Celebrate Vaccines

Once again, into the fray. I am so grateful for vaccinations in general and the COVID vaccine in particular. It is so fitting that Katalin Karikó and Drew Weissman won the Nobel Prize this year, and so nice that it came on the heels of their world altering contribultions--they literally saved untold millions of lives, and they were able to witness the fruits of their labors. The discoveries by the two were critical for developing effective mRNA vaccines against COVID-19 during the pandemic that began in early 2020. Through their groundbreaking findings, which have fundamentally changed our understanding of how mRNA interacts with our immune system, the laureates contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times. 

Travel in the Age of COVID--The French Version

I am newly home from a ten day trip to france and while it is certainly still possible that I might have gotten COVID while I was gone, France is certainly doing a good job of making both it's citizens and it's visitors feel like the risks are minimized. I was very trepidatious about traveling abroad. I was fretting and I am not one to do a whole lot of fretting. One of my friends noted it as being unlike me, what exactly was I afraid of? And what would help me to feel better? If it had been up to me, I would have stayed in the US, vacationed somewhere, to be sure, but close enough to get home without much fuss. My spouse, on the other hand, was adamant. He needed a vacation that approximated a pre-COVID vacation, and because I love him, I agreed. That did not mean that I planned. Oh no, we were still booking accomodations after we landed, but go we did. France is higly vaccinated, far more so than the US, and in order to go into a public building or a restaurant you needed to display your helath pass, issued by the government after reviewing your evidence of vaccination. They QR code is scanned at every place you enter--wearing a mask-- and so in many ways, I felt safer than I have any reason to feel at home. It was a breath of fresh air to see people masking up and protecting each other.

Keeping Kids In School

Can kids do in person school this year? It seems doomed to failure, especially in places where there is no mask mandate and people are doing pretty much whatever they want. In my university town the college students are back and a quick jog across the library revealed that about 2/3 of students were not wearing masks. Vaccinated or not, they can spread COVID, and last year that was the beginning of the rising death toll. Never a recipe for success when it comes to public health matters. This year our governor is forbidding people from mask mandates, so it is unlikely to go well. The truth is this is exactly what happened in the Spanish flu pandemic. It became clear that wearing masks and keeping apart really slowed the spread of influenza, but after a while, people ignored that, and the second year of the pandemic was far deadlier than the first had been. It was partly because the flu itself got deadlier. Will that happen this time? The current variation is definitely more successful at spreading and there are definitely more children hosptialized, some because they are unvaccinted and some because they can't be vaccinated. None of this troublesome news seems to motivate people to do better, at least at this moment, and soon we will all be heading back indoors.

Children and the Delta Variant

August has seen a dramatic rise in children with COVID being hospitalized, some of them going to the ICU. Pediatric ICU's are filling up, and there may not be room at the inn soon, which should be terrifying, but from what I can tell from news reports coming out of regions where the unvaccinated exceed the vaccinated is that they have no regrets and they are definitely not getting vaccinated. Which means that they are perfectly comfortable with killing other people, including children. Around the country, child hospitalizations for Covid-19 have increased to levels not seen since January, when U.S. cases and deaths were at their highest levels, according to the latest government data. Doctors in the hospitals hardest hit by the recent surge say the situation is worse than it was in January. It happened fast: As of mid-August, U.S. hospitals were tending to an average of more than 1,200 children a day, twice the number from the end of July and four times from the start of July, according to an NBC News analysis of data released this week by the Department of Health and Human Services. The data show the U.S. facing another peak in child hospitalizations as the delta variant of the coronavirus hits communities hesitant to get vaccinated. So while unvaccinated adults are filling ICUs in parts of the South, minors in those areas are filling up the pediatric wings at an alarming pace. And it is getting worse not better, again because too few people think about their community, that there is a greater good beyond yourself to think about. Get the vaccine and stop sickening and killing children.

Sudden Population Shift

These are the local statistics for my neck of the woods. I live in a red state, one that voted for Trump despite the fact that more of us died per capita than in the country as a whole, and re-elected a governor who literally said that she was not going to close businesses because the hospitals still had beds. She cares not if people needlessly die, and as of now, she endangers more of us each and every day with her lack of attention to public health. Despite that, we are protecting ourselves and our community. We are vaccinated, and I have every reason to believe that as the guidelines about getting booster shots start to emerge, that we will comply with these quidelines as well. Today, however, our university town opens its doors to students starting the fall semester today and all bets are off as to how that will go. It went exceedingly poorly last fall with a rise in COVID and hospitalizations directly linked to students returning and bars being open. Data rolled in showing that communities that had universities had excessive rates of COVID infections amongst non-student residents, and that having a univeristy nearby put you at greater risk of both infection and death. So what happens next? Will we do better this time around or will history repeat itself? The delta variant lays in wait for us to let down our guard. One way or the other, we will know soon enough.

Raging Back

I have seen this bubbling up all around me. The rising anger of the vaccinated towards those who refuse to be vaccninated, the selfish amongst us who cannot even have a needle in the arm to protect those around them, to help their community, and by virtue of that, their country and our economic stability. I had an encounter today that summed up my personal feelings of anger about it. I have been talking about the vaccine with everyone I see since November. It is a public health emergency, with people dying unnecessarily, straining the resources of the health care system, and putting us all at risk both medically and financially. Not to mention the psychological strain it puts front line health care workers under and their on the job risk of contracting the disease. Today is the first time that I was questioned for doing so--I answered them back, swiftly and with reasons from a number of different fronts. When I mentioned it puts children under 12 at risk, they said, without a thought, "I don't have children at home." This epitomizes the anti-vaxxers. They care not who they harm, not children, not the elderly, they care only for themselves, they are mean in spirit, and this is the bad part--I have lost my empathy. They no longer have a corner on the anger market. At first I was sad about this, but then I remember--it was anger that propelled people to the polls in 2020 and so maybe a little anger goes a long way.

Delta Dawn

Delta Dawn, what's that flower you have on Could it be a faded rose from days gone by? And did I hear you say he was a-meeting you here today To take you to his mansion in the sky? And so on and so on it goes. The delta variant of COVID is rampaging through the country, worst in places where there are no mask mandates and fewer people are vaccinated, but it is everywhere. We are now well over 100K people testing positive a day and we are starting to inch back up to a thousand people a day dying. And the real numbers of people who have the virus is likely to be well above that. The Provincetown outbreak taught us a lot. The first is that while for most of us this is our first epidemic, for gay Americans, this is the second round, and they learned a hard fought lesson that knowledge is power. We owe the largely vaccinated vacationers on Cape Cod who underwent testing for the knowledge we have going forward. But what good is it doing? The vast majority of those who are dying and severely ill are unvaccinated, but we now know that vaccinated people get sick with the delta variant and that they can definitely spread it. There are two thing that really break my heart about this. Besides just how insanely stupid it all is. The first is that there are more and more children who are hospitalized--many of them too young to be vaccinated. Just at the moment that they are trying to reopen schools. We cannot even for a moment prioritize children. The other is that for healthcare workers who have spent the whole pandemic watching people die are now watching senseless preventable deaths. It just has to take a toll on their mental as well as physical health. So mask up!

Mask Up!

Today is the birthday of one of my parents, and both of them are quite elderly. They followed all the recommendations to a tee. They barely left their house all through the pandemic, I did not see them without a mask and I did not eat with them for over a year. Today I want to remind you all that today, right now, in the case of COVID, it is the unvaccinated who are getting sick and dying. Almost to a one. So the lies being told about the vaccine are killing people and COVID is the vector. So no matter what, in a health care setting, where there are people who have compromised immune systems, it is mandatory that we all wear mask. Do it for the people who you care about. And stop harrassing health care workers. Health care should be a right, but acting any way you want is not.

Super Spreaders

Heather Cox Richardson touched on the subject of disinformation and it's spread. The algorhythms that are used on social media to feed you information that is tailored to your beliefs and interests are being manipulated in such a way to promote the development of deeply felt beliefs, some of which are founded on lies. The vaccine lies have been traced back to 12 liars, the super spreaders. The motives they might hold, be they nefarious or immature, matters less than the effect they have. I get that if they are designed to weaken America, like the Russian disinformation campaign that led to Trump being elected, the motive matters, but I think it matters less than what in fact happens. In this case, the combination of people who are deeply afraid of the vaccine and the spread of a COVID variant that is highly infectious is leading to pockets of infection that are overwhelming rural communities where not being vaccinated is a point of prideand mask wearing was never in vogue. So there is a direct link between the lies and people dying. It is hard to see how this helps conservatives. but much like all the other lies, it is hard to let go of, even when it is hurting them.

Second Pandemic Birthday

Today my mom joins many of us in having a second pandemic birthday. We are all grateful to have been vaccinated, some of us several months ago, and slowly, gradually we started to see each other again. This has been hard on each and every one of us, and most of all young school aged children (and their parents), but followed closely by the very old, which is where my mother lies on the lifetime spectrum. I am very proud of both she and my father for how completely they followed the COVID guidelines, getting groceries delivered in, and not seeing any of us without a mask for over a year. We did arrange to have their great grandchildren play on their front lawn a few times when weather permitted, but it didn't happen very often and it certainly wasn't the same as sharing a meal with them. The thing about it is that their time is likely to be the most limited of any of us, so that year plus represents a piece of the time they have left. Why does that matter so much to me? We all treated them like this was very important, that we stay apart in order to all survive this, but so many people did not care about that at all. And in Iowa, our government cared the least of all. There was no protection from them for the most vulnerable of all, saying that people would "do the right thing". Well, if that were true we really wouldn't need the police at all. The governor should be first in line to defund the police, but of course she is not. She just doesn't care at all for the very old, and she isn't crazy about the rest of us either. Despite that, we made it.

COVID Vaccine Reflections

The thing that stands out for me as the one stark difference between 2020 and 2021 is the COVID vaccine. I know, technically it was approved last year, but the very first day that you could get the Pfizer vaccine if you were not in a vaccine trial was December 14th, and seventeen days later, the very eariler that re-vaccination would be recommended would put you squarely into 2021. For oh so many reasons it is time for a do over, a restart in order to get off the treadmill of sameness that we have been on for almost a year and to think about what we might and might not be able to do going forward. The answer is that we don't quite know. At least to start off, it will change very little. We still wear masks in public places and masks and face shields are still haute coutour at the hospital. We still keep apart from each other, and we are not certain that vaccination keeps you from becoming a carrier of sorts. The other key point is that because we have done such a crap job of staying apart from each other, the virus has changed, mutating to a more contagious version of its former self and it just isn't clear what the response will need to be to that. The good new is that at least for right now, the time being, it seems like a big step in the right direction. It is just a shame that the whole thing became about the politics of re-election and 1/2 a million people had to die because the wrong man made the wrong choices and people chose to believe someone with a vacabulary that does not top 500 words over science and a man who has over 500 months of infectious disease experience. We cannot change what happened in the past, but let's work to make a brighter future.

COVID Resilience

 Here we are, ten months into the pandemic, and there are more than 200,000 new cases a day and on average 2,000 new deaths.  The plague that swept through Europe in the Middle Ages and it took two years to get it under control.  When did that happen?  After everyone started to stay home.  The importance of protecting yourself, your family, and your community cannot be emphasized enough, and yet so many people continue to disregard the simple steps of masking up, staying many feet apart, frequent hand washing, and if you need to be in close, wearing a face shield.  

The consequences of not doing so are raining down on us, Los Angeles being the current example of where reckless behavior brings one.  There are oxygen tank shortages because hospitals are over capacity and patients are being held in temporary tents outside the hospital or worse yet, in an idling ambulance.  They are ceasing presumed futile resuscitation in the filed rather than bringing to the hospital.  There just is no room for that.  And ICU beds are hard to come by, some hospitals with triple the number they normally have.  It is sad and infuriating that we are on the cusp of having an intervention, a miraculous vaccine developed in record time using novel technology and yet before such a scientific breakthrough can work it's magic, many more will die.  Thankfully my elderly parents have been able to stay safe until now and got their first dose of the vaccine this week.