February 6, 2021

One year. 366 days (2020 was a leap year). 527,040 minutes (sorry Jonathan Larson but you’re wrong every fourth year). It was initially assumed that the first US COVID death happened on February 29, 2020 in the Puget Sound area. But, when the pandemic began to take off in March, the medical examiner’s office went back to a couple of mysterious unexplained deaths in otherwise healthy people following a flu like illness and found the presence of the novel coronavirus in tissue samples of individuals who died on February 6th and February 17th. One year later, according to the Johns Hopkins Coronavirus counter, the US is at 460,311 deaths.

How big is that number? If it was a US city, it would be 44th in population, coming in between Virginia Beach and Long Beach, California. It’s 10% higher than US World War II casualties making the pandemic the third largest mass casualty event in US history, bested at this point only by the Civil War and the 1918 Flu pandemic. (And at the rate we’re going, I imagine we’ll top both of those by this summer as we’re more than 2/3 of the way there). It’s enough to fill the 101,821 seats at Bryant Denny stadium four and a half times. It’s enough to have killed one out of every 719 Americans who were alive a year ago. As the average American has a cirle of acquaintance of roughly 5,000 individuals, statistically each of us has lost seven people who were in our lives a year ago. For me, it’s a much larger number than that given the nature of my profession. I lost seven people of my acquaintance during the first week of January alone as the surge driven by holiday gatherings reached its peak.

Fortunately, things are beginning to calm down somewhat. Numbers of hospitalizations, at least locally, are beginning to dwindle. There is one outlier, Tuscaloosa. I was in a meeting at the VA this past week where there was much consternation about a rapid spike of COVID among veterans getting are at the Tuscaloosa VA compared to the rest of the state. All you have to do to explain it is look to the night of January 11th when UA clinched the national football title and the young people of Tuscaloosa poured into the streets to celebrate. Human behavior drives the patterns of viral outbreaks in predictable ways. Most of those young people did not become seriously ill and most elderly veterans in the area were not chugging beers on University Boulevard in the wee hours of the morning. The mass of assembled people, however, allowed for the virus to be passed along to a greater portion of the population at one time. With higher numbers infected and a greater reservoir of potential carriers, older people in the community were just more likely to come into contact with someone infectious, even with normal precautions.

Map of corona virus mutations

WIth vaccines rolling out in fits and starts, there’s a sense of societal ennui in the air regarding the coronavirus. I can’t quite put my finger on it, but its sort of a ‘OK, that’s over let’s move on’ sensibility which fits in neatly with both our short attention spans and need for the new, especially within the infotainment journalism we’ve perfected over the last few decades. COVID is so 2020, let’s move on to the next big story. The problem is that the virus hasn’t gone anywhere and it’s just waiting for us to change our behaviors in ways it can exploit to do its one and only job, propogate. When we allow it to move through the population, we create two major issues. The first is the obvious costs of morbidity and mortality. The second is we give the virus a chance to encounter more types of humans and more environments and increase the chance of mutations. Viruses are relatively simple organisms. There aren’t a lot of pieces so the genetic code isn’t all that long. Errors in transcription of genetic code happen all the time – anything from 1/100 to 1/1000000000 depending on the organism and whether it’s DNA or RNA or mRNA. The more different environments the virus encounters, the more likely one of those mistakes is going to aturn out to be an evolutionary win in a new situation and give a new strain a little bit of an advantage. What is a win for the virus may very well be a lose for us. The novel coronavirus that causes COVID is very closely related to the virus that caused SARS in Asia a couple decades ago. If a mutation occurs which causes this one to develop the same lethality of SARS, we may be in a world of hurt. It’s mortality rate was about 14% compared to about 2% for COVID. With that morbidity, we’d be looking at between 3.5 and 4 million dead in this country to date.

I’m not pooh-poohing the vaccine at all. It’s an incredibly useful tool and it’s a tribute to human ingenuity that it got from identification of the virus to people’s arms in less than a year. But it’s not the be all and the end all and it cannot substitute for good public health practices. It’s going to take a while to get everyone at higher risk from COVID (somewhere between 1/3 and 1/2 the population) vaccinated. The other things that we’ve been working on such as masking, hand hygiene, and social distancing need to continue for a little while longer. It’s still a bit unclear as to what is safe and what is not once you’ve received your vaccines. I’m still not eating out or going to the movies, but I feel better getting together with a couple of people, especially if we’ve all been vaccinated. I need a weekend away for mental health in the near future. I figure as long as I pick somewhere where I can do outdoorsy things.

We’ve still got a huge political problem in this country when it comes to public health. The change in administration, while it did put people who will listen to and follow the science in charge of the pandemic response, did nothing to change the gap between red and blue America. I think the most dangerous thing that can happen over the next year is for the administration and blue America to dismiss the concerns and attitudes of the antimaskers and their ilk as insignificant noise coming from a bunch of uneducated yokels. The analysis of the composition of the mob at the Capitol shows that these are not uneducated or unsophisticated people. They have, for whatever reason, bought into an ideology that those on the opposite side of the political aisle must be destroyed by any means necessary and their ideas must be ridiculed and abrogated. This morning I read an article that the governor of Iowa is eliminating all social distancing/masking and other coronavirus mitigation measures. One does not get to be a governor of any state by being a stupid person. But one does make political calculations based on various competing agendas.

I’m afraid our political split is here to stay unless some significant social surgery is performed (reinstatement of the fairness doctrine, repeal of Citizens United). I am under no illusions that things are over, not by a long shot. The Republican party is in thrall to a radicalized base where any attempt at comity is seen as heresy. As that base pulls itself further and further into a world of ‘alternative facts’, I have no idea what the leadership is going to do or what the economic powers behind the leadership are going to do. My guess is, as radicalization becomes bad for business, the polticians attempting to use those impulses for their advantage will start to see funding sources dry up until they fall back into line but you never know. It always comes down to money in our culture; it’s the only common language. The later millennials and generation Z seem to have figured this out, witness a group of Florida high schoolers eviscerating the National Rifle Association and a bunch of tech bros using the Robin Hood App to bringa hedge fund to its knees.

I feel like I’m blathering on a bit now so I’ll sign off, but not without my usual litany. Washa yo hands. Wear yo mask. Stay yo distance. Get yo vaccine when yo can.


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