August 20, 2021 Corona Update

If our goal is, we need 50 percent of people to go up to 70 or 75 percent of people (vaccinated), and you have the governors of two of the largest states in the country that are preventing community institutions from pursuing lifesaving methods, that is killing people.

And we’re not used to that, dealing with that kind of thing in politics. But it has to be called out. It’s a kind of — it’s a lethal political development in our common life.”

Michael Gerson, former aide to President George W. Bush

Florida Covid Cases 2020-2021

From the Emerging Pathogens Institute, University of Florida

Winston Churchill observed that “Generals always fight the last war.” The governors of Florida and Texas have declared that they are going to continue to fight last year’s enemy, despite overwhelming evidence that the enemy has morphed into a totally different beast, capable of infecting children, overwhelming hospitals in areas with low vaccination rates, and increasing death rates to levels not seen since the surge of cases in January. 

There is good news, however. Florida’s unprecedented spike in cases appears to have peaked. (In every age group but school age children, where infection rates are rising.) Over the last several days, infectivity rates, and cases per 100,000 population have come down in Florida. It’s possible that this round of virus will infect so many unvaccinated people, that it will serve as a vaccine for the unvaccinated, like a black-eyed pea dip serves as a substitute for caviar. The refusal to change course in managing the virus in highly infected parts of the country will assure a harsher resolution of this fourth wave of the pandemic, with more deaths and hospitalizations, and more long-term cases of Covid 19.  

In Maryland, things are not looking bad. The current wave of virus appears to be peaking here too, at much lower case numbers than in previous waves of infection. Governor Larry Hogan reported this morning that over 80% of eligible Marylanders have been vaccinated, and that 94% of Maryland residents over 65 have been vaccinated. The high vaccination rate here is serving as a backstop to insure against a huge outbreak. 

The big question, over the next few weeks, is what will happen when schools open? Because all children under 12 are not vaccinated, and only 30-40% of children 12-18 have been vaccinated, the virus will likely spread through schools here and all over the country. It will be difficult stop the spread. Masks will help. Most schools plan to keep students in small pods, rather than allowing them to interact with everyone in the school. Thirty students spending all day in a classroom together virtually assures transmission if anyone is infected in that pod, but the quarantine can be limited to a small number of students. Alternatively, schools can test students in the pod twice a week, and quarantine only those who test positive. The idea is to be able to keep the schools open, and quarantine smaller numbers of students as it becomes necessary. This worked well in many colleges last year.

If you have school age children who have not been vaccinated, either because they are too young or have chosen the more difficult path, and you are not vaccinated, please get vaccinated. Now. If not, you will get Covid from your child. That’s almost guaranteed. The amplitude of the wave of infection from school’s opening around the country will be directly related to vaccination rates of the adults in that community. We will likely see a small bump in total cases here, because Marylanders have done a good job getting the vaccine. 

The other major development since the last update, is the official recommendation for almost everyone, to get a Booster shot with one of the mRNA vaccines (Moderna or Pfizer). The revaccination program is divided into two groups:

  1. Immunocompromised individuals, and health care workersBoth of these groups can get the booster now. Immunocompromised people consist of a) those currently receiving chemotherapy for cancer, b) organ transplant or stem cell transplant recipients on immunosuppressive medication, c) known chronic immunosuppressed conditions (low serum antibodies, etc.), d) untreated HIV infection, and e) those receiving high dose corticosteroids
  2. Everyone else should get their booster shot 8 months after the completion of their second shot of the vaccine. The vaccination program for boosters for the general population will begin on September 20, 2021. Please wait your turn. If everyone gets this when appropriate,

Lastly, if you are unvaccinated and have symptoms of an upper respiratory infection, and you would like to make an appointment with us, please let us know that you are unvaccinated. We will make arrangements to see you remotely or outside of the building. Testing for Covid will be part of that evaluation. We are trying to keep our office environment as safe as possible for our more frail patients. Right now, respiratory symptoms = Covid, until proven otherwise. Make pretend your grandma is sitting in our waiting room.

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