July 12, 2021

Right on schedule and completely unsurprisingly, the Delta variant of Covid is starting to spike in red states. There are now more cases of Covid in Arkansas than there were in July of 2020. New hot spots are emerging in Nevada, Louisiana, and Florida. The curve is shifting upward again at a steep pace. The relative numbers of cases remain low but it’s not going to stay that way with a more infectious strain and large unvaccinated populations in which it can easily run rampant. The number of deaths daily is back up in the 100s nationally, not on the scale of 2-3000 a day at the peak of the winter surge, but definitely going the wrong direction, especially as the individuals now heading to intensive care units and ultimately the morgue are tending to be in the 20-60 age group. (Those older have, for the most part, gotten their vaccines and are less likely to congregate in groups).

It’s become very clear from the data that we have separated into two distinct populations when it comes to public health – divided by politics into red and blue, for want of a better shorthand. Blue populations are much more likely to be vaccinated and in regions where they are dominant, the line against Covid is being held. Red populations are less likely to be vaccinated and are playing host to the vast majority (upwards of 95%) of new infections. Data out of Florida shows that case rates in red voting counties are double those in blue voting counties. We here in Alabama, currently in last place when it comes to percentage of the adult population who are fully vaccinated (not yet to 40%), can’t seem to get anyone out to vaccine centers so they have, for the most part shut down. There is plenty of vaccine to be had through commercial pharmacies and county health departments but no takers.

I’m just waiting for Delta to fully take hold. It’s here. It will happen. We could easily see local numbers similar to last year. I don’t know what to do about it and I think there’s very little I can do as an individual other than gentle encouragement on a one to one basis with patients (pretty much all my friends and acquaintances are vaccinated) and their families and patiently answer questions and try to dispel myths. But when a political party at its rallies and conventions has turned anti-vaccine rhetoric into applause lines, there’s not much else to do but hunker down and let them learn the hard way. If I was running a political party, I would not want to take positions that were likely to kill off my most ardent adherents, but that’s just me. What happens when numbers really start to take off in August? I don’t know, but I plan on being here continuing to observe and write and help us all muddle through this rather peculiar time in history. And if they do, a second volume of The Accidental Plague Diaries is pretty much a guarantee.

Do the completely different political realities of blue and red America devolve into civil war? I certainly hope not but I put nothing past the major mental health crisis the country seems to be going through. I think an actual shooting war would be difficult as the populations are so intermixed. There are blue and red states, but even in the red states, the cities and economic engines are blue and it would be very bad for business to round up all your educated city dwellers and run them out of town. The Khmer Rouge tried that in the 1970s and we all know how well that turned out. Perhaps we would go the way of 1980s Northern Ireland with blue and red neighborhoods with a sort of no mans land in between. I don’t think either side would stand for that as waste ground and barbed wire in the middle of your subdivision is bad for property values and likely against your HOA policies. I think we’re going to be stuck in a sort of mutual revulsion for a while longer until some sort of major existential threat forces us back together again. One would think a global pandemic would have done it, but obviously that’s not the case.

Today was definitely a Monday at work. No Covid, but a lot of significant mental health issues complicating family dynamics and patient care. Individuals have just reached their breaking point due to societal stress and brains awash in catecholamines and, when you add elder care responsibilities on top of all that, things are starting to go a bit haywire. The current elder generation, with their very long lives, don’t die rapidly. They decline slowly over years to decades and children, who take them in, thinking it’s going to be a year or two are feeling rundown after a decade or more with no end in site. Covid has made communal living for the elderly a less attractive option and hiring in home care, not a Medicare benefit, is prohibitively expensive for most. It’s going to get even worse over the next decade when you add in the denial of the realities of aging evidenced by the mind set of the aging baby boom. If I have day after work day like today marching into the future, I won’t be able to stick with it long term. I can absorb a lot with my empathic abilities but even I have my limits. My usual ten hour work day stretched to twelve and I arrived home with no energy to do much of anything other than feed the cats. The legal cases I am working on will have to wait.

I no longer think I have to end these posts with my litany of wash your hands, wear you mask, stay distant as only the first of these is really required if you’re fully vaccinated and moving among other vaccinated populations. That, however, may change as the variant spreads. There are more and more reported breakthrough cases of Covid infection in the fully vaccinated including some clusters. However, the vast majority are infections that can be treated at home and are not life threatening. Just use common sense out there. And if you have unvaccinated friends or family, gently urge them to begin the process now before things start to get hairy later this summer.

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