Working in the Virus’ Shadow: SARS-CoV-2, 26 November, 2020, 1200 Hrs

March 2020 through November 2020, nine months. As of 25 November, 2020 there are 259,256 COVID19 deaths and 12.5 million infections in the US. We in the United States account for about 20% of the World’s cases and deaths due to this Pandemic, although we are but 4% of the worlds population.

A quarter of a million deaths. How many is that? how can we visualize, humanize that number?

It is as if we wiped out Birmingham, Alabama (Population 209,000 in 2019); Chandler, Arizona (Population 261,165 in 2019); Little Rock, Arkansas (Population 197,312 in 2019); all of Irvine (Population 212,375 in 2010) or most of Oakland, California (Population 390,724 in 2010); all of Bridgeport (Population 144,229 in 2010) and most of Hartford, Connecticut (Population 124,775 in 2010). Perhaps you get the point. It is a disaster.

North Dakota, the State where I was born and spent part of my youth, is now the highest risk place for infection in the United States as far as the SARS-CoV-2 (COVID19) pandemic. North Dakota, with a total population of 672,591 as of the 2010 Census has 158.5 cases per 100,000 population (COVID.CDC.GOV 11/24/20). If North Dakota were a country, it would have one of the highest, if not the highest, COVID19 death rates in the world.

A quarter million deaths. A quarter million families with empty chairs this Thanksgiving.

And most of this could have been prevented. Not with chloroquine. Not with Bleach. Not with “strong light”. But with Public Health Measures: Testing, contact tracing, masking; where closures were needed, financial support of the people and businesses would have been required. This was not done in the US except at the very beginning of the Pandemic. We haven’t the infrastructure to test as needed; even those of us who are being exposed daily are not being tested unless we have “symptoms”. This despite knowing that between 20% and 40% of infected people are without symptoms. We do not have the appropriate testing because of the mismanagement of the Pandemic in the US by the administration of Trump and his corrupt and incompetent enablers.

Even if we ignore that Trump suggested ingesting bleach and using (internal?) “strong light” to kill the virus – idiocy beyond belief – Trump, his HHS Secretary, and his COVID Committee did not invoke the Defense Production Act so that we would rapidly produce the testing machines, reagents, and materials needed to adequately test our population. Personal Protective Equipment (PPE) was not produced in quantity. The result? Our healthcare workers are forced to re-use disposable/single-use items and are thereby put at high risk of infection.

And what happens when nurses, physicians, clinical pharmacists, nursing assistants, environmental service workers – all critical to the running of a hospital – become ill? Everything stops. There will be no-one to care for you. We will die, but so will you.

This is the point. The irresponsibility of the Trump Administration, the Governors of North and South Dakota – among others – and, as of today, the Mullahs of the Supreme Court of the United States with their decision on “religious freedom” related to limiting the number of worshipers in churches, put all Americans at risk. These so-called leaders put ideology before safety and science. What the character played by Jeff Goldblum, in Jurassic Park, states regarding the possibility that the created life-forms will reproduce: ‘Life will find a way’ is also true as regards the SARS-CoV-2 virus. Our foolish, vindictive and destructive leaders cannot spin the virus; it will find a way to infect us – kill us – if we continue to ignore the science.

So, on this Thanksgiving morning, with great sadness for the lives lost and hopes destroyed, with a heaviness of heart that is almost overwhelming, it is my hope that, with a new Administration, we will soon begin to approach this Pandemic seriously and scientifically.

As it is Thanksgiving, I am reminded of Eugene Debs, who once proclaimed:

While there is a lower class, I am in it, while there is a criminal element, I am of it, and while there is a soul in prison, I am not free.

I have no country to fight for; my country is the earth, and I am a citizen of the world.

Gentle Reader, be safe. Show compassion. Care for your neighbor.

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the approximately 10 years until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director and Co-Chairman of Critical Care Medicine in PA; this ended in 2017. He served as a Physician in the Surgical Group with Médecins sans Frontières (MSF, Doctors without Borders) through 2018 and is presently an intensivist in Florida, struggling through the SARS-CoV-2 crisis. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". Follow on Twitter @ajlayon
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