COVID-19 Update, Wednesday November 11th

Some scattered thoughts and a little news. It is heavy today.

As numbers around the country soar frustrations are on the rise and misinformation is once again plentiful. I want to start with a brief look at some of the places around the country that are reporting some significant struggles.

• North Dakota hospitals, at 100% capacity, announced that COVID-positive nurses can stay at work. From the Grand Forks Herald

• In Texas (the state with 10%+ of all US cases), El Paso officials are bringing in 10 refrigerated morgue trailers to help cope with surging cases. According to Reuters

• The virus is spreading rapidly in Maine, which has the US’s highest COVID-19 reproduction rate over the last 2 weeks according to the Portland Press Herald.

• A small number of “superspreader” locations, such as restaurants and religious establishments, account for a large portion of the disease transmission, COVID-19 according to an article in Nature.

On a positive note: A new drug has been approved for the treatment of mild to moderate COVID, it is a drug similar to what Trump received and this is a very promising development that could help prevent people from progressing to severe cases. It is also a great reason to test if you suspect you have COVID.

I would also like to address a few misconceptions/misunderstandings I have been hearing. I am getting comments regarding how the restrictions "don't make sense" and "how is x ok and y isn't"? These are good questions and can, at first glance seem non-sensical. It is important to note that what you are experiencing in your state and/or community is not the same as what other people are experiencing in their state or community. Some states have policies much more stringent than I would ever recommend myself. It is hard for me to speak to those states actions because I am not there, and they haven't taken the path I would have chosen, but if you have specific questions I am happy to attempt to find good answers.

For the rest of us, I would like to discuss, just briefly, the "rules" if you will. It is worth noting that these rules vary from place to place based on the governer. And then individual businesses are left to determine how to implement the policies. Keep in mind businesses don't have experience or training in this and they don't always know the best way to implement the policies, so they do their best.

Sometimes the way things are done is designed to protect workers and sometimes patrons. Often there is a rationale behind why things are done - such as wearing a mask to get to your table in a restaurant - although it may not seem obvious. And occasionally the way things are done in a particular place is just because the business doesn't know precisely what to do, remember they aren't epidemiologists, public health professionals, or risk mitigation specialists. They are business people interpreting the rules established by their corporate office or governer and then attempting to follow those the best they know how.

And again, not all states look the same, some are still in very strict shutdown environments while others have very little restrictions other than masks - and yet others don't even have mask mandate, so keep in mind that it varies greatly from place to place. If you are unsure as to the purpose or rationale of different policies I am happy to try to explain those, just post them, and tag me.

My next random batch of thoughts today is regarding misinformation about the vaccine so I want to give a quick overview of how vaccine trials work. Most importantly, we do not give the study participants the virus. So Pfizer, the current leading vaccine, did not give people the vaccine and then expose them to the virus. What happens is that 1/2 the people get the placebo (fake drug) and 1/2 got the vaccine. Then we wait. They go about life and we wait to see who gets COVID more, those with the vaccine or those with the fake. This takes time and we can't rush it - we just have to wait for a certain number of people to become infected so we can see which group they were in and if the vaccine protected those who got the vaccine. This takes as long as it takes and is one reason we can't know for sure when the trials will end and the vaccine will be ready.

I know there is some hesitancy regarding the vaccine, as there should be. This process has been fast and furious, as it needed to be, but that has, of course, caused people to express concern. Good. But do know that the entire scientific community is with you on that and monitoring the vaccine development closely. Also worth noting is that the average person will most likely not be offered the vaccine until at least the spring. So by the time you have to make a decision, there should be considerably more information available to help you make that decision.

Things are getting worse for much of the country, I want to again encourage you to pay closer attention to your county more than your state as a whole and start making adjustments as needed. There have been grumblings and anger starting to bubble up over the concern that we are heading into lockdowns. Let me assure you, as a public health professional and epidemiologist, lockdowns can be avoided - but it requires that people do four simple things: 1) wear a mask when outside your home and around people who aren't part of your household, 2) wash your hands frequently, 3) socially distance from people who aren't in your household and 4) stay home whenever possible, avoid unnecessary outings. If the majority won't do those things - then I anticipate we will indeed end up in lockdowns again.

FINAL THOUGHTS: Times are frustrating and exasperating for sure. I continually remind myself that when seatbelt laws were first introduced people wildly revolted against them and said it was a violation of their rights - now, 90% of people wear seatbelts. I am so grateful to all the veterans who sacrificed to serve our nation so that we could be the type of country where we can voice strong opposition to the government - because there are many countries that can't. I find boxing to be an excellent release for frustration. Find what works for you because we rise or fall together and I need you to be on your A-game as we head into the bottom of the 9th.