We are now at the beginning of the beginning for addressing the virus. I have a slightly contrarian view of our new national approach to combating the Covid-19 pandemic through the vaccination strategy. Conventional wisdom indicates that we vaccinate the people most at risk in our society to prevent needless death and suffering in the vulnerable cohorts; elderly, infirm and people with co-morbidities.
While I understand this approach and the scientific data that supports these interventions, I would ask the question, what happens to the young who are at risk for infection and those infected who will suffer unknown impacts to their health status going into the future?
I am of the age and health designation that I will be one of the first to get the opportunity for vaccination. I have a vested interest. My wife, who is younger, will fall into the category of being next in line but she may have a co-morbidity that will make her eligible for earlier vaccination. I am concerned for her health. I have two daughters in their twenties that will be the last to be vaccinated. I worry for their health and futures. I raise the question; is the risk for delaying vaccination to our young too great, to the overall well being of the country and world at large? What will happen if we inherit a world of sick young people who will impact our healthcare capacities for a disproportionately longer period of time if they were to be infected, survive but develop chronic illnesses secondary to the disease? What happens to our workforce? What happens to our economy?
I would hope that we will have an approach that addresses this conundrum in public health safety and future impacts on the economic viability of a world with sick young people needing health resources for a long time and not being able to work due to illness, reducing tax dollars into our national coffers, further impacting our country’s future ability to serve our population. We need more vaccines now and a wider distribution to a more varied base of recipients without age considerations. We must save our future by saving our young.
The Lesson of Thalidomide for Covid19, Look Before You Leap – My youngest daughter will say in the most excruciating terms that I am old, especially when I am trying to make a point based on some ancient piece of information that I remember to support an argument I am trying to win. She calls me ‘Lesson Plan Dad.’ It’s not a term of endearment. I usually go off and shake my head because she will sometimes ignore me or dismiss me from existence. But a funny thing happened as she was going out recently, she whispered to me before I had a chance to ‘advise her’ about following Covid19 precautions, “don’t worry Dad, I remember everything you said I had to do to remain safe. I hear your voice all the time.” This pleased me to no end because, 20 years after the death of my own Mother, I still hear her ‘voice’ warning me and giving me good advice. I’m sure some of you have that same experience.
The proverb, ‘Look before you leap’ has been a form of advice that has been given for centuries. This proverb was first noted in a 1380 manuscript and then captured in a collection of English proverbs by John Heywood in 1546; describes unintended actions and reactions that can lead to untoward results. The first use of this term in America is associated with a failure in diplomacy in the late 1600’s that occurred in New England during the time of the colonists and a war that caused significant damage of property and loss of life for both the Native Americans and many colonists who had previously coexisted uneasily (King Philip’s War). As defined, both sides in this tragic circumstance did not take-into-account all the consequences of their actions and could not avert the turmoil which befell them all.
In 1957 West Germany, a medication that was hailed a wonder drug and was marketed as a treatment for, nervousness, anxiety and morning sickness and distributed over the counter (OTC), turned into a nightmare for the German people. Many side effects of this medication included horrendous birth defects in the guise of malformation of the limbs, still born babies, tumor development and many other conditions. This medication was named Thalidomide. This drug was prevented from being introduced to the American market by a pharmacist, Frances Kelsey at the Food and Drug Administration (FDA), because of her concerns for the safety of our population. Because of the horrific birth defects noted in the so called ‘Thalidomide Babies,’ greater constraints and regulatory oversight of medications before their use in the public space has become one of the hallmarks of our American medical and pharmaceutical model. Appropriate oversight by the FDA has saved lives. We are looking before we leap!
During these dangerous times, in the Age of Covid19, our well-founded fear and concern for the lives lost and the lives at risk could have the effect of eroding the lessons of the past when it comes to the manufacture and distribution of a vaccine before the necessary due diligence has been implemented. I understand this rush for a cure, but I am reminded and informed about the possible consequences of not performing the work needed to safeguard ourselves from a malady of our own making. There is a reason why there isn’t a Corona vaccine in the world’s arsenal, its hard to create. Mutagenesis (DNA mutations that are engineered secondary to induction by an external factor) and Carcinogenesis (the result of agents capable of developing malignant tumors by inducing cellular changes) are the untoward effects that can result from the introduction of an external, uncontrolled factor into the population. I am not a fear monger, nor am I a scientist, microbiologist or anything remotely approaching an expert in the field on immunology or virology. I am a nurse by profession with a healthy appreciation for the rule of unintended consequences.
Let’s do this by the book! I am informed by the ethical boundaries of not experimenting on animals and conducting animal studies but in this most hazardous of times, please employ ethicists to conclude if utilizing an animal for determining if generational impacts can be averted in the human hosts who will be the final recipients of any vaccine that is developed can be averted. I am not a ‘Night of the Living Un-Dead Roach Avengers’ kind of guy but take a look at our oceans and see the harm we have done by introducing plastics to that environment and see the fish that have plastics in their systems that we are eating now. You get my point. There are potential downstream repercussions to our actions that must be considered and explored. For our children’s sakes, let’s not muck this up any worse than it already is by allowing political expedience to be determinative for the science that is necessary to figure this out and arrive at the best course of action to take.
Can you see the future? It is daunting. I see a change in some privacy protections regarding Covid19 status. Pre or Post Covid19 infection certifications. A loss of some HIPAA protections in the guise of Public Health prerogatives. Let the lawsuits proceed! What will be the civil liberty concerns as this pandemic changes the social structures of our future. Before going into a restaurant will you have to show your Covid19 certification? When you enter a hospital or go to an Emergency Room, will your Covid19 status dictate which door you enter. As a Black man who understands the ramifications of bias, my experiences extend to the general public: will my Covid19 status determine my access to jobs, travel, opportunity. Will dating apps now reveal the Covid19 status of the prospective date?
I know this seems absurd on the face of it but you would be surprised what fear will do to a society (see the Red Scare period of our country’s history). If and when a vaccine is developed, will the anti-vaccine crowd be denied access to public schools upon refusing to use it. Will you be able to refuse the vaccine based on religious grounds? There are public health laws that allow the incarceration of individuals that pose a threat to the general public, will this happen here if an individual is presenting symptoms but refuses to self-isolate? Get used to proximity tracking of your travel in cities based on your Covid19 status. Our days of innocence are over. We will not be able to look down on the political decisions of the leadership of China in their authoritarian way of governance to control their populace. Can that happen here? And be cautious America, be on guard for the hardline, authoritarian political leaders who will want to control many aspects of your life based on your Covid19 status. Any excuse for power-grabbing is fair game in the post Covid-19 age.
Will Covid19ism become the new racism? Or will all this fade as we get accustomed to this new reality. Our norms will change, are changing already.
Handshakes are a thing of the past, doorknobs will disappear (who wants to touch those anymore?). We will wash our hands more as a result which is a good thing and anyone entering our homes will be expected to wash their hands immediately (I suspect there will be a decrease in seasonal Influenza). We have to be alert to the possible erosions to our privacy and freedoms. I am all for testing , but please maintain my privacy. I know that a balance will have to be found to protect my individual privacy and the protection of the public and my neighbors. I just want to give you some food for thought.
A Town of Bandits: Tombstone never looked like this. Wyatt Earp would have gone crazy. The line in front of King Kullen in Bridgehampton, NY and countless other supermarkets in the country are full of people wearing masks, bandanas of every color and stripe, waiting on line (6 feet apart) to swipe that Lysol spray. They are on line (6 feet apart) to get that last roll of toilet tissue in aisle 9, on the left behind the Bounty. “I refuse to use the Bounty to wipe my As…….. Too rough on the butt, but plenty absorbent!”
The Bandits are on the loose! From Montauk to Flatbush, from Sag Harbor to Bed-Stuy, the Bandits are everywhere. Who would have thought? You can’t tell the good guys from the bad. “Oh look at that bad desperado over there in the shadows, leaning over to the side, with that slow purposeful walk; slight glint in their eye. They are heading right toward me. I’m getting scared now. Of course they have a mask on, hiding their face. What am I to do? Nowhere to run or hide. Here they come, reaching in their pocket, taking out a…. set of glasses…. oh she’s smiling….it’s Grandma. Damn I feel foolish now. I guess I’ll just have to trust my neighbors more”. There are some bad people in the world but overwhelmingly good people are around us. Just look at the heroes in every Hospital, Nursing Home and providing Home Care services. The GOOD GUYS are fighting the good fight and will win this war!
We are all Bandits now. No time to look at each other with jaundice eye. Our plight is the same. Social distancing in an age of disease with imposing names, SARS, Corona Virus, Covid-19 or as it is known in the inner city….”The ‘Rona.” We are ALL IN THIS TOGETHER! We are all Bandits now, faced with the same circumstance, forcing us apart but bringing us together like never before.
I was taken aback the other day when I was getting ready to order door front service from a local store in Southampton in an effort to support a local business. I witnessed multiple people going into the store, opening the closed door with their bare hands; no gloves on, no masks on (hey businesses, leave your doors open when possible to prevent the spread of virus on door handles). I left the store not ordering anything knowing that it was a risk. EVERYONE has to take this seriously, accept their responsibility for each other’s health; this is about life and death.
To all my fellow Bandits, please continue to wear your masks, wear your gloves, wash your hands, wash your hands, wash your hands! Let’s #flattenthecurve. Practice social distancing, keep in touch with the elderly shut-ins, call a friend, ZOOM videoconference with the proper safety and privacy features enabled to stay connected.
Wash your hands, wash your hands, wash your hands!!!DO NOT place your hands to your mouth, nose, eyes and in your ear. These are all PORTALS OF ENTRY for the Covid-19 virus to gain entry to your body and cause infection. Any discussion about the danger of the Covid-19 virus must be first started by indicating that the best way to help arrest the spread of this pathogen is to insist that you wash your hands, use a lot of friction, wash up to your wrists, remove all your jewelry, wash your hands for no less than 20 seconds, force your fingertips into the palm of your hand to clean under your fingernails, use friction when washing between your fingers and then repeat this ritual multiple times a day. Do not get bored practicing this exercise in survival. It is important to note that the use of an alcohol based hand sanitizer is no substitute for hand washing; it is only a stopgap measure when you don’t have the ability to wash your hands thoroughly. Insist that visitors to your home or business first wash their hands when they enter your home. It’s OK to ask. You are not being rude, quite the contrary. You are showing the utmost respect as a host showing your concern for you company’s or customer’s wellbeing.
Normal practices are going to vanish for a while. DON’T shake hands when greeting someone. Respectfully decline and instead touch elbows or nod your head. These are challenging times and we must collectively meet the challenge of this danger among us. This is not the time to panic. It is never a time to panic. It is a time for effective, collective action. Take the time to show your kids how to wash their hands and make it a ritual. Kids respond to rituals and they like to follow the leader. Make it a game of who can wash their hands more. Tell them to keep count on the amounts of times they have washed their hands during the day and see who can ‘win’ the count. Let your young kids see you rush to the bathroom to be ‘first’ to wash your hands when you get home from school pick-up, a visit to Grandma and Pop-Pop (please wash your hands when entering any elder’s home. This virus is disproportionately impacting the elderly, especially with those who have underlying chronic diseases such as diabetes or hypertension). Your kids will run to beat you every day. Start this at the earliest time that your youngster can understand the need to wash their hands (3 years old).
When putting gas in your car, wear a glove. Wear a glove when placing your credit card in the slot, there are germs there. Wear a glove when handling the spigot putting gas in your car. Carefully take off the glove when entering the car without touching anything then before you touch your steering wheel, sanitize your hand. Yeah, I know…that’s a lot of steps, but once you get used to it, this becomes second nature. Just remember that viruses can live on surfaces for a long time and the amount of time this virus can exist on a surface is undetermined. Remember, THINGS HAVE CHANGED!!!
Businesses on Main Street, restaurants, grocery stores should make their bathrooms available for hand washing and stock the bathroom with soap and paper towels. Write this expense into your budgets and manage the bathrooms well. Businesses should schedule times during the day that they will clean the doorknobs leading to their store. Door knobs and handles harbor a vast among of germs and keeping this clean will go a long way to protecting your customers and staff. A simple solution of 1 part bleach to 10 parts water will suffice. Wash your hands after cleaning these surfaces.
If you have counters in your business, similarly clean these surfaces on a routine schedule. No less than once every ½ hour if it is a busy day. If, available provide a ‘Purell/ hand sanitizer station at the store entrance. You can gently ask customers to use the sanitizer upon entering your shop. If every store does this, it will become customary and not seen as an imposition. Normal Operating Procedure. We can do this.
Now for the virus. High fever, Shortness of Breath (SOB), difficulty breathing, coughing and cold symptoms, feeling like crap are hallmarks of this disease. See you doctor. If you cough or sneeze, please do so in the crook of your elbow or in a tissue that should be disposed of in the trash. Wash or sanitize your hands. Covid-19 is called a droplet infection and is carried primarily by germs in the droplets you sneeze or cough out. If you are symptomatic, it does not mean definitively that you have the infection but out of caution you could wear a surgical mask. For the uninitiated, regular surgical masks will NOT protect you FROM the illness but should be used by those who are symptomatic to reduce the amount of infection spread. Over -The Counter (OTC) N-95 designated masks will provide some protection against infection but these are not ‘Fit-Tested’ which means these masks are not specifically molded to your face so there still remains some risk for illness while wearing these OTC N-95 designated masks. Save your money! Self quarantine/isolation is not always practical but may be necessary in your own home to prevent the spread of this illness before seeing a doctor.
This is a PANDEMIC. Pandemics unfortunately have histories of coming in waves. During the Spanish Flu of 1917-1918, there was a first wave of illness, then it subsided, making everyone think that things were improving, but the virus mutated and came back more dangerous and deadly on the second wave. We must be cautious and vigilant. Be consistent in your approach to addressing this disease. Good consistent hand washing will go a long way to keeping you and your family and community healthy. This is by no means a complete list of things to do to protect you and your family and community but it will give you a start on how to think about this illness and our response to it.
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