COVID-19, Confusion, and Complications

The lines were long. People with children were standing in line for a shot in the arm, eagerly waiting to be immunized against a killer disease.


Those of us old enough to remember 1955 may recall the fear, the lines, and the shot. We still know people who survived polio and maybe had lingering effects the rest of their lives. Or those who died while lying in those horrible contraptions known as an iron lung, struggling to breathe.


COVID-19 is our polio epidemic. COVID-19 is our reason to stand in line and await immunization (twice in many cases). Then, Jonas Salk was our savior.


I still have vivid memories of signs written in soap on store windows in my hometown of Newark: “Thank you, Dr. Salk.” Swimming pools were closed as were movie theaters, and for a little kid in the blistering heat of New Jersey, this was a catastrophe. We were also told by our grandparents that if our trousers or shorts got wet, we could “catch polio.”


Like today, there was a palpable fear, a piercing anxiety that at any moment the virus would sweep down on our homes and paralyze everyone.


We have reached the tipping point when it comes to information overload. Our brains cannot process the relentless digital bludgeoning especially when there are matters of life and death.


Today the big names in pharmaceuticals have come to the rescue. One of the greatest scientific achievements of the 21st century has been the warp speed development of amazingly safe and effective vaccines against COVID-19. A recent study from the Middle East suggested that these vaccines are far more effective than previously documented. Finally, there was a light at the end of the grim, long, dark year of COVID.


But then something happened.


With the emergence of mutant strains or variants of COVID-19, the conversation has shifted. The UK variants initially appeared to be highly contagious, highly infectious but not as lethal as the original novel virus. However, there are emerging concerns that the UK variety may indeed be lethal and may not be consistently contained by the current vaccines.


On the other hand, it is unclear if the South African variant is contained by the current vaccine programs. To make the situation even more complicated, a soon-to-be-approved vaccine may provide benefit or efficacy in about 70% of patients rather than in the typical 90 to 95% of patients.


There has been an apocalyptic increase of COVID-related infections in Brazil, and it seems that the molecular structure of the virus has shifted to make it far more contagious, far more complex, and perhaps not readily contained by the current vaccine programs. This mutant has now been identified in more than thirty countries, and there is concern that these variants may become the predominant virus infecting the United States as we head into the late winter and early spring.


No wonder we are drained, confused, and have trouble concentrating, sleeping, and just performing the routines of life.


Life became even more complicated. Long-awaited normalcy took a gravel road.


And at the same time, the bottlenecks and the frustrations of obtaining the vaccination loom on the horizon although there is the expectation that the vaccine program will ramp up. Less than 10% of the American population eligible for the vaccine has received the first injection. We sign up online for notices about when it’s our turn. We scramble for a precious appointment time.


We are willing to stand in line, once again, sleeves rolled up, to prevent a dread disease.


How does the average citizen somehow absorb these complex epidemiologic and molecular controversies? A simple analogy is preparing for the tax season. For most of us, this is hardly the highlight of our calendar year, but paying our taxes is an expectation of good citizenship. Most of us cannot be expected to understand fine points and the subtleties of tax regulations, but we are expected to bring to the table the pertinent documentation, have some rudimentary knowledge of how the system works, but then to seek the services of a licensed, credentialed professional. We do our homework but then we get help.


A similar analogy applies to the virus.


Until it’s your turn to roll up your sleeve, consider double masking especially in high-risk areas such as a grocery store. Avoid bars and restaurants, groups, gatherings. The sacrifices we are making are worth it. We don’t have iron lungs these days, but you don’t want to be on the modern-day equivalent—a ventilator. I’ve been with too many patients whose loved ones had to make the agonizing decision to turn off the ventilator.


Hang on. Just for a few more months.



Photo: Centers for Disease Control and Prevention



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