I am in my fifth day of quarantine due to COVID; I return to work tomorrow. My only symptoms have been those of a mild upper-respiratory illness, which has now nearly resolved.
I diagnosed the first case of COVID in our area on March 17, 2020. I went nearly 22 months without contracting COVID, despite seeing COVID-positive patients in the hospital and, with the recent surge of the Omicron variant, potentially positive patients at the clinic, all with proper protective equipment. I am fully vaccinated for COVID and have received the booster.
When I was a boy, my dad bought an electric lawnmower, which was my responsibility to use for mowing our yard. The salesman guaranteed that my family, and specifically me, would run over and cut the electric cord sometime in the use of the electric mower. I never did damage the cord, but I always remembered how sure he was of his prediction.
We are at that point in the COVID infection for a similar prediction. The prediction: Nearly all of us shall be infected with COVID eventually. It is becoming an endemic illness like influenza, and, like with influenza, the illness is usually mild for those individuals vaccinated. The caveat is that every prediction regarding COVID has been incorrect.
As we sit in Ames, Iowa, today:
- the Iowa State University students returned from the Christmas/year-end break yesterday,
- our county positive-test rate is 21%,
- our fully vaccinated rate is 61%,
- the number of COVID patients is underreported because the number does not account for rapid, at-home testing,
- my clinic, McFarland Clinic, is putting out a patient guide due to an “extremely high volume of calls and requests for appointments for multiple upper respiratory illnesses, including COVID,”
- and my hospital, Mary Greeley Medical Center, had its highest total census of COVID patients ever – 40 – on Jan. 13.
During the three weeks before my COVID infection, I had the highest number of patients with active COVID infection in my practice ever, but I have had no COVID patients in the hospital for two months. The vast majority of my patients, who are nearly all vaccinated, are suffering only mild to moderate upper-respiratory symptoms. I engage in telehealth to verify the severity of my patients’ symptoms and assess how I can assist them.
Does my fatalistic prediction evoke pessimism, optimism, both, or neither?
For me, the prediction evokes the attitude I have in regards to an endemic that I cannot prevent. In such an endemic, like influenza, medicine attempts to prevent the preventable and to treat and minimize consequences for those with unpreventable infections. All the actions that we have heard of in the last two years come to play – social distancing, staying home when sick, masking, getting vaccinated, and aggressively treating those patients with severe symptoms.
Furthermore, the COVID world is divided into two subsets of possible patients – the vaccinated, who will very likely have only mild to moderate upper-respiratory symptoms with Omicron – and the unvaccinated patients, who are playing Russian roulette with the potential for “the ugly side of chance” (a quotation that I just picked up from Amor Towles’ The Lincoln Highway), with the possibilities of hospitalization, ICU admission, ventilation and/or death.
Rightly or wrongly, our society has seemingly accepted this scenario with no lockdowns (at least in Iowa) being imposed during this surge.
A final thought: One of my most respected partners at the clinic discussed the unvaccinated as being individuals who do not care about the safety of their fellow Americans. I agree about the end result of their actions. But, after many discussions with many of my unvaccinated patients, I do not believe they understand that effect. I wish they did.
I believe we are moving into the reality of COVID being endemic, with COVID being an inconvenience for vaccinated patients, a continued danger for unvaccinated patients, and a major drag on our economy and society.
Welcome to the new world.