It’s late June here in Northeastern Pennsylvania. Up here in the highlands, the mountain laurels in my yard are in bloom. I know from experience that the vast expanses of laurel in places like Hickory Run State Park, and in Sullivan County, on the Loyalsock Trail, will also have erupted. It’s time for some hiking and photography.

Here in Luzerne County, we are finally in the “green” phase of our coronavirus lockdown. Our benevolent overlords will finally let us live life in a quasi-normal state. Businesses can reopen, providing they attend to mask-wearing, and social distancing.

We can now sit at a bar, even one indoors, and enjoy eating in a restaurant so long as the capacity is properly limited, and the tables appropriately spaced. There are some quirky rules, like the requirement to wear a mask on entering a restaurant, but not after you are seated. People, I think, sense the illogic of this, which will ultimately erode compliance.

Of course, while we all politely comply with the state edicts, all sorts of people are out on the streets of our larger cities rearranging the statuary. I suspect their mask usage has less to do with protecting others and more to do with protecting their identities.

We are seeing additional cases of COVID reported. In our county, the numbers of new cases per day are generally in the low single digits. Hospitalizations and deaths also continue to decline statewide. There have been no changes in this with the phase changes, suggesting that perhaps a seasonal effect is indeed happening.

In reviewing the numbers from the various states, there are certainly curiosities. First, while it is true that daily numbers of cases in Florida and Texas are increasing, when you review the overall curve, you get the impression that they actually never peaked. This is true also of some of the Western states like California. There the curve has been slowly rising since March. Interestingly though deaths per day are flat or decreasing perhaps again suggesting a decrease in virulence of the virus.

Florida had a very minimal early peaking in early April, began to gently decline, and now has had a precipitous rise starting perhaps a week ago. Mortality, however, remains flat to decreasing. Deaths are obviously a late effect however so there still may be a bump there.

Georgia is also seeing an uptick in cases. They originally peaked in early April and were having a slow noisy decline in activity. Within the last couple of days, they had a second higher peak. Georgia as you may recall lifted its lockdown in late April, but still declined for weeks afterward. Another state with this profile is Washington which also peaked in April and now has had a higher second peak again within the last several days.

Given that Atlanta and Seattle have been the sites of some significant mayhem starting perhaps 3-4 weeks ago, I do wonder whether there is a relationship.

Another interesting detail is that the new cases are shifting to the young, which is probably explainable by the fact that they tend to be the ones most eager to take advantage of reopened social venues (not to mention the protests, etc…). It may also be why the death rates have so far not increased.

Perhaps I’m suffering from fear fatigue, but I’m at least personally not as frightened at the possibility of acquiring this infection. Other people still are though, and particularly of contact with me. This is hopefully because of my status as a healthcare worker. It is kind of ironic, because as the cases dwindle, I am largely confined to my office, and have not had any known COVID exposures in more than a month. I suspect there is more risk of exposure out in public than here at the VA, where we screen everyone who enters the building and test everyone we treat.

Anyway, it’s nice to be out and about, to catch up with friends and acquaintances, and to sip a draft beer (albeit from a plastic cup). And is nice to see my 94-year-old father be able to emerge from his quarantine and enjoy a restaurant (on an outdoor deck). Conversely, it sad to see those businesses could not tolerate the lockdown and will never reopen. I hope the owners and workers find other opportunities.

Still, it’s still worth being careful. The virus is still in the population, hopefully, weakened and decreasing in prevalence. I sincerely hope it fades away over summer, not to return.

In the meantime, I’ll be out with my camera and my tripod surrounded by the white blossoms of a Pennsylvania June (and probably the damn blackflies).

Enjoy your new freedom. I hope it lasts.

We are now in week 12 of the Wolfe/Levine coronavirus religious and economic lockdown. Most of the eastern portion of Pennsylvania is now in “yellow phase”. This does allow more businesses to open. It includes the so-called nonessential merchants, as well as bar/restaurants, the latter so long as they have an outdoor deck. “Personal-care” businesses such as barbers and hairstylists are still closed.

We found out yesterday that on June 19th, Luzerne County will be permitted to move into “green” phase. As great as it sounds, the rules for this phase are still very restrictive. I guess we should be grateful our benevolent overlords will permit us a little bit more of our rights.

Looking back on the previous weeks, I’m still puzzled by the whole question of nonessential businesses. Wouldn’t it have been smarter, for instance, to allow more retailers to stay open which would have the effect of spreading the pool of shoppers over a larger number of businesses?

Not that anyone cares about this in the governor’s office, but also wouldn’t that have been fairer?

Now that we are opening up, it would’ve been easy to rationalize some of the unusual precautions required by the new rules, such as temperature taking greeters, and mask-wearing waitresses. Hell, we’re all just glad to be out.

But then there was the vision of our governor, admittedly masked, but standing shoulder to shoulder with others in a large demonstration in Harrisburg (Dauphin County “yellow phase” no gatherings larger than 25 people). We watched as the ultimate zealot of pandemic propriety flouted the rules that he imposes on us non-protesters. No matter how worthy the cause, Mr. Wolf’s actions were hypocritical in the extreme. Kind of makes the “6-foot rule” feel silly doesn’t it? Remember, this is the man who called people protesting the unconstitutional lockdown “cowards”?

Want to protest and maybe do a little vandalism and looting? Apparently, it’s OK. Want to worship? Not so much.

 Almost as perverse was watching our health secretary, Dr. Levine using pretzel-like logic to justify the governor’s behavior.  Does anyone now doubt that the prolongation of the restrictions was purely political?

I don’t.

A couple of thoughts on the virus itself:

First, the WHO keeps changing its opinion as to whether asymptomatic people are likely to pass the infection on to others. First, they claimed that this is unlikely. Then they kinda backtracked. If the former is true, it suggests that taking one’s temperature on entering a business makes some sense, and there are technologies evolving that will allow us to do this automatically.

I do wonder however whether we should revert to the original CDC recommendations for facial coverings (only for patients known to have COVID 19, and their caregivers). I have certainly noticed as time goes on the people are getting more and more cavalier about masks, and I suspect their use will continue to decline.

The numbers of cases are certainly coming down. As I write this our local paper reports that there are no new cases in Luzerne County in the last 24 hours. This is likely the first time this is been true since mid-March.

When you look at the graphical data there is a clear decline since about mid-April. From March 15 to last Friday when we went into “yellow” phase, our county’s precautions have been in a steady state. If the virus had a constant level of infectivity, the curve should’ve leveled off at a roughly steady rate of increased cases/day, instead of steadily dropping as it has. To me, the continual decline suggests that something else is at work. it might be that the hoped-for warm weather decrease in the virus’s infectivity or virulence is real. Let’s hope this is the case.

There is talk of bumps in infection numbers in Texas and Arizona that some will blame on reopening. The infection rates in those communities are still very low and likely explained by significant increases in testing volume over time.

Though I am hopeful, I have no illusions. There is still COVID 19 in the environment, and if the wrong person ingests a significant amount of virus, then they may get sick and even possibly die. It will be some time for instance before I encourage my 94-year-old father to go out in public. It does not appear however that the average young or middle-age worker, or customer is at much risk. As long as the vulnerable are protected, we need commerce to resume.

I will be glad when we are finally allowed a more normal way of life.

Unless of course, our governor and his protesting friends cause another bump.

Who’s the “coward” now?

We have reached week 11 of the suspension, by decree, of religion and commerce in the Commonwealth of Pennsylvania. Here in Luzerne County, we are scheduled on 5 June (Friday) to move into the “yellow phase” which means that the Wolf and Levine team will allow a tepid amount of additional business activity.

Whoopee.

This is occurring in the middle of a new crisis, namely the protests/riots in our cities caused by the universal outrage over the apparent murder of George Floyd, a black man, by a Minneapolis policeman who has been subsequently fired, charged, and imprisoned.

Scenes of large crowds of masked and unmasked protesters, provocateurs, and criminals, freely associating in our urban centers, to say the least, has been destructive to the culture of social distancing we have come to know over the past weeks.

Suddenly, coronavirus feels like yesterday’s news. With this new crisis, I suspect the caution and fear people felt about the pandemic will begin to dissipate.

There may be other reasons for this. Certainly, in most areas of the US, the number of new infections and deaths is clearly decreasing. No longer do we wait breathlessly for the state and federal coronavirus broadcasts for the most recent bad news. Drs Birx and Fauci seemed to have faded from the public view.

There was a report this week out of Italy (which appears to be the proximate source of our eastern viral strains) to suggest that the coronavirus there has become significantly less virulent in recent weeks. Based on basic virology, this would make sense.

First, it’s important to remember that this virus comes from a specific species of bat, where it infected large colonies with minimal deleterious effects. This is likely because the bats had a degree of “herd immunity” and the virus had evolved to maximize its spread by minimizing virulence. A virus receives no advantage by killing its host.

Then it spread to humans, whether from freshly slaughtered animals in a Wuhan market or more likely released by accident from the neighborhood virology lab. Humans had little or no immune defenses to this novel agent, and the virus had not yet evolved to avoid excessively sickening the new hosts.

Add in a little globalization and voila… a worldwide pandemic.

Now, if over time, there are multiple mutations of this virus (which there are), it makes sense that some of them will be more aggressive and some less. The strains that make people obviously sick, and/or dead, will tend to be more quickly diagnosed, and the patient isolated, impeding further spread.

Less symptomatic strains will be less likely to attract the attention of the public health system and thus have more opportunity to spread to and replicate in a new host.

At some level, the most successful viruses will be among the mildest ones. The virus has to be aggressive enough to infect the right tissues (respiratory ) to facilitate transmission by coughing and sneezing, but mild enough that the illness will provoke little concern from others and can spread freely.

Now consider a virus such as Ebola, with a horrifying presentation. In modern times an infected patient is quickly recognized and carefully isolated, reducing or hopefully eliminating spread.

In one of Dr. Fauci’s last publicized statements, he feels there is now hope that there will be no recurrence of the virus in the fall. I don’t entirely understand the data that this is based on, but it is undoubtedly good news.

With the good weather, and now obviously with the mayhem, the enthusiasm for social distancing is fading, and I think will eventually become extinct, rules or not. If there is no meaningful bump in cases around the country after all of the mass gatherings that have been occurring, then I suspect the sense of the coronavirus as a threat will reasonably ebb. The practice of masking, and spacing ourselves out, will likely then feel dated and unnecessary.

We are obviously living through extraordinary times. More than anytime in my life, I find myself praying for the welfare of our country and its citizens. I do believe that in God’s good time, there will be recovery and a return to a slightly different, but acceptable baseline.

I just hope this happens before there is more damage to our economy, our infrastructure, and our psyche.