COVID-19 has a big impact on each of our lives. We make decisions daily regarding COVID-19 that influence the lives and futures of those we love and care for. As a result, I have been giving COVID-19 a lot of attention and thought for many months now. I would like to share some thoughts, opinions, and speculations about COVID-19 that may spur your thinking. I invite you to share your thoughts, opinions and speculations as well, in case they may be helpful to me.
The Bottom Line
COVID-19 is a new virus, to which none of us has prior resistance. It has become endemic throughout the world. The combination of extensive spread and little resistance means that the vast majority of the population of the world will probably become infected sooner or later. Pandora’s box is open, and there is no going back. To some extent, our efforts to stop the disease resemble a child building a sandcastle to try to stop a tidal wave. The primary question is not, “How effective will our countermeasures be?” The primary question is, “How big is the wave?”
When the early results of antibody testing began to become available, I concluded that roughly 350,000 people in the United States would probably die of COVID-19 by the time the first wave of the disease had run its course (the first wave being here defined as about 70% of the population becoming infected with COVID-19 for the first time). I concluded that there were steps that could be taken to influence how quickly people died, but that those steps would not have a large influence on how many people actually died of COVID-19 in the end.
I do not say this lightly. I do not want 350,000 people to die. I may be among the people who die. People I love may be among the people who die. But saying or pretending that we can have a significant impact on the number who die of the infection will not make it true. Sometimes the power of fallen nature dwarfs our puny human efforts.
However, in my initial calculations, I may have underestimated the foolishness of certain public officials. By placing active COVID-19 patients in nursing homes with the most vulnerable portion of the population, some state governors managed to create an even higher death rate than I anticipated for their states. These types of counterproductive actions could conceivably raise the death toll for the first wave as high as 500,000.
On the other hand, the death rate in recent weeks has been lower than I anticipated. I am not sure if medical professionals are developing more effective treatment protocols, if the virus has mutated to a less deadly strain, or if some other factor is at work. In any case, I rejoice, and hope that this development may keep the total initial death toll to as low as 250,000.
Although our puny efforts may have very little impact on how many people die of COVID-19 itself, they may have some impact on how many people die as “collateral damage”. If we can slow the transmission of the disease, we may help to keep the healthcare system from being overwhelmed by COVID-19. This will enable medical professionals to continue to treat the other, non-COVID-19 illnesses and injuries that people are experiencing in the midst of the pandemic. So it is helpful to try to slow the spread of COVID-19, not so much to reduce the death rate of COVID-19 itself, but to reduce the death rate from other causes during the course of the pandemic.
Mask wear probably helps to slow the rate of infection a little. Masks may also help to reduce the severity of any infections that they do not prevent by reducing virus load. So in general, I think that mask wear should be encouraged.
Public health officials did a grave disservice to the country by discouraging mask wear early in the pandemic. By knowingly lying to the public about masks at that time, they forfeited their credibility, and sowed the seeds for the current public discord over this issue. I think once you have lied to people about the efficacy of wearing masks, it is foolish to try to mandate that they wear them. Human nature being what it is, a lot of people are going to feel that they are being led around by the nose, and they will rebel. Then masks take on a symbolic rather than a practical significance, and the possibility of a rational discussion has been lost.
In that context, I must confess to being a mask chameleon. If I am with a group of people wearing masks, I am happy to wear a mask, because I think it helps a little. If I am with a group of people not wearing masks, I am happy to not wear a mask, because I don’t think it helps all that much. So I love everyone, whether or not they are wearing a mask. But all other things being equal, I wish they were wearing a mask.
Some of my friends think that sending kids to school is tantamount to putting them under a death sentence. I think the risk of them dying in an accident on the way to school or on the way home is much higher than their risk of dying from COVID-19 contracted at school.
There is an element of risk for the teachers, just as there is an element of risk for all the rest of us who have gone back to work. Some of my Facebook friends who are most opposed to schools restarting have been posting quite a bit about how much alcohol they have consumed during the pandemic. I don’t understand why they think that alcohol is important enough for liquor store employees to need to go to work, but that education is not important enough for teachers to need to go to work. I think that if public school teachers are less committed to education than grocery store clerks are to feeding us, then we should eliminate public education and privatize the school system.
Early on, the concern was that students would catch COVID-19 at school and transmit it to their families. Subsequent studies have suggested that the risk of child to adult transmission is vanishingly rare.
Indoor and Outdoors
Some of my conservative friends are concerned about transmission during protests and riots. I am not. The risk of outdoor transmission seems to be extremely low.
I wonder how much impact this low rate of outdoor transmission has had on the pattern of infection in cold weather versus warm weather states. Early in the year, when people in cold weather states spent a lot of time indoors because of the weather, the rate of infection was higher there than in the warm weather states. When the heat of summer came, and the inhabitants of warm weather states withdrew inside to air-conditioned comfort, their rate of infection rose dramatically. As the cold weather states also began to get hot, the rate of infection began to rise again there. It will be interesting to see what happens when things begin to cool off again in the autumn.
Stay at Home Orders
I have not been able to discern any relationship between issuing or relaxing stay at home orders for healthy people and infections rates. Stay at home orders don’t seem to be effective to me.
It does seem to make sense for people who are sick to isolate themselves away from the healthy. This seems to be an effective way of slowing the spread of the disease.
The common cold is another corona-virus. We all know from bitter experience that getting a cold does not confer lifetime immunity. I suspect that being infected with COVID-19 will also not confer lifetime immunity. I do expect, however, that subsequent COVID-19 infections will tend to be less severe than the initial infection.
I think it is unlikely that a vaccine will be developed that will confer lifelong immunity to COVID-19. The attempt to develop vaccines for other corona-viruses has not been very successful. They may be able to develop vaccines that provide temporary immunity or that reduce the severity of infections. I do not want to be a guinea pig for a poorly tested vaccine for a disease that has a reasonably high recovery rate. I am not against vaccines in general, but I get the impression that corners are being cut in COVID-19 vaccine research.
Well, there you go. My thoughts, opinions, and speculations about COVID-19. What do you think, and why? I hope you are able to share something that will help me polish my expectations and make better preparation for whatever is to come.