WC.com

Tuesday, July 27, 2021

How Does the Story End?

How will the pandemic of 2020 end? Well, it won't end in 2020, that much we know for certain. Beyond that, there is a lot of discussion. From the standpoint of the Florida OJCC, we remain open and operational as we have throughout. We are welcoming folks for live proceedings. And, there is travel going on. Recently an Orlando attorney walked into the Pensacola office for a mediation. Yes, things are getting back to normal.

I was recently sent a copy of a Statnews article: "How the Covid pandemic ends: Scientists look to the past to see the future." My first thought was this whole endeavor would have perhaps been a lot easier on us all if we had a historical perspective. I know some pointed at prior influenza events, and some discussed Ebola. But, for the most part, there was a fair bit of "novel" being presented and a sentiment seeming to suggest that that meant unprecedented and thus of little help.

This May 2021 article said we are about 1.5 years into this thing. But, as I remember it, the virus was discussed in January 2020, but no real reactions until a bit later. Of course, earlier in China. For an exceptional recounting of the day-to-day of SARS-CoV-2, check out Channel 6 in Orlando. Some key dates are:
"March 1, 2020 - first Infected Floridians reported."

"April 1, 2020 - Governor DeSantis issues statewide stay-at-home order."

"May 4, 2020 - much of Florida begins a reopening."

"July 6, 2020 - schools ordered to open in-person for fall 2020."

"September 25, 2020 - Florida moves to stage 3 reopening."
According to the Associated Press, our first "jabs" in Florida were December 14. I still struggle with the effort and focus that brought those vaccines so rapidly. I admire the initiative, intelligence, and enterprise that drove that effort. And, since then, a fair few Floridians have been injected. We are now about 48% vaccinated, just over 10 million people fully. That does not mean we are safe, just safer than we were.

For those of you who have been waiting, the time is here. A USA Today article laments that many "young, otherwise healthy people" are being infected and seeking care. A doctor is quoted saying "One of the last things they do before they're (patients) intubated is beg me for the vaccine . . . , I hold their hand and tell them that I'm sorry, but it's too late." Now Pat Benatar 1982 is stuck in my head: "It's a little too little, it's a little too late." What you don't want to hear in the hospital, ever, is "it's too late." And, anyone that ever watched a medical show knows they want to avoid intubation if possible.

So, how will it end? For some, it has already ended. They are reporting over 4 million deaths from COVID worldwide. But also 175 million recoveries. I lament the dead, and those with long-term complications, but a 2.3% death rate is a tribute to the medical professionals, their derive, nerve, and fortitude. The 1918 flu pandemic killed 3% of the planet's population, between 50 and 100 million people. More died then than in the First World War.

The Statnews suggests that there was some chance of actually beating SARS-CoV-2, but the chance for that is over. It is also dismissive of the chances of "vaccinating our way out." Not that the vaccine will not help many, but contending that the whole world will not be able to access it. The article stresses that "the truth of the matter is that pandemics always end. And to date, vaccines have never played a significant role in ending them." It provides the anecdote to support this from 1918, 1957, and 1968 (I recall none of these ever being mentioned to me before COVID. Perhaps my grandparents waxed eloquent about the pandemic and it never registered. But, I vividly remember tales of the great depression, crop failures, ration books, and more.

The article describes how each of these prior viruses "underwent a transition," and then explains that the transition was essentially a learning curve of our own immune response. Our bodies "learned enough about them to fend off the deadliest manifestations." Pandemics of the past did not end suddenly (as the siege does in War of the Worlds, Paramount 2005). No, it says that "instead of causing tsunamis of devastating illness, over time the viruses came to trigger small surges of milder illness." Those diseases were eventually painted into their corner.

This author contends that this pattern will be repeated with SARS-CoV-2 and it "will at some point join a handful of human coronaviruses that cause colds." A quoted World Health Organization scientist says that some believed "we’d be out of this acute phase already.” She insists that the virus and its variants "is controllable,” and she cites in support various countries with proven success in shutting down the transmission.

The science from past pandemics suggests to the Statnews writer that "viruses morph from pandemic pathogens to endemic sources of disease within a year and a half or two of emerging." That is not to say this must be the same, because this is not an influenza we are dealing with, and its pattern and timing could be different. This is, after all, a "novel" coronavirus. There is some value to prior experiences, but not a true roadmap.

That does not mean we are without any historical reference. the author says there have been four human coronaviruses. Since they were not in the modern age, there is less known about who they are and how they do what they do. There was less to research, less science available to apply to the issues. And so, we remain doubtful of prognostications about the future based upon studying what is known about those four.

The article dumps water on the hoped-for herd immunity we have all mentioned at least a time or two. The sources cited in this article doubt we will reach the "herd" status, and claim that we will each nonetheless develop a level of immunity or resistance. We will be periodically ill on an ongoing basis, but not as seriously. They relate to the cold, and remind that we may resist the cold, but there is no cure. The sentiment is that the endemic result will soon occur and the real mystery is about how serious or perhaps deadly will it remain in the early stages of that endemic state. There is hope, however, that a vaccinated populous may inhibit both the transfer and severity of the viral infections even in the endemic time.

There is the belief that the endemic period is approaching, but there is no unanimity. Those who believe the period is close also seem convinced that countries that have both high infection rates and significant inoculation will fare well when that occurs. The U.S. is in this group. However, other groups point to India and Brazil as examples indicating that this virus is slower to incubate, to afford recovery, and therefore to end its non-endemic, or pandemic, stage.

So some think the end is near, and others warn that this is our first modern coronavirus pandemic, and the real data on it entering an endemic state is too thin at this time to make real predictions. They seem to caution that this pandemic era may last for a significant time. In the end, the article brings multiple perspectives and thoughts and is a worthy and interesting read.