“We have nothing to fear except fear itself!”
Thank you, FDR!
We are hearing a lot these days about testing and many of our recommendations and decision-making come to us from nonmedical individuals like mayors and governors. Wear a mask outside (even when not ill and of limited benefit), our jobs are restricted, our parks were temporarily closed, churches hold virtual services, restaurants closed except for takeout, our kids can’t go to school, no college students on campus, spectator sports ruled out, the list goes on and on. Buzzwords abound — social distancing, flatten the curve, stay safe, and watch out for the surge.
Our world appears to be spinning out of control despite the science that tells us that this particular virus is quite similar to what we have seen in the past. According to “R naught” data (which indicates how contagious an infectious disease is), COVID-19’s transmittability is not much higher than seasonal flu or even the common cold. Some 85-90% of infected individuals have minimal or no symptoms. As always, elderly individuals with chronic medical illness or a compromised immune systems are more at risk of serious illness like pneumonia or even death.
Age alone is not a major factor. Healthy younger age groups and children handle this infection quite easily with minimal risk. Mortality data is clearly trending downward in the range of annual influenza. Antiviral agents like remdesivir and others show promise and soon will be more readily available.
We have a well-regarded Stanford Nobel prize-winner saying that according to his analysis, staying home may prove to be a big mistake, and immunologists question whether reducing antigen exposure may detrimentally affect normal immune system response in healthy individuals. Looking around the world, we have a control group situation in Scandinavia where there is no significant difference in mortality data with Sweden taking the common-sense approach (i.e., hand-washing, home when sick, etc.), while Norway has put in serious restrictions and closures.
A wise medicine professor talking to us medical students once emphasized that whenever you are considering ordering a test, consider how it will change or affect the treatment of your patient. Now in the COVID-19 era, I think of how this advice applies to our current dilemma. Sports talk is full of complicated schemes to return to play with frequent testing of asymptomatic players, support personnel and eventually even spectators. Unrealistic fears of infection or transmission are fueled as a result.
What happens next year if another virus surfaces? Does that mean another round of restrictions and shelter in place? Coronaviruses do not appear to mutate easily so an effective vaccine is probable, hopefully sooner rather than later. However some people are anti-vax in spite of clear benefits, and as we see with flu vaccine, still mortality runs around 30,000-40,000 annually. The real key, then, is the continued development of good therapy options.
Let’s say we accept the risk of COVID-19 but returned to living life as we have known it. Let’s say we then apply common sense precautions if we get sick. Every day life always has its risks, but we ordinarily do not allow fears to dictate how we live our lives. I, for one, would stand up and cheer especially in our state where many people are in serious difficulty because of irrational fears of disease (and liability) on the part of politicians.
OFF TODAY: New York Times columnist Maureen Dowd is off.