My wife works with Todd who is a former EMT from New York. He was telling my wife about the terrible tragedies that have been happening all around him ever since the Covid-19 pandemic has taken hold of this country. He said that at least thirty people that he personally knew have passed away from the virus, relating to complications. He knew of one particular friend in his forties that died. His friend was a father of two young kids, 6 and 8. What’s worse was that his friend’s wife had also died from the coronavirus and that the kids were now parentless. The family was scrambling to find a will so that they knew that the kids would be taken care of. Todd, being a new father himself, was particularly affected by this news. He said that he was glad that he was still working during this time, otherwise, he would be so grief stricken that he wouldn’t know how to handle himself.
There’s a lot of collateral damage that this pandemic is causing. It’s breaking up families. It’s causing an increase in domestic violence.
It’s cratering the economy and forcing people to lose their livelihood. Not to mention, people are living in fear on a daily basis, increasing rates of depression and anxiety. When this is all said and done, this decade is going to be defined as a post-covid world, where everything is changed. It will be changed, not just by how medicine is practiced and managed, but it will also hopefully change how the government is prepped for these types of disasters.
Coronavirus will also define the new social norms, where day to day social interactions will potentially be more virtual, potentially more distant, potentially more sanitized.
But we aren’t there yet. The post-covid world is still well ahead of us and it’s important to maintain perspective in terms of where we are. The social/physical distancing measures that have been implemented throughout the country and the piecemeal statewide stay-at-home orders seem to be having an affect on the trajectory of this pandemic. We’ve all heard of “flattening the curve” as the term to describe the way we hope this pandemic goes, where the trajectory of new infections is spread over a longer period of time as opposed to all happening at once. This is to ensure that our healthcare system is not overwhelmed by the sheer number of people facing dire complications of covid-19. Based on newer projections, it appears that it may be happening to some degree, although, it needs to be stressed that most of this country has not yet reached the zenith of their infections. Not California. Not Louisiana. Not Florida. And while this is very promising news, it is also important that we don’t stop the restrictions that we now have in place.
We need to remember that there is a lag between the time of new infections and the death toll. Just as an example, the documented 1,970 people that died on April 7 represent the 11,075 new infections that occurred on March 24, two weeks earlier when patients were initially diagnosed. On April 7, over 33,000 new infections were recorded, which can represent a death toll significantly higher than the numbers we’ve seen before. Hopefully, the house of medicine will respond quickly enough to curb that death toll number to a much less horrific number. It is also important to note that while we may be flattening the curve, we are not eliminating the problem. By flattening the curve, we are only giving our healthcare system an opportunity to keep up with it. The number of infections will happen over a much lengthier period of time as opposed to the course of weeks. We are flattening the curve, but we’re also drawing it out. It means that there will still be sick people to take care of in the foreseeable future, but at least medical resources will be available to them, and therefore, the casualty count will be hopefully reduced.
It still means that we have to practice physical distancing even when the stay-at-home orders end. It still means that the solution to this problem is still quite some time away.
As we speak, doctors and scientists are running trials on new treatment options, like convalescent plasma, antiviral medication combinations and vaccines. Convalescent plasma appears to be promising. Convalescent plasma is plasma that is taken from recovered Covid-19 patients and transfused into sick patients. The plasma contains the antibodies that have been developed as a result of the immune response of the recovered. In early trials, critically ill patients seem to be recovering with these transfusions. Other therapies and drug trials with hydroxychloroquine and remdesivir are still underway. The effectiveness of these drugs are important to determine prior to any widespread use of them as safety and efficacy are always the first priority when making blanket recommendations. As a physician, the first task I am given is to do no harm.
The only thing that will definitively tell us that we are finally in that post-covid world is a vaccine. That’s when we can see that metaphoric light at the end of the tunnel. I remember in the pre-covid world, there were hundreds of thousands of antivaxxers that subscribed to the thought that vaccines were more dangerous and harmful than they were beneficial. We are now living in a world that is proof positive against that argument. We are not living in a world that is vaccine free. We are only living in a world where one vaccine is missing and desperately needed. The post-covid world can’t happen without it. Life as we used to know it cannot happen without it because there won’t be herd immunity until that time. The vulnerable people in our population will always be at risk without a vaccine. The diabetics, the heart patients, the asthmatics, the elderly will always be at significant peril without it.
For some, like Todd, they are already living a new reality in the covid world we now know. We need to remember that are fates are intertwined in this. Todd’s reality can easily be our reality. We’re making progress, but there is more work to be done if we’re ever going to get to that post-covid place.