At the time of writing of this blog, we are at over a hundred and fifty thousand new cases per day of Sars-cov-two and we are about two weeks from Halloween where people were getting out and interacting. We’re willing to put money on that number going up significantly two weeks after Thanksgiving. If we’re right, we will be at over one hundred and sixty thousand new cases per day by December seventh. We’re willing to wager that we’ll be over one hundred and eighty thousand new cases per day around the seventh of January which is two weeks after Christmas. Now we know that many in my community don’t want to talk about this any longer and are ready to move on. But as much as we’re all tired of dealing with this, we have to face reality of what is about to happen. We wrote this blog on November 12th and just yesterday alone, we had two thousand deaths. If there’s any silver lining in all of this, we hit that same death toll in early May when we were recording twenty five thousand new cases per day. New drugs and COVID nineteen therapy protocols have saved more lives compared to the early months of the pandemic, but significant increases in the number of daily cases will still lead to a significant number of fatalities.
As we said, we think we’re all ready to move on. In this community, the discussion of this illness has become controversial, but based on the numbers, I think we’re in for some very difficult times ahead that will impact us all directly, and we think it is part of our responsibility to you to make this blog and caution you about the future we all face. Since City Prepping started, we’ve done blogs on the threats of pandemics, interruptions to our food supplies, a look at the influenza pandemic of nineteen eighteen, and what we can glean from that, and several videos on SARS-CoV-two, itself. We thought it was time to take a step back and then a step forward by seeing where we are at in this pandemic and what we still need to watch for and prepare for. In this blog, we will look at where we stand in all of this, what we can expect, how this pandemic will forever change our lives, the hope of a vaccine, what we should know, and what we should continue to do. While twenty-twenty-one will bring some great bright spots, we aren’t out of twenty-twenty yet, and the prognosis continues to look pretty grim.
1- Where We Are At Right Now
Democratic Governor Andrew Cuomo of New York state is requiring travelers to get a Coronavirus test before and after they arrive. Republican Utah Governor Gary R. Herbert had for months refused to order residents to wear a mask, but after Utah’s worst single-day infection rates ever, he reversed course, declared a state of emergency, and mandated masks. Utah has reported just over 132,000 cases and just 659 deaths since the start of the pandemic. The President-Elect and the current President seem to have different opinions on mask-wearing, as do many of your neighbors and friends. There is one school of thought that believes mask-wearing suppresses immunity function and one that believes mask-wearing reduces the amount of exposure to the virus and the amount of virus spread from asymptomatic spreaders.
If history is any lesson, masks will be mandatory in many areas of the country and in all public places throughout the country. There will be fines associated with non-compliance with the order. During the 1918 influenza pandemic, many local governments mandated masks. Most people complied, others poked holes in their masks to smoke or refused the orders outright and were fined. At the end of that pandemic, fifty million people died worldwide, 650,000 or so of those were in the United States alone. Currently, after approximately 10 months since the first reported cases in the United States, we are at 36% of the 1918 pandemic’s death toll. Does that mean we have at least 20 more months of this to go before we are ahead of it? Quite possibly.
As a rule, epidemics create what researchers call a “U-shaped curve” of mortality—high death rates among the very young and very old, lower rates among working-age adults. For reasons as yet unknown, the U-shaped curve does not apply to today’s coronavirus. Some theories are that we protect our children, insulate them, pull them from schools, and keep them from large gatherings, so their infection and exposure rates are so much lower. But, we have also learned that this virus, unlike the influenza virus, affects multiple parts of the body, from the lungs to the heart to the blood and the kidneys. The virus’s long term health effects and complications are still largely unknown. COVID-19 seems to complicate and exacerbate other conditions of the body from asthma to inflammation to latent diseases like leukemia. As the body engages in its immune response to the virus, it perhaps gives way to other diseases or creates an environment where other diseases may emerge. The facts are that we don’t have all the facts. We are still learning about this virus every day. We also don’t have any singular treatment or prevention yet.
Are you concerned this will get worse?
2- What Can We Expect in the Coming Months?
If history is to provide any guidance as to when we might emerge from this, we have to ask ourselves what was the cause for us emerging out of the 1918 flu pandemic. Some outlying theories are that the virus mutated and became weaker, but viruses spread throughout millions of hosts don’t just all of a sudden decide to simultaneously mutate. Unlike the novel coronavirus, the 1918 flu wasn’t entirely new. It was a variation of a virus that circulated in 1898. So, there were some people walking around with at least some naturally acquired resistance to it. The 1918 flu strain is thought to have circulated until 1975 when a new flu strain replaced it. Our herd immunity became stronger, but the virus didn’t just disappear overnight. The fact is our overcoming the effects of that virus was a combination of factors.
When the 1918 pandemic hit, medical professionals had no reliable diagnostic test, no effective vaccine, no antiviral drugs, and no antibiotics – which might have treated the bacterial complications of the flu that killed most of its victims, in the form of pneumonia. Now, just like then, our treatments need to rise to the occasion. It’s not that the virus will get weaker, maybe it will, but that’s not likely. Our treatments and our understanding of it will increase. After the 1918 pandemic, we saw the first national health groups emerge, more sharing of treatment studies, better hygienic practices, and better medicines. We will likely see the same boost after we get ahead of COVID-19, but we have to accept that it’s here to stay.
In the coming months, we can expect more lockdowns, the implementation of some contact tracing, the beginning tests of new vaccines, and new treatment approaches and therapies. We will become aware that pandemics are a social problem, not an individual one. Expect people to begin to be personally impacted by the virus. At the current rate of infection, well over 150,000 new cases reported daily in the United States, we can expect that communities, even isolated and insulated communities will begin to experience the virus. The economy will suffer as more people fall sick, but it will also adjust to more virtually productive and work from home strategies. People are already expressing their displeasure with mask orders, so it’s not likely people on either side of the belief in COVID are going to willingly line up to be tested or inoculated with a new vaccine.
Would you take the vaccine?
3- How will this change the way we live in the years ahead?
Oddly enough, little existed in the historical record of the 1918 pandemic. It wasn’t until around the mid-seventies where it began to be explored and researched. Perhaps that was people avoiding thinking about it, or perhaps it was overshadowed by the first and second World Wars, perhaps other diseases like polio and tuberculosis became more prominent focal points in our minds. Whatever the reason, it did change our society. Our approaches to medicine, our treatment of pneumonia, our understanding of both bacterial and viral infections, our health and safety standards, even nationalized medical practices, all rose out of this dark but brief period in American history.
Our understanding of crowd diseases, our awareness of infectious spread has increased dramatically. Had you ever heard of a super-spreader event before this year? We can extrapolate from this that large gathering events will continue to decline in popularity. Movie theaters, concerts, sporting events, even maximum occupancy levels will all be changed.
Our sanitation practices will change. Buildings and public transit hubs and vehicles will periodically be closed for fumigation and sanitation. Handshaking is already on its way out. Hand washing is becoming more popular by the day.
Our economy will have to pivot and rapidly adjust. Countless small and large businesses have folded already, and businesses will have to rethink their models if they hope to survive. Americans are traveling less, eating out less, recreating less. In a weird byproduct of that savings and spending priorities shift, Americans have been paying off debt at an unprecedented rate this year, while corporate credit levels have risen sharply. The financial markets will continue to suffer from short-term funding stresses, suppressed consumer demand, and long-term funding stresses as COVID continues to plague countries around the world.
Are you making any changes in your life due to Covid-19?
4- Is a vaccine around the corner?
The headlines have been buzzing with one company’s trials of a vaccine with an alleged 90% efficacy rate. Pfizer recently announced that early data showed its vaccine prevented Covid-19 in more than 90% of trial volunteers. Other companies, including Moderna and Novavax, have also reported encouraging news about their vaccines. This is all great news if it all pans out. That would make it the magic bullet in this fight, and it is true that never before in human history has one virus been studied so much. Never before in human history have so many scientific minds and research funds and testing been dedicated to a singular disease, so maybe it is possible that globally, collectively we are on the cusp of a breakthrough like this.
We have to wonder, though, is Pfizer’s vaccine or any other company’s vaccine at this point a game-changer? Since modern flu vaccines don’t have that kind of efficacy rate, people will not rush out to get inoculated and won’t be forced to be vaccinated. Poorer, populous countries may not be able to effectively inoculate their people.
We remain optimistic that some type of semi-effective vaccine will happen, perhaps, next year. If the virus continues to spread at such high rates, people might even seek out a trusted vaccination. If the infection rates are low, however, it’s likely most people will avoid any vaccine. After all, though vaccinations have been proven again and again to be a valid preventative measure, large segments of the population will choose not to be vaccinated.
Do you think we’ll have a reliable vaccine next year?
5- What should we know?
If you follow the math and science behind this pandemic, we can be encouraged that the quality of treatments is improving. The hope here is that we will be able to dial in an effective treatment plan that keeps people out of our hospitals and off of ventilators. The improving quality of treatments is evident in the death rate: Only about 1.5% of diagnosed cases have been fatal in recent weeks, compared with 1.7% in late July and early August, and a whopping 7% during the virus’s initial surge in the early spring. Treatments are getting better, and if they continue to improve we could see communities reopening, people returning to work and normal life, and children returning to school.
Current testing is getting better, as well. We will, in the coming months, have a test for T-cells to add to our tests for COVID antibodies. Testing for T cells to the virus will allow us to determine with greater accuracy someone’s potential immunity to the virus. Determining who may have some potential immunity is the first real step to safely opening our businesses, economy, and schools. Antibodies tend to garner most of the attention, but levels of antibodies fall and can become undetectable. T cells that remember the virus are a better indicator because they can easily kick the body into protective mode to fend off an exposure. It is a solid improvement upon tests that merely determine if a person has antibodies to the virus.
But treatment effectiveness is only part of the problem. This virus spreads more easily than other viruses we have encountered before. We are seeing a surge of cases throughout the world. The number of cases is increasing daily. In the United States, new cases are growing at a rate of over 150,000 per day. So, while we have treatments improving and fatality rates falling to just barely under 2 out of every 100 hundred people, we likely will not be able to hold the line there because of the infectious surge we are experiencing. To be honest, there aren’t enough hospital beds and there isn’t enough medicine in production. Remdesivir, for instance, has shown some effectiveness. It is one of the drugs the president received, but the drug just recently received FDA approval and is only available to hospitalized patients at certain institutions who have the medication available, or through a clinical trial. The results of those trials won’t really be known for months. As the cases increase, the treatments are still sparse, so we can expect the fatality rate will likely go up again before we can get it back down.
6- What should we do?
As bad as 2020 has been for many, 2021 will show only a little improvement if we don’t begin to act collectively to get ahead of this virus. We would like to tell you it’s going to get better, and in some ways, we think it will. When the T cell test is readily available, we will determine who in our herd is less susceptible to infection. These people will be able to go back to work and to school and move more freely in public without too much fear of reinfection.
It is a tradition, of course, to gather during the holidays, but we may see a trend away from that this year. Already several officials have warned that we should confine gatherings to those family members within our households. Add to that the decreased travel, travel restrictions, and some state and local quarantine and testing rules we will continue to see if cases continue to increase, and the holidays will be small this year. With rates so high right now, it is advisable that we focus on our immediate families to ensure their safety. On the upside, you won’t have to put up with that crazy aunt or uncle this year.
We should follow guidelines as health officials develop them. In the early days, they were trying to hit a moving target. You should continue to practice frequent hand washing, mask-wearing, social distancing, and avoid large public gatherings if at all possible. Take advantage of contactless grocery pickups, if available. Cook and eat at home whenever possible.
The time for doubting this virus’s presence has passed. As it overwhelms some communities, realize that this can impact our work and our food supply lines. Make sure your preps are topped off. Continue to slowly fill in any gaps should we not be able to get things under control. Realize that hospitals and medical centers will be forced to continue to prioritize the affected and this will impact your routine medical care. Press your doctors to prescribe for you larger quantities of critical medicines you need to survive.
We are entering the hardest days of the pandemic. The next 3 months will see an unfortunate but predictable rise in infections and then deaths. There is a light at the end of the tunnel, though. We will get through this pandemic. Never before have we leveraged so much collective computational ability, brainpower, research, and the fast-tracking of potential medicines and cures. Just as the old LP record has become a thing of the past and music and images are digital now, our world is forever changing as a result of what we are experiencing today. It will change as a result of this virus. Our old normal is being replaced by what we hope will be a similar new normal.
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As always, please stay safe out there.