Well, it has been since January 2020 that we have been talking about COVID-19. It was December 2019 when first cases of infection were described in China, or maybe when the first case appeared in these United States on the West Coast.
The disease or the pandemic as it is called now has affected several million folks in the U.S., India, Brazil and other countries. It has killed almost four million people. Some say the count is lower than in reality because we are not testing everyone, and others say we are overcounting as the hospitals are labeling many cardiac and pulmonary deaths as COVID-19 deaths to get higher reimbursement.
The disease is affecting mostly elderly men, blacks and Hispanics, and those with heart disease, lung disease, kidney disease, immunosuppression, and others with diabetes and hypertension and smoking history. This is what our study in the American Journal of Cardiology showed.
There was much scare initially in Europe, and now all these countries are facing a second or third or even fourth spike. These countries have had lockdowns to contain the disease, and then intermittent opening of the economy – how long can they keep large number of people, young and old and in-between, in their homes? The schools and businesses are opening and closing and opening again. And then the teachers do not show up. What good is the opening of schools and businesses?
The incidence of lonesomeness and unhappiness is rising because people must stay home. The dynamics of interpersonal relationships between spouse and children have become strained as people are on each other’s faces all the time. No wonder the divorces are at all-time high, as is crime. The number of suicides is up, even among children, particularly among Blacks. Has anyone figured out why the suicides are much higher among Blacks?
We are animals that like to wander around, and go to the countryside, jungles, oceans, and skies, and visit our friends near and afar. We like to go to art galleries, symphonies, movies and take part in or just watch sports – which are all or mostly closed, or “on-line.” On-line stuff whether be educational or entertainment is not the real enchilada.
Despite an initial setback, the stock markets around the world keep setting new highs. I guess people have lots of cash that must be put to use somewhere. And playing in the stock market gives a sports-like high.
In February and March 2020 when the disease attracted everyone’s attention, I thought it would disappear by summer, and I was nonchalant about it even though I personally had almost all the risk factors. I used to help others think that it was a short-lived, mild problem that would just “go away.” Some believed me, most did not.
We had planned trips to places near and afar, including Florida, Montreal, Boston and Europe. We did not go to any restaurants, but I kept going to Kroger and Walmart and Sam’s, and occasionally to the mall, more for getting my walking steps than for shopping. Everywhere we went, we had a mask on. It was no fun.
We had visits from our children and even one from my then 9-year-old grandson Jasper who took his first solo trip ever. The visit was brief and pleasant, but I had some mixed feelings because we had to be ever so careful.
Now the summer or 2020 is gone, and so has fall, and it began to get wintery cold, and then came the spring and summer of 2021. Some days in Little Rock in winter were colder than in Boston. The year 2021 is more than half gone. We are still talking about COVID and new variants – Delta that originated in India and rapidly spread around the world. In Arkansas, the Delta variant is the primary cause of a new wave of COVID hospitalizations and deaths.
I guess a new reality has set in. I am not seeing new patients – just follow-ups, mostly by phone.
Even the patients I see in my clinic appear bored. Many come for a visit to get out of their house. Some like talking on the phone, but there is no personal connection, and whatever is there appears artificial.
The hospitals lost money for lack of patient visits and the “procedures” that were in any case meant to generate revenue and on the side “help” patients. Hospital revenue began to pick up around the winter of 2020. Patients in the hospitals were allowed minimal visitors to keep the bug away. But then as COVID-19 was controlled in the U.S., clinics and operating rooms and cath labs were opened, and all was back to “normal” around February and March 2021, and the healthcare industry started all its money-making operations.
Restaurants that closed for months began to open on a limited basis around the beginning of 2021. Even those that were open had to enforce social distancing and use of masks. So, you eat with your mouths closed!! Gyms were by and large closed and are now open, but people still manage to eat out, go out to establishments and use gyms. No wonder we have second and even third spikes of COVID-19. Perhaps it is time we call it COVID-20 or COVID-21?
People felt lonesome stuck at home. Children were staying at home as schools were closed or open intermittently, studying at home on Zoom, and going berserk, as were parents, many of whom never had the experience of having children at home for spring, summer and fall and winter as they forgot about the on-line education. Even my daughter Asha moved with her family to Florida where schools were open and the weather was warm.
I had an interesting interaction with a patient. I mentioned it to Paulette and she wrote it up for me. In essence, one of my patients who was taking care of an elderly man was very upset not because she was let go from taking care of the elderly subject by his family, but more so because the man died of loneliness, not because of COVID-19, but from lack of his only contact.
We expected one or more vaccines to be available to protect us from Corona virus, but the virus keeps changing initially into type A and B, or D614 and G614, and now it has mutated in Denmark in sheep. It will now affect mink prices since the government there has ordered culling of millions of sheep. So, the vaccine may not be effective, or only partially protective. And of course, the Delta variant which started in India and spread worldwide. More variations will come.
The vaccines came, initially from Pfizer-Biotech, then Moderna, and AstraZeneca and Jensen, and of course from China, India and Russia.
The U.S. elections came and went (not really!); the Trump team did not believe the results. I will remember these elections forever. Very few people voted in person, yet more votes were cast than ever before – by mail because of the Corona fear. The former President is still contesting the election with fights in courts. Can anyone deny that (mis)management of COVID-19 cost him the election as POTUS? He claimed we will have the vaccine before the election; it never did happen. He himself had COVID-19. He got better enough to campaign mightily, but that was not enough.
Well, Joe Biden is now the President. He has mobilized COVID vaccinations and almost 55 percent of the population is vaccinated, but COVID infections continue to soar in the U.S., India and many other countries, a result of people becoming more used to COVID and not following precautions. India until recently the world’s supplier of vaccines had a shortage of vaccines and oxygen for their patients; it is asking Germany and other countries for the gas generating plants.
There are now Indian variants, UK variants and South African variants. Vaccines may or may not be effective against the variants. And before I forget, the AstraZeneca vaccine has been associated with unusual thrombosis in the cerebrovenous sinuses and the hepatic veins, a picture mimicking TTP. I wrote a paper with Peppino in Italy and Pier Paolo in Ireland.
I am afraid I will get COVID and die of it, although they say that vaccinated individuals are unlikely to get serious infection and less likely to die, but with poor lung and CV situations, who knows?
Oh, COVID, don’t be so proud. We will get used to you, or you will just disappear – after killing millions, a price to pay to pacify you.
Jay Mehta, M.D., Ph.D., served as the Director of the Division of Cardiovascular Medicine at UAMS. Currently, he serves as Distinguished Professor of Medicine, Physiology and Cell Biology, and Pharmacology and Toxicology.