Well, the real answer is: we just don't know. Our "new normal," which hardly feels normal, is getting old. On the one hand, I imagine we are settling into a routine and are making lists of all the things we took for granted and want to avail ourselves of…but when?
The scientists and medical experts certainly have amassed a vast amount of knowledge of COVID-19, since January 11th, when the first Coronavirus patient in Wuhan China succumbed to the illness. That is just over three months ago. From an unknown to a household word, inside of 3 months. Staggering. In Massachusetts, we are experiencing the "flattening of the curve." Our hospitals are seeing fewer admissions, our Intensive Care Units can transition patients to lesser care units, and the Recovery Centers are making plans to return patients home with the support they need. We know that we have done well. Very well, indeed.
COVID-19 may not have affected anyone in our immediate circle, but we watch with heavy hearts, the experience of those up close and personal with the illness and its' victims. Maybe we have been affected more personally. Family, friend, client, neighbor, household member… maybe ourselves. Have we escaped the worst that the virus can do? Have we had mild symptoms, more extreme, or somewhere in between? We have moved our work home, redefined the way we conduct business, and created a new way of life where we merge homeschooling, elder care, self-care, and work from Home-Sweet-Home.
We know for sure that schools will reconvene in September. As we approach May 1st, it seems unlikely that "Main Street" will be open for business. How and when? All at once or in phases? How is the decision made? What are the deciding factors?
Massachusetts General Hospital and Massachusetts Institute of Technology have joined forces in a collaborative effort in the antibody detection project to try and determine the general publics' presence of antibodies to COVID-19. To develop antibodies to an infectious agent, one needs to have been exposed and infected. The chief mysterious nature of this coronavirus is how it infects and affects people differently.
In a recent study conducted in Chelsea, a community hard hit by COVID-19, a random sample of 200 people found that 63 tested positive for antibodies to the virus. Of the 63 that tested positive, 12.5 percent had shown no symptoms at all. Larger sample tests show the figure is closer to 15%.
One of the differences between COVID-19 and say, influenza (flu), is that the flu is almost always symptomatic. Chances are...if you have it, you'll know it. To be carrying the coronavirus, unknowingly, may mean you take very few precautions for yourself or others.
The imagery of fire, ash, and wood, I borrow from my friend and colleague, Dr. Jay Isaac of Blackburn Primary Care in Gloucester, MA. The virus is the fire and those infected. The ash is those who have antibody protection (those who have been infected). The wood is the rest of the population which the virus "consumes."
Our first goal is to remove the firewood away from the flame to reduce the "fuel." Here is where our social distancing removes the wood from the flame, separates healthy and sick people, and reduces the opportunity for transmission. As we may spray the firewood with water or cover it to protect from combustion, this is our effort concerning personal protective equipment (masks, face shields, and more) and vigilant personal and material hygiene.
Many levels of decisionmakers, mostly political, are "opening up" or "remaining restricted." What science and medical experts seem united on is the risk. Opening up "Main Street" too soon can have a backlash result of the containment we have been successful at, up to this point. Everyone speculates about what the "right" time is. As Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease, says, "the virus will tell us when it's time." That council seems scientifically based and prudent.
While we are all eager for things to get "back to normal," a few realities may be waiting for us on the other side. The meaning of "normal" will be redefined. Hopefully, generalized hygiene in our immediate worlds will be vastly improved. If we can take what we've learned through
this pandemic and maintain a much higher standard of personal and community hygiene, that's a huge plus.
Infectious disease has always been with us and always will be. Now that we have been challenged by COVID-19, we need to take the lessons we have learned, personally, locally, and globally to be empowered and prepared for what is next.
The support shown to the medical community across the spectrum of care, essential workers, and hopefully in our own families and neighborhoods might be the silver lining. "Zoom" will surely be added to Miriam Webster's new words of the year. Maybe some bad habits were broken, perhaps some new bad habits were gained. Our creativity is undoubtedly improved. Weight is up or down. Despite how we have fared through this upside-down time, we have had an opportunity to strengthen our resiliency muscles, to model distress tolerance to our children, and to think outside the box and consider how our behavior impacts others. A high price to pay for these lessons, but sometimes, that's what it takes.
