Sunday morning musings from the trenches, July 19, 2020

  1. Good morning and welcome to my end-of-week thoughts and ramblings. This whole blogging endeavor began on a frustrating March Saturday morning when I felt powerless, unable to find testing sites for my patients, and feeling a bit overwhelmed (possibly tearful, but I would never admit that). In the words of Yogi Berra, it is deja vu all over again. Testing is abysmal. Not only are testing sites few and far between, but the turn around time for results in an embarrassment. While on call this weekend, I had 3 separate phone calls with patients in a span of 2 hours yesterday that left me flummoxed. All needed testing. One patient lost his sense of taste of smell, had a cough, and was with 30 family members the week before in a not-so-socially-distanced setting. Another patient had direct contact with a client who just tested positive, then took two flights home from his business meeting. He is now at home with his immediate family who are appropriately worried. The last case was a home health care worker with a loss of taste who visits elderly patients on a daily basis. How can we get ahead of this thing if we can’t test, get fast results, contact trace, and then quarantine/isolate? Simple answer, we can’t. By the time a patient navigates the Department of Health website, finds a testing site, and makes an appointment for 2–3 days later (at best), they have already possibly infected a whole slew of loved ones, and maybe a few enemies as well. By the time the results come back 6–10 days after testing, we are now almost two weeks out from when this information was needed and actionable. This is ineffective, dangerous, and distressing. “Hello Aunt Shirley, may I speak to Uncle Jerry, wanted to tell him I just got my test results back after 12 days and they are positive.” “Would love to put him on the phone, Johnny, but he is dead.” Oopsies. The United States is wealthy. Other countries are not, and they have shut this down. Vietnam has shut it down. Italy, after being the hardest hit country on Earth, has shut it down. New Zealand has shut it down. The NBA is poised to shut this down. Yet 40 out of our 50 states are surging and we are the world’s laughing stock. Suck it, Iceland.
  2. I am not getting off of my soapbox yet. Brian Kemp — you are an idiot. I don’t care if you are a Democrat, a Republican, or a Whig. I don’t care if you are red, blue, or orange. Mask wearing is our way out of this — stop being an a-hole. This is not a political thing, this is a humanity thing. Wearing masks is our only chance right now, people. This country is on fire. Not in an NBA Jam sort of way. We have no effective testing strategy, tracing strategy, cure, or vaccine. Until we get to cure or vaccine, we need to trust science. Science is the only way to get back to simpler days of hugs and high-fives. The days of viral videos of the Kardashians putting on eyeliner instead of convenience store yell-a-thons involving disenfranchised mask-refusers. Oddly, the wearing of masks is the only way to get back to the time where we didn’t have to wear masks. This simple, easy, and only mildly-annoying intervention will allow us to return to some semblance of normalcy. You wear one, I wear one, and carry on. It can be a gaiter. It can be a bandana or a schmatta. It can be surgical mask, an N95 mask, or a KN95 mask. Go crazy, and throw a shield over that mask if you want. Mask + mask lowers the risk of transmission significantly. We have seen this time and time again. Stop arguing with data. Stop arguing with truth. Stop waiting for this to personally affect you before you acquiesce to the truth. I am looking at you Chuck Woolery. It is such an easy thing to do. Why is it so hard for some of us? We’ll be back in two and two.
  3. Deep breath. At least we are not dealing with the Black Death. Oh wait, we are. The bubonic plague, which killed 50 million people during the Middle Ages, is back. In a squirrel. In Colorado. The WHO defines bubonic plague as a re-emerging disease. Awesome. Remember, squirrels are rats with tails. Don’t play with them. If you do, wear a mask. It would suck to get the bubonic plague and coronavirus in the same week. Finally, a legitimate work excuse: To Whom it May Concern, Jerry won’t be coming in this week. He has COVID-19 with a touch of the Black Death. He probably won’t be coming in next week either. Probably a good time to start interviewing for his replacement.
  4. Is there any realistic way that kids get back to in-person school in the Fall? Without a cohesive national strategy, there are too many “what-ifs” to make this happen. The newest data this week is that children under the age of 10 do not transmit this virus as easily as kids who are over 10, who spread this virus like adults. Yes, this is one study. But it shows the complexities of school reopening decision making. Under 10 — come on in! Over 10, stay home. Some countries, like Denmark, had a successful school reopening. Others, like Israel, were not as successful. There are too many unknowns. Unknowns create fear. There are less unknowns with keeping kids home. But, this is not a simple answer. Parents need to work. Parents are not teachers. Virtual school is just that — virtual. Many children do not have the necessary technology to make this work, nor do many school districts. We are all flying by the seat of our pants here, but I really think we need effective vaccine before children hop on buses and flood into school buildings again. Amazing what we take for granted when we see how odd things have become.
  5. There is only one thing that makes a pandemic worse. My continued inability to plug a USB connector into a power supply the correct way the first time. I always guess wrong. Always.
  6. Big week ahead — the first of the major sports returns. Major League Baseball is back on July 23rd. I’ll take it. Things have gotten desperate. Actually watched the Philadelphia Union play this week. In Spanish. Yes, baseball is boring. Yes, no fans will be present (sort of like a home Marlins game). But, I’ll take it — the sounds of the game will be amplified — the crack of the bat, pitches hitting the catcher’s glove, the sound of tobacco juice hitting the turf. Not to be a pessimist, but I doubt this season will get through to the finish, as there are too many unknowns. There will be positive tests. More players will opt out. But, for now, let’s sit back and enjoy live sports and the hint of normalcy in their return. At least professional baseball players can get tested.
  7. Thanks for reading. Today’s rant was inspired by the sweet sounds of Mumford and Sons. I dare you to listen to their album “Wilder Mind” and not love every song. In fact, I triple dog dare you. Not a bad song on the album, and it makes for nice background music to whatever you are doing on this extremely hot Sunday. Marcus Mumford can sing — not so sure about his sons.

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Harris Cohen, M.D.

Harris B. Cohen, MD is a Family Physician who enjoys writing about medicine, while injecting a sense of humor and calm.