COVID-19 Update: Friday, September 3rd, 2021

New variant, numbers, a message for the vaccinated, and long-COVID. This is heavy today so skip it if you aren't having a good mental health day.

1. You may have heard there is a new variant currently being monitored, mu. Mu was originally identified in Columbia but has now been found in 39 countries. It is currently considered a variant of interest (VOI) but early indicators suggest it can evade both natural and vaccine acquired immunity so I anticipate it will become a VOC very soon. Not good. Keep a close eye on this one.

2. Kidney damage has been added to the long list of long-term complications of having COVID. Just a reminder that while you may not die from COVID, and your symptoms may not be severe, you can still experience long-term health issues that may not manifest right away.

3. I believe that hearing numbers and seeing a picture of the numbers is two different things, so I want to show you a picture. We are going to look at two charts: cases and deaths. We will take them one by one.

FIRST, cases. It is important to note this chart represents the CHANGE in cases, not the total number or even the new cases, but the difference from one week to the next. So for example, if one week we had 4 cases and the next week we had 10 cases this chart would show 6 cases. I have put red boxes around last August and this August so you can see where we were last year at this time compared to where we are now. Notice the dramatic increase between July of this year and August. Also, note how much higher cases are this August compared to last August. Epidemiologically this is concerning because 1) viruses tend to follow a seasonal pattern once they prove to be seasonal - meaning if a disease is more common during the summer - it tends to stay more common during the summer. COVID has proven to be worse in fall/winter. So we are heading into the "COVID season" but we are heading into it with already higher numbers than last year. We can therefore assume that this fall/winter will see more cases than last fall/winter. This is a forecast of course, and forecasts can be wrong, but unless something changes quickly, we should anticipate a rough fall/winter COVID wise. You can see that this year's August numbers - including this week's numbers, are already in alignment with what we were seeing last November. 2) this fall/winter there are some very different factors that could make things worse than last year. Things like face-to-face school, and reduced restrictions (many places have no restrictions of any kind now). So again, anticipate a potentially rough fall/winter.

Chart 2 is Deaths. This chart shows the INCREASE in deaths - so again, not a count or even a change, but it shows how many more we had from week to week. So when it goes down, it shows how many less there were and when it goes up it shows how many more people died from this week compared to the week before. For example, if 7 people died last week and 10 died this week it would show a 3. I want you to note a couple of things. A) Take a look at July 2021 numbers compared to August 2021. There is a big increase. B) Take a look at August 2020 compared to August 2021 - again, considerably more now in comparison to where we were last year. Worth noting - the CFR has gone down. So we now have a CFR (case fatality rate) of 1.6% (which is great!) but we are taking that 1.6% from a larger number of sick people so it is still equating to more deaths. As cases increase, deaths will also naturally increase despite the fact that we are getting better and better at keeping people alive. And finally, C) you can see that we are now seeing numbers more in alignment with where we were last November(ish).

4. For those who have been vaccinated, thank you. Truly. Most of us were a bit nervous about it, (as indicated by all the people who passed out) but you did it anyway. Most of us did it so we wouldn't have to worry about COVID, so we could ditch the masks, hug our loved ones, go to public places and help resolve the COVID issue. Unfortunately, the time has come to resume most of the precautions you were taking pre-vaccine. The facts are, that the original vaccine was not developed with Delta in mind so it doesn't work quite as well against it. Still, 86% effective (give or take, and regardless of which vaccine you got). There are other, more common vaccines that are less effective - so know that it is working. And it is working quite well to protect the vaccinated from severe illness - which is very important.

And as we have discussed previously - some vaccines prevent you from being able to get/spread the virus and some prevent symptoms or severe symptoms. The COVID vaccine does not prevent you from shedding the virus. Essentially, what happens is if you contract COVID once vaccinated, you can give it off to others even if you yourself are never ill. (you will not shed the virus if you don't have it, so being vaccinated does not cause you to give off COVID despite what some FB posts may be trying to tell you). If you are exposed to COVID, your immune system kills it off without you even realizing you got it. But you can still spread it and if you are around the unvaccinated, that matters much more than if you are only around other vaccinated people. In some instances, you may still get sick. Most of you know at least one person who is fully vaccinated and still got COVID. As time goes on, you will know more. As you know, some people get vaccinated and never develop immunity - so they would still get sick when exposed to COVID.

Dosing is another critical piece. The more COVID you are exposed to, the more likely you will experience a breakthrough infection. For example, if you are in a room for 30 minutes with 1 COVID positive person, you are less likely to contract it than if you are in a room with 4 COVID positive people. Staying in the room longer increases risk too. So "dosing" is dependent on how many COVID people you are exposed to, how long the exposure lasts, and how frequently you are exposed.

Finally, genetics, biology, age, risk factors, and the variant of exposure all contribute to the likelihood that you will experience a breakthrough infection. New variants are emerging, and the vaccine doesn't protect you against all variants. So....it's time to start limiting those public outings, keeping the hand sanitizer close, and masking in public places again if you weren't. It's time to start limiting our time in large gatherings, particularly those that are indoors. Because flu season is also coming and our medical facilities are strained. Take a look at your Labor Day plans and make sure they are COVID-wise. We don't need to be hermits, we just need to be diligent.

FINAL THOUGHTS: I once again find myself physically and mentally exhausted as I am sure so many of you do as well. But today, I ventured out very early. I was greeted by a host of "good mornings" by the others unfortunate enough to have to be out that early. I know it's silly, but I found those greetings to be uplifting. Something that simple, "good morning" made me feel a little less dreary. It made me want to pass that small kindness on to someone else. I was reminded that our attitudes are contagious and that small gestures of kindness and courtesy can go far. No one I passed today knew me. None of them knew I was tired and worn out. No one knew I was discouraged. And none of them know that their small act of saying good morning, reset my day and put me on a much better trajectory. They simply said, "good morning" with a cheerful voice. That simple act of courtesy changed my day and reset my attitude. Never underestimate the power of simplicity and kindness. Never diminish the strength of having a small part in something bigger than yourself. You do not know the difference you are making in other people's lives, but you do impact every person you encounter today. Decide that your impact will change them for the better, even if it is as simple as a good morning.