COVID-19 and Collaboration

When I grew up, my parents made it clear that I was not independent. If Mom was doing dishes, I was doing dishes. If Dad thought helping him in the yard was a good idea, by golly that's how it turned out to be.

They grew up during the depression in rural southeast Texas towns. Sometimes these days, patients tell me "Oh, I don't know if my brother has heart disease or not. I'm not so much in contact with him anymore." Not back then. My relatives knew each other and all about each other. Staying together got our families through the depression. When the Second World War came, Uncle Sam conscripted many of them for service on the death-dealing battlefields. They were, and my family still is, proud of that kind of freedom and that kind of mutual sacrifice.

Fast forward a few decades and social collaboration is now feared, challenged and sometimes refused. Even though health authorities tell us that masking and distancing is good for us, people complain that their liberty is being taken from them and that their rights are being violated.

Freedom Without Responsibility

What has our overblown sense of freedom cost us? Let's compare to a country similar to ours, such as New Zealand. They have similar public health assets, accurate disease reporting, an advanced economy, a similar age distribution and lots of Northern Europeans. Pretty much like us? Just a little more responsible?

Using numbers from April 3, the entire country of New Zealand has suffered 2,501 cases and 26 deaths from COVID-19, compared to over 30 million cases and a half a million deaths here.

On a more local level, an average county our size here in the US has suffered 18 deaths, compared to 2 here in Jefferson county. In NZ, you would need 15 counties our size to get 2 deaths.

Too much detail? Let's keep it simple. Per million Americans, 1670 have died so far. Per million New Zealanders, four.

What price did they pay besides [two periods of lockdown](https://en.wikipedia.org/wiki/New_Zealand_government_response_to_the_COVID- 19_pandemic)? Well, less than us, as their 2020 economy grew 0.4% and ours shrunk by 3.5%.

Pandemics Are Similar to War

We never know how they are going to turn out. War generals use the OODA loop, the cycle Observe-Orient-Decide-Act, repeating this over and over.

All last year when patients asked me questions about COVID-19, I answered that I trusted those who were working on this full time. I pointed out that the answers would change as we gained experience. No battle plan survives contact with the enemy, nor would our anti-COVID-19 plans. And just as we eventually became friends with our WWII enemies, our current altercation with the SARS-CoV2 virus is bound to simmer down after a while.

We are a part of the whole. Our job is to listen, to be alert as to the situation, and to do the best we can.

Situation Report April 2021

We're still masking up in the office and require you to do so as well. We still check temperatures and maintain distance. We've had our shots and encourage you to get yours. Dr. Locke at our local health department works hard to make sure we're giving the types that work best.

We've always cleaned office surfaces and we are even more compulsive now, but please understand that COVID transmission by surface contact seems to be rare. If I see a mask on the sidewalk, I'll put it in the trash with my bare hand and wash when I get home. This virus travels airmail.

Discipline, Freedom and Collaboration

One stage of growing up is to find our own inner freedom at the same time we find our place in the world around us.

As the high school poem says

Stone walls do not a prison make, Nor iron bars a cage;

Physics and chemistry teach us that nature obeys the most stringent laws, and yet, look out your window-what infinite creativity nature exhibits. We humans are a part of nature and we accomplish the most with heartful self-discipline and a fruitful relationship with those around us.

The people of NZ followed the pandemic control rules in overwhelming numbers. Any complaints were not loud enough to cross the Pacific Ocean. The reward was the freedom of needing those rules for a shorter time and with a smaller hit to the wallet. Discipline and cooperation have always paid off for us humans.

The Near Future with COVID-19-Masks

Infection rates in Washington rise, but deaths continue to fall. More people have been exposed and the Pfizer and Moderna vaccines are proving to provide continued protection. As you know, these vaccines target the spike protein, the part of the virus that binds to our cells. The virus can't change the spike protein too much or it can't bind to our tissues. And if a new variant does find a way, our new vaccine technology allows us to develop and deploy a new vaccine quickly.

Health authorities continue to recommend masking even if we have been vaccinated. Similarly, though we have safer highways and cars, we continue to wear our seatbelts. Masks and seatbelts are a simple way to improve our odds.

The Far Future-Rabbits

Varieties of the coronavirus that cause COVID-19 disease also cause winter colds and flu. Cellular animals such as ourselves have coexisted with viruses and bacteria since we appeared on Earth.

Over a century ago people introduced rabbits to Australia. These non-native animals had no predators and exploded over the land, destroying habitat. Australian authorities introduced myxovirus and, as planned, this killed 5 out the 6 million rabbits in Australia. Over time, however, weaker versions of the virus and stronger progeny of the rabbits reached an equilibrium.

I suspect the same thing will happen with us and COVID-19, except instead of survival of the fittest, we've got the vaccine. We can incorporate it into the annual flu shot if we need to.

Collaboration Wins

We are still in a shooting negotiation with this virus. No one really knows how it will end. One thing is certain-we'll get through it.