COVID-19 Update: Thursday July 23

Baseball, Chronic COVID, kids, Spys, and COVIX. It's a little heavy today so do a mental health check before reading.

1. Today is opening day for MLB. They will open with no fans, no spitting, limited touching, masks, and they will be required to keep a list of quarantined or isolated players. Fauci is set to throw out the first pitch. Check out today’s photo of baseball during the 1918 pandemic.

2. Physicians in the UK are advocating for recognition of what they have termed, “Chronic COVID” for patients who are experiencing symptoms for months. These patients typically do not require hospitalization or medical intervention but experience symptoms that linger. Symptoms reported are nearly identical to those we discussed yesterday: cardiac, gut and respiratory issues, skin manifestations (remember COVID toes?), neurological and psychiatric problems, severe fatigue, relapsing fever. They have seen patients who have had symptoms for over 16 weeks.

3. California and Mississippi now report that over 10% of their cases are in children. (the National average as of the last time it was updated was 4.4%). Florida is reporting that 1/3 of all tested children are positive and Texas is reporting that 11.4% of their cases are in children. In related news, 7 summer camps around the country have closed in the last month due to COVID outbreaks – they represent 191 staffers and campers.

4. The US-DOJ believes the Chinese and Russians are trying to hack in and steal our vaccine secrets. In related news, Moderna, Pfizer, and Merk report that they will price their vaccines to make a profit while Johnson & Johnson and AstraZeneca say they will price theirs at cost with no profit. Moderna, and AstraZeneca received federal funds to develop their vaccine. Pfizer did not. I do not know about the others. In still more related news, there is a movement among countries to help assure global access and equitable distribution of the vaccine. Over 75 countries have joined COVAX – those committing to help finance vaccine distribution. The idea is that through voluntary donations, they will deliver 2 billion doses of approved vaccines around the world by the end of 2021. The 75 countries who have joined will partner with poorer countries to assure there are able to access vaccines. AstraZeneca has agreed to provide 300 million doses of their vaccine to COVIX should it be proven safe and effective and receive approval.

5. There has been a lot of fluctuating information regarding isolation and how long that needs to last for those who have tested positive. In part this is because we are learning more every day, in part because there are differing opinions from different organizations (mostly because we are learning more every day). The general rule right now is that if you have COVID you need to isolate from others for the duration of illness and then 3 days after symptoms are gone (including no fever without medication). Many places in the US are no longer requiring post-tests. This is the general consensus currently, expect that this may change as we continue to learn more. Some cases will clearly vary so those too will look different. Follow your doctor's recommendations.

FINAL THOUGHTS: Several years ago, I taught in a School of Pharmacy. Epidemiologists and Pharmacists are quite different. Pharmacists operate in a world of precision, as they must, to ensure our health and safety. Epidemiologist operate in world of chaos and ever-changing information, as they must, to ensure our health and safety. One thing I learned the painful way during that time, was that most people don’t do well with uncertainty. Some people work best when the information is xyz and the answer is A – and it is always A. They like solid numbers they can count on, after all, if you count how many apples are in the orchard that is the number in the orchard. This has been ingrained in us since grade school. But you may recall, we discussed that Epidemiology is like counting the number of apples in the orchard as wild horses run through overturning baskets, eating apples, smashing apples under their hooves all while someone, somewhere, is launching apples into the orchard. The information is fluid and ever-changing. Fortunately, there are people who enjoy this and typically it is all done without the general public having to see or experience it.

But we are not in normal times and everyone on earth has been thrust into that crazy- wild horses in the orchard scene- and that is quite unnerving and stressful and crowded while somehow leaving us feeling oddly alone . Even those who were trained for this environment weren’t trained to have so many people in the orchard trying to “help.” So, there is madness a-plenty, stress a-plenty and chaos a- plenty. Oh, and let’s not forget uncertainty because we have plenty of that to spare right now and that just may be the worst part. The exhaustion, lack of motivation, grief, and stress we are all experiencing is very real and warranted. So give yourself and others some grace. That unexpected and unwanted change so many hate is very real and consuming. And it is ushering in a new normal. Life “before” is no more. We are moving into something new just as they had to do in 1918. And some good things came out of the 1918 pandemic, things that reshaped society in good ways. Good will come out of this too. Eventually, many things will return to “normal” just as they did back then, (churches reopened, restaurants and schools did too, masks were no longer required).

We will look different for having lived through the pandemic of 2020. We will be different. But eventually, Hollywood will start filming again, concerts will resume and little league games will once again fill the small stands in neighborhoods around the country. We will throw our masks in the garbage or pack them up in a box to collect dust. We will tell stories that start with “remember when” and we will proudly don the T-shirt that shows we went through 2020 and have the t-shirt to prove it. This will end. And in ways that we don’t yet know, it will make us better. Good will come out of the pain, it always does, even when it is nearly impossible to see.