Friday, May 21, 2021

One year ago I wrote a piece called “Change” about the promise of vaccine clinical trials and summer reopenings, versus the possibility of summer (2020) COVID surges. The article ended: “What we don’t know is, will May of 2020 be part of the beginning, the middle, or the end?”

Well, it’s May of 2021 now, and we still don’t know. As a historian, I’m itching to periodize the pandemic, to give it a narrative with causes, developments, peak, and aftermath, like a textbook discussing World War I. But we’re not there yet and signposts point in every direction. For example:

Path One: We’re coming out of the woods this summer.

  • The Eiffel Tower will open on July 16! The Tower tweeted that we are welcome to visit and tickets go on sale June 1. If the Tower’s open, can Paris be far behind?
  • The Games will go on, even if Japan’s state of emergency continues, according to the International Olympic Committee. Polls have shown that 70% of Japanese firms think the games should be delayed or cancelled, but so far no one is backing down.
  • California will allow theme parks and mega events to open up at full capacity on June 15. There are conditions/recommendations for tests/vaccinations, but this will be a major opening for parades, sports, county fairs, concerts–you name it–all the fun stuff we’ve been looking forward to. Mega means over 5,000 people indoors or over 10,000 people outside, so I ask: how will we celebrate the Fourth of July? Too soon to tell.

Path Two: We have a few swamps to cross before we’re home free.

  • Southeast Asia is seeing a steep rise in cases and deaths. In addition to India, countries affected include Nepal, Vietnam, Sri Lanka, the Maldives and even Taiwan and Singapore, which were doing quite well due to strong initial measures.
  • Taiwan was doing great, but . . . The case rate was so low that even hospitals stopped testing and the mandatory quarantine on non-vaccinated airline pilots was reduced to three days. Taiwan’s recent outbreak of the UK variant B.1.1.7 has been traced to a group of pilots staying in the same hotel. Don’t stop testing. That’s how you catch outbreaks early.
  • Deaths in the United States have reached a new low, averaging less than 500 deaths a day for the first time since March, 2020, according to the latest Johns Hopkins report. But India now has the world’s highest mortality rate, reaching 4,529 deaths on May 18. The previous record daily high was 4,472 deaths in the U.S. on Jan. 12, 2021.
Deaths worldwide over the past year show a battle still raging.
Johns Hopkins Coronavirus Research Center
  • Variants can spread fast. The variant B.1.617, first identified in India and recently identified as a “variant of concern” by the WHO, now has three sub-lineages. One of these, the B.1.617.2 sub-variant, has doubled in England in less than a week and dominates some sections of the country. Public Health England has found that it takes two doses of AstraZenaca vaccine to protect against this variant. One dose is only 33% effective. Similarly one dose of Pfizer-BioNtech vaccine is only 51% effective. Second doses are now being fast-tracked in England, especially where the incidence of B.1.617.2 is high and especially for people in their teens, 20s, and 30s, who comprise most of the cases.
Change of variant frequency in U.S. in just 3 months. CDC Data Tracker.

Path Three: Swamps to cross and dragons to fight. Don’t take off your armor yet. The BMJ calls them the “Known Unknowns.” We have done so much research and so many studies in only a year, but we need time to consolidate our knowledge, reconcile the differences, and understand the effects over time.

Examples of things we DON’T know:

  1. Extent of mutations and characteristics regarding infectiousness, severity of disease, resistance to vaccines/therapies
  2. Strength and duration of personal immunity after infection and/or after vaccination.
  3. Duration and impact of long COVID on individuals — is neurological damage or organ damage permanent?
  4. Impact of long COVID on society — in terms of employment, medical costs, care required
  5. Mental health consequences of the pandemic period short-term and long-term in old, young and in-between
  6. Biological markers, contributing factors, vulnerable populations in relation to all of the above

And then there are the unknown unknowns. Things we don’t know that we don’t know. Things that just might leap out at us. But let’s not go there.

Don’t lay down the sword yet

Today’s Notable Headlines

“France to reopen Eiffel Tower this summer,” The Hill, May 22, 2021. https://thehill.com/policy/international/554891-france-to-reopen-eiffel-tower-this-summer

“‘Absolutely Yes’: Games Will Go On Even in State of Emergency, I.O.C. Says,” The New York Times, May 21, 2021. https://www.nytimes.com/2021/05/21/sports/olympics/olympics-japan-state-of-emergency.html

“California theme parks can return to full capacity, must verify COVID-19 vaccinations and tests,” OC Register, May 21, 2021. https://www.ocregister.com/2021/05/21/california-theme-parks-can-return-to-full-capacity-must-verify-covid-19-vaccinations-and-tests/

“UN agencies appeal for funds as COVID-19 surge eclipses South Asia,” UN News, May 21, 2021. https://news.un.org/en/story/2021/05/1092432

“Covid-19: What went wrong in Singapore and Taiwan?” BBC News, May 20, 2021. https://www.bbc.com/news/world-asia-57153195

“Two Covid vaccine doses needed for strong protection against B.1.617.2 variant found in India: Report,” Hindustan Times, May 22, 2021. https://www.hindustantimes.com/world-news/two-covid-vaccine-doses-needed-for-strong-protection-against-variant-found-in-india-report-101621681161772.html

Additional Sources

“State of California—Health and Human Services Agency, California Department of Public Health,” Beyond the Blueprint guidelines for mega indoor and outdoor events. Announcement: May 21, 2021. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Beyond-Blueprint-Framework.aspx

COVID Data Tracker, CDC, https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases

Johns Hopkins Coronavirus Research Center, https://coronavirus.jhu.edu/map.html

“Covid-19: Second vaccine doses expedited in areas of England where new variant is high,” BMJ 2021;373:n 1266, May 17, 2021. https://www.bmj.com/content/373/bmj.n1266

Alice’s Adventures in Wonderland by Lewis Carroll, John Tenniel Illustrations. Random House 1946 edition.

Why am I doing this?

The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. I intend to journal the pandemic experience from three perspectives: as a retired medical technologist, as a historian (Ph.D., 2014), and an ordinary person living through an extraordinary world crisis.

One thought on “Year 2, Week 11: Which Way?

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