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It was about exactly two years ago when I started covering COVID in this column. I recall making a crazy prediction as cases rose dramatically that we might reach the unimaginable level of 50,000 infections per day in the U.S., yet we surpassed 300,000. Subsequently, we dropped back to that 50,000 number (which then frighteningly seemed an acceptable level). We’ve now easily surpassed the 300,000 level and it seems that we will likely exceed a million cases a day (probably already history by the time this goes to press).

And there’s a chance this level still may not be the big one. Case growth has drawn a classic parabola, a line straight up. And with this going on, as I survey the social landscape, I still see people packing football stadiums for bowl games (with nary a mask in the crowd) and marginally protected large New Year’s Eve celebrations everywhere, all this with over a half million cases reported daily. There’s something about headlines like “Expect a Tsunami of cases” which told me I needed to celebrate my New Year’s at home to make 2023 a more likely occurrence.

As with the Spanish flu, I’m guessing that eventually one half of the entire U.S. population becomes infected, that’s 150 million people. We already stand at 55 million and at the current daily rate that’s not far away. Additionally, a large number of cases are never diagnosed or reported.

Home tests are not recorded and many people will never test at all. This number was estimated at 17 million way back in June, it’s clearly much higher now. With Omicron, these numbers will rise dramatically. On the positive side, with Omicron there is a 50-90% (estimates vary) less chance you’ll require hospitalization and an 80% lower chance of dying.

South Africa has announced their fourth wave may now be mostly behind them. But, even with the dramatic jump in case numbers, they did not get the spike in deaths which was expected. What improves your survival odds dramatically? Vaccination. Even a 75-year-old lady on immunosuppressant medications after a double lung transplant has a less than 1% chance of dying of Omicron if fully vaccinated. Why wouldn’t you want those odds? Maybe most importantly, the numbers above suggest that half the people in this country never even need to get the disease. Clearly, everyone would prefer to be a part of that group. What works? Masking.

It amazes me that we still have ongoing studies checking into whether or not masks work. It’s just frightening that there is anyone who still needs convincing. Maybe they need an example they can understand.

If you dip yourself into shark infested waters with a deep cut on your leg and start thrashing around, the sharks are going to turn you into an appetizer. Now if you do the same inside the confines of a shark tank, where the sharks can’t pass in between the bars, you’ll be fine. Thrash away. MASKS ARE THE SAME. If you wear a mask which filters the viral particles (N-95) and fits securely to your face without leaks, you’ll also be fine. Is that such a hard concept? For heaven’s sake everyone, wear a proper mask! Sometimes I just fear for our world.

Here are some other things that make very little sense. Think of them as “COVID theater.” Early in this pandemic the mode of transmission was uncertain. There were those early reports that the virus could still be detected on some surfaces of that original ill-fated cruise ship even after 19 days. We all remember the images of guys in dramatic Hazmat suits with large devices strapped to their backs, spraying down large public areas with a fog of chemicals to kill the virus on surfaces. No matter where you were in public, there was some guy hired to run around marginally wiping down every surface in site. Did any of this really make a difference? Probably not.

COVID is an airborne infection. Unless you are in the habit of walking through a COVID ward, touching everything in sight then sticking your fingers in your mouth, you aren’t going to get COVID from some surface. Where money could be better spent would be supplying the public with N-95 masks. Masks with better designs, which can actually be worn comfortably without cutting off the blood supply to the face of the user, additionally working on improving air filtration and circulation systems in all public areas.

What else is “good” about Omicron? As it turns out, the reason it’s less fatal is that it tends to cause much less damage to the lungs. Respiratory collapse has been the leading cause of death from COVID. Also, an Omicron infection protects you from Delta which is far more dangerous. Interestingly though a Delta infection does not provide Omicron protection. The current vaccines protect you from Delta but not as well against Omicron. However, all vaccines do protect against severe disease and death with both variants. Of the current vaccines, the scale of effectiveness is J&J being the worst, then Biotech, then Pfizer, with Moderna being the best of the breed. The best booster (Moderna) looks like it may offer only three months of protective coverage, but they promise new Omicron specific vaccine by early spring. And If you feel slightly confused by what you just read, you’re not alone. But that’s what we know so far.

Okay, let’s say that you have done all the right things and you get COVID anyway, now what?

You must turn your home into a COVID ward.

⦁ Maintain mask use at all times, all members in the household. Those contacting you should use gloves.

⦁ Practice social separation in your household, or better yet, find a designated room and stay there.

⦁ Have someone deliver you what you need.

⦁ Stay in isolation for five days after testing positive. Only break this isolation if you are clearly better after those five days.

⦁ Have an air purifier in the room and open windows.

⦁ Tell people you’ve recently contacted you’ve tested positive. This isn’t a time to feel ashamed or embarrassed.

⦁ Monitor your condition, watch your temperature, monitor your oxygen saturation levels if you have a way.

⦁ Treat yourself like you would any flu, lots of fluids, maintain nutrition, take vitamin C (and in this case D), take mucolytics, get rest.

⦁ Very soon we’ll have access to COVID antivirals, Merck’s Molnupiravir and Pfizer’s Paxlovid, both requiring a 5-day course and said to reduce the chance of a complicated course by 50-90%.

⦁ Days 5-10 are very important. If you are not better after five days and are developing severe respiratory issues, you need to see a doctor. Don’t delay this visit.

Unfortunately, most of the old monoclonal antibody treatments are not effective for Omicron. Regardless, your chance of surviving is very good. The vast number of Omicron patients do well with supportive care only, and especially if they are vaccinated.

The pandemic has currently evolved into something that can attack anyone. The difference of being vaccinated or not now lies in the odds of having a complex case and surviving. Consider this statistic: In Michigan, an overwhelming majority of patients admitted to hospitals for COVID are unvaccinated. The number is 98%. Just think about that. Hopefully, I’m preaching to the choir here, but as we watch the current cruise ship slowly sinking beneath the surface, modern science has tossed us this miraculous lifeline. It’s up to each individual to decide if they wish to swim without it.

Doc H

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