September 3, 2022

The acute Covid infection is over. It’s been a week now and all that’s left is a bit of a stuffy nose and a feeling of significant fatigue that leads me to needing a nap and ten hours at night rather than my usual seven. There’s no fever, no myalgias, no feeling sick. I hope the fatigue clears itself up over the long weekend and isn’t going to settle into some sort of post viral chronic fatigue. Ain’t nobody got time for that. But what will be, will be and I’m pretty good at reading my body and what it needs. I still haven’t heard much from my dueling employee health departments on when I can actually return to work. I’m hoping Tuesday, but who knows. I may be stuck teleworking another week… or two… or three… It’s hardly ideal but I can at least stay caught up to a certain extent, at least on the UAB side. The VA decided somewhere in the last six months to revoke my telework privileges over whatever arbitrary unfiled form so there’s not much I can do there until they clear me for duty.

So how have I occupied my last few days of confinement? I’m working on the final edit of Volume II of these Accidental Plague Diaries and if all goes well it will be out by the end of the month. I’m working on my lines in a prayer of being off book when I get back to rehearsal this next week. I’ve done some clean up around the house. I broke out the Xbox and realized I’m just no good at Grand Theft Auto V. I’ve read most of The Once and Future Witches which I quite like, other than some rather ham fisted political allegory. Just the usual things a sixty year old man does when left to his own devices at home for a number of days.

I’ve been living with a ghost. Binx, my new cat, absolutely refuses to have anything to do with me or Oliver, my geriatric cat who seems to live mainly on my bed these days. I know he’s here in the condo. Food disappears. Poop appears in his litterbox. I occasionally hear him late at night or catch a glimpse of him out of the corner of my eye. I figure one of these days he’ll figure out I’m not that scary or dangerous and he will start coming out of his hidey holes more often. I’ve found a few more he’s utilizing – behind the washing machine, on one of the bookshelves behind the foreign language dictionaries – he’s going to run out new ones soon. There’s only so many possibilities.

This evening, I ventured out. It’s been more than five days so under current CDC guidelines it’s OK as I have been asymptomatic and afebrile more than 24 hours as long as I keep a mask on (which I did). The opera chorus got together to sing Libiamo from La Traviata at the wake for one of our own who died a suicide a few months ago. I had known my colleague for a very long time. He was a physician like myself, although a generation younger. He had sought me out early in his medical school career as I was one of the very few out gay male faculty at the time and I helped him as a gay man in a homophobic profession through his med school years. He eventually went away for residency for a while and then came back to Birmingham about two years ago when he joined UAB as junior clinical faculty. He attended my church, sang with me in the church choir and the opera chorus and we were always friendly.

When someone commits suicide, especially someone who seems to have a happy and functional life, there are always unanswered questions. The what ifs. The did I miss somethings. Having lost a number of friends to suicide over the years, all I can say is they’re fairly useless questions. We can never really know the interior lives of another, even those with whom we share intimacy. I lived for well over a decade with both Steve and Tommy and never completely understood what they were thinking or how they would react to a given situation. There were always surprises. That’s part of what held the relationships together. There were new discoveries and hidden facets there to be found.

The gathering tonight was a party in a local nightclub/bar, hosted by his fiance (it was the place where they had been planning to have their wedding reception) and it was very much a festive wake. Music, dancing, food, drink and celebration for the fact that he had lived and touched all of us. Despite the surrounding gaiety (much of it literal), I was melancholy. I was having flashbacks to Tommy’s memorial of four years ago. Tommy’s affair was more sedate and had far fewer hula hoops in evidence but had the same air of festivity combined with sorrow for a life cut short. I suppose, at least for the next few years, any memorial I go to for a younger person is likely to jerk me back in that way. The memorials for older people who have passed in their eighties or nineties that I’ve gone to haven’t affected me in the same way. They’re much more of a bravo for a full life well lived.

As I read through the Covid news digests that I receive regularly in one form or another, I wonder if we’re about to head into another surge with the fall and if that is going to lead to more lives cut short, especially younger ones with so much yet to accomplish. US life expectancy has plummeted nearly three years since the beginning of the pandemic, from 79 to 76. Got to remember what that number means. Life expectancy from birth is the calculated actuarial statistical average length of life of the cohort born in that year. Babies born in 2019 could look forward to an average life of 79 years. Babies born in 2021 could look forward to an average life of 76 years. The last time there was this precipitous a drop was in the early 1940s when World War II killed a lot of young people; for it is early preventable deaths that have the most effect on the number. A person that dies at 30 loses about 50 more years of life than someone who dies at 80. And Covid continues to kill young healthy people.

The government of South Africa has a very robust wastewater monitoring program. They take sewer samples (as we all shed virus into our toilets when taking care of business) and find the coronavirus and genetically sequence it and map out the various subtypes that are turning up week to week. They were the first to identify omicron through their diligence last fall. They’re starting to find some new variants in their recent samples. Whether they are more contagious or virulent remains to be seen but when I hear of reports from there, my antennae go up.

On the good news front, both Moderna and Pfizer have had their bivalent vaccines approved for use (Pfizer for 12 and older, Moderna for 18 and older). The bivalent means that there are two different targets, one for the original Covid and one tailored specifically for omicron. Both vaccines are now being manufactured and are working their way into the supply chain and may become available quite soon. Check with your pharmacist. You can get it if you have had a recent Covid infection as long as you’re fully recovered. You can get it if you have had either one or two boosters prior. It appears to work best if there’s roughly a two to three month window since your most recent booster. So, if you had a booster in July or August, I would wait a few weeks. If you had it earlier than that, go ahead and get it ahead of fall. The more I see of the disease and the unknowns, the more I believe that you can’t have too many boosters. There have been hundreds of millions of doses given in this country with minimal problems and it’s certainly best to have as much immunity in place as one can. I’ll be marching out to get my bivalent booster within the next few weeks as I had my second in April.

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