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Is COVID-19 finally winding down?

          After more than three years of living through a pandemic we are seemingly on our way to adjusting our lifestyle to the endemic form of the disease. Roughly eighty percent of Americans have either had the natural infection or have received one or more doses of a vaccine, or both. Sadly, it still kills a few hundred people every day and that will only decline very slowly.

            The COVID vaccines have been a disappointment in one sense: they do not prevent infection. The protection that they provide is short-lived, perhaps only about three months. There are two very significant benefits, however. The risk of dying among vaccinees is greatly reduced; a recent observation indicates a 90 percent reduction in mortality compared with those who have not been vaccinated. To the relief of those of us in the health field, the frightening side effects, such as enhancement of mortality among those who received the vaccine and who were later exposed to the natural virus, never materialized. Myocarditis (inflammation of the heart muscle) and Guillian-Barré Syndrome (nerve inflammation that is sometimes fatal but often temporary) are more likely with the vaccine that is the least utilized in this country.

            In the endemic form, this coronavirus is here to stay, for a couple of reasons. Dozens of species of animals, both wild and domestic, now have been infected and will be a reservoir for outbreaks forever. Americans living in sparsely populated parts of the country have been somewhat protected, but will suffer occasional clusters of infection. And then there is the upcoming generation of susceptibles, children who are infants now or only a gleam in their parents’ eyes. If a COVID vaccine does not become part of the usual slew of vaccines that kids must endure by the time they reach kindergarten – a very unlikely situation – they will form a virgin population that will eventually become infected, and will spread it to adults whose immunity is waning.

            By the Fall of 2023 we can expect a vaccine that includes both coronavirus and influenza and because both have such a prominent inclination toward mutation, you will need that vaccine every year. However I’m quite confident that by the end of this decade things will change; we will have a combined vaccine that will only have to be  given once, maybe twice and whose protection will last a lifetime.

Lifestyle

From a physiologic point of view, there really isn’t a “best” time of day to exercise. Although there may be small differences when exercise is conducted early or late in the day, what matters most is when it’s most convenient for you. You need to pick a time that you can make part of your regular lifestyle routine – forever!

            For working folks who have to get up early for a long commute, a 4 or 5 a.m. start isn’t very appealing. If you’re fortunate enough to have a reasonably long lunch hour, a mid-day workout or walk might be ideal. You might seem to have the most free time at the end of the day but dinner, time with the spouse and kids or other responsibilities cut into that. Studies show that exercising two hours before bedtime really won’t interfere with your sleep but simple fatigue is often the stopper.

            If you work from home, use the time that used to be your commute time and walk, jog or work out. The average commute is slightly less than 30 minutes and that can give you an hour five days a week. What a bonus!

            If you go to a place of business, park about 15 minutes away from the workplace. Voila! Thirty minutes a day for five days equals 150 minutes, just what the health experts tell us to shoot for.

            The hard reality: you might have to alter your routine to fit in an hour or so of exercise at least four days a week. What few people realize is how important exercise is for good health. For those who complain that they simply can’t find the time, my admittedly callous response is that there will be plenty of time in stroke rehab, cardiac rehab or the waiting room of the prosthetics clinic where they fit artificial legs to replace those lost to diabetes. An awful thought, but true. Just look around at your most senior friends and family members.