April 30, 2020

The end of the month

The end of April is here already, for some of you it has been a lifetime and for others the blink of an eye. I have been sensing a shift, a subtle feeling, an awareness of a change, similar to the feeling we get when summer is over and fall has arrived. Subtle but real. Bittersweet. The shutdown is winding down, for better or worse. Good for getting people out and back to work, harder for the increased risks involved. Here in Seattle, we have done such an amazing job of flattening the curve, I fear we will be in shock, when infections start rising again.

We have started doing COVID-19 antibody tests at my clinic. Several of my patients got the test done already because they were pretty sure they had COVID in February or early March. Most were surprised when their test was negative. Not completely surprising to me. Because we flattened the curve so quickly we shut down community spread. What they had was a run of the mill upper respiratory infection. Testing for exposure by testing for antibodies is helping epidemiologists understand the spread. Here not so much, much higher in New York. Doing these tests is mostly helpful in confirming exposure, but does not denote immunity. We wish we understood more.

Data out of Korea is concerning for 2.7% of adults retesting positive again after having cleared the virus, but we do not know what that means yet. This data is shifting our understanding and agrees with what I have been saying all along-we are learning as we go. Data helps us understand more about SARS-C0V-2 and what it does to its human host. This New York Times article expresses this really well. We will keep refining and updating our approach as we learn, but it takes time.

But now our lockdown is coming to an end. My friend and mentor Kelly Wendorf wrote a beautiful blog post about her bittersweet reasons to not want the lockdown to end. For many, this time has given them the gift of expansiveness they had lost in the flurry of their prior lives.

Returning slowly to the world will help us buy time, as my friend Debbie Speigleman wrote so beautifully: “Time. Time is so precious. Everything you do right now is buying someone time. Time for researchers. Time for healthcare providers. Time for treatment developers. Time for those at risk. Time. You will never again have this power to buy time for those you love, time for your comrades on the front lines.” Thanks, Debbie, for this reminder.

Wash your hands and cover your nose.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.nytimes.com/2020/04/30/opinion/coronavirus-treatment.html?algo=combo_lda_unique_clicks_decay_6_50_ranks&fellback=false&imp_id=133282866&action=click&module=moreIn&pgtype=Article&region=Footer

https://www.jwatch.org/fw116598/2020/04/30/covid-19-positive-retests-federal-prisons-mental-health

https://www.newsweek.com/south-korea-experts-say-recovered-coronavirus-patients-retested-positive-because-dead-virus-parts-1500998

https://mailchi.mp/equusinspired.com/dreading-the-end-of-lockdown?e=[UNIQID]