Even I need a haircut. I miss weekend diner breakfast and my family is starting to catch on the food I cook is different (and healthier) than what they might have periodically eating out. The gym is still closed, and I am getting out of shape again. In the open stores, if I round a corner to find a person and end up four feet away for a second, I am now accustomed to the resentful glare. Despite directives by organizations like the World Health Organization that masks should only be worn by sick people and those actively treating people with infectious disease (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks), I wear one because I’m supposed to. I realized I am feeling sorry for myself because I am unable to live the way I am accustomed to. Really it is not so bad. It is mostly that I want to feel like I am more in control of my life than I feel with all the restrictions.
In my job, I speak with many people in a variety of life circumstances. So many are so scared. Everyone seems to have a different take on what the numbers mean. I realized at some point when a person says they have had COVID-19, they have been through it, people seem not to know how to respond. At this time, I have a good number of patients who are very much alive and have been tested positive for COVID-19 antibodies. This means they have had the virus and have recovered. As soon as someone tells me they had the virus or that a loved one had it and lived to tell the tale, I get excited. Am I foolish feeling excitement for these people? Some of them say they did not even get sick. Some say they had the worst flu they have ever had but made it through. Some say it was horrible and they ended up in the hospital. I only know of one person who died. She was one of my favorite people on the planet and I will miss her dearly. She was just about to turn 81 and I have known her and her family since I was twelve. Aside from that, everyone else I have known to have had this virus has survived.
It seems to me the survivors are confused. One person expressed to me he was happy to be over the virus but is very scared it will happen again. I explained to him I am no virologist and not an expert on viruses but the unique thing about this COVID-19 virus is our immune systems have never seen anything like it before. What I have read indicates our bodies allow this virus to multiply on our lung cells for a while before realizing it is a problem. I explained to this person once he has had it his body should realize anything even similar poses a problem. The new infection would be attacked much earlier and the immune system should be infinitely better prepared. He might get a cold from another strain or even a flu, but my understanding is he is unlikely to have a severe case.
Another person explained her mother had COVID-19 and runs a small business. Her mother has been scared to go back to work even though she feels well. It has been at least three weeks since her symptoms ended. She did not want to feel responsible for bringing the virus into her workplace. Again, I am no expert, but I believe people stop being contagious only several days after the symptoms of illness end. Feel free to check me on this. I understand the information here is not concrete yet as much is still being learned about the virus but I have read and heard experts in the medical field discussing a several day window of caution and not a several week window.
Every time I hear about a COVID case from someone who has recovered it represents a step in the direction of herd immunity which will hopefully ultimately happen in the world. Our restrictive precautions seem to have slowed the virus but also are slowing mass resistance to it. Experts indicate a vaccine may be a long time in coming if at all. I hope for the sake of the significantly immune deficient people out there they discover a vaccine. For the rest of us, it is our duty to ourselves, our families, and our society to nurture our immune systems. I have committed to writing this blog weekly since our society shut down in protection against the virus, to stay in communication with patients, friends, and relatives who I do not get to see in person right now.
How many of us celebrate recovery from, and therefore a level of immunity to the virus? When you hear someone had it and recovered, is the impulse to avoid that person or to embrace them? We all experience fear of the unknown. For instance, it is hard to explain why 66% of new COVID-19 cases in NY are in people who were sheltering at home (https://www.washingtontimes.com/news/2020/may/7/andrew-cuomo-says-66-of-new-covid-19-patients-were/).
Back to nurturing our immune systems. In my opinion, this is our best bet. In graduate school when we learned about viruses, we were taught they have a funny way of getting around. This seems to be reality in our world currently. The Irish Medical Journal devoted their entire May 2020 issue to the role of vitamin D in the immune response (http://imj.ie/irish-medical-journal-may-2020-vol-113-no-5-vitamin-d-debate/). I’ve touched on a host of other immune supporting behaviors we can perform in my blogs of weeks past.
When trying to understand data, sometimes it helps to look at a small sample. Small data samples can be misleading, but they also sometimes help shed light on understanding of larger data samples with more robust information and diversity. Just about two weeks ago the town where my office resides posted a COVID-19 information website. As of 5/20/2020 the township posted there have been 121 confirmed cases and 25 COVID-19 related deaths. (Please read this through if you have made it this far.) This might indicate a one in 5 chance of dying from the illness. The website goes on to show the cases happened in people ages 25-100 year of age. For statistical purposes, the incidence in men and women is similar. I have been playing a game with patients in the office this week. I ask them, “How old do you think the youngest person who died in Green Brook from COVID-19 has been?” So, what do you think? How old was the youngest person who died of the 25 deaths in people ages 25-100 according to the township department of health’s website? Do you have your guess? The youngest person was 73 years old. I have heard an unconfirmed rumor the majority of these deaths happened in a nursing home. Our town is only one by four square miles and is not densely populated as compared to other local municipalities. Instead of a one in five chance of death based on these numbers, the numbers suggest a much lower risk in people under age 73. (http://www.greenbrooktwp.org/cms.aspx?page_id=217&page_name=The%20Township) Some might call this abacus math but I hope it helps shed light on how these numbers could be easily misrepresented in generalizations about the disease.
Have peace and if you choose to venture out, feel free to drop by the office to say hello.
Leonard Siskin
May 20, 2020 at 6:10 PM
Thanks for all the info! My son, his wife and 2 boys all had COVID19. They are all recovered and not severe cases. Their biggest complaint was not being able to smell or taste anything.
May 20, 2020 at 5:42 PM
Thanks so much for your input Dena! They are saying lack of taste and smell are significant things to look for in patient interviews to suspect a person has COVID-19. I'm glad you liked it:)