens in a new windowdeadliest infectious disease, after pneumonia and diarrhea.

About 10 million people become ill with TB every year, and 1.5 million to 2 million die. About 300,000 of those deaths are in India.

“Some 1,400 people die each day from TB in India, compared to only a handful in America,” Jain said. “This disease is treatable, and this death is preventable.”

Roughly 85% of people who are diagnosed with TB can be treated successfully with a six-month drug regimen. Since 2000, an estimated 63 million lives have been saved worldwide through TB diagnosis and treatment.

In 2010, Jain and Dr. Salil Bhargava, a respiratory medicine specialist, launched the  opens in a new windowCollaboration for Elimination of Tuberculosis among Indians (CETI).

They send volunteers to villages to educate, test, diagnose and treat TB victims. They started in Indore, then expanded their mission to nine other nearby villages and cities.

Last month, CETI signed a $1 million contract with USAID to train district TB officers to use the same quality control principles Jain used working for QSource. 

Jain’s TB work in India has informed his COVID-19 work in Memphis.

Like COVID, TB often attacks the lungs, but can invade any part of the body.

Like COVID, TB is airborne and spreads through aerosols and droplets when people cough, sneeze, sing or even talk loudly.

Like COVID, not everyone infected with TB becomes sick or shows symptoms. Some TB infections are dormant for years or decades.

Unlike COVID, people with TB are infectious only when the disease is active and they develop symptoms and become obviously ill.

That makes the spread of TB more controllable, but only if those who become ill are identified, diagnosed, isolated and treated.

The World Health Organization (WHO) has warned that the COVID-19 pandemic is threatening to reverse global progress against TB. Nations like India have had to reallocate resources from TB treatment to COVID prevention and treatment.

As a result, countries are reporting 25-30 percent fewer TB cases — meaning that many fewer cases are being diagnosed and treated. The underreporting could result in an additional 400,000 deaths from TB, WHO estimates.

Jain hopes the global response to the coronavirus pandemic will aid the fight against TB.

“Masking, social distancing, testing and tracing have become commonplace practices due to COVID-19,” Jain said. “These hold the key to TB elimination as well.”

India and Memphis

Jain travels to Indore at least once a year. He walks from shack to shack in slum areas, asking people to let him test for TB.

“We find cases of TB so that people who are carriers do not inadvertently spread the disease to their family and neighbors,” Jain said. “And the only way to find people who need to be tested is to go door to door.”

In every other home he visits, a family of five or more lives in a space the size of a college dorm room.

And in every fifth house, at least one person has a cough or a recent fever, and cannot tell if they are suffering from TB or a common cold.

Jain teaches parents and schoolchildren about the cough and low-grade fever of TB. His organization runs a TB hotline to make sure patients are isolating and taking their medicine.

He knows that large-scale testing might be the only way to dramatically reduce and eliminate TB, especially in large slums.

“But at a cost of $50 per person, that sort of testing is impossible,” Jain said. “People are unable to afford it. I had abandoned the idea.”

In November 2019, Jain attended a meeting on TB in New Delhi hosted by the Indian government and the WHO. In a breakout session, Jain brought up the need for mass testing.

An Indian microbiologist said the solution was pooled testing. He told Jain the PCR lab test is so sensitive, it can detect the slightest trace of TB.

“That would allow us to collect samples from entire families or clusters of homes,” Jain said. “By pooling samples for testing, we could reduce the cost five or ten times and it would be just as effective.”

Jain brought the idea home with him.

Last April, Jain began challenging Memphis area labs to use their PCR machines to try various forms of “assurance testing,” including  opens in a new windowpooled and pod testing.

Lab directors credit Jain with helping competitors become collaborators.

“He motivated and challenged the labs and others to think outside the box to find innovative ways to solve testing and contact tracing problems,” said Jim Sweeney, CEO of Poplar Healthcare.

“His contribution has been vitally important in moving the city in the right direction with testing, which saved lives.”

‘Birth of a virus’

When Jain returned from India in early 2020, he was more worried about the seasonal flu.

There was no evidence of widespread coronavirus infection in U.S. Most of the focus was on China, Iran and Italy, and travelers from those countries.

Meanwhile, children and adults with fevers, coughs and other flu-like symptoms were filling schools, workplaces and hospitals. Nearly 15 of every 100 patients in local emergency rooms had a flu-like illness.

“Without a doubt, we have a widespread infection of the flu in our community at this time,”  opens in a new windowJain wrote in Feb. 3 guest column for The Daily Memphian.

But Jain didn’t dismiss the threat of coronavirus here.

The World Health Organization warned in 2007 that infectious diseases were emerging at a rate that had not been seen before.

Over the previous two decades, Jain had confronted SARS, MERS, Ebola, Zika, and the swine and bird flus.

He knew that newly discovered infectious diseases, especially those that emerged from human interference with animals, could be highly infectious, lethal and unpredictable.

Dr. Manoj Jain gets his COVID-19 vaccination at Baptist Memorial Hospital Dec. 17, 2020. (Patrick Lantrip/Daily Memphian file)

“With the coronavirus, we are watching the birth of a virus, and its journey through the human population,” Jain wrote. “Where it will end will depend not as much on the virus but on how well society and human hosts are able to contain it. Our window of opportunity is now.”

Jain noted that those who are asymptomatic still can transmit the coronavirus.

He reminded readers to wash their hands frequently, avoid touching their faces, cover their coughs and sneezes, and stay home if they felt ill.

“Social distancing is critical in stopping the spread of the virus,” he wrote. “And if you are in the same home consider a mask and keeping a distance from the infected person.”

By mid-February, Jain was more concerned about the coronavirus than the flu.

The county health department was monitoring 20 people who had recently returned from countries affected by COVID-19. None had symptoms and all were cleared.

“I worry with the COVID-19 we are in uncharted territory,”  opens in a new windowJain wrote in a Feb. 19 guest column for The Daily Memphian. “By clinical symptoms alone, doctors cannot tell if a patient is ill with the flu, common cold or COVID-19.”

He noted that coronavirus is more infectious than the flu, and “spreads among close contacts, those who are within 6 feet of an infected person.”

It’s also more lethal. The death rate from COVID-19,” he wrote, is 50 times greater than seasonal flu.

There still were no reported cases of local transmission in Memphis or any other U.S. city. But Jain urged local government and public health officials to start preparing.

“We need preparedness to act rapidly if a local transmission case or death from COVID-19 is identified,” he wrote. “The future disease course of the virus is unpredictable, and we still have a long journey ahead.”

When COVID hits Memphis

On Feb. 25, 2020, The Daily Memphian posted another opens in a new window guest column by Jain.

Jain noted the COVID-19 outbreaks in South Korea, Israel, Italy and Iran, and posed an ominous question: “What will be the scenario, if COVID-19 enters a U.S. city like Memphis?”

It starts, Jain wrote, with “the index case, the first patient in the community with the virus.” That person likely was infected in another city or country.

“The index case then spreads the virus to three others, and the virus caseload doubles every seven days, with one in three infected persons going to the doctor and one in 10 persons being hospitalized,” he wrote.

“By the time the first case is identified, the virus has been circulating in the community for over a month, and we are playing catch-up. We may only be able to identify through symptoms or tests half the cases that may be in the community.”

The first death will occur “a few weeks after the initial case is identified,” he wrote.

He counseled that “earlier, aggressive intervention can lead to control of the epidemic.

“We know that interventions such as quarantine and a ban on large gatherings can reduce transmission,” Jain wrote. “Closing of schools, and working from home allows for social distancing, reducing the spread of infection in large populations.

“And personal hygiene following the mnemonic WASH can reduce infection further: W for washing hands, A for avoiding touching face and surfaces, S for sneeze and cough covering, and H for home-rest when ill.”

He ended the Feb. 25 column with a plea: “We need to prepare for the worst and hope for the best”

Later that day, the Centers for Disease Control warned that coronavirus could cause “ opens in a new windowsevere disruptions” to everyday life in the United States.”

The next day, Feb. 26, Shelby County  opens in a new windowhealth officials held a press conference to reassure the public.

Hospitals were stocking protective gear, setting up screening protocols, putting masks on patients with flu-like symptoms, and increasing the number of negative-pressure rooms.

“I think the CDC yesterday kind of lit a fire when they said it’s not a matter of if, it’s a matter of when,” UTHSC’s McCullers said.

UTHSC, which has one of 14 regional biocontainment labs in the nation, had received live coronavirus for testing.

At the health department, Haushalter counseled calm. She said the CDC’s announcement didn’t significantly change the department’s preparation for coronavirus. It already had a plan to address public health threats.

“We had a measles outbreak several years ago,” Haushalter noted. “We contained that to seven cases of measles in our county and one in an adjacent county. That is a reflection of the ability of this community to mobilize quickly and to communicate and work together.”

India in Memphis

On Feb. 25 last year, the same day the CDC warned of “severe disruptions” due to COVID-19, India’s consul general came to Memphis.

Jain took Dr. Swati Kulkarni to City Hall to meet with Mayor Strickland.

“Good meeting today with @CGI_Atlanta Dr. Swati Vijay Kulkarni as we work to increase our economic and cultural ties with India,” Strickland tweeted that evening.

Kulkarni had been to Memphis the previous fall to help Jain and others in the Indian community celebrate the 150th anniversary of Gandhi’s birth.

They placed a garland before a bust of Gandhi at the National Civil Rights Museum, and dedicated two honorary “Gandhi Way” street signs nearby.

Strickland and Jain had met a decade earlier through a mutual friend, Jim Gilliland Sr. The Jains had the Stricklands over for dinner.

After the meeting with the Indian consul, Jain told Strickland to give him to call, if he needed any advice about the coronavirus. Strickland told him he would.

On March 6, Gov. Bill Lee announced the state’s first case of coronavirus — a 44-year-old Williamson County man who recently had traveled to Boston.

“Preparedness is critical, and I have full confidence in the preparedness plan we have put in place,” Lee said.

The state health department said the state’s lab had tested eight people for the virus and ha materials to test 85 more.

“The fact that it’s under 100 should give us concern that the health department is not treating this as a serious threat that requires extraordinary measures now; not when the illness has spread,” state Rep. Mike Stewart (D-Nashville) told reporters.

Later that day, a lab director at Baptist Hospital drove a COVID-19 test sample from a Shelby County resident to the state health department’s lab in Nashville.

Meanwhile, Jeff Warren was returning from a meeting of the National League of Cities in Washington. At the conference, he sat next to a councilwoman from California, a physician who kept coughing as a CDC official briefed the audience on the coronavirus threat. Warren didn’t have a mask, so he got up and moved.

After the meeting, Warren learned that at least a dozen participants had COVID-19. “As soon as I got home and got back to work, I thought, man, we all ought to be wearing masks,” he said.

He told Strickland. He also suggested that the city needed the advise of an infectious disease expert like Jain.

A little after 10 a.m. on March 10, two days after Shelby County announced its first case of COVID-19, Mayor Strickland texted Jain.

“Can you come to City Hall today to advise us on Covid?” Strickland texted.

From doctor to adviser

The city doesn’t have its own health department. The Shelby County Health Department reports to County Mayor Lee Harris.

On March 10, Jain met for two hours with the mayor and members of his executive team, including Chief of Staff Doug McGowan, Police Director Michael Rawlings, and Fire Director Gina Sweat.

Jain gave the group a slideshow tutorial. He called it “Coronavirus Response – Memphis.”

In a series of charts and graphs, Jain showed how coronavirus could be more infectious than polio and more lethal than the flu, the opioid epidemic, car accidents, and gun violence.

He explained how the virus can remain viable on various surfaces, and how social distancing and masking can greatly reduce transmission.

Infections Disease expert Manoj Jain (right) talks with Tennessee Governor Bill Lee during a visit to the Christ Community COVID-19 testing site in Frayser on April 25, 2020 as hundreds of Memphians line up to be tested. For the first time, testing is being made available to residents not showing symptoms of the disease. (Jim Weber/Daily Memphian file)

Then he offered some sobering estimates on the number of COVID-19 cases and deaths the Memphis area could suffer in the coming 12 months.

The number of cases could range from 13,000 to 189,000 to 400,000, and about five percent of the cases would require intensive care.

The number of deaths could range from 68 to 1,900 to 8,000 — depending on how aggressively the city responded to the virus.

Jain presented the Power Point again on Friday to City Council members and dozens of other city officials.

The next day, March 14, Strickland hired Jain to become the city’s medical adviser.

The city uses  opens in a new windowCARES Act funding to pay Jain $125 an hour. Over the past year, he’s been paid $191,625.

On March 17, the day Shelby County Mayor Lee Harris returned three days early from a Memphis in May trip to Ghana, Strickland declared a state of emergency.

“The mayor is being driven largely by science and data and expert information to make these decisions,” city attorney Jennifer Sink told reporters.

On March 19, Jain and Warren presented the Power Point to Harris. They all wore masks. 

On March 23, Strickland issued the “ opens in a new windowSafer at Home” order. The number of confirmed COVID-19 confirmed cases passed 100 and were rising fast.

On March 26, the health department reported the county’s first COVID-19 death.

Nearly a year later, Jain’s mid-range estimates have proven correct. Shelby County has identified about 90,000 cases COVID-19 and about 1,500 related deaths.

“Hiring Dr. Jain was one of the best decisions I’ve made during the pandemic,” Strickland said. “His medical and scientific advise have been instrumental in just about everything we’ve done, from ‘Safer at Home’ to asymptomatic testing to preparing for the holiday surge and the vaccine. And he’s always thinking ahead. Over the past month, while everyone else has been focused on the vaccine, he’s been focused on how to identify and respond to the virus variants.”

Jain is concerned about the COVID-19 variants, especially the UK variant, which could become the dominant one in Memphis.

“It has the same potential to spread that Covid did a year ago,” Jain said. “But we have more tools now, and greater knowledge and public health buy-in from people. Testing and tracing and continued diligence will be key.”

‘Going that last mile’

Meditation is a core spiritual practice in Jainism. It’s as medicinal as it is spiritual.

A recent study found that “individuals who practiced meditation after their flu vaccine had stronger antibody response compared to those who did not do the relaxation technique,”  opens in a new windowJain wrote in The Commercial Appeal in January. “Good diet, exercise, sleep and relaxation are all critical to a strong immune response both to fighting the virus infection as well as to getting a good antibody and T cell booster from the vaccine.”

That regimen has been a challenge for Jain over the past year.

Dr. Manoj Jain in his home on Wednesday, March 3, 2021, has had a lead role in advising the city’s response to the pandemic over the past year. (Mark Weber/The Daily Memphian)

He’s normally up by 5:30 a.m., making notes, reading, and preparing for whatever meetings he has that day with the mayors, city council or county commission, and various pandemic-related task forces.

He spends most evenings checking on a dozen patients via Telemed, and a half dozen others in the COVID-19 monoclonal infusion clinic he developed with Baptist. He’s on call every fourth weekend. By the time he’s finished making his rounds, and talking or texting with medical colleagues or local officials, it’s 11:30 p.m.

“My God, do you have any idea how many hours he puts in to this every day?” Warren said. “He’s got two full-time pandemic jobs — treating patients and advising the city. He’s kept us at the forefront of the science on this.”

Jain admits to being a workaholic and a bit of a control freak.

“Sunita often reminds me that I’m just an adviser, not a decider,” Jain said. “I know it’s not all on my shoulders, but I feel very privileged to be in this position, and I have a responsibility. I can’t fail.”

Jain still feels he has failed at times.

When COVID-19 cases surged, he couldn’t persuade the health department to accept help with contact tracing from the city, from hospitals, or from him.

He couldn’t persuade hospitals or nursing homes or Shelby County Schools to test all of their employees regularly.

He couldn’t persuade enough people to distance and mask soon enough, and then wrongly assumed people would continue to mask and distance after the first wave of cases.

“My failure was not being able to convince people, as hard as I tried,” he said.

He came up with ideas that didn’t work, such a social distancing app that would show users which “hot spots” to avoid.

He got frustrated by the jurisdictional battles among various levels of government, and how so many people politicized the virus.

“He’s adamant and some people are put off by that,” Warren said. “But he’s really just laying out the facts. If you do X, this will happen or this won’t happen.”

Mostly, he has been stressed by the stealth, speed, and stamina of the virus itself. Dozens of his fellow health care workers and a dozen extended family members became ill with COVID-19, including his 76-year-old uncle, who died last September in India.

“Every time you think this is going to get easier, there’s another bombshell,” Jain said. “Every day, every hour, there’s a new problem and new information. I’m always fearful that I’ll make a misstep or give the wrong advice.”

Colleagues say Jain can be too hard on himself.

“The only weak spot he has is that he is not a virologist, so his understanding of the science is based on an epidemiologic view, which does not always lead to perfect answers,” McCullers said. “But he’s dogged in his pursuit of data and opinions both through reading as new science is published and discussing with friends and colleagues constantly. I give up on certain things that just seem unsurmountable, but he has not given up on anything.”

Jain says giving up is not an option for him or anyone. He spent a lot of time last week talking to local officials about the coronavirus variants and the need to remain vigilant.

He’s concerned but cautiously optimistic. 

“With the vaccines and with more active testing and tracing for the variants, I can see us moving in the next three to six months from community transmission down to clusters and then down to seeding,” he said.

“We just have to sacrifice a little longer, but our resilience and our endurance will take us that last mile. We’ll get to a place where getting a coronavirus vaccine will be so routine, it won’t even be in the news.”

This story first appeared at dailymemphian.com under an exclusive use agreement with The Institute. Photos reprinted with permission of The Daily Memphian.

David Waters
Written By

David Waters is Distinguished Journalist in Residence and assistant director of the Institute for Public Service Reporting at the University of Memphis.

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