July 29, 2022

Covid cases continue to inch up, but they are flattening a bit so maybe the current surge won’t be as bad as feared. Numbers continue to be above where they were a month or so ago but they aren’t increasing terribly rapidly on either the national or the local levels. Fingers remain crossed. Of course, it’s not the only viral illness in the headlines at the moment. Monkey pox continues to spread fairly rapidly with something over 5.000 cases reported in the US to the CDC over the last month or so. It’s a very different disease than Covid and, as it spreads through interpersonal contact rather than being airborne, it’s nowhere near as equal opportunity as Covid has been. It will also be easier to contain should we choose to make good public health choices.

As monkey pox is spread person to person, isolating individuals infectious with the disease is enough to interrupt transmission chains. Contact tracing and self imposed quarantines would do a lot of keep it from spreading but that presumes the existence of a robust public health system to do the tracing and check up on the isolation. Unfortunately, Covid and its political fall out has done a bit of a number of public health measures. The mere mention of quarantines or the privacy concerns of contact tracing has been enough to rile up some political groups into attacking public health officers pushing good people out of those roles and leaving the system a bit threadbare. We’re fortunate that monkey pox, while temporarily disfiguring and painful, is not that dangerous a disease. There have been no deaths to date in the US and only one in Europe, a Spanish man with significant immune system problems. There is an effective vaccine, which is becoming more available to at risk populations and so far vaccine misinformation spreading through the darker corners of social media has been pretty minimal. If you are over fifty, you’re pretty well protected by your small pox vaccinations from your childhood and you need not worry a whole lot.

I’d like to stop writing about viral epidemics. There’s so much more to life than those but they do remain an overriding concern for those of us in health care. The damage to the healthcare system and public health infrastructure over the last few years is incalculable and I do worry sometimes about a truly dangerous virus such as Ebola or Marburg getting lose these days and the havoc that could cause before American society is willing to pull its collective head out of its collective rectum regarding such issues. I am hoping that the current surge fizzles out over the fall, that things remain relatively calm with the availability of the new omicron specific booster in a few months and that I might be able to wind down these Accidental Plague Diaries after three years. Will I find something else to write about? Almost certainly but I wonder if I’ll still be able to create as much quality material as quickly without the seismic shifts in society and health care as fuel.

It’s Friday night. I toyed with the idea of taking myself out to the movies and then decided against it. It’s not a pandemic thing. It’s a lack of energy thing. I’ve been very sedentary and solitary these past few weeks. Those of you who know me well know that there’s been a little bit of domestic drama around here, one that I might write about eventually, but now is not the time. Sorry to vaguebook with that but I am cautious in terms of dragging other people into these writings in ways that may not reflect kindly on them. Oliver the cat is keeping me company, sleeping next to me on the bed when not yowling for more kitty treats. He has been joined by a new little brother – Binx, a gift from a friend. Binx arrived yesterday and is still very much in hiding at being in a new environment. I have barely seen him. As long as he knows where to find the food and water and where the litter box is, I’ll let him come out and join the party in his own good time. And so Oliver and I are enjoying old episodes of 30 Rock on Netflix, as I work my way through some neglected work projects and a glass of Pinot Grigio.

I’m working my way through the first galley proofs of The Accidental Plague Diaries Volume II – tentatively subtitled Vaccines and Variants or some such. It should be out in about six weeks for all of you who have been keeping a space for it on your library shelves. I’m not going to push this one like I did the first, just put it out there and see what happens. I will be available for readings and signings should your group want to schedule one and am willing to travel reasonable distances for such events. I used to travel a lot for work, but most of that has dried up the last few years. Even pre-pandemic, my job was switching away from academic pursuits into more routine clinical work and the lecturing and conferences and such that I used to attend somewhat regularly were drying up. I doubt they’ll be back in the way that they were in the past moving forward for any of us. The clinical demands on those of us left to prop the system up are such that finding the time off to head off somewhere for a week is becoming more and more difficult. Plus the budgets for paying for such expenses have been significantly reduced. Plus we’re all used to attending meetings on zoom and we’re just all doing that now more and more.

When Tommy and I were first together, in the early 2000s, he was the chief nursing officer for the local Federally Qualified Health Center and responsible for a number of federal grants. I was still working with a number of organizations that met in DC routinely. That first couple of years, one or the other or both of us was in DC every other month or so. We would usually add a day on and take a bit of a break together – favorite destinations being Meskerem Ethiopian restaurant in Adams Morgan, shopping at Dupont Circle and Sunday Service at All Souls Unitarian Church. I haven’t been back to DC for well over a decade now. I assume it’s about the same but the images of January 6th still cast a bit of a pall over the sights for me. Perhaps someday again I’ll walk the halls of the National Gallery and the Air and Space Museum. Maybe I’ll even have someone to share it with.

A decade before Tommy, I had a lot of meetings in Bethesda at NIH with the Cardiovascular Health Study. I had to fly from Sacramento to National Airport about once a quarter, grab the Metro out to Bethesda, collapse for the night, attend meetings all the next day, go out to dinner with people and collapse a second night, and fly back on the third day. It was always a bit surreal as the trips were so quick and basically indoors the whole time. The work was interesting, being a group review of medical records to determine whether deaths were related to cardiovascular disease or not for study purposes. We were the group that discovered things like squiring sublingual nifedipine into patients in the ER was actually killing them. I enjoyed the big research phase of my career but I was also smart enough to know that it was never going to be my true calling. You have to have a real fire in your belly for grantsmanship to lead that life and I didn’t. I much preferred to actually doctor real humans face to face and so ultimately, due to my internal philosophy and various happenstances of life, the research faded away. It means I’ll never be a department chair or a dean but I can live with that.

What I’m having difficulty living with is a society that is willing to turn selfishness into an exalted virtue and which down plays humanitarian impulses into some sort of weakness. Do others a favor. Wash your hands. Don’t spread disease. Get your shots.

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