When the country’s second-largest school district reopens for business despite tens of thousands of positive coronavirus tests among students and staff, things have changed.
As the state of California, which led the nation in caution, tells medical staff who have tested positive about going back to work if they are asymptomatic, things have changed.
When you listen NPR’s “On Point” podcast and hear doctors say that in the midst of the rise of the Omicron variant and hospital fatigue, there are reasons for optimism, and that “if you are vaccinated, you can start living your life again,” things have changed.
We are two years into a pandemic that has killed around 5.5 million people globally and changed lives in both big and small ways. Last January, I wrote a column suggesting that there was hope for a turnaround because the best available medicine – vaccine – was pumped into my arms everywhere.
So where do we stand now?
I have been trying to figure it out and would very much like to give you a definitive answer. But going forward, the virus will give us a new look and we will have to adapt.
Overall, we are in much better shape than we were two years ago. And better shape than we were a year ago, when getting the vaccine involved a crazy battle to find a place in line at a pharmacy or supermarket.
“I am very optimistic,” said Dr. Kimberly Shriner, a specialist in infectious diseases at Huntington Hospital in Pasadena.
But do not take it as an invitation to hold a party and invite everyone you know.
“We need to be very humble in the presence of this virus,” Shriner added.
Humility is not something we saw much of from national leaders in the early days of the pandemic. Even now, after more than 800,000 deaths in the United States, the pandemic in many circles has been politicized and science despised.
And we have know-nothing influencers like Green Bay Packers quarterback Aaron Rodgers and tennis star Novak Djokovic who send out the message that no one has any responsibility to others.
It is shocking that at this point we have to keep repeating the obvious.
“Those who are vaccinated and boosted are highly protected from serious illness and death,” said Dr. Robert Kim-Farley of the UCLA Fielding School of Public Health.
The vaccine does not prevent infection, just as the flu vaccine does not necessarily prevent you from getting the flu. But you probably have it easier on that.
Another important advance is the rollout of a COVID-19 treatment agent called Paxlovid, which Kim-Farley called a game-changer. Used immediately, he said, “there is an 88% reduction in hospitalization and death.”
We also now have a quick antigen test, and “it did not exist a year ago,” Kim-Farley said. But we need far more of them to help us know if we are infecting others.
The LA Unified School District’s decision to reopen schools led to more than a bit of chaos this week, with 62,000 students and staff out after testing positive. The district reported 135,000 student absences Tuesday.
But Kim-Farley supported the decision to reopen.
“We know that children suffer if they are not in the classroom, and distance learning, even if it is better than nothing, is not a very good substitute for being in the classroom,” Kim-Farley said. “We also have new tools in our hands for students, including the vaccines we are now able to give them.”
If schools everywhere can perform more weekly tests and can move quickly to improve ventilation and air filtration systems, Kim-Farley said, the risks will be further minimized.
As for the state, which tells health professionals who test positive but are asymptomatic about staying on the job, then it is not a risk-free option. Like the reopening of schools, it is a calibration of lesser evils. The Omicron wave and the rush to hospitals from patients who are predominantly unvaccinated have ravaged the front line.
“We have some infected staff, but have not reached the point where we are bringing back people who are infected,” Huntington’s Shriner said.
Her hospital is currently busy with about 100 COVID-19 patients. If it gets to where the patient’s life is at stake, Shriner said, corona-positive asymptomatic staff will be called in.
“If you need their expertise to save a life, you bring them back,” she said.
She added that if “my own beloved” was such a patient in need of critical care, she would want staff to “mask themselves, go in there and save a life.”
Last weekend I received a personal reminder of how frustrating and frightening this time can be for anyone with medical issues, including issues that have nothing to do with COVID-19. My daughter needed attention for a rapidly worsening infection and we had to assess whether it was more risky to go to the emergency room in the middle of a COVID-19 climb or wait a day and try to get in to see her regular doctor.
We went to the emergency room where she was treated and released with a prescription. Two nights later, with yet another fright, we thought of returning to the emergency room, but an employee said the hospital was flooded.
Going to the emergency room should be a last resort and we did not want to burden critically ill patients or staff. But I will not pretend I was not angry on behalf of everyone whose access to care is compromised because the system is overloaded with unvaccinated hordes.
If I let my mind go to the darkest places, I fear that because so much of the world is unvaccinated, we may well see one variant after another circle around the globe, and we do not know if the next will be the most mortal yet. I am also concerned about the continuing attack on public health protocols and the slander of experts.
Kim-Farley called the virus “an outside attack on humanity”, and he despairs over the ways in which politicized, “aggressive anti-scientific” messages have shattered an opportunity for the country and the world to unite against the threat. In a healthier atmosphere, he said, we would celebrate the fact that a Republican president moved quickly to develop a vaccine, and his Democratic successor moved quickly to make it accessible to all.
When I spoke to Shriner, she had just checked patients at Huntington’s “long COVID” clinic.
“Our youngest patient is 26, the oldest is in his 70s,” she said, and long-term COVID – also known as post-acute sequelae of COVID – has also been seen in children. Her patients have blood clots, inflammation of the brain, heart and lungs. Some have brain fog, some have gotten better and have returned to work, some have not.
So much the more reason to vaccinate, mask and distance yourself and enjoy the freedoms that come with these precautions.
I asked Shriner how often she is asked by friends, family or colleagues for advice on what she may and may not do. Every day, she said, and she tells people to pretend they have 10 risk cards.
“You have to decide if you want to use one of those cards,” she said when I asked if I should eat in the parking tent at a restaurant near her hospital.
I told her I can not believe how many times I have seen a ball game on TV and noticed that most spectators are not masked. Even at an outdoor game, is it safe?
“If you want to participate in a football or baseball game, ask if that’s where you want to use a risk card,” Shriner said. “Traveling right now is very dangerous, but some people have to do it. If you have a loved one who is feeling bad, you may need a card for that.”
If she’s outdoors and walking her dog, Shriner told me she’s losing her mask. But if anyone comes close, she pulls it up again.
“I do not come from ‘everyone has to get it in school’. I do not want it. It does not look fun,” said Shriner. “I do not have to be locked in, but I have to be sensible. “We can be hopeful because we have overcome all kinds of obstacles in the past. This is just going to take time, patience, justice and selflessness.”
So maybe you can breathe a little easier than you could in early 2020 or 2021.
But do not betray your guard yet.
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