Dr. Robin’s Covid-19 Updates

The Election and the Coronavirus

Hope is a thing now

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The numbers get grimmer. On Saturday November 7, the New York Times, presenting the rapid increase in cases and hospitalizations, wrote there are “almost no hopeful signs in the data.”

For me, however, there is one gigantically hopeful sign, and that is the election of President-elect Biden.

Why am I hopeful?

I am hopeful because he has already appointed a number of fantastic physician-scientists to a Covid transition advisory panel and they already started work this week, and they all have deep roots in public health and all are known to have “the right stuff.”

I am hopeful because this means the new approach will be — as promised — based on “bedrock science.”

I am hopeful because jumping right to work demonstrates a deliberate commitment to try to decelerate this runaway train.

I am hopeful because it means the new administration has a better chance to hit the ground running the third week of January.

Of course, things will be different in January. There will be progress in the science of testing, treatment, vaccines.

At the same time, hospitalizations will no doubt go higher still because of the holidays.

We need to remember hospitalizations usually go up three to four weeks after exposure events and the Inauguration falls almost exactly four weeks after Christmas Day. So all the people who catch serious Covid at Christmas gatherings will be landing in the hospital right around when Biden takes office.

And horribly: Christmas happens four weeks after Thanksgiving.

Although it’s terrible to think about family members being hospitalized over Christmas because of get-togethers during Thanksgiving, it’s definitely a real risk. Even more reason to “close the circle” and “only eat inside your bubble.”

In another vein, I am hopeful that much of the ensuing guidance from the new administration will be with the recognition we are all linked together in fighting this pandemic — with the empathy and compassion this requires.

One of the devilish parts of this bug is how often (40%-50% of the time) people don’t feel ill but are contagious. You can be walking around feeling perfectly fine but you’re actually infected and blowing virus everywhere.

  • So if you’re unknowingly sick and you sit on the couch watching the football game with Aunt Petunia’s next-door neighbor, boom, he can get it. (Aunt Petunia, who is sitting out the game in the kitchen with her Chardonnay, might for once be safer.)
  • Or if you spend 15 minutes chatting with your co-teacher during a “mask break” at school, wham, she can get sick.
  • Or if you walk down the aisle with the bridesmaid as an asymptomatic-but-infected groomsman: kaboom, she can come down with it.
  • Etc Etc Etc (Important: Those are all true stories.)

This disease more than many shows the incredible interconnected web of our humanity.

Some people say, “I don’t know anybody who has died of it.” The best response I’ve heard to this is, “You just don’t know their names.”

  • It was the guy who drove your food to the grocery store.
  • It was the woman who helped your grandmother take a shower.
  • It was the grandchild of your cousin who lived in assisted living since the car accident.
  • Etc Etc Etc. (Again, these are all true stories).

It takes imagination and empathy to see how we are all links in these chains of infection.

There is early evidence the Boston Biogen super-spreader conference led to disease in Boston homeless shelters.

Virtually all studies now show when younger people turn positive (our grocery store workers, our group home employees), a few weeks later there will be an uptick in older people getting hospitalized.

Current estimates find that for every 10% of people who are non-compliant with Covid Etiquette (masks and distancing) there are 100,000 new cases.

I am hopeful the reverse is true: that our new administration will help people redevelop the imagination and empathy and knowledge we need to create a new 10% of people who DO start to mask and stay six feet apart, and so we will thus have 100,000 fewer cases.

I am hopeful the government will communicate so well with Americans that I and other doctor/writers will become redundant.

You know, I stumbled accidentally into this role of being a-Boston-cancer-doctor-who-writes-about-Covid. I wrote a short post to my friends (with some red wine), and then another longer one and then another one, that one definitely detailed and fact-checked (at which point: no more red wine).

I figured I would give my friends the basics — “Just the facts, Jack, nothing but the facts” — during those first few chaotic weeks in March and April. I assumed I would do this for a few weeks and then the government would step in and convey their science-based instructions to us all.

But as we now know, further instructions were not forthcoming. There was never clear messaging from the federal government and in fact the opposite.

At the same time we had this perfect storm of

a) internet mis-information

b) the confusion that always results from emerging science (“building the airplane while we fly it”) which is so hard for everyday readers to track

c) the impact of the 24-hour news cycle: When every second needs to be filled with click-bait, a lot of unedited or distorted (and often later disproven) gunk comes pouring out

It became practically impossible for the average person to know what to believe or what to do.

So a bunch of other doctors and I stepped up to write “just the facts, Jack, and nothing but the facts.” And here we are, nine months of weekly posts later.

When I write these posts, it is so heartening to see how many people respond to the facts and adjust their behavior. It is heartening to see how so many people truly want to do the right thing. People want to keep themselves and their families safe.

I am hopeful once we start getting trustworthy communication from the government, even more people will respond in kind.

John Barry, the guy who wrote “The Great Influenza,” that fantastic book on the 1918 Pandemic, wrote this past March: “…the most important lesson of 1918 is to…tell the truth. At its core, society is based on trust.”

Barry also wrote, in July, “When you mix science and politics, you get politics.”

Fundamentally, I am hopeful now that we are arriving at a place where we can get back to the science, Jack, just the science, and nothing but the science. And that we’ll be able to aim it right at that 10%.

Written by

Radiation Oncologist at Massachusetts General Hospital/Emerson Hospital. Writer. Teller. Mom. Currently Covid-Obsessed. www.DrRobin.org, @robinshome

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