COVID-19 Update: Friday, February 19th, 2021

Schools, numbers, double masking, vaccines, and J&J.

1. There is new guidance from the CDC about reopening schools so I thought I would remind everyone about what we know regarding kids and Covid. We know that not attending school (and some children haven't been in school for nearly a year) is having a profound negative impact on children. We also know that numerous research studies conducted around the world tell us that kids are not a major source of spread and that most kids get COVID from a family member and not from school. Young children are at a much lower risk for developing severe symptoms or requiring hospitalization although it is possible and does happen. Children are also at risk for MIS-c an inflammatory condition found in some children after being exposed to COVID and cases of MIS-c are on the rise, which is somewhat expected as more kids are exposed. Currently, there is no vaccine for children but they are currently conducting trials on vaccines in children so eventually, we will have one. Wearing masks and social distancing at schools are viewed as the most effective prevention measures. If your children are returning to face-to-face school make sure they are masking, and keep hand sanitizer in the car so when they exit school they can hand sanitize right away. Then have them wash their hands when they get home. My kids have been doing face-to-face school nearly the entire time if that makes you feel any better. Here is a nice resource for COVID and Kids including state by state data. https://www.covkidproject.org/

2. Cases are declining, by quite a bit. Check out this graphic for some encouragement. Just look at that drop-off!

3. In addition, deaths are declining too. Check this out.

4. Interestingly I have heard very little in the news about the CFR (case fatality rate) increasing, but it is. It has been slowly increasing for about 4 weeks. I want to share this with you in the event that the media does eventually cover it. Several things should be considered, a) deaths we are seeing now can include people who got sick up to a month ago or more. So while cases decrease it may cause the CFR to artificially appear increased. We won't know for sure for about a month. b) the new variants could be connected - but they may not be, again we won't know for sure for about another month. Currently, the case count is decreasing faster than the fatality count. Most likely this is due to the length of time people are hospitalized so we won't know for sure if the CFR is truly increasing (i.e. while fewer people are getting sick, a larger percentage of them are dying) or if that is just about timing right now. The current CFR for the US is 1.77 and for the world, it is 2.21 - meaning 1.77% of people in the United States who get COVID are dying from it. This is a crude rate - meaning it has not been adjusted for age, sex or race. Even with the slight increase, we are still far better than we were over the summer, as you can see here.

5. I want to weigh in again about double masking. As we have discussed, the virus has increased in transmissibility and in some cases lethality. It has "upped its game" so to speak so we need to do so as well. This means better quality and better fitting masks. You need a mask with at least 3 layers and it needs to fit your face snuggly all the way around. If you have those two things you do not need to double mask. And you should not double mask with two disposable masks because it could actually create a worse fit. If you are going to double mask, ideally you would use two totally different styles of masks. For example, a disposable - surgical style mask under a gaiter which would give you a nice snug fit (thank you gaiter) and multiple layers (thank you disposable mask).

6. If you get vaccinated you still need to mask - for a while but not forever. Remember that the Pfizer and Moderna vaccines aren't that effective against the SA variant which is in the US, so you won't have protection from that. And we still aren't 100% about your ability to spread the virus even though you don't have it. (we have seen this with some vaccines in the past) so for now, keep masking.

7. The Johnson and Johnson vaccine should be on the scene soon. I am working on a document to compare the 4 vaccines and what we know about each so look for that next week. The J&J vaccine works pretty well against the SA variant, uses an adenovirus style vaccine (for those nervous about the mRNA technology) and only requires one shot. Like all drugs, there are always risks - I will provide you an overview of those next week once we see J&J's data.

FINAL THOUGHTS: Yesterday I was running on an indoor track and I was miserable. It was cold, even inside, and I was sore from a prior day's workout and...I just wasn't feeling it. To make matters worse I was doing intervals to work on my speed. Now for the sake of full disclosure, I am not a fast runner - I am a sloth. I have no shame in that because I typically go for distance not speed. And these old joints can't handle too much speed for too long. I am a middle-aged, overweight woman who runs....slowly. But once every week or so, I try to do intervals because they get my heart rate up higher than a "regular" run does which makes me feel like I am doing something particularly good for my heart. I tell you all this because I was running 2 laps around the track at a pace faster than was comfortable and then walking one. Then, repeat and I was miserable.

So on my last run set, I was super close to the end but not quite there yet and I started to fade out. I was breathing hard (ok ok, I was gasping for air like a fish on land), my muscles were screaming and my mouth was dry and I could feel myself starting to slow down. I was getting slower and slower and slower when this song came on about not giving up - suddenly I realized what I was doing - quitting right there at the end. So I dug deep and pushed myself to pick the speed back up and finish strong. After which I collapsed. Not really, I walked my lap gasping for air and bemoaning my choice to do intervals.

So often we give up just as we are about to be victorious. Don't do that. Sometimes when you can see the finish line it makes it feel ok to just give up, relax into it and coast through, but don't. Don't give up, because we are getting close and you want to run through the finish line victorious - but we aren't quite there yet. Now that doesn't mean you can't take breaks, or you have to pretend you are ok when you aren't or even that you have to like it. It just means find your ugly face (you know the face you make when you are trying really hard) and keep going. Grunt, groan, yell out into the space, but keep going. It's ok to take breaks. As you know I highly recommend it. It's ok not to be ok. Reach out to someone. But don't give up. We can finish this together. Get some rest this weekend. Stay warm and safe and I will see you Monday.