Health authorities continue to stress that slowing the pandemic means everyone should be washing their hands frequently, practicing social distancing and wearing face coverings when out in public.

As we enter the 16th month of the COVID pandemic, many problems still remain.  Why after 16 months does it often feel like we’ve really made so little progress?

First, the good: 1) There are a multitude of highly effective vaccines, 2) The national and state governments are doing their best to regulate human interaction without crippling the economy, and 3) People by and large really are trying to be responsible. The bad:  1) There is still 30% of the U.S. population that is refusing vaccination, 2) There are many places in the world that are currently going through dramatic infection waves (India, Chile), and 3) The resistant, more dangerous strains are becoming much more prevalent. Let’s look at the problem side a bit.

Herd immunity (if there will ever be such a thing) is now being quoted at 80%. As more strains develop, the number will only get higher making it an unrealistic goal. Then there’s the cost. Who will pay for the people who decide to not be vaccinated? Imagine it’s 2025, the pandemic is basically over. A man shows up in an emergency room. He’s got pneumonia and it’s hitting him hard. He tells one of the doctors that he had COVID a few years earlier. He had refused to get vaccinated and ended up contracting the coronavirus after most people had gotten theirs.  Why did he refuse? Something about politics, or a post he saw on Facebook. He doesn’t really remember. His lungs do, though. By the end of the day he’s on a ventilator, his lungs still dysfunctional because of earlier COVID damage, damage which could have been avoided.

You and I will pay for that man’s decisions. He has been clearly compromised, possibly for life and his level of future medical care will reflect that. That’s the scary thing about this virus. We really don’t know the long-term aftermath after perhaps even just a mild infection.  Did you ever think something as severe as shingles would develop 60 years after a case of childhood chicken pox? We will only know how this thing will plays out decades later. As the pandemic evolves, new findings are published daily. One recent study finds that 34 percent of COVID survivors are diagnosed with a substantial neurological or psychological condition within six months of recovering from the initial illness. Risks were greatest in, but not limited to, patients who had severe COVID. That’s a scary big number.

As time goes on, it’s becoming more and more obvious that this is a disease we will never eradicate. The war against COVID will never be a slam dunk win like the battle with polio or smallpox. Like the common cold or flu viruses, there will be yearly mutations. This will necessitate yearly vaccination updates. We will get used to living with it like we do with the cold or flu, but frighteningly it’s not those. The common cold has never been responsible for mass burial pyres as we are currently seeing in India. The best we can hope for is a yearly vaccination which mostly prevents, but even more importantly limits the severity of the disease. This is a realistic goal. 

The U.S. has mostly curtailed uncontrolled spread. This far from being the case in other parts of the world such as India and Chile. What went so terribly wrong there? Each of these examples highlight dangerous mistakes which can be made managing this pandemic. First, we are never going to beat it with one weapon. Beating COVID requires an entire arsenal, and one used consistently. You cannot let your guard down. Chile had one of the world’s best vaccination rates, but COVID is surging there anyway. What happened? Chile’s population was primarily vaccinated using the Chinese developed CoronaVac. It turns out this vaccine may not have nearly the same level of effectiveness as the U.S. vaccines. Also, the country’s borders, which had been closed to travel from March through November 2020 were then opened allowing a large inflow of the Brazilian P.1 variant which is far more dangerous.

Similar mistakes were made in India. Their government also declared victory over COVID far too early. The country subsequently removed virtually all restrictions on large social and religious gatherings, some consisting of millions of people. Anyone watching the news lately knows how well that went, with over 300,000 new cases and death records being broken daily. India and Chile serve as examples of what can happen anywhere if complacency reigns and things are allowed to return to normal before true mass immunity has been achieved.

As for Oregon, last Friday, Gov. Kate Brown again placed 15 counties back in an “extreme risk” category, banning indoor dining at restaurants and limiting the number of patrons at gyms. She imposed the restrictions after cases rose by 51% in two weeks (the fastest increase in the nation at the time) and hospitalizations jumped by more than a third. As cases were declining in much of the rest of the country, Oregon had lurched in the opposite direction. Virus mutations are partly to blame. The highly contagious United Kingdom B.1.1.7 variant currently accounts for more than half of Oregon’s recent cases. So, although we probably are closer to resuming a more normal life in the United States, the true end of the global pandemic is still horrifyingly far away.

To have any hope of controlling this virus there needs to be an 80+ percent vaccination rate utilizing a highly effective vaccine. Even then, in the near future we should still require masking with social separation as well as travel restrictions. We need to enforce what’s effective. The U.S. recently had the sense to close travel to 80% of the world’s high-risk counties. This is good policy. It’s equally important not to enforce useless rules such as outdoor masking (unless in a crowded area) where the risk of transmission is only about 5% that of indoor activities. Our country seems to understand what’s needed. Still, there is enormous pressure from various groups wanting to throw all caution to the wind and immediately return to normalcy. That’s exactly what happened in Chile and India. Common sense always seems to be fighting an uphill political battle. This should not be political.

In the end though we’re going to need to face the facts, that life on our planet has changed.  Something eventually always has to give. The rubber band can only be stretched so tight.  We’ve been overcrowding it, poisoning it, overheating it, and truly amazingly, no one still really gets along. As humans we’ve been on a reckless path for quite some time now. There have been many times in history where the reset button gets pushed. This is one of those. My hopeful side thinks that we as a species could learn something extremely valuable from this.  But, if our past serves as an example, I fear we won’t.

Doc H


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