Interview with Hiram C: Let your grief fuel the revolution

On August 27, 2023 William Silversmith (he/him) interviewed Hiram F. Caraballo (he/him), a 27 year-old Afro-Latino grad student at CUNY studying Public Policy who acquired Long COVID while experiencing the acute pandemic crisis in New York City. At the time, Hiram was a member of the Queens Democratic Socialists of America and is now a member of the Revolutionary Communists of America. He would later join the SCORE Steering Committee for the 2024-2025 term.

Will S.: Tell me a little bit about yourself.

Hiram C.: My name is Hiram F. Caraballo. I'm a 27-year-old graduate student at CUNY studying public policy and thinking about concentrating in political theory or international relations. I'm Puerto Rican / Afro-Latino and am involved with the Queens branch of NYC DSA. I've had COVID-19 three times and have Long COVID and have some opinions about that.

Will S.: How did you experience the early pandemic? How did you catch COVID-19 the first time?

Hiram C.: I was doing a double major at Hunter College in biology and political science. I was working at a ramen restaurant while also doing cancer research. The research was in early-onset colorectal cancer, the same kind of cancer that killed Chadwick Boseman. I was trying to set myself up for medical school; my life (and GPA) was on an upward trend. Then COVID happened and life turned upside down.

The second or third week of March 2020, I contracted COVID via my mother. She worked in the Bronx Supreme Court as an Spanish-English interpreter. This was early on, and for some reason, [the NYC/NYS Govt] didn't shut down yet. People were reporting to work with fevers and were visibly sick. There were no preventative measures, masking guidelines, etc. So when the court shut down later in March, she had already contracted COVID and brought it to a home of four.

We lived in a one-bedroom apartment in the Bronx where I shared a room with my sister. Mom and dad slept in the living room. I did my best to isolate myself from everyone else as best I could in a one-bedroom apartment. I spent my time playing League of Legends in the kitchen. I felt... confused, like I was in a fugue state. I had a temperature of 103 to 104 degrees Fahrenheit. This was early on, so there were no tests or anything but, yup, I had COVID.

I had a biomedical background and thought it might be a good idea to sweat it out, so I put on a lot of blankets and layers. At night, I wrapped a T-shirt around my face to try to protect my sister since I had to sleep in the same room as her. I don't think she caught it, it was just my mother and myself that did. When the armed forces [ed. national guard] finally set up drive-thru PCR testing locations [ed. Polymerase Chain Reaction, a technique that is used to test for viral genetic material], I tested positive a few weeks after my symptoms. [ed. PCR is very sensitive and can detect the genetic material of inactivated virus while it's being cleared from your system for weeks after.]

During my initial symptomatic phase, I had a fever day one and malaise. I was on a strict keto diet during and prior to COVID. My first month post-infection I had some noticeable changes in emotional regulation, and my heart felt like it had been scraped through broken glass. It was a fleeting feeling, but a terrifying feeling. That particular sensation only happened once, but after that I knew that shit was different.

Obviously, I had a lot of COVID anxiety afterward. This thing was still mutating and people had failed to shut this down. I wasn't going outside.

Will S: That is a very scary sensation. I hope your heart is okay! Did you have other issues stemming from your first infection?

Hiram C.: Physical activity can be a trigger for Post-Exertional Malaise (PEM). My memory is shit, I'm gonna talk about that a lot. After the first infection, I wanna say I returned to a baseline of health. I felt a bit different, my memory was different.

When I got back to the cancer lab, I felt like I had forgotten everything I learned. The relearning process I could tell was going to be... I felt like I completely blanked on basic things like a Western Blot. It was kind of a gentle wake up call like maybe I couldn't do this anymore.

Personally I wasn't too sad about this because I wasn't that happy with my job in the lab. My theory is that because I was working on someone else's research, I just wasn't as into it. I did have my own idea I wanted to look into—that microplastics are a driver of gut dysbiosis. The good flora and the not-so-good flora get out of balance... microplastics are inflammatory. I was thinking that maybe they could be a link to cancer in young people. Anyway, I kinda ghosted the program. My interest was gone.

Will S.: I'm really sorry to hear that. I wrote an article about cognitive effects from Long COVID and knew that it was making it harder for people to do their jobs, but I hadn't met someone so young who (in part) quit their science job over it up to this point (though I can't say I've met as many people as I usually would the past few years either). Was there anything you were doing to try to improve your symptoms?

Hiram C.: I was keeping up with a lot of pre-prints [ed. science manuscripts posted to the internet prior to being published with peer-review] on COVID research. I was on the r/covid19 subreddit and it was all pre-prints. All the freshest research.

I knew that my life was gonna be different. I was kinda fucked. I had some knowledge to read the papers and understand the gravity of the situation. I'm not taking this sitting down. I'm looking for ways to improve heart health, neurogenesis, circulatory issues, and anti-inflammatories. I found some pretty decent success with supplements.

Will S.: What else can you remember about your experiences in 2020?

Hiram C.: I lived near Jacobi Medical Center in the Bronx. I remember the ambulances speeding past. During the day you would hear them very loudly. At some point, the sirens were off but you could hear the vans racing down the street. It was extremely dystopian. You can't make this shit up. This is real life.

In the fall of 2020, I got a job at Pandemic Response Lab (PRL). They had a lot of business with the city because of what they could do at the time. COVID was mutating. It was a hazardous job. The company used automated pipetting [ed. drawing fluid precisely and transferring it to another vessel using a "pipette" tool]. They were doing sequencing.

My job title was Accessioner. I was doing the bottom rung work. Companies would send test samples, and I would log it into the system matching patients with samples and note if there were any reasons the test would be inconclusive. The most physically strenuous thing I did was decapping samples. We would inactivate the virus with heat in ovens. The whole stick point for the business was they could do PCR turnaround in 24 hours due to their proprietary automated machinery. We might have done millions of samples. This was all pre-vaccine.

That was where I decided to leave the biology field, the medical field. I put it down. I couldn't fathom trying to get through to people that deny science; plus the rigor involved for med school... my memory, I just couldn't hack it anymore. I'm still interested, still reading papers, but couldn't see myself in a professional setting... I got laid off because the initial vaccine [ed. many testing requirements were relaxed as the vaccine was delivered, in addition to lower case counts from the effectiveness of the vaccine on the virus at that point] caused the volume of test samples to fall from thousands to hundreds per shift. I worked the overnight shift. Around this time, Winter 2020 or Spring 2021, Mt. Sinai opened a Long COVID clinic. They had their core clinic in Union Square.They gave me a formal diagnosis of dysautonomia. I understand it as a dysregulation of the autonomic nervous system.

The autonomic nervous system performs those functions you do involuntarily: breathing, digestion, erections, things of that nature. They always say don't Google shit, but I had a bad evening. So I looked it up, and saw there was a type of dysautonomia that has a life expectancy of less than 5 years, but I don't think I have that one. At least I hope. After a few panicked messages to my physicians it was more likely to be POTS (Postural Orthostatic Tachycardia Syndrome). My cardiologist said that it's probably that one. 

It feels like a die roll on my life. Am I gonna live until 99 or am I gonna live till 30? [I felt] ready to explode. That's why I decided to go to school for Public Policy/Political Science. I wanted to study why this happened and who/what is to blame for this failure. I began to read The Social Contract and Discourses by Jean-Jacques Rousseau on my breaks at work. It was a book from the 18th century that contributed to the French Revolution. I don't think Marx is the be-all-and-end-all of socialism and communism. I think modern leftists are lost and unguided. 

I was searching for Marx's influences and began to look into proto-socialists. Rousseau was a key inspirational figure for what eventually became the American Revolution with his political theory work. It took me a while to read it since it was Olde English, 1700s and 1800s English. I couldn't take my job anymore and applied to grad school.

So, my second infection. When I got my second infection, it was definitely the Omicron variant. That spread like wildfire through my job in 2021, which is where I think I caught it. I always felt a little insecure eating my meals and the policies around masking were still unclear.

COVID [cases started to increase again] after that summer and I was talking to HR to try and return to work and they gave me an opportunity to work the day shift. I was appreciative of that. I enjoyed the people I worked with.

As Omicron spread, the volume was colossal. We moved to another location and the company was pulling folks from all parts of the company. It felt like what I imagined WW2 factory production looked like for a week or two. Then [the workers] became vectors and brought COVID around. We were still wearing cloth masks at the time. We were not wearing N95s. 

It was bad. Around that time, my mother passed away. I requested an autopsy. I'm pretty sure she passed away from complications of Long COVID, and that was radicalizing beyond anything else. I took that shit personally. Through sheer international incompetence, the people in power contributed to the death of my mother.

The day my mom died, I remember I was looking up bikes because mine was recently stolen and that was how I was commuting to work. My partner at the time came to get me with the car filled with my two best friends. My sister, who still lived at home, was updating me with traumatic phone calls and facetime videos. They were all trying to call me, but in the lab you don’t really have access to your phone (it's a hazard and also unsanitary). In preparing myself for medical school, I understood the importance of a healthy bedside manner because death is common in that line of work. I prepared by reading Being Mortal and When Breath Becomes Air. Nothing can really prepare you for this kind of loss.

It was heartbreaking. I couldn't have a final conversation with my mom. Me and my mom left off on a sour note. When I went to see my mom, she was already in a body bag. I don't think it was intentional, but these [callous medical staff] just lack compassion. My family was very distraught. The autopsy report came back. It was a DVT that caused a pulmonary embolism. I have the report. That did it for me. I handled the funeral. I did everything in a week. Working with the funeral industry really shows how every single thing is a racket under capitalism.

Will S.: Was your mother sick for a long time or was it sudden?

Hiram C.: It was extremely sudden. From my father and sister, I learned she had gotten up and then collapsed. She hit her head. My dad panicked and worried she was already dead from how she had hit her head. That seems in line with the reports of how people were just dropping in the streets in China. I think that's what happened to my mother. I can't confirm if she caught it a second time or if she had Long COVID. She was very stoic, very religious. She was here one minute, gone the next, and my life hasn't been the same since. 

The passing of my mom radicalized me. There is only revolution. I cannot exist in capitalism. I'm fortunate in the sense that I am still able to be physical. I push, I push hard. If I die, I'm gonna die doing the things that I enjoy. I try to embody memento mori–remember you will die in Latin.

With that sentiment in mind, I personally will never let the loss of my mom go. I don't even know how to start grieving. Capitalism killed my mom. The government didn't keep us safe because they put the economy ahead of human lives. The safety/security measures were non-existent beyond social distancing. The government has passively pushed repeat infections and it's been The Hunger Games for everyone ever since.

Editor: Thank you for reading Part 1 of our interview with Comrade Hiram. Part 2, which was a separate interview conducted on September 4, 2023, addresses the experience of grief, how to care for yourself when you’ve been abandoned by the state, and taking action against the barbarity of forever-COVID under capitalism.

Hiram C.: My third bout with COVID was after hanging with some friends at a local bar. I was out and about. I wasn't taking precautions after thinking the vaccine was all I needed to protect me from COVID. I drank the kool-aid thinking everything was okay if you just got vaccinated, and that's on me. I got vaccinated and boosted and I even thought I had a mild infection.

My [long COVID] symptoms came roughly after that event. After I tested positive on a rapid test, I trusted the test, but I went to find out about the antiviral Paxlovid. Paxlovid is two antivirals [ed. Paxlovid's formulation is Ritonavir boosted Nirmetralvir], one of which is a popular treatment for HIV patients. To get that, I called my pharmacy because I assumed it would just be available to people who tested positive. To get it, I was told that I needed to get a formal PCR diagnosis which required me to go out and expose other people. I masked of course, but this was before the N95 upgrade I made. So, I went to my urgent care clinic and got a PCR test done. I had to advocate for myself to receive Paxlovid because I wasn't in the right demographic to get it. This leads me to contemplate the dangers of structural racism within the medical profession, and how that continues to impact BIPOC folks who just want to reduce the severity of the disease with these drugs.

I had to tell them I had COVID twice before and currently suffer from long COVID and I wanted Paxlovid. I saw a nurse practitioner. She was saying it can cause long term damage, and I said I can't imagine it doing more than COVID. Because of the lack of thought in this society, I had to go out three different instances in the same day to get a diagnosis and to get antiviral medication. This just needlessly exposes other people, why isn't it just delivered to your door? [ed. New York City did partner with an online pharmacy in 2022 to deliver Paxlovid door-to-door, but many people were not informed about this program.] 

I guess I wanna say I didn't feel the third infection too much. The antivirals worked. I [rested], and followed the 5 days of quarantine. The infection, mentally, felt mania-inducing. The first 24-48 hours felt like a massive manic rush. It was really weird. It almost felt like I wanted to spread the virus because of the mania. Like I just wanted to be outside, but I rationally knew that wasn't a good thing to do. I felt like I was hijacked almost. I felt... I don't wanna say energized, but very electric. I just stayed home and chatted with people. I don't know if it was just me having a panic attack and I had negative experiences in the past. That was similar to the second time I got it. We know COVID affects the brain. We don't know how. That's definitely an avenue of future research.

In terms of what I feel in terms of Long COVID, I feel a level of heat intolerance, and intermittent chest pain. In the hot and humid MTA subway stations, I sweat profusely and I sometimes get chest pains. It's been really humid in NYC and the subway stations. I continue to have brain fog and I have issues with memory recall. For example, some of my friends will say I said something and I just cannot remember and reject that I said it at all. In my grad program, I do a lot of highlighting and annotations and rereading of material.

In my experience, [during my] second and third infections, society forces you to expose people. It might make more sense for people to be able to self-report positives and get the care they need sent to their door. That would substantially reduce incidences of exposure. There is a lack of political will among any competent governmental body in America. Some Asian governments have probably done stuff like that.

Will S.: Why do you think that is?

Hiram C.: Capitalism. You and I know it's capitalism. There's no monetary incentive to provide this care to people on an individual level despite people getting LC we're essentially disabled, and it's a [huge monetary] loss in the economy. Because there's no monetary incentive, every person is left to their own devices in a Hunger Games like scenario. May the odds be ever in your favor.

Will S.: What is your experience of the Trump and Biden response and how will it go in the future?

Hiram C.: The first phase of the pandemic was in the election season, 2020-2021, Trump presidency. You and I know there was a plot to hurt and disable people in Democratic regions. There was an anti-science approach coming out of the CDC. I think if there was an immediate response in terms of masking that could have mitigated countless deaths. We wouldn't have this polarization around basic hygiene. We share the air. If someone is sick, then that air is compromised [ed. There is strong evidence that SARS-CoV-1, the virus that caused the SARS pandemic in 2002, was airborne. With that knowledge, it is strange that COVID-19, which is very similar to SARS, was not treated as airborne when it was discovered]. The Trump admin could have explored ways to improve ventilation in public schools and buildings. Could have provided capital to business owners to refine their air spaces and private venues. That could have helped mitigate this.

[ed.: The vaccine was paid for by the federal government in Operation Warp Speed and was offered for free until the end of the PHE.]

Biden, I wanna say he made the rollout of vaccines as smooth as possible. I don't wanna say disinformation, but lack of will to provide a concise message and platform for COVID prevention. The desire to minimize this pandemic has been substantial in the Biden administration. There should be more funding to make sure we have accurate rapid tests, sequencing of variants, and a more coherent plan as it continues to mutate.

Will S.: I just want to push back a little on the relative differences between Mr. Biden and Mr. Trump. I'll try to put this as factually and neutrally as possible and I want to get your take. Under the Trump administration, 450,000 people died in America from COVID-19 while under the Biden administration, over 700,000 people have died officially. What do you think of that?

Hiram C.: Under Trump we had substantial shelter in place orders. Up until Omicron, people were forced to quarantine for a week at a time. Trump had some level of quarantine procedures, and Biden has done without it. Biden's return to work policy–there's an air of [dismissal from] the Biden administration. I know some people who have tested positive and still go to work because they have no other choice.

There's a conflict on the individual level between protecting one's self and being a contributor to capitalist society and society as we know it. Each individual is engaging in this internal struggle around the pandemic 

The pandemic protocol should have been normalized. The core issue I find is that shelter-in-place would be a big damper on the economy. That's the rhetoric they're using. That's why they went from 14 days of isolation to 5 days. Based on the info you shared that people can transmit 14 to 21 days after an infection, 5 days isn't enough. There's a lack of a coherent response.

Will S.: Tell me about your experiences in DSA. What should DSA be doing?

Hiram C.: I think that with respect to the pandemic, I can't recall if... I think it was your proposal, about ventilation, masking. You were with the Disability Working Group (DWG) right?

Will S.: Yes, I was with DWG and we introduced the DSA Organizing for Pandemic Justice resolution to the 2023 DSA National Convention. However, this resolution was not debated.

Hiram C.: Wow... these people fuckin' suck. Wow.

There's a lot to critique actually. First and foremost, if this org is to be considered legitimate in terms of political power, they should try to be... the vanguard. They should not be following official guidelines and should be doing their own research.

You provided a proposal about ventilation and N95 masks. They should be running counter to the political establishment. I think that this is common sense for this airborne pandemic protocol that we're experiencing. The three simplest ways to mitigate an airborne virus are N95 respirators, HEPA filtration and HVAC upgrades, and online accessibility. This way, from the comfort of their homes, comrades can engage. It is kinda disappointing.

I mentioned some level of COVID caution and brought it up at a recent DSA meeting on social strategy or something. I was one of only two people wearing an N95 in this musty-ass NYC DSA meeting. No filters. Bad air.

I said we should have N95s and filters in this space. I don't think it got a response.

Will S.: Just to be clear, they did have filters there, but they weren't on?

Hiram C.: I saw a makeshift filter attached to a fan, like a DIY filter, but it wasn't on. I hope that more people share their Long COVID experiences and are protected in the spaces they wish to engage in.

In fact, I feel that if DSA wanted to, they could facilitate these conversations because it's clear that the two major political parties do not care about the safety of Americans.

Will S.: Is there any way you think DSA should be politicizing this issue?

Hiram C.: This is a complex question because DSA is not a separate entity to the Democratic party. I feel that they subscribe to the democratic party. I feel that the democratic party is not paying any mind to COVID or Long COVID. There haven't been any revisions in safety precautions so the DSA will struggle with politicizing it because they are so attached to the Democratic party. Masking has become politically charged, paired with a real lack of consensus. You can argue that masking is an act of solidarity because you protect anyone in your vicinity. I feel that this rhetoric can be applied to any airborne illness or pathogen. My case would be a cautionary tale for people who haven't gotten COVID.

I think as people get COVID-19 and get disabled, they will be increasingly radicalized because they will no longer be able to engage in society as we know it today. I think because of this, that the DSA should develop a type of pandemic platform to greet members with this affliction with compassion. Obviously, I want to extend that to other people that are disabled. This is more a pandemic response / disability platform for the differently abled.

I think this is on the table, it's political savviness. This is a group that's constantly going to move away from the fringe as more and more people get affected and substantial resources should be available so people know there is a community.

Will S.: Thank you Hiram, it was great talking to you!