September 16, 2020

Orange Beach AL after the storm

It’s hurricane season again. Sally (not to be confused with my sister-in-law) has been busy battering the Alabama coast line and is slowly making its way northeast into Georgia and points beyond. Here in Birmingham, about 200 miles from the coast, we only got a few of the outer bands which brought lovely cool temperatures, some wind and a smattering of rain. Nothing to cause any difficulties here. Friends on the gulf coast have been checking in and everyone seems OK but there’s been a lot of flooding and wind damage in the beach towns. My guest suite is currently unoccupied if someone needs respite for a few days. There are four more storms lined up out in the Atlantic so we may get something worse in the days to come. Fires in the west, flooding in the south, pestilence everywhere. Just another week in the life of 2020.


Jefferson County, home to Birmingham and the most populous in Alabama, has generally posted somewhere between 70-130 new cases of Covid-19 daily over the last month or so. Yesterday, they posted over 1,000 new cases. The number is so out of line with where things have been that I assume it’s a data anomaly due to a data dump or an adjustment in the statistics. Either that or we’re seeing the result of people getting a little too friendly with each other at their Labor Day picnics and barbeques a few weeks ago. Time will tell. The numbers at UAB hospital have remained relatively steady. Far more than we would like, but low enough for the system to handle without buckling.
The medical residents are back on their usual rotations and I have had a flock of new interns rotating through my UAB Geriatrics Clinic over the course of the last month or so. Residency is hard enough and I can’t begin to imagine what it must be like with the added stresses of duty on Covid-19 wards and the shut down of a lot of the ways that young people like and need to blow off steam after grueling weeks. Our rotation is pretty easy for them compared to others that they have to do and we try to give them a chance to explore some of the more interesting things that geriatrics has to offer in the hopes that it might rub off a little and one of them might be willing to make it a career choice. We occasionally succeed but we need a lot more of them to look our way. We are really down on clinical faculty and it’s very difficult to find new ones and entice them to Birmingham. One of my best tools has been taking them out on my rural house calls with the VA, but those remain in abeyance due to Covid-19 risks. Hopefully I’ll be out in the field again after the first of the year. Telemedicine is useful but it doesn’t give you the real picture of what’s going on.

Appropriate mask for mask deniers


I’m getting a little tired of video evidence of ‘anti-maskers’ or ‘mask deniers’ or whatever they’re calling themselves these days. It’s a piece of cloth on your face, you wear coverings on most of the rest of your body without incident. It’s not chain mail or barbed wire but the amount of carrying on that seems to go on with some people for political reasons strikes me as being completely out of proportion with what is being asked. Perhaps if people would stop posting video of ordinary people behaving badly in Target or Wal-Mart, there would be less self aggrandizement and less monkey see, monkey do. Do me a favor and don’t send me a copy of the latest ignoramus in high dudgeon over being asked by society to do something relatively simple to help other people and society as a whole.
I was reading Andy Slavitt’s notes the other day. (If you haven’t heard of him, he was the head of the Center for Medicare and Medicaid Services under Obama and he’s a fierce defender of science in public health). He’s become a significant critic of the Trump administration’s response to Covid-19 and does a routine deep dive into the science which he puts out on Twitter and on his podcast. He did some modelling based on what is known about the Ro (infectiousness of the virus in a naive population) and Re (infectiousness of the virus in a population taking steps to control the pandemic) and came up with a rather startling figure. Every 1% of the US population that refuses to mask will result in an extra 10,000 deaths from Covid-19 over the next year. So, if 30% are anti-maskers, there will be an additional 300,000 deaths in this country that doing something as simple as universal masking when out and about would have prevented. I highly recommend following him and reading his notes. They are literate, easily understood by the lay public, and point out the real issues. He also is incredibly experienced in how public health and governance work together.


There is an old saying that the one who saves one life, saves the world entire. Encouraging an additional percentage to mask up spares 10,000 lives. That’s got to be more than the world, perhaps the galaxy, or at least our quadrant. I just don’t understand the complete lack of empathy that our culture seems to have bred into a considerable percentage that leads people not to want to do something so simple to help others. It just doesn’t compute. The ultimate message of almost every religious tradition is one of caring for the stranger as you would care for your own so I don’t see how people who profess to follow any sort of spiritual life would have any qualms about not only masking up, but assisting their neighbor in doing the same. I guess it just shows how poisoned some religious traditions have become in a lust for secular power. Until we all take this seriously, I and my coreligionists in our church choir will continue to meet by Zoom and discuss how we can have a safe community sing/rehearsal in the church parking lot where we can be masked, socially distance, and out of doors.


Enough of that rant. Time to switch over to a different part of the brain. I have a couple of new movie columns to finish up. If you have films you want Mrs. Norman Maine to tackle in the coming months, she’s taking nominations.

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