It is week 30 of the Chinese-sourced scourge that is the COVID pandemic. Throughout the country, cases are soaring. Everything is increasing including the percentage of positive PCR tests, the number of hospitalizations, and to a lesser extent deaths.  Happily, the ratio of hospitalizations to new cases remains significantly better than in spring.

This matters to me, as I too have become a statistic.

I was feeling fine until Saturday. I have had a very nice prime beef brisket in my freezer probably since the winter. With no possibility to socialize, it remained frozen. This week I decided to cook it, either to share with friends or freeze it for further use. Cooking a brisket at 225° can be an 18-hour event. I started it late at night and then tended to it periodically until morning. When I woke up Saturday morning feeling tired, it was no surprise.

I went to bed early that night and awakened on Sunday, nine hours later having apparently slept well. If anything I was more fatigued and began to notice muscle aches and pains, and a cough. I figured I had developed a more mundane viral infection, but realized as a practical matter I would have to be tested before going to work at the hospital on Monday. I ultimately had a rapid COVID test in our hospital emergency room Sunday morning which turned out to be positive.

I was uncomfortable most of Sunday, with fatigue caused undoubtedly by the interleukin levels provoked by the virus. In the late evening as I prepared for bed I had a sensation of flushing and brief nausea which cleared after about 10 minutes. 15 minutes later, I was no longer fatigued and felt better. Other than some minimal sporadic headaches, I have basically felt fine since.

Therapeutically, I have been taking zinc and vitamin D on a fairly regular basis. Back in March, I had obtained a course of hydroxychloroquine, and azithromycin; despite the conflicting data, I elected to take them in the morning right after I was diagnosed. I’m not sure whether they were helpful or not but I’ve experienced no unpleasant side effects.

I think the worst part of this has been the isolation. I’m lucky to live in a big old rambling Victorian, and it’s easy enough for my wife and me to isolate from each other. I have been basically existing in my office at the back of the home which has my computer, and a pullout couch (not particularly comfortable). There is an outside entrance so that I can go up to my shed/workshop in the back. I distance myself from my wife and wear a mask in her presence.

I don’t know why, but she seems pretty happy with the arrangement.

This is not meant in any way to trivialize the pandemic. I know that my friends working in other healthcare facilities are once again under stress. People are really sick.  I suspect, if my good fortune continues, it is because of the fact that for 37 years as a physician I have been quite intimate with the coronavirus family of viruses, and thus probably have some immunity. Obviously, others have not been so lucky.

With my newfound perspective, it is interesting to watch the states respond to this surge. I’m actually sympathetic to Governor Wolf in this situation, as his options are very, very limited. Hopefully, he understands that another shutdown like the one in March would truly devastate the economy, wiping out the businesses that barely survived the restrictions in the spring. The new Pennsylvania restrictions tighten up on interstate travelers except those that have to travel every day (which kind of makes this moot) and increased mask-wearing to include certain outdoor circumstances, and indoors when your family has a visitor.

Governments, after all, have to be seen to do something about crises. But as I’ve said before, it’s becoming more and more clear that this virus is on its own schedule. It’s likely to run its course, at least until there’s a viable vaccine. This will hopefully be soon. Happily, the current surge means that a lot of people’s immune systems are becoming familiar with this coronavirus, and will hopefully have relative immunity to it. I suspect over the years it will join the rest of the coronavirus family, as merely a periodic irritant.

Meanwhile, I’ll continue my exile, and maybe even wallow in self-pity.

At least there’s brisket.

As always, I’d be honored if you’d share this post.

Header image: View from Elba (Sony RX100 Mark 3)

It has been 29 weeks or 8 calendar months since we locked down our society to battle the scourge of COVID 19. Nationally, we are clearly in the third run of new cases. The graphs from the Atlantic’s COVID Project reveal escalating peaks with July higher than April’s, and this new peak already exceeding July’s peak.

Interestingly, there are also 3 peaks of hospitalization, though so far they are roughly equal in size. Considering the ratio of cases to hospitalizations, it appears that a significantly lower percentage of people require admission. There is a small surge in deaths, though nowhere near as many as in April (so far).

Here in Pennsylvania, the pattern is slightly different. We had a large peak in new cases in April and a comparatively tiny peak in July.

Cases are now heading upward again in Pennsylvania with daily rates roughly double that in the spring. There have been however roughly 3 times a number of tests done compared to April however suggesting a lower positivity rate. Despite doubling the new cases the rate of hospitalization remains about 40% of what it was in the spring. Deaths have not yet surged since the summer numbers.

As mentioned, 2 weeks ago, my hospital is seeing sporadic cases of COVID, but we now have an excellent treatment protocol including remdesivir, convalescent plasma, and when necessary, steroids. I think it’s worth saying that there is much less fear among the doctors and staff this time around. Other hospital systems in town are also admitting COVID patients once again. Unlike the spring, the hospitals are now better prepared, so that elective surgeries and other procedures are still going on.

There is also recent news of a COVID strain affecting mink populations in Denmark. This virus can apparently pass from humans to mink, and then back to humans. To my knowledge, this is the first mammal with whom there is a back-and-forth spread of the virus. Still, there is no evidence that this is a more virulent strain, or that the mutation, will render it resistant to vaccines.

Speaking of vaccines, of course, the big news this week other than the election, was the announcement by Pfizer that the preliminary results of their COVID vaccine suggest a 90% effectiveness, and that immunization might be available as early as late December. This is wonderful news.

One wrinkle in this however is that Pfizer decided to try to decouple vaccine from the Trump “Warp Speed” program, instituted earlier in the year to try to speed along vaccine development. It clearly was a part of that program as evidenced by Pfizer’s contemporary press releases.

Though it’s easy to accuse them of perfidy, especially if you’re a Republican, I suspect this was actually an attempt to decrease public resistance to the inoculation.  Both “anti vaxxers” and some Democrats, expressed concern about the safety of a vaccine produced so rapidly.

There is of course a related reluctance to give any credit to the president. In this vein, Andrew Cuomo actually expressed regret that the vaccine was released during the Trump administration, rather than presumably waiting till late January?

Forgive me, but what a callous, pompous ass.

 Pfizer clearly wants to sell doses, and not have the vaccine sink into a political morass. I think any reasonable person is hopeful that it will be effective, no matter who gets the credit.

Trying to look on the bright side, the end of this mess may be in sight, as vaccination begins, and as a large number of positive tests means even more immunity throughout the community. In the meantime, we need to continue with masks, distancing, and protection of the vulnerable.

Oh, and I’d avoid Danish minks.

 Just to be safe.

As always, I’d be honored if you would share this post.

Header image: Path through the Barberry (Sony RX100 III)