Will It Cripple Us Again?

Weare still in the middle of a wonderful Covid lull but there’s probably some storm clouds gathering, mostly in the form of that Omicron variant called BA.2.

Numbers of cases, deaths and hospitalizations are going down in the US but skyrocketing in other parts of the world, including places like the UK which has super high numbers. This is worrisome because the UK is one of our “Prediction Countries” — they tend to have patterns in Month One (late March) that we usually follow pretty closely in Month Two (late April).

In addition, our wastewater situation is worrying — there’s a bunch of places in the US that are showing an increase in Covid particles in the wastewater, and that tends to be very predictive. If you see rising numbers of particles in the poop it’s pretty inevitable that a few weeks later you are going to see a rise in cases.

Even though testing and reporting is getting lousy (fewer places to test, more at-home tests), the fact is BA.2 is more transmissible than BA.1 makes it probable that — as “good” as things are now — we may have some kind of a surge of cases in late April/May.

We can’t say exactly when, and what we really can’t say is how high and how long or in what parts of the US.

But it seems quite possible that in the late spring we’re going to start hearing about more friends and family getting sick and we may have some disruptions again in our private lives.

That’s the bad news.

The good news is that I doubt a BA.2 uptick will affect our public lives. I don’t think schools will shut down or hospitals will get so jammed they will have to cancel surgeries or routine care again.

There is some good news about BA.2 as well:

— the vaccines are still protective against severe disease with BA.2 like they were with BA.1

— several of our treatments are still effective against BA.1 (one is not)

— BA.2 seems to like to live in the nose more than the lungs, which may be one reason we are seeing fewer pneumonias and more mild illnesses

The other good news is that we know what to do when/if a surge hits in the late spring, and/or then again in the fall. We re-mask and start to take more precautions, and that, along with vaccinations (and maybe fourth boosters) will help keep many people out of the hospitals.

I’m a Boston-based cancer doctor and I’ve been writing weekly fact-based-no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020. If you liked this and some of my other essays below, you can support both Medium and me here.

Aswe enter our third year of dealing with this and seeing how “this isn’t over yet and there may well be more to come,” I have taken to keeping a sort of mental gratitude journal.

Life is still hard for a lot of people in a lot of ways and super hard for many. Lately I’m finding it helps me to think about how things — while maybe hard and exhausting and frustrating — are still better than they were two years ago.

  • Two years ago there was a very real risk we could die a terrible death with this disease. Now if we are vaccinated and boosted and immunocompetent our chances of dying are incredibly smaller.
  • Two years ago we were absolutely terrified for our children. Now we are still concerned, but the statistics have continued to be reassuring: kids get it frequently but they seldom get it badly.
  • Two years ago we didn’t have adequate PPE or testing. Now we do.
  • Two years ago we had no idea how to protect ourselves. We were still putting our Amazon packages in the garage for a week and freaking out about whether to put the can of beans in the refrigerator before we opened it.
  • Two years ago we didn’t know if we’d run out of toilet paper or if we should cross the street when someone approached us on the sidewalk or if civilization was going to come to an end.
  • Two years ago we didn’t know if we could survive “six weeks”(LOL, rueful laugh) of being home with our spouses or teaching our kids or whether we could keep our sanity or humor or perspective intact. Now we do. (One way or another.) We have been through that valley of tears and fears.
  • Two years ago we started watching the science get built. It’s not easy watching “the science sausage get made,” but we got to witness exactly how it’s done: question by question, test by test, study by study, bit by bit, word by word, bird by bird.
  • Two years ago we had no vaccines and no safety net. Now we do. We can still get Covid when vaccinated, but we now have very little chance of ending up hospitalized and a super tiny chance of death.
  • Two years ago we didn’t know if safe vaccines could be made in bulk. Now we do. Gajillions and GAJILLIONS of vaccines have been given with minimal issues. And since you very rarely see side effects after a few weeks, these are probably going to end up some of the safest vaccines in the history of the world.
  • Two years ago we had no treatments except oxygen. Now we have monoclonals like bebtelovimab and anti-virals like Paxlovid and prophylactics like Evusheld.
  • Two years ago the immunocompromised had no protection at all: Uncle Leonard with the kidney transplant, Aunt Leonarda with the antibody-blocking MS drug, Cousin Laura on Rituxan for the rheumatoid — all these loved ones were out of luck. But now they can get Evusheld and have a chance at pumping up their Covid antibodies.
  • Two years ago nobody had any vaccine protection at all. Now the elders do (although they may need more), the middle-aged do (although they might end up getting more), the young people do, and soon, all of our children will.
  • Two years ago we didn’t know it was going to take a whole stack of Swiss cheese protection techniques to keep us from getting seriously sick: distancing and staying home and testing and vaccines and masks and air quality and etc etc.

But now we do.

Soif/when this comes back in the late spring or the fall or the winter, we can restack the Swiss cheese so there’s fewer holes, and put our masks back on and go out carefully and stay SafeR.

And pull out our gratitude journal while we’re at it and remember how even though this sucks, it sucks a whole lot less than it used to, and that’s worthy of some pretty fierce thanks.