The More Things Change, the More They Stay the Same

Dancing in the Streets?

“Calling out around the world

Are you ready for a brand new beat?

Summer’s here and the time is right

For dancing in the street”

-Martha and the Vandellas (1964)

Without pointing fingers or name dropping, there are clearly different camps on this one when you listen to politicians and the media.  So, to quote Michael Buffer, “Let’s Get Ready to Rumble.”  In the blue corner, donned in the impermeable space suit with donkey logos we hear that cases of COVID are at record numbers and that this is the fault of our federal government and imbecilic behavior of the citizens of certain states or constituents that are not in favor of complete lock down.  In the red corner, licking the top turnbuckle donned in swimming trunks with an elephant logo we hear that COVID has been conquered and all is well in the land.  So which camp has the right answer?  Shockingly (insert favorite eye-rolling emoji here), neither of them.  That being said both camps have some valid points.  And for the most part, both camps are led by people who are elected public servants for the genuine purpose of leading us through thick and thin.  Our society seems to thrive though on making them have to choose different viewpoints.  Could we not just stick to watching boxing and MMA?

Without further ado, let’s go through some of the details of where we currently stand in this pandemic; what is known, what is speculated, what is near term realistic, and what is the type of dream that only Willy Wonka could bring to fruition.  Anyone want a snozzberry?

Are things getting better or worse here in the United States?

This is the multi-trillion dollar question.  This is also not quite easy to answer, because it depends on how you frame the question.  Based on number of confirmed cases, the number is indeed increasing at a higher rate again.  Every day, as we heard a few months back, there are “record” numbers of COVID diagnosed.  However, we are also now able to test a lot of folks that were not being tested previously.  By extension of Rule #10 of the House of God: “If you don’t take a temperature, you can’t find a fever.”  The record numbers of COVID cases are in part because we are looking for it.  And this is not suggesting to not test people, just you need to properly interpret the data you gather from doing so.

If you instead base the answer on the death rate, you get a somewhat better, though not satisfactory answer.  In this case, what you see in the US is a gradual decrease in deaths on a weekly basis since the beginning of May.  That is, of course, until this week, though the difference from the prior week is a small increase.  This manner of viewing the issue does not account for is how many folks were quite ill, but saved due to improvements in care of patients with COVID.

Suffice it to say, there are some clear points to take home from the actual data:

  1. There are a lot of people with COVID and a lot of people they will continue to infect
  2. There are still a significant number of deaths from COVID
  3. Social distancing almost certainly lowered the number of deaths from COVID….to this point

How is this going to end?

As has been stated in prior posts, there are a limited number of ways this pandemic ends.  As a refresher, they are as follows:

  1. So many people get it and develop immunity that it can no longer circulate (herd immunity).
  2. We successfully develop a vaccine and vaccinate the population
  3. We successfully develop a medication regimen that can effectively treat those that contract COVID
  4. We literally lock every individual in their home for three weeks to ensure that no further spread could occur.  This is listed for completeness, but clearly not even a remotely viable ending.

When is this going to end?

This depends on the paths we choose.  One strategy is to maintain complete social distancing as we had been doing until recently.  The weekly death rate will appear low.  This strategy works great if there is some cure or preventative measure coming down the road in the short term.  If we fail to cure or prevent the disease in the short term, the overall deaths will be the same as if we did not distance, but with the added bonus of destroying ourselves psychologically and financially over the course of a couple of years.

Another strategy is to go back to business as usual.  We will see record numbers of cases.  We will see lots of deaths in a short period of time.  Then one would expect we would generate herd immunity and this would be over in a period of months.

The last strategy is one that was implemented in “Get Him to the Greek” at the behest of Sergio (Sean Combs) where Aaron Green (Jonah Hill) was advised to keep Aldous Snow (Russell Brand) inebriated to a degree without going overboard in order to get him to the Greek Theatre for his anniversary performance.  In COVID speak it means permitting folks to go about their business while ensuring we do not overwhelm the hospital system.  Remember all the talk about “Flattening the Curve?”  This, and the hokey pokey, are what it’s all about.

When are we getting a vaccine?

When are the Rangers going to win another Stanley Cup? Could be a few months.  Hopefully, sometime in my lifetime.   Seriously though, there are many candidates being tested.  If we are extremely lucky, 2021 may bring with it a vaccine that is effective.  Realistically, making an effective vaccine is not that easy and usually takes several years.  On the bright side, they have been working on developing coronavirus vaccines in humans since SARS a decade ago and in livestock for even longer so they are not starting from scratch.

When are we getting a cure?

When are the Islanders going to win another Stanley Cup?  Could be a few months.  Hopefully not sometime in my lifetime.  Hydroxychloroquine….not a cure for COVID.  Medical management has improved the outcomes with COVID patients including decreasing use of ventilators, differing positions of those with respiratory issues, use of steroids to lessen the inflammatory reactions that increase disease severity.  There are some candidate drugs in early phases of testing being published in some of the basic science journals.  One such publication in the journal “Science” last week documented a couple of candidate compounds that appear to have low toxicity in animal studies and are effective at targeting a protease (enzyme) that is necessary for viral replication.  As with vaccines, this could be something that becomes reality in the next several months.  Or several years….

What should I do?

Nothing significantly different than we have advised all along.  Continue to go out of your way not to expose your elderly and high-risk family, friends, or enemies to COVID.  This is not The Purge.  Do not be hanging out in large groups.  Wear a damn mask when you are around folks outside your home.  Yes, that should include our Commander in Chief.  And not with your nose sticking out above the top.  Or dangling from your ear. Yes, I am calling out the other individual running for the highest office in the land too.  Lastly, if you are not feeling well, quarantine yourself.

I don’t feel well, should I get tested?

For what?  For the medicine we don’t have to cure you?  If not severely ill, stay home and don’t spread your cooties to others.  There are false negatives with testing, and to assume you are not spreading COVID because of a negative swab is a dangerous assumption.  That being said, if you are ill and have questions, start by placing a call to your physician and ask for advice.  Not every illness is COVID and there are no blanket recommendations for care as a result.

Is there going to be school in September?

You will know in the middle of August.  If there is going to be a big spike due to relaxation of social distancing measures that is likely when you will see it.  Fingers crossed.

Can I now go enjoy my weekend?

Yes.  Hoping the weekend long thunderstorm prediction is “Fake News.”  Again, all kidding aside, this is about living your life and minimizing the risks to yourself and others.  We can do a lot in this world without high risk.  Did I mention to wear a mask when you are out and about?