HERE'S TO YOUR HEALTH: Lessons learned from our 2+ years of a pandemic
When I was in the Navy, if an incident/accident/challenge occurred, we would have a “debrief” afterward, to study what went well, and what did not.
So now, having been both an observer and an active participant in one of the more trying episodes of US history, what can be learned from this experience?
Although we are not “done” with Covid, we have seen several iterations of the disease, albeit with varying mutations and varying degrees of severity and infectivity. I'll look at various parts of our response, including initial response, prevention, and treatment.
We started, as in most epidemics, with a fear of the unknown, and a typical over-response that was a bit of a “one size fits all.” Before the first case ever made it to Yates County, we had shut down churches and indoor gatherings. This is certainly forgivable when you don't know what you are dealing with. Add to that the horrors of what was happening in New York City, and no one wanted to make a false step that could bring New York City's outbreak here. The deaths that occurred in the Bath Nursing Home further helped drive home the point.
Next, came masking and social distancing. These are time-honored steps that have been proven to work in previous pandemics. The 1918 flu was, at the time, the “Mother of all pandemics” (no longer, we've now exceeded the deaths from Spanish flu by 50%). Studies of the Spanish Flu showed that cities that enforced mask wearing (like Baltimore) did reasonably well. Cities that did not enforce mask wearing (like Philadelphia) did poorly. Despite all the hubbub you've heard about masks, they do work. Some (like N95's) are so good that they protect the wearer and the people around you. Others (like cloth masks), are not as effective. They are still better than no mask, and they do protect those around you. They must be worn properly (covering mouth and nose), and must be used all the time you are indoors and around others in order to work. Nothing new here.
The issue is when should we stop wearing masks? We learned early on that viral spread outdoors was very low, and that masking outdoors was unnecessary. One of the problems is that masking was instituted as a “one size fits all,” so people in areas where there was little spread had to do things that people in areas of major spread were doing. Early on, there was a big difference between New York City and Yates County (I know, there is always a big difference). Ultimately, decisions were made state by state, and then by regions of the state, which was a significant improvement. Recently, the CDC further narrowed the mask-wearing decision to the county level. The metric used is based on the availability of hospital beds, and the level of infection in the county. This makes the most sense. An overwhelmed healthcare system not only can cause harm to people severely sickened by Covid, but also the people with heart attacks, severe pneumonia, and appendicitis. If there is “no room at the inn,” people need to be sent elsewhere, and the delay can be deadly. Covid not only killed those who caught it, it killed others who could not receive the care they needed in a timely fashion.
Then came the vaccines. This was science at its best. We rapidly solved the puzzle of Covid's RNA and created a vaccine to protect us from it. Hats off to the brilliant scientists, and also to President Trump for funding the research (remember Operation Warp Drive). Worldwide, nearly 5 billion people have been vaccinated with at least one vaccine, which likely saved hundreds of thousands, perhaps millions of lives. The safety and efficacy has been even better than expected. If it wasn't for the infusion of politics into this aspect of the pandemic, we would have likely saved thousands more. If you haven't been vaccinated, the data still shows that you probably should. The stories from the ICU doctors and nurses of the unvaccinated patients on ventilators are absolutely heartbreaking. Watching someone die from Covid is difficult even for the professionals.
So, where are we now? Omicron is rapidly subsiding, probably because it has already infected so many, plus the number of vaccinated individuals has made it more difficult for the virus to find a suitable host. The CDC's most recent iteration is a “red/yellow/green” report that is based on what county you live in. If the risks are low, masks are unnecessary. If the risk is high, masks are still recommended. You can find out the risk level in Yates County (or any other county for that matter) by going to cdc.gov. The first screen has a link to “Check Your County.” You enter the state and county you are interested in knowing and the result is provided. At the time of this writing (3/6/22), Yates County is at Medium risk (we had been at High risk as recently as the previous week) and masks are recommended if you are a high-risk individual.
My final thoughts (at least for this column) about the pandemic:
1. We are still at the mercy of the Covid virus and its mutations. While the 1918 Spanish Flu virus ultimately mutated into a less lethal virus, other viruses (like measles, HIV, and smallpox) never did. The future is still very much up in the air. In the coming months, we will have the added benefit of anti-viral medications (you may have heard of Paxlovid, which works well if taken early on, but is only available in limited quantities right now). Testing early will thus be very important. Testing is now readily available. Testing early can also help to mitigate spread. If you test positive, stay home and isolate from others, especially high risk family members. If you've tested early on, you may be eligible for anti-viral medications. Work is underway to “test and treat”, likely through pharmacies.
2. I think the saddest part of the pandemic is the intrusion of politics into the realm of science. There really are provable scientific facts. Unfortunately, the drone of social media and misinformation has made it more difficult to hear the voice of science above the background noise of unproven opinions. It makes me ever more fearful of the next public health crisis. We have an excellent Public Health Department in Yates County. They are dedicated professionals who have our county's health and safety in their hearts, and as the core of their mission. I've worked closely with them over many years, so I can attest to this. Sara Christensen follows a long line of top-notch nurses (Deb Minor and Lauren Snyder to name two). Our county has been blessed by these nurses who have stayed true to the science, and done the right thing to protect our community.
Hopefully, I won't have to write many more columns on Covid. My goal has been to provide you with useful information to protect yourself and your family. Be well, stay safe, and we will get through this. Here's To Your Health!
Dr. Wayne Strouse, MD is a Family Practitioner in Penn Yan.