April 17, 2024

More than 4 years have passed

Somehow, I let the 4 year anniversary of this newsletter and the pandemic pass by unobserved. Perhaps, because the virus finally caught up with me. Judging from how long I tested positive, I’m glad I waited so long to get it. I came out OK in the long run. My main symptoms were a runny nose, mild cough, and fatigue (apathy really.) All symptoms are better after a month.But it took 2 1/2 weeks to test negative. I had a resounding rebound after Paxlovid.

So grateful that the vaccines seem to have protected me from severe disease and I don’t have symptoms of Long Covid for which I am grateful. Except for my inability to recall names. (Maybe I should blame it on my age, but it seems worse really.) One of the worrisome effects a COVID infection can have on people is some change in cognition, more likely in people with long COVID, but can still happen in people with symptoms less than a month. A compelling reason not to get infected again. As I age, I want my brain running as smoothly as possible!

But it makes me wonder about the CDC change in recommendation for isolation only if your symptoms are improving after 24 hours, then masking for 5 days. Granted, most people have been vaccinated or infected or both so they are less likely to get seriously ill, but still others are vulnerable,

The CDC is using wastewater surveillance to look for viral activity. Much more reliable since most people, me included, don’t report when they have a positive home test. But looking at the map, I see that I went into dangerous territory when I went to New Mexico. If I had stayed home, I probably would still be a Novid.

From last month, levels in New Mexico were high, much better now. I suggest checking this when you travel.

So much has changed in 4 years. A look back is instructive. Six million Americans were hospitalized and 1.18 million died from Covid-19. Children were more affected than many were led to believe. 9,655 developed the serious condition called MIS-C, or Multisystem Inflammatory disease. Plus, 17.5 million Americans are estimated to be living with Long Covid, which continues to confound experts.

We knew little about COVID when the pandemic began, we know more but not everything. In the beginning we worried contaminated surfaces could spread the virus, but now it looks not so much. Transmission is more from aerosols, tiny particles that float and drift in the air, and infect people farther away than 6 feet. And the virus is evolving to spread more easily, which is why we are getting new variants that spread faster.

Learning about how immunity develops and how long that immunity lasts are still major questions for this virus, different than others. Symptoms have evolved as well, with less loss of smell. Understanding Long Covid is evolving. And the idea of some people being “super-dodgers” is fading. That means there are unlikely to be people naturally immune to COVID, they are just really really good at avoiding exposure. Yay for all you NOVIDs out there!

The COVID vaccines have been excellent for preventing serious illness and deaths, not so much for eliminating transmission, especially as new variants arrive and immunity seems to wane. They also have few serious side effects, the main one is myocarditis in young patients, rare but real. Independent reviewers did not find an association with other claims of harm, except for shoulder issues from the shot in some.

Paxlovid is now the interesting question. Studies now show it doesn’t make much difference in healthy vaccinated patients. It does make a difference in high risk patients, especially if unvaccinated. I wonder if they have the length of treatment wrong, because of so many rebound cases. Perhaps it would work better if given for 7-10 days. Sigh.

We also know that school closures and their effectiveness were complicated. Closures did not seem to stop the spread of infections. Children suffered harms from the closures and many are still behind academically. Could it have been managed better? Yes, but I am not sure we have the political will as a nation to make it work better next time.

If all this stresses you out, here is an interesting 20 second “micro-compassion” exercise that works just as well or better than a longer meditation session.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available. Thanks for reading.

Share this post if you know of others who may be interested. All links are listed at the bottom of this post. The New York Times articles have links that are gift links, allowing you to read the article for free.

https://jamanetwork.com/journals/jama/fullarticle/2816704

https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html

https://www.cdc.gov/ncird/whats-new/ventilation-respiratory-viruses.html

https://www.cnn.com/2024/03/01/health/cdc-covid-isolation-recommendations/index.html

https://www.nytimes.com/2024/02/28/health/long-covid-cognitive-effects.html?unlocked_article_code=1.lE0.r77B.HO3NYogNiBbP&smid=url-share

https://abcnews.go.com/Health/4-year-anniversary-declaring-covid-pandemic-virus-numbers/story?id=107880309

https://www.nytimes.com/2024/03/13/us/covid-national-emergency-anniversary.html

https://www.nytimes.com/interactive/2024/03/12/well/live/covid-pandemic-lockdown-anniversary.html

https://www.seattletimes.com/nation-world/what-the-data-says-about-pandemic-school-closures-4-years-later/

https://www.statnews.com/2024/03/28/covid-immune-system-response/

https://www.nytimes.com/2024/03/09/well/live/covid-symptoms-mysteries.html?unlocked_article_code=1.iE0.xFIY.SVr1AAJII7J4&smid=url-share

https://www.nejm.org/doi/full/10.1056/NEJMoa2309003

https://www.statnews.com/2024/03/28/covid-immune-system-response/

https://www.nytimes.com/2023/03/21/well/live/cleaning-disinfectant-bleach-risks.html?unlocked_article_code=1.iE0.o6Tf.9hOpXtuhAQ03&smid=url-share

https://www.seattletimes.com/nation-world/a-trick-to-reduce-stress-spend-20-seconds-a-day-doing-this/