Written by Dr. Susan Blum
It’s been a while since I wrote or spoke on the Public Health issues with COVID-19 swirling around us. When the pandemic started I held open live office hours every Friday for about 8 weeks to answer your questions, and to share my Public Health expertise to make sense out of what we were going through collectively.
As our long summer days at home (and hopefully outside, too) come to an end, I feel the need once again to provide information and to offer my view of where we are and what to expect as we are now moving into the fall.
THE GREAT MASK DEBATE
Public health is the understanding that decisions need to be made by the government to protect the health of the public — with the known understanding, and acceptance, that these laws or rules can infringe on someone’s personal liberties. The idea is that individual people need to sacrifice some personal liberties for the sake of the community.
Public health has always been the place where there has historically been tension between individual rights and the collective. And nowhere has this been on grand display but in the United States for the past few months and the great debate over whether it’s ok to make people wear masks.
While in many places in our Country you are seeing a shift toward individual sacrifice for the greater good, not everyone feels this way. I am not saying this to make a political statement, but to point out this has always been understood as a classic public health dilemma, and we are seeing it play out right before our eyes.
Evidence continues to mount every day proving that wearing a mask slows the virus spread, and my hope is that this battle will finally end. We seem to be moving in the right direction. But the battle lines have already been drawn, and I expect other public health initiatives (like vaccines) to be met with resistance in many parts of the country. Our country’s internal war has added to the stress and burden that we all carry during the pandemic.
WHEN WILL COVID-19 END?
I am not terribly optimistic. Get used to your current living situation, or make plans for the winter now, because I predict we will be living like this until Spring 2021. Here are the various ways we will get out of the pandemic, with my rating of the likelihood of each one:
We still don’t know how long immunity lasts, which means that even if we get a vaccine, we don’t know how long it will protect you. Any early vaccines will be fought over between all the countries of the world, and in our country, it will be doled out, based on who-knows-what formula. Which means that I wouldn’t expect the general public to have anything until next spring. Which suits me just fine, because I wouldn’t recommend being the first guinea pigs to get the vaccine for the first few months anyway!
Bottom line: Don’t count on the vaccine to save you this winter. Hopefully there will be available vaccines that work by the spring. And…be prepared for the possibility that no vaccines will work.
BETTER COVID-19 TREATMENT
Some promising drugs are out there, but there hasn’t been a centralized effort to get enough doses produced to distribute to everyone. Remdesivir is a good example of a drug that has been shown to work in hospitalized people to reduce virus load and decrease hospital stay. It has been distributed to only some hospitals, and even those hospitals are now running out. Everyone is fighting for a share of the limited supply. Without a national response, treatment is hodge-podge depending on what hospital you go to, and which state you are in. And there is the issue of affordability now that the drug company is charging full cost going forward. This in my opinion has been a disaster. I think we won’t get this organized until there is national leadership on this issue.
There are some interesting new treatments in the pipeline, but I don’t expect we will see them before the winter if they even prove effective.
And this one I think is really interesting:
Bottom line: Don’t count on life going back to normal again this winter based on the treatments that we have so far.
Think of herd immunity as something that happens when the virus runs its course through a population. It keeps going until it infects enough people and then fizzles out because there aren’t enough uninfected people to keep it burning. Public health dogma has always been that at least 50% of people need to be infected for this to happen, and we are far away from this number. Unless there is a drastic change in our approach or some big medical breakthrough (which would be GREAT), this virus will continue like a forest fire that will keep burning until it’s done. If this is the scenario, then we will all be home perhaps longer than next spring.
HOWEVER, cases have started leveling off in our country (probably due to more widespread mask wearing and social distancing) and some areas are doing well, like here in NY. I am wondering if the virus might also be slowing down in some areas (like NY) because there is more immunity in the community then we think, and/or that herd immunity is being reached sooner than we expected in areas that saw the worst outbreaks. These are intriguing ideas and I am hoping these are true!
Bottom line: Even if there are pockets of immunity to the virus, most areas are still very susceptible and this fire will continue to burn well through the winter.
BEST CASE COVID-19 SCENARIOS
OK, now that I’ve been a real downer, I will end this blog by sharing what I hope will happen. This is the information you should be looking for in the news to give you some optimism.
Here is what to pray for every day:
- Antibodies to the Coronavirus last at least 1 year after infection or vaccine, and protects you from reinfection. This is a requirement for almost everything else to work!
- A mutation in the virus makes it less deadly (this is the one that I pray for the hardest because it doesn’t rely on humans to figure out the solution). I think there is a fairly good chance this might happen.
- Herd immunity happens much sooner than anyone thinks. Some new mathematical models suggest for this virus, it could be 20-30% of the population instead of 50-60%. This would mean the forest fire would still rage unchecked for months, but self-extinguish sooner. There are signs this might be happening!
- The people in our country unify around best public health practices to slow the spread and save lives. I pray that our internal war on Public Health will end.
WHAT YOU CAN DO TO BOOST YOUR IMMUNE SYSTEM
It is frustrating to have such little control over the world around us. But you can feel more empowered if you take control over your own health. Making sure your immune system is primed and ready to go, just in case it encounters the coronavirus, should be your number one job during the pandemic.
I have written before in previous blogs about supplements, but my main focus as a Functional Medicine physician is on the foundations of a healthy immune system: food, stress, gut health, toxin load, oxidative stress and inflammation. If you haven’t read my book on this topic, The Immune System Recovery Plan, what are you waiting for?!