COVID-19 Update XIV

General Course of the Pandemic

The daily number of new cases, both in the US and worldwide, is twice what it was in April. Vietnam, the exemplary country, has posted its first three deaths, while it tries to manage an outbreak in Da Nang (a foremost tourist destination). Almost every country in Southeast Asia is going through this “second wave” anxiety. Australia is closing Melbourne down. Spain has seen daily increases in its numbers. Italy has been given a respite, so far.

Almost every country in the world has seen a decline in the rate at which infected people are hospitalized, get admitted to ICU, or die. There are many potential explanations: all of them probably valid. Younger (healthier) people are getting infected. Doctors have learned a lot about how to deal with and prevent complications. Remdesivir and dexamethasone have helped. There is more convalescent plasma available. Maybe the virus has mutated into something less deadly (don’t tell that to Herman Cain).

Inexplicably, mask-wearing continues to be a source of controversy, not only in the US. Even worse, it has been universally appropriated as a battle emblem by right-wing, totalitarian heads of state. I figured it may be a good idea to identify masks as fashion accessories. Cool things to have.

Testing

We may be finally accepting pool testing as an adequate solution for the delays that we currently experience in getting results back.

The UK just bought millions of test kits that check for influenza and Covid-19 in the same specimen. They have promised that results will take 90 minutes, and they expect excellent accuracy. They plan to deploy these in facilities that care for the elderly.

There is a growing chorus that wants to accelerate the deployment of home kits that only need saliva to obtain an accurate result. I may have more solid information on this next week.

Treatment and Vaccines

There is nothing new on this front. As I have warned in the past, we are beginning to see people taking sides on which group of citizens will get to receive the vaccine when and if a successful candidate is approved. This “noise” will only get louder as we come closer to the rollout.

I want to use the rest of this space to rant against my fellow citizens of all stripes. To your eternal shame, you have used an unprecedented tragedy to try to make your political opponent look bad. Yes, all of you. One news station says that our death rate is the worst among wealthy countries. This is not true. The other side says that we have the best results in hospitalized patients. Also false. One side claims the current administration is disastrously incompetent. If this were the case, we would not have ramped up three years’ worth of vaccine work into three months. The other claims that we are the world leaders in innovation: not true; there are many contributors. It goes on and on.

Few politicians seem to be interested in working together to come up with a coherent effort at the state, city, and neighborhood level. I understand that the current national leadership has been absent from most of these efforts, but looking at how irrational people can be when all of them are grouped into a large cohort, maybe it was a good idea to try to handle this county by county. Now it is too late: we will have to take our lumps and see if we can make it to the other side with the least damage possible.

Let us talk about what “the other side” will look like, and when we can expect to reach it. Barring divine intervention or egregious political corruption, approval of a successful vaccine will not take place before November. Most likely it will be January before high-risk individuals are given their first dose. Most vaccines under investigation will require a second dose a month after the first one. It will take four to six weeks after that for patients to generate enough of an immune response. This gets us into late March, and only for the small percentage of the population that is at high risk. To vaccinate everyone will not happen before June 2021.

That is the best-case scenario. If the new vaccines only provide 50% protection, or if a serious side effect is identified after 200,000 people have been immunized, we can be in the same situation that we are in now twelve months from now. Unless someone comes up with an inexpensive, oral, effective treatment regimen. Do not hold your breath waiting for that to happen.

This should not be hard to understand. You, that means you, cannot continue to expose yourself to potential contagion because you are sure that our smart doctors will come up with an answer. That this plague will go away; that it has to, must go away. Not so.

The next issue is our schools; high schools; colleges. I wish that everyone will just stop screaming about this and take a deep breath. Read what I wrote above. We cannot keep children and adolescents out of school for another year. People who advocate closing the schools now are somehow delusional that this will be only a temporary state of affairs. All of the evidence points out otherwise. A large percentage (I think 30% is large) of our citizens will refuse to wear a mask and ignore suggestions to be judicious. We cannot even get millionaire baseball players who are under close supervision to grow common sense. It is unrealistic to assume that contagion will soon decrease enough to make it safer to open schools.

What to do? We need to treat this as the true emergency that it is. Hundreds of billions of dollars need to be spent on new ventilation systems, bigger classrooms, in-school nursing help, small dispensaries within easy reach, etc. We need to come up, now, with a rapid test that uses saliva or a mouth swab. Something that can be done daily. We have to give our teachers and other school employees “combat pay,” like we give our fighter pilots. We must have an agreement on how to make sure that no one is worried about liability in case a teacher or student gets sick. We must keep schools open twelve hours a day, twelve months a year, until our students catch up.

This is a huge undertaking. The alternative is much easier: we keep screaming at each other, we keep blaming the opposing party for anything that goes wrong, and we, all of us, get sucked into the whirlpool as we get flushed down the drain. Do not think that your job, your home, your investments, and your currency are safe. Do not, for a minute, assume that this is somebody else’s problem to solve. This is about you, it is happening now, and you better get to work on it.

Have I made myself clear?