General Wellness

I hope everyone had a nice Thanksgiving.

It was different but hopefully enjoyable for most of us.

As far as all the travel and unwise gathering decisions many people made, in addition to all the college kids coming home for the duration of the semester, the holiday weekend’s impact on the pandemic will be evident in about 7-10 days. We are likely heading into much more trouble.

I did my best to limit watching the news but did a little monitoring of what was going on in the vaccine world. More good news but keep in mind that the news did not come from the CDC or any other independent body reviewing the data. It all came as press releases from the companies directly. Rock Hudson made a press release that he was not gay and did not have HIV. That turned out not to be so accurate. I am not saying that we should not believe the news and be hopeful, just wait until the safety and efficacy are reviewed by independent scientific bodies. By the way, anytime anyone makes a claim that something is “100%” effective, take it with a grain of salt. One of the vaccine companies made just such a claim.

That having been said, so far, there are 3 great vaccine candidates. 2 of them have 90%+ efficacy at not only generating an immune response but decreasing the risks of actually contracting it, not just diminishing the disease burden, which they also have been shown to do. Two require 2 doses, separated by 6-8 weeks. The third is a little less effective at 70%+, which is still much better than the annual flu vaccine, but only requires one dose and is much easier to transport with less stringent temperature/storage requirements. On a worldwide scale, this third one will probably be the most effective overall,

There will clearly not be enough vaccine doses initially for those who want it, even assuming that 50% of Americans may not even elect to get it. Also keep in mind that vaccine policy is a state controlled issue. Each state has different rules and policies, as well as ways of dealing with people who oppose vaccination. Seems like it could be a mess to coordinate.

The rough numbers provided by the CDC include 4 broad groups:

• 21 million healthcare personnel. This includes first responders like ambulance and EMS workers.
• 87 million essential workers. Between the federal guidelines and state essential worker orders, a number of major sectors overlap. Some essential workers include those working in some of the following industries:
  • Energy.
  • Child care.
  • Water and wastewater.
  • Agriculture and food production (like meat plants).
  • Critical retail (i.e. grocery stores, hardware stores, mechanics).
  • Critical trades (construction workers, electricians, plumbers, etc.).
  • Transportation.
  • Nonprofits and social service organizations.
• 100 million adults with high risk medical conditions. This is a vast UNDERESTIMATION.  ALmost 50% of American adults have hypertension alone (108 million) and 42% are obese (138 million). 20% of kids under 20 are obese! If you also add just being overweight, a risk factor for Covid-19 by itself, the total number rises to 75% of Americans, or 247 million people.
• 53 million others over 65 years of age without an established medical condition.

In a nutshell, EVERYONE needs to be getting the vaccine if there is any hope of reaching herd immunity or for those at risk of getting some protection.

The most optimistic estimates are that it will be well into spring before everyone gets vaccinated. We still also do not know how long the protection will last. It is quite possible that by the time the last of the population gets immunized, the protection offered to the first wave is no longer active and the cycle of infection and spread will start all over again.

I don’t mean to be a Debbie Downer but we all have to be realistic about this virus, how it spreads and the probability that it will be with us for a lot longer than we want. No one wants the flu to come back every year, but it does. Other coronaviruses re-appear every fall and immunity from last year’s infection has waned, making us susceptible again. The same is likely to be true for this virus.

While all this gets sorted out, please continue to do all the things we know help slow the progression and limit the degree of disease.

GET HEALTHY. I’m putting this at the top because it really is the most important, not only to deal with Covid, but with everything else going on out there, including our deteriorating environment. None of what we are sacrificing today means anything if our descendants don;t have a planet to live on. Eat more plants. Eat less animal products. Sleep better. Move more….

WEAR A MASK. Wear a good one and wear it properly.

DISTANCE.

WASH YOUR HANDS.

DON’T TOUCH YOUR FACE.

PROTECT YOUR EYES.

VENTILATE.

VACCINATE,at Least for the flu for now. Also, get the shingles vaccine if over 50.

Stay safe and be well. 

AC

I thought I was done posting for the weekend but I needed to add one more.

I heard an interview this morning with a doctor who works in a medium sized south-west Texas hospital. Because of both doctor and nursing shortages, he has not had a single day off in 254 days! And his days are grueling. He just does not have the relief to take care of the patients. That is dedication but clearly not sustainable. I know what it is like to deal with a patient here and there with Covid in the hospital, and it’s terrifying and exhausting, but to do it all day long, every day for that many days in a row is unimaginable.  That’s a true hero. 

If the deniers including our leaders could just spend 5 minutes in his shoes, our pandemic response might look a whole lot different.

So why is there such a shortage of healthcare providers? Getting sick is one problem. Despite the PPE, when you deal with sick patients all day long, the odds are you’ll get sick eventually. I know a few docs who have really been kicked in the butt with this disease. Early retirement is another. The trend, even before Covid, was for people in healthcare, especially doctors, to retire earlier and get out of the rat race of paperwork, administration and fear of litigation. However, more people have felt compelled to come OUT of retirement to help with Covid than have left medicine and healthcare. More true heroes. 

The BIGGEST problem is how widespread this infection and the disease is all over the country. Every state is on the rise. Most hospitals are strained to the max.ICUs are out of beds. We are breaking all records every day. Yesterday was the highest death count in 6 months, 2100.

Back in April and May, there were pockets of significant disease, like NYC where there were mobile morgues on the streets to deal with all the dead. Back then, healthcare workers from many unaffected areas were flocking to the hotzones to help out, just like first responders did during 9/11. Now, their own locations are hot zones so they can’t leave. The WHOLE freaking country is a hot zone! There are mobile morgues in South Dakota and in Texas, inmates are used to move bodies around!

The whole system, all over the country, is being taxed to the limit and a few weeks from now, after Thanksgiving, what some epidemiologists are calling the “mother of all super spreader events”, we are likely to have the collapse of the whole healthcare system.

I hope not, and I try to be optimistic, but hearing that doc this morning, with no day off in 254 days, and no help in site, I’m concerned.

PLEASE stay safe and keep all those around you safe.

You know the drill so I’ll skip it this time.

AC