Life in the time of COVID: Current Concepts and Constant Change

Life in the time of COVID

Current Concepts and Constant Change

Things in the world of COVID are rapidly and constantly changing. This week’s column is a brief compendium of some of these changes.

The alphabet soup of COVID variants and subvariants grows daily. Four weeks ago, we were talking about the new Omicron variant XBB. Now we are reading about the subvariant daily. A month ago, we were starting to discuss the properties of the original XBB. Now XBB.1.5 is considered the most infectious version of COVID yet. It’s not clear if symptoms are going to be worse than previous versions, but it does appear that regardless of previous infectious or vaccine status, almost everybody is going to be infected.

It is not even clear how useful masking is, since very few people use masks properly and consistently, and this variant seems to be able to get around simple protections like surgical masks. It already makes up more than 75 percent of COVID infections in the northeast United States, and deaths per day—which is the most accurate indicator of the effect of the virus—continue to increase. Some sources feel that unless somebody has been recently infected or appropriately boostered, they are going to have very few defenses against XBB.1.5. There is already a new CDC recommendation to increase precautions; masks, distancing, avoidance of groups, and get the latest boosters. The number of fatalities daily has been spiking upward and in the United States is now over 400 per day.

Two weeks ago, in a column we called “The China Syndrome,” we pointed out that the Chinese government was releasing amazingly low numbers of COVID cases and COVID deaths. This week they’ve decided to come clean, or at least reasonably so. The Chinese government is now saying there were 60,000 deaths from COVID in the previous month and unofficial statements from Shanghai state that 70 percent of the population has been infected recently. This number may be as high as 80 percent in Beijing. It is estimated that more than 100 million people in China have recently had COVID. This, of course, is an unfortunate outcome of the Chinese government failing to take advantage of the delay provided it by its total lockdown program. Very few Chinese have been recently vaccinated and less than half of 1 percent have had boosters in the past six months. Considering that about 250 million people in China are over 60 years old and, by definition, all of these are high risk, the possibility of as many as 5 million deaths in the near future is possible. The Chinese government has refused to approve the mRNA vaccines developed in the U.S. and Europe for its own citizens (though it allows it for foreign nationals), and has not obtained a significant inventory of Paxlovid.

COVID, for the second year in a row, is the leading cause of death of active duty police officers, though the number is improving from 2021. The improvement is felt to be due to better treatment, reduced infection rates, and availability of vaccines and their acceptance.

Research from Kaiser Permanente suggests that exercise in almost any regular amount is protective of COVID. The CDC has reported that “physical activity is associated with a decrease in COVID-19 hospitalizations and deaths, while inactivity increases that risk. Other research also has linked regular physical activity with a lower risk of infection.” Of course, whether this an effect or just a correlation is not known. It’s possible people who exercise have better vaccination rates or take better precautions (though my experience at the Clark Sports Center suggests otherwise).

Scientists are performing experiments to see if Paxlovid can improve Long COVID symptoms. It was observed that some people with suspected reinfection who were treated with a course of Paxlovid reported a decrease in their Long COVID. The theory is that, in some cases, the virus persists in the body after the initial infection and round of symptoms.

The reported case rate for Otsego County last week was approximately 1 percent. As opposed to last month, when the transmissibility was low, this is now high, probably representing the spread of XBB.1.5. Only 63 percent of the county has been fully vaccinated. It is very clear that the risks of serious complications from COVID is orders of magnitude higher than the risks of vaccination. I’m tired of writing this but wear a mask properly, keep vaccinations up to date and avoid crowds.

Dr. Richard Sternberg is a retired Bassett Hospital orthopedic surgeon.

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