September 19, 2022

The pandemic is over. How do I know? Joe Biden said so yesterday on 60 Minutes. I wish I had his confidence but I’m not quite so sure. Today’s statistics show that we’re still losing more than 400 people a day and that number, while trending down, has remained relatively static for some months and is nowhere near as low as the troughs after the Alpha variant wave and the original Omicron wave. We still have over 30,000 people hospitalized nationwide with a coronavirus infection, roughly 10% of whom are in the ICU, and the test positivity rate (percent of tests done which are positive for illness) is something over 10%. The WHO sets a ceiling of 5% on this to declare an epidemic or a pandemic controlled. So, by any measure, Biden’s statement is one of wishful thinking.

There are also new Omicron variants in the wind. The one that is currently most widespread and causing most clinical illness is variant BA.5. However, variant BA.4.6 is on the move in New England from wastewater surveillance studies (fortunately, it doesn’t appear to be more infectious or virulent than other omicron varietals). It could lead to a surge if there happens to be a mutation. There’s also a new variant BA.2.75.2, not yet widespread but with multiple new mutations on the spike protein which could greatly increase its affinity for human cells and its chance of causing clinical disease. While there are very few cases, the number have been doubling every week the last few weeks and we should not forget the power in exponential numbers. Think back a year. At Thanksgiving last year, the original Omicron variant was just a whisper in South Africa. By Christmas, it was everywhere and cases were skyrocketing.

The end of the pandemic will come when the disease and its effects fade into the background of our daily lives as yet another endemic disease, something that isn’t going to seriously affect our lives and plans, but rather those of some comfortably distant other. We’re well on our way to doing that. The classes in this country who run our politics, economy, and society are predominantly healthy and vaccinated and as the virus interacts with them these days, it’s mainly as a nuisance. My recent infection wasn’t that bad as far as disease goes. The quarantine and time off work was more of a hassle. My long Covid symptom of fatigue feels like it’s beginning to lift. I definitely have more energy this week than I did last.

So what does the end look like? Ticker tape parades and church bells pealing out? More likely, just a willful indifference to something that can be relegated to the background as we all return to our usual daily distractions. We seem to be content with letting Covid settle in as the third leading cause of death after heart disease and cancer just as long as it’s not wreaking havoc in our particular social group. The health system can handle the current burden of 3-4% of hospital beds nationwide taken up with Covid patients. It’s only when the number gets up to 10% and above that the system completely breaks down. Like flu, the serious cases will be pushed more and more into populations of the old, the ill, and the marginalized.

There are still a lot of unanswered questions. What is long Covid and what causes it? Is it autoimmune in nature, the body’s natural defenses being over activated by the virus into attacking normal body tissues? Is it continued viral infection with the virus hiding deep within some organ system and continually causing minor flare ups? Is it a complication of micro clotting and hemorrhages in the capillaries leading to malfunctioning body systems? We don’t know. But more information comes out daily suggesting that the virus is bad news long term. A study from today has shown that older people with a Covid infection are 75% more likely to be diagnosed with dementia within a year than those without. Is the virus neurotoxic? Are there tiny strokes involved? Will this lead to much higher levels or earlier onset of dementia among the rapidly aging Baby Boom?

There’s still a lot of vaccine and Covid denialism out there. It’s not as prominent in the mass media as it was a year ago but those attitudes have not disappeared overnight. Most of the older generation got their vaccines but they haven’t been nearly as popular with the middle aged for political and other reasons. Unfortunately, today’s middle aged adults are tomorrow’s elderly and as the unvaccinated age and have the normal decline in immune function that accompanies getting older, they may find themselves in the cross hairs of the more serious complications of the virus. The vaccines remain our best weapons against this. I’m getting my bivalent booster shortly and, if you’re over fifty, I strongly recommend you do as well. I’ll get my flu shot in October. Living in a Southern climate, our flu season comes a bit later so getting the shot mid to late fall is usually OK. The Southern hemisphere flu season, especially in Australia, was rather hot and heavy this year. That’s usually a good predictor of what’s likely to happen to us. And I really can’t recommend getting Covid and flu together at the same time.

I’m going to get every booster that comes down the pike. There’s no reason not to and I kind of like living with most of my organ systems functioning to original manufacturer’s specifications. I’m a bit eccentric like that.