Consulo Indicium - 12/28/20

Information for your Consideration… 

Vaccines Matter – If you run into someone who thinks that vaccines don’t matter, refer them to this chart. It very graphically shows that over time, immunizations for measles, mumps, rubella, polio and a garden variety of other diseases – over time – have been managed effectively through the use of vaccines. Where there is a surge in recurrence of these diseases (e.g. pertussis), it is because of the fact that children are not being vaccinated. It’s data. It’s irrefutable! And, most importantly, it’s applicable to our current situation with COVID-19!

The Big News and The Periodic Rant – Of course, it was the fact that the US Food and Drug Administration authorized both Pfizer and Moderna to begin distributing their COVID-19 vaccines. But, the real news is the partisan bickering that has resulted in a nationwide lack of coordination between the feds and the states in large measure due to insufficient funding. Then, Congress finally got its act together by passing the massive COVID-19 supplemental relief bill of $900+ billion tied to an ongoing $1.4 trillion regular appropriations bill only to have it sit – not on the President’s desk – but on his card table at Mar-a-lago awaiting a signature (as of this writing, we’re still waiting). The end result is chaos with no real purpose except to take one’s golf clubs and go out to play whenever they want. This is disgusting behavior but it befits the temperament of our outgoing President. Making lives worse by not helping them with relief in the midst of a global pandemic, failing to provide funds so that government could continue to operate in one of the worst situations we’ve faced since WWII, creating chaos and seeking supplication from sycophants is not leadership. It is narcissistic behavior gone amok! Thank the Lord – or whoever you worship – that January 20th is just around the corner. OK, Kevin!! Let’s get back to data…

pandemicAnd, How Do We Compare? – If you’re interested in gaining a perspective on the USA compares to other countries in terms of both Total Pandemic Deaths and Deaths Per Population – take a look at this table. What becomes abundantly clear with even a cursory review is that the USA has by far the worst results of the various comparable nations of the world. The only two major countries missing from this compilation are China and Russia – whose statistics would be suspect from the outset. In other words, the USA is the worst. Canada holds the second worst record by about 2½X the death rate of the USA followed closely by Germany at near 3X the USA.  More importantly, look at those nations that have substantially better results or, Vietnam, Thailand, and Taiwan. What’s the common factor? Those nations require the use of masks!! It just shows that when it comes to the pandemic, simple solutions can have significant results.

The Little Reported Public Health Brain Drain – The Associated Press and Kaiser Health Network have been conducting an ongoing investigation related to the loss of leadership among public health works since the beginning of the pandemic. By last count, about 181 state and local public health leaders from 38 states have either been fired, resigned, or retired since April 1, 2020. This exodus represents the largest loss of public health leadership over such a short period of time in American history. So, why? It appears to be related to the fact that conservative groups, anti-vaxxer extremists, and other extremists have elected to move beyond protesting to actual threats and personal attacks. This is craziness run even further amok from the amok-ness described above!!!! These health care professionals, in general, make far less than more traditional health care providers. They commit themselves to a career in public health. They are driven by a mission of making our water, sewage, schools, restaurants, streets and other common areas safe and secure. From my perspective such behavior on the part of these extremists is akin to shouting “fire!” in the middle of a theater. We wouldn’t allow it and we should not allow it!

Let’s Not Panic! – The rapid spread of a new variant of coronavirus has been blamed for the introduction of new travel restrictions for those traveling from and to England, Scotland and Wales as well as some other countries in the UK orbit. Scientists are going after the problem with an immediacy that should provide some degree of comfort. Viral shift is not an uncommon occurrence. In fact, we should be expecting it – especially for a virus that has infected so many people across the globe. At first blush, it appears that the viral shift has allowed COVID-19 to be somewhat more infective but not necessarily more deadly. The implications are unclear. The new viral strain was first detected in September and by November about a quarter of all the new cases in London were attributed to the new viral strain. Again, such changes should be expected. The virus originally discovered in Wuhan, China is not the same virus swirling around the world at the present time. Rather, the dominant strain that has swept the world is one that emerged in February (probably from China) that had the D614G mutation. Remember, the outbreak in Spain last summer? That was the A222V variant which spread across Europe. The issue at hand is that we need the resources of the World Health Organization deployed and conducting ongoing laboratory analysis of the viral strains to determine if the viral shift is worsening the spread of COVID-19. May I suggest that this means we need to rejoin the WHO pronto! It’s in our best interest – as well as the interest of human beings across the globe. If you want more details, read the first hyperlink from a BBC overview about ten days ago on the viral mutation issue. 

Uplifting Not Downplaying – I know that some will suggest that this is highly partisan. But a colleague following the campaign shared an ad from the Biden-Harris Campaign that touched my heart. It is entitled “America” with background music by Ray Charles. Regardless of your political stripes, it should resonate with you on how – if we come together – we are an incredible nation!!

Standing In Line, Patiently –There are a number of calculators that have become available for use by all of us to determine when we might become eligible for the COVID-19 vaccine. The most notable one is from the New York Times that was developed in collaboration with the Surgo Foundation and Ariadne Labs. By using the app, I discovered that there are 313,604 individuals in the state of Maine with my situation = people with moderate co-morbid conditions. I also discovered that there were 343.957 people ahead of my cohort or, roughly a half a million people standing in line in front of me. Well. That’s OK. What it means is that I will not be getting my vaccination anytime soon. Most likely, I’ll become eligible sometime in the February or early March timeframe – just in time for my XX birthday. Furthermore, it simply means that I will have to wear a mask somewhat longer than I really wanted to…but, then again, I want to wear a mask as long as I have to… 

Pandemic Stomach: The Latest Stressor – First it was Personal Protective Equipment (PPE), then face shields and masks, then gloves, and then ventilators. These were the first real shortages that appeared as Covid-19 spread across the USA. Then, the real challenges started to lift their lack of availability on the horizon with a run on toilet paper, eggs, paper towels and whole sections of items at the grocery store (at least at my store). You could actually feel the great consumer anxiety at the store. But, the latest is a new syndrome referred to as “Pandemic Stomach” that has caused a run on over-the-counter and prescription antacids. Oh, my Lord – there are no Tums?  Oy vey – it’s a good thing I stocked up several weeks ago not only on my stash of Tums but also my stockpile of Famotidine – the active ingredient in Pepcid 😊.  But, the bigger questions is: What are we going to do with the growing number of “depressed” people around the country – me included – who need anti-depressants? First, it seems to me that we need to make the turn on January 20th and press on. There have to be better days ahead because it can’t get much worse. Then, we need to press ahead with a new President who seems to have a plan – AND, wear our masks for 100 days. That’s it! 100 days and then, reassess where we are at. Perhaps this too shall pass…  PS – I’ll share my Tums and Famotidine but you’ll have to travel to Boston to get some. I’m stuck at home…

No Room In the Inn – California – like the some of the states that preceded it (i.e. New York, Massachusetts, North Dakota and others) has its hospitals filled to the brim with COVID-19 patients to the point where regular old health care problems (e.g. Congestive Heart Failure, Myocardial Infarctions, fractures, etc.) have having a hard time gaining admission. The pandemic has taken over and swarmed the traditional facilities with cases. We don’t seem to be learning. Masks work and until vaccination becomes the norms (= not still mid- to late-summer) we should expect that the viral infections will continue to swarm health care episodically across the nation. Hmmm – perhaps a mask mandate or, if not a mandate – a mask education program that saturates us from TV, the Internet, public media and the like – might just be the trick to helping to get the COVID-19 pandemic under control in the good ole’ USA?

The Longer Term May Be The Bigger Concern – As I continue to purvey the literature (and, I am not an expert), one of the issues that continues to percolate are the longer term issues related to the COVID-19 pandemic. There are the medical issues for individuals as well as the social issues for groups such as children and other students attending school. There are the management issues for leaders who – like me – are becoming Zoomaholics - a condition marked by extreme multi-tasking, loss of nuanced observation, inability to decipher conversation due to multi-talking situations continuously and the like.  On the medical side, we are increasingly recognizing the long-term side effects related to cardiovascular and cognitive problems which are likely on the beginning of a list that affects other organs as well. On the social side, I’m actually very concerned (without evidence at this point) that children who seemingly have no physical side effects will have long-term cognitive and other affiliated medical problems associated with their COVID-19 infections.

Following the 1917-18 pandemic the Poskanzer-Schwab Hypothesis (PSH) was proposed that suggested the increase in Parkinson’s Disease in the 1920’s and 30’s was due to infections during the pandemic. One comprehensive study found that the data did not support the hypothesis over the longer-term evaluation. However, the same study suggested that a growing body of evidence related to viral infections – in general – may be a culprit for the disease. Dr. Anthony Fauci recently noted that: “[Long Covid] “is a phenomenon that is really quite real and quite extensive.” I concur but, again, I’m not an expert!! It is increasingly clear that the longer-term implications of infection are significant. As we explore these issues; however, we need to make sure we don’t simply visit the problems with a strictly “medical” paradigm. Consideration of the social and managerial issues will also be very important and will require research dollars along with the medical side of the equation.

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