Rupal Ramesh Shah has a Master of Science degree in microbiology from Clemson University and a Master of Public Health degree from Boston University. She is a global health professional with experiences in South Africa, Tanzania and Haiti. She shares her thoughts on the current pandemic, specifically differing perspectives and circumstances and the behaviors they produce:

“Do not waste water. Don’t use too much water when you take a bath.” These are the phrases I remember growing up to as a child in a rural town in Kilimanjaro, Tanzania. My father continually reminded us that not everyone in our country had access to clean drinking water. In addition to dad’s reminders, we regularly saw mom boiling and filtering the tap water to sterilize it and the housekeeper storing buckets of water in case of a shortage.
According to the World Health Organization (WHO), approximately 1.8 billion people use drinking water from a contaminated source, and approximately 159 million people collect drinking water from surface water sources. Out of those people, 58 percent live in sub-Saharan Africa.
When my family moved to the U.S., access to water changed. In the U.S., tap water is clean and mostly drinkable. We have never experienced a water shortage.
As we go through life, the choices we make are based on our perspective of what is going on in our environment and in our world at that time. In Tanzania, I consciously conserved water because it was scarce. In the U.S., not so much because we live under different circumstances where we never experience issues related to water accessibility.
As of early June 2020, the pandemic has disproportionately affected New York with over 350,000 positive cases and close to 30,000 deaths due to COVID-19. The next hard-hit states are New Jersey, Massachusetts and Pennsylvania. As a result of the high transmission, states such as New York, New Jersey, Pennsylvania and Maryland have a mandatory requirement to wear a face mask when out in public. On the other hand, since May, states like South Carolina have had a lower number of cases, with over 12,000 positive cases and 500 deaths. Neighboring states, like Alabama, Kentucky, North Carolina and Tennessee, have also had lower transmission rates, except for Georgia with over 2,000 deaths.
Therefore, such states require working employees to wear cloth masks but not residents, although it is strongly recommended. The laws differ from state to state as governors decide what is best for their state residents based on the circumstances in their state.
Unlike countries, such as China and India, in which the governments imposed strict lockdowns that included shutting down the public transportation systems, the U.S.’s approach has been to provide recommendations at the federal level and allow state governors to make decisions regarding their respective states. As a result, each state has had the autonomy to develop regulations regarding the usage of masks and levels of shutdowns. It is a blessing to live in a country where essential services, such as public transportation, waste collection and mail deliveries, are still functional. However, the lack of coordinated effort throughout the country is evident right now, as there is widespread debate on whether states should lift the stay-at-home orders.
Currently, state governors are issuing various guidelines on the stay-at-home orders. According to a piece published by The New York Times, some states, such as New York, New Jersey, Massachusetts and Maryland, are still enforcing stay-at-home regulations. Other states, such as South Carolina, Georgia, Tennessee and Alabama, have eased the restrictions allowing some businesses, state parks and beaches to open. The country is going through debates on whether states should ease the restrictions or not. Some media sources have stated that the differences in regulations are reflective of the divide between states that are predominantly Democratic or Republican.
While there could be patterns that support that, I want to offer a different explanation. Most who live in New York and New Jersey are likely to know someone who has tested positive. As the states have issued strict guidelines to have mandatory face masks, the effects of the pandemic seem that much more close and real. In contrast, states like South Carolina have not had high transmission rates nor death; hence the effects of the pandemic are not felt as heavily.

Many residents have raised concerns regarding the economy and, more importantly, their livelihoods. According to the U.S. Bureau of Labor Statistics, more than 33 million people are unemployed, at a rate of 20.6 percent, making it the highest since 1934. As a result, states all over the country, from Alabama to Michigan to California to South Carolina, have observed an increased number of protests from citizens who want freedom over fear. The residents are demanding the country to re-open so that they can go back to work. Again, it is all about perspectives and circumstances. Those who are unemployed feel the effects of losing wages and sustaining livelihoods. The reality for that group of people is the lack of income, and hence, there is a strong push to return to the workplace.
At a time like this, I am reminded of what I practiced as a child in Tanzania and how my behavior changed when I migrated to the U.S. My perspective of water accessibility in Tanzania versus the U.S. is different based on what I observed in my environment. However, it does not change the fact that the data still indicates that water is scarce in Tanzania and other low- and middle-income countries. Based on the data, I can choose how to utilize and/or conserve water.
The reality for each group of people, in each state of the U.S., is different based on personal circumstances. I hope we can cultivate empathy because everyone has different perspectives due to their personal circumstances. This is an unprecedented time with many uncertainties about the disease. There are ongoing changes as we learn more and adapt accordingly. While some people are staying indoors to take care of loved ones affected by the disease, others must work to maintain livelihoods.
With that in mind, we can all continue to do our part, as best as we can, during this time.