Archive for November 16th, 2020

BEING OLD IN THE AGE OF COVID

November 16, 2020

Last week, the Cascade Volunteers scheduled a volunteer appreciation day outside at a ramada in a nearby park.  I was a bit concerned even being outdoors, even limiting to 100 people, that this event was unsafe in the Age of Covid. When I heard that beer would be served, I was convinced it was a bad idea. Fortunately, the governor the day before limited all gatherings to 6, and that plus the first major storm of the fall changed the event to virtual.

Some still don’t get it. We are talking about having an overnight Board retreat in February. Not me.  Even on hikes and Crew outings, some still carpool. It’s dangerous.  We have to be careful in the woods, even though there are fewer of us.  Halloween parties and people having friends over lately, and this and that… and well, our cases have exploded in Oregon and there is frank community spread. We rank 40th nationally in case number, lower for deaths per capita.  It’s generally worse, elsewhere.  The Dakotas just blew right by us, but our 7-day average has doubled here, and deaths, while still low, are a lot higher. It’s hospital capacity—and that means working, well, rested individuals who have enough PPE, not number of beds—that concerns me.  I hope not to get Covid; I also hope not to have some other medical condition or be injured during this time.

Each day, I open Worldometer and look at the worldwide Covid stats.  For awhile, it looked like India might eventually pass the US in numbers of patients, but that trend reversed, not necessarily that India is doing better, for I have been told, through a responsible journalist I know in New Delhi, that many cases are going uncounted. Still, we’ve solidified our hold on first place. I now know what America First really means.  The other countries in the list are changing places. Even Germany moved up from 22nd to 13th.

I then look at the US data, the top 10, now having Wisconsin at 7, and that and a few other states in detail; Texas, Florida, the Dakotas, and lately Illinois, before looking at Oregon.  Some days, I check Idaho and Montana, and pretty soon, I will probably look at Michigan and Ohio.

It’s awful. The Dakotas have had remarkable case numbers; North Dakota had over 2000 a day before a mask mandate. That is 1 in 300 people being diagnosed, every day. Nurses in North Dakota finally got a mask mandate after protesting the WTF policy of being allowed to work if they tested positive without symptoms. Wearing a mask, even in North Dakota, shouldn’t be considered an unreasonable burden. It protects the wearer, this Duh moment finally being recognized by the people in power.  That’s how it should have been rolled out in the first place.  Do governors not see what happened in New York?  Or Arizona?  And what happened when the governors got serious?  Should we wait until the hospitals are closed for patient care?  Where do they go, Minnesota?  That’s where North Dakotans who wanted testing went. Minnesota hospitals are filling up, too. 

I worry that much of the country is unaware of what is happening to nurses and physicians.  I practiced medicine where some days I literally ran from patient to patient, the times I had to work, when I was occasionally sicker than my patients—with pneumonia one time—and eventually burned out. What I went through is nothing like hoping to have PPE, putting it on for hours at a time, working extra hours, seeing no end in sight, dealing with patients that often linger for days before too often dying, and dying alone, and seeing people outside complain that they can’t go to a bar and have to wear a mask. Poor things.

When does it stop, Gov. Noem?  When hospitals literally have no staff and people dead on the street? That’s what epidemiologist Mike Osterholm is worried about. This Mike has thought about dead on the streets for quite some time. Who is going to care for those of us who need medical care for other conditions, elective surgery, which may be elective, but improve life?  Three more doublings of cases will be a million a day, with 3000 deaths—a daily 9/11—by Biden’s inauguration at the current rate of doubling every 19 days.

We knew how to deal with this, even after Mr. Trump didn’t read the pandemic plan that George W. Bush had put together. We just had to follow what Gov. Cuomo did.  He offered it to states, but apparently the fact that Cuomo wasn’t perfect got in the way of what he did right  Even while New York’s cases are rising, their deaths are still much smaller, but as many of us know, there is a lag time, and even with improvement of care, deaths will rise should the sheer numbers, of course, and from the fact that the beds, staff, meds, proning, or ECMO simply won’t be available. 

Wisconsin has a governor who wants to control this, but the legislature won’t meet and any time the governor tries to do something, the Courts say he can’t. Nothing like judges practicing medicine.  I still remember last May the picture of a happy, overweight man walking into a bar in the state. Yep, bars and indoor dining matter. Education, not so much, and a quarter million Americans, no longer alive to comment.

Idaho had a hospital that was 99% full, and the county acted by revoking the county’s mask mandate. One of the board members said she didn’t believe coronavirus was making people sick. Another had given up. Now, Gov. Inslee of Washington is telling Idaho’s governor to get his act together since Spokane’s hospitals have come under the gun.

I know, Covid has been hard on our mental health. So is reading the last paragraph. So has been Mr. Trump.  But the Brits dealt with the Blitz, being bombed night after night, couldn’t have indoor dining and bars open, and weren’t forever scarred as a people. The world even dealt with the loss of a generation of young men in World War I and then had the 1918 pandemic.  The people born back then became part of the Greatest Generation. My parents.  The people born today may never know their grandparents. We are losing another generation.

Ninety per cent of the deaths are those over 70, so I have a vested interest in seeing this pandemic over.  But, when we reach half million deaths in this country, which we are on track to do by the first anniversary of Covid, that means 50,000 deaths in people under 70, a full year’s worth of auto deaths, and they won’t all be over 60. That’s a lot of premature deaths, and we aren’t discussing long term sequelae of the lung, heart, kidney, blood clotting ability, chronic Covid, and the possibility of being re-infected. Those with chronic Covid, or long haul, are not the elderly but previously healthy, productive members of society. We don’t know how they will do, whether this is treatable, goes away, or hangs on indefinitely. It is cavalier to treat this disease as a live-die dichotomy.  It isn’t. 

We don’t get it. If the hospitals get overwhelmed, medical care stops in this country, and that will be catastrophic. 

We have since had problems with Halloween parties, Covid fatigue, people just getting together in groups. I know. I hike with a group, and people like getting together. The Club has a “arrange your own transportation” policy on out of town hikes, and plenty carpool. I’m leading a hike Saturday, and I won’t carpool.

We now have vaccines that work, but it will be the 2nd and 3rd quarter 2021 before they will be widespread. Still, there’s hope.  But we need to wear masks, shut down if necessary, and support those displaced through at least the first half of 2021. We need to fine those who congregate in groups.  Where’s the money coming from?  We don’t need to have an active military at the moment, and we had a trillion dollar tax break given to people who aren’t going to trickle it down. Some money can come from there. 

The rest becomes our national debt. At least we will be alive to deal with it and so far, the dollar is still a good currency world-wide.  For now.

Social distancing, called safety, in the age of Covid. The person in the middle is a little close to the sawyer, but he is looking up at the top of the log to make sure it isn’t going to cause problems. Right now, we are clearing the trail. Fixing the bridge will come later. There are about 200 trees down and at least 3 bridges. North Fork of the Middle Fork Trail, about 15 miles from Oakridge, Oregon.

Author, 3 April 2020, with a balaclava mask. I was an early adopter.