Covid: Good New, Bad News, Misinformation and Insanity

I was not going to write a post this week. I’m burning out a bit. But I heard some things this week which I just had to write about.

THE GOOD NEWS. Worldwide, there are NO HOT SPOTS of Covid. Unless you consider China, which is one huge hotspot and their proclamations that the way they handled the Covid crisis was nothing short of a “miracle” is ludicrous. Case counts worldwide are decreasing but those numbers are very questionable because of the significant dropoff in testing and reporting. Deaths from Covid are much more reliable than case counts and those are also decreasing, but not by much. Oddly, Taiwan, one of the countries with the best Covid mitigation strategies early on in the pandemic, has one of the highest per capita death rates worldwide.

THE BAD NEWS (Reality Check) Covid is certainly still not gone. Not by a longshot. 

Covid deaths remain significant and continue to rank 3rd as the leading causes of death in the US. Heart disease is #1 causing about 1900 daily deaths, followed by cancer with 1600 deaths. This week, the daily Covid-related death average was ~400. This is followed by accidents and then stroke deaths. That is still a lot of Covid deaths that society seems to have just accepted as the norm today.

Most of those deaths are in people over 65. If you are over 65, you should be insulted at how little the rest of the population gives a crap about whether you get Covid or not! Although you probably should be concerned more about the state of your health to begin with. Being healthy is your best defense against getting really sick or dying. And you have complete control over that.

MISINFORMATION

Recently, there has been a lot of media traffic about a Cochrane Review article which essentially stated that masks have done nothing to stem the tide of Covid and are basically useless. This is patently wrong and dangerous information. Cochran Reviews have been thought of as detailed, well researched studies, which have analyzed all the literature out there worldwide, coming up with a conclusion about specific issues. As far as this particular review is concerned, it is not surprising that they came up with this conclusion as the authors are known to be critics of vaccines and in a review of the Flu vaccine 10 years ago, they came to the conclusion that the flu vaccine was not helpful. This is clearly also wrong and biased. As far as this mask review is concerned, they lumped many different types of studies together (healthcare and community) and very poorly separated out the quality of masks. There were a variety of other issues with the conclusions this review came up with and many holes they did not address. This is very dangerous and is evidenced by a subsequent NY Times op-ed piece championing this article and its results.

It is clear that masks work, but the quality of the mask and how it is worn is very important. One of the surprising findings for me which I learned during this pandemic is how poorly surgical masks actually are at preventing spread of infections, both ways. No different than single ply cloth masks. And I’ve been operating on and treating very ill patients with these types of masks almost exclusively for 30 years! Not anymore. I wear an N95 or KN95 almost exclusively, in the office, hospital and operating room. It is probably one of the main reasons I have not gotten infected, at least to my knowledge. I did some blood work on myself a number of months ago and did not have any evidence of SARS-Cov-2 antibodies. I have plenty of vaccine related antibodies though.

This article also misrepresented how Covid spreads, implying that it was similar to the flu, transmitting via large droplets. This is also inaccurate. Covid spreads mostly through simple aerosols. Just breathing spreads it the most in fact. It is also not seasonal like the Flu.

OTHER MISINFORMATION. The Florida Surgeon General made public comments recently about the dangers of the Covid vaccine, quoting numbers from the Vaccine Adverse Reaction Reporting System (VAERS). He quoted raw numbers which are not representative of reality. If you get a migraine headache the day after a vaccine, that is reportable VAERS. It is irrelevant that you may get migraines every week and have for many years. If a symptom happens shortly after a vaccine administration, it gets reported. Clearly, it is impossible to attribute that migraine to the vaccine given the frequency of migraines before the person even got the shot. I have a relative who died 3 days after she got the vaccine. The doctor who signed the death certificate assigned their death to a condition impossible to make without hospital admission, which did not happen. The vaccine was blamed even though that person had many admissions to hospital long before the pandemic with similar symptoms. They were very old, and they died. That’s it! But the vaccine is an easy scapegoat. VAERS is a tool but must be interpreted in the right way. Do side effects from the vaccine occur, of course. NO drug is free of side effects. The drug which causes the most side adverse effects and causes the most deaths worldwide is aspirin! GET IT OFF THE SHELVES. STAT!!! Obviously that is also ridiculous.

VACCINE DENIER INSANITY

It is clear that getting vaccinated and boosted against Covid has a tremendous impact on reducing the severity of illness and preventing death. It certainly can also prevent infection altogether as well. The incidence of side effects and complications remain very low. No greater than any other vaccine or medication in general.

Despite that, legislation was introduced in Idaho by 2 very misinformed legislators which would make administering or prescribing mRNA vaccines to patients a misdemeanor. Doctors and pharmacists could go to jail for taking care of patients! Pretty sad. This kind of idiotic thinking is why healthcare providers are quitting or retiring in droves. Next time you hear that the wait to see a doctor is 6-12 weeks or more, or the wait time in the ER is 12 hours, think about Idaho.

COVID POLICIES ARE TOO LOOSE

Lastly, I saw a patient this week for an unrelated ear issue who recently got Covid. He got it from his middle school son. The school’s policy was to stay at home for 5 days and then return with NO mask requirement. No distancing requirement either.  He went on to say that the school encouraged parents not even to test for Covid, just keep them home if they were ill until they felt better and come back, no testing or mask required. He was told that they would rather not know!

I understand that our kids have probably been impacted by this pandemic the most, but completely ignoring this disease and throwing caution to the wind is not the right answer either. We have yet to see the long term impact this disease may have on brain development, affecting things like IQ, attention and behavior. There was a time when ALL kids were homeschooled. Staying home for a week won’t prevent them from getting into Harvard, but it may prevent further spread of this disease and lessen its effects.

Unless you live under a rock, you would know that this is the one-year anniversary of Russia’s invasion of Ukraine. I don’t like calling it a war since Ukrainians are not fighting anyone. They are simply defending their land and their freedom. This is a brutal invasion and has evolved into a genocide. 

Please support Ukraine, appreciate what you have and take care of each other.

🇺🇦❤️✌️

Stay Safe and Be Well.

AC

Today I am feeling a combination of gratitude, sympathy and guilt.

I attended a large Ukrainian event last weekend. It was a black tie affair at the Bellevue Hotel in Philadelphia. It was a lot of fun and I saw and spent time with many friends and family and it was great. All three of my children came in for the event. There were about 600 people and the hall and adjacent rooms were packed and they were loud.

Unlike last year’s event, when there were some rules about masking in certain areas along with a covid vaccine requirement to attend, this year, it was a free-for-all. No rules. Just fun. There was only 1 person I saw the entire evening wearing a black KN95 mask. I don’t know if he was wearing it because of risk factors or he just wanted to protect himself. I did not wear a mask. I thought about it alot and felt that it may be time to let go a bit. I did so at a similar event the week before and came out unscathed (although some others did not).

Not too surprisingly, a few cases of Covid have turned up this week amongst my friends. Fortunately, so far none are suffering any severe symptoms. All have been vaccinated and fully boosted as far as I know. There will undoubtedly be more and there will likely be many who got infected but were asymptomatic, spreading the virus as they go about their lives.

I don’t think any of my friends came to the event infected. They most likely got infected at the event. This most recent variant can start to show symptoms within 48 hours after exposure.

I am sympathetic to their illness, grateful that I dodged another bullet (despite what I do, I have still not had Covid) but feeling guilty for not being more vigilant and recommending that attendees at least consider self testing beforehand. 

I appreciate that we have to move on with life but this event highlights the fact that this very infectious virus is still very much amongst us and is causing all kinds of trouble. Absenteeism from school and work, feeling ill as well as the potential for serious complications, illness and long-term side effects.

How do we juggle this persistent pandemic and move on with life? I don’t have the answer. Many aspects of this pandemic are out of our control. There are however things well within our control. Perhaps mandating vaccination and constant mask wearing is unreasonable for such an event, but appealing to peoples self interests and perhaps compassion towards others will. Testing beforehand is not a big deal. Tests are cheap and, although not 100% accurate, they are all we have. In addition, if you have any symptoms of illness, it may mean that you should stay away so you don;t pass whatever you have along to others, some of whom may have serious underlying conditions.

Before any such events, I test myself, regardless of how I feel. I would feel horrible if I was the cause of someone else’s illness or serious complication, not to mention death. 

Another thing we have 100% control over is how we take care of ourselves. Getting healthy is your best defense if you have been exposed. Eating well, focussing on a whole food, plant-based diet, stay well hydrated, daily exercise, stress management, sleeping well and social interactions are all extremely important for good health.

Please continue to be careful out there.

MASK up when reasonable and appropriate.

DISTANCE and/or ISOLATE if you are ill or live with someone who is.

TEST when there is a concern or if you plan to be amongst people, especially there may be at-risk individuals. Given the state of most Americans’ health, there is almost a 100% likelihood someone in your group is at risk. 

GET HEALTHY.

VACCINATE and BOOST.

Stay safe and Be well.

AC