Pandemic Perspective #10  May 23

Uncertainty rules

The only thing certain in this COVID-19 challenge is – uncertainty. I have been collecting articles from medical journals as well as the media and the range of opinions, “discoveries” and “statistics” – a stack now two inches thick – is a tangled mess.

Don’t give up hope. I’ll have some positive comments at the end of this blog.

At the forefront is the question of openings. Protests border on rebellion. Churchgoers and barflies want to get together again – each in their separate venues of course. Big box stores and grocers allow the entry of a few patrons at a time but those same shoppers can’t go to their favorite gym. So we’re eating more and exercising less. Even our superheroes are affected!

That mask that Batman is wearing should be upside down. It hasn’t helped that government experts haven’t decided whether face masks matter or not. Their own opinions range from: only healthcare workers need to wear masks; any kind of mask works; no masks are completely effective to prevent getting infected; wearing a mask is mandatory even when going into a bank or a 7-11 store, something that would have brought out armed security or the local cops less than three months ago. Confused yet?

Vaccines are in the headlines this week. More than 100 laboratories are developing their own with recipes that are as varied as those for fruitcake. (Hmmmm! Interesting analogy.) Isn’t it amazing that something as tiny as a coronavirus is made up of so many components that a vaccine might target?  The reaction to the news about the most recent developments: maybe the vaccine won’t work. Maybe we’ll have to get a booster every three months. We might have to get two doses, each with a different vaccine. We are still 18 months away from a vaccine. We’ll have a vaccine ready for distribution in October (maybe November, maybe January, maybe…) One of the vaccines is composed of a coronavirus particle attached to an adenovirus. Adenoviruses are common causes of the common cold. Many older persons have antibodies to adenoviruses because they have lived so long and have had so many colds. Therefore they might have antibodies to the vaccine adenovirus, so that the vaccine won’t work for the people that are the most susceptible to the coronavirus. Has your head stopped spinning yet?

How long can the coronavirus stay alive and dangerous on an inanimate surface? Take your pick: 20 minutes, 2 ½ hours, 2 days, 2 weeks, three months (!). Happy news: the CDC has just announced that inanimate surfaces are not likely to be the source of infection. Whew! Recently when I bought a newspaper I gave the clerk a five-dollar bill and told her to keep the change. After all, I didn’t want to handle the bills and coins that she and dozens of other perverse virus-carriers had handled.

Can you get reinfected after you have recovered from this coronavirus? Some recoverees have been found to have pieces of virus in their throats for three months. Some (but not all) scientists say that those particles won’t cause disease. Stay tuned. They might change their minds later.

And – God forbid that you should take hydroxychloroquine or its plain vanilla cousin, chloroquine, with or without a side of Zithromax. A couple of studies show that coronavirus patients are more likely to die if they take it; other studies state that if you take it early in the illness you won’t need a ventilator and you won’t die. Doctors who have used it for decades tell us that they have never had a patient with lupus, for instance, who died with a heart complication from chloroquine. Journalists tell us that you are very likely to die of an abnormal heart rhythm if you take the drug. They don’t seem to be aware that it has been used for about 65 years to prevent and to treat malaria in millions of persons. A search of the medical literature this week came up with a meta-analysis of 86 articles regarding chloroquine side effects published up to July 2017. The median length of treatment was 7 years; the longest 35 years. Death due to cardiac complications occurred in 24 patients. (Unfortunately the abstract didn’t reveal the total number of patients in these 86 studies. Getting the full article would have cost me about 30 bucks so I passed on that. Sorry!)

There is actually some good news among all this confusion although the most useful scientific information won’t emerge for a year or two after the political chaff has been blown away to reveal the wheat. We will eventually learn what the best means are to prevent widespread disease. We will have an effective vaccine although it might require annual shots, as we need for influenza. We’re going to get pretty good at using disinfectants and cleaners. We’ll get to know our spouses and children better, and especially how to keep from pushing their buttons. Board games are coming back; we’ll all become very good at using Zoom and its counterparts. Plastic barriers at store counters will be permanent fixtures but we might see fewer influenza infections and colds next season because of them. I’ve become better at handling money, i.e., I try not to handle it at all!

I hope that you will forever be mentally positive and coronavirus negative.