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Apples, oranges and viruses

The old cliché, you can’t compare apples and oranges, certainly applies to many aspects of the COVID-19 epidemic. Why are attack rates and mortality rates so variable between countries, cities and even racial groups? When will business get back to normal? It will be months, perhaps years before we have complete answers but here are some thoughts that might help you to make sense of the news stories that are circulating among the media.

If we look at the tragic numbers in New York City we can get an idea of why it has been hit so hard. First, the population there is incredibly dense, as you undoubtedly know if you have ever walked through Manhattan or traveled on crammed subways or commuter trains. Social distancing is difficult in clusters of apartment buildings and offices, and warnings were not disseminated early in the outbreak.

It didn’t take long to recognize that the elderly were at serious risk of dying from this disease but there are several factors that pertain to that age group. Many of them have underlying heart disease, which by itself accounts for nearly a million deaths per year. They are more likely to be overweight and diabetic; both conditions impair immune systems that are already in decline simply because of age.

Is race a factor? Yes and no. Pacific islanders are particularly susceptible to leprosy, for instance and Native Americans to certain fungal diseases. But viruses don’t appear to discriminate by skin color. On the other hand, CDC statistics reveal that blacks are almost three times as likely as Asians to be obese (49.5% vs. 17.4%) and that carries a much greater risk of type 2 diabetes. The COVID-19 mortality rate among blacks is roughly twice as high as their representation in the population. It is well known that black communities have less access to health care but that is only a part of the reason why they are suffering in greater numbers from COVID-19. Of 19 people who died of this virus in Milwaukee, all but four were black and all of them had diabetes or disease of the heart or lungs.

Unlike entertainment and sports venues, business that cater to small numbers of persons at a time will probably open up first. After all, if supermarkets can continue to do business, why not hardware stores, libraries and hotels? Tests for viruses and blood tests for antibodies are on the way but probably won’t be widely available at least until mid-summer. I’m hopeful that a vaccine will arrive by late September; never has the vaccine industry moved at such speed.

The face mask issue gets more complicated by the week and I’ll address it in another blog. Yes – do wear one when you leave the house. It’s better than nothing and is a reminder of the three Ds: don’t touch your face, distance yourself from others and do wash your hands after touching anything that might have been touched by someone else.



Another annoyance of aging: How dry eye am.

About 70 percent of persons over the age of 70 have dry eye syndrome, a condition that results from insufficient tear formation or rapid evaporation of tears. It truly is an annoyance but seldom results in eye damage.

Causes include wearing contact lenses, exposure to tobacco smoke and prolonged computer use. Some medications, especially those prescribed for allergy, high blood pressure or depression may lead to dry eye syndrome. A rare cause in this country is vitamin A deficiency.

Sometimes it only takes a change in the environment to relieve the condition: avoid tobacco smoke, wear wraparound glasses if you can’t avoid a draft or change your computer habits. Your doctor might adjust your prescription medication or prescribe artificial tears or even recommend Restasis, a medication that is effective but has some side effects.

Dry eye syndrome always calls for an evaluation if simple steps don’t work because it could be due to an autoimmune disease such as lupus or rheumatoid arthritis, or type 2 diabetes.

The message is clear: don’t hesitate to get an evaluation by an ophthalmologist. It could spare you years of discomfort and possibly save your life.

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