Posted by: cornvillenutmeg | April 25, 2020

Back to Memoir, But First


I know all seven of my blog readers prefer when I write memoir.  I am getting back to that.  In fact I’ve been writing about my best Sharon friend.  But something is bothering me about the clarion call for testing everyone for CORONA – 19, so I have to step away from Sharon in the summer in the 1950s for just a little bit.

Play along here. Imagine imaginary person Griselda who lives in the imaginary state of Adelachute.  In Adelachute, just shy of two thousand people have tested positive for you know what, and of those, 101 have died.  Of those who have died, ninety-one percent also had pre-existing conditions, and all but four were seventy-one or older.

 Griselda is, of course, worried about contracting COVID – 19, and she should be.  By all accounts, a bout of COVID  can be the ultimate hard time, or not.  She also worries about her parents who are, as the designation goes these days, elderly (as am I and almost everyone I know), thus at greater risk.  Her mom is in her late seventies, and other than aging, she has no disease, but her dad, older than his wife by four years, has a pacemaker and a history of high cholesterol.  Put another way, her mom is vulnerable, he dad is dangerously so.

Griselda lives alone. She was married once, but no longer, and she had no children of her own.  She hasn’t had much to distract her lately.  She’s been baking her heart out for the neighborhood children, she’s been reading classical literature at least one hour a day, without fail.  She had thought to take up crocheting again – something she hadn’t done hardly at all since joining the workforce – but could not find the yarn and crochet hook she was certain she had put away in the bottom drawer of the bureau in the guestroom. Neither her supermarket nor pharmacy carry such things.

Given her pervasive anxiety about everything COVID – 19, she naturally makes it a point to watch almost all of President Trump’s Daily Briefing which she calls,  Everything You Need To Know about the Novel CORONA – 19 Virus, and More.  Lately it seems to Griselda, a briefing doesn’t go by without all sorts of information and questions about testing.  Griselda is beginning to think that, indeed, testing might very well be the answer to the problem.

And that was what Griselda was thinking about when she turned off the light that evening.

Next morning, Griselda woke up with a headache, a pretty bad one.  By noon she was coughing and hacking, and exhausted.  She was forever falling asleep, but her cough kept waking her. Griselda was certain she had the novel CORONA – 19 virus.

Following protocol, she called her primary care physician, Dr. Cares, as it happens.  She told him her symptoms and her suspicions.  Dr. Cares said, “Well, Griselda, it sounds as if you may well have the COVID – 19.  Have you taken anything for the headache?”

“No,” Griselda said.  “Do you think I should.”

“I do.  Do you have Tylenol?”

“Yes, I do, almost a whole bottle of it.  Is that what I should take?”

“Yes, Griselda, you should.  You can take two every four hours.  And do you have anything for that cough.  It sounds very uncomfortable.”

“Nyquil, but it’s the kind you take in the day time.  How’s that?”

“Sure, that should help some, but check the ingredients to see how much acetaminophen the Nyquil has.  That’s what Tylenol is, you know.  You shouldn’t take too much of that at one time.  And cough drops.  You can have as many of those as you want.  Oh, Griselda, you’re not having any trouble breathing, catching your breath, are you?”

Griselda took a deep breath, and then another, but the second started her coughing again.  She hadn’t felt out of breath, though.  “No, I’ve got plenty of breath.”

“Well, fine Griselda.  Tell you what, I’ll call you first thing in the morning to see how you’re doing.  How will that be?”

Griselda had been thinking about testing all the while they talked, and she was a bit surprised, and not pleasantly so, that Dr. Cares hadn’t suggested it.  “What?” she said, and then remembered what he’d asked.  “Oh, that’s fine, but, Doctor, there is one more thing I wanted to ask, if I may?”

“Of course.”

“Shouldn’t I be getting a test?  To see if I have it or not?”

Dr. Cares was not as enthused about testing as most of the people Griselda heard talking on TV.  He thought to himself, well, I could authorize Griselda to get tested.  Then she’d have to pull herself together and drive to the nearest testing sight, not as near as all that.  Then she’d have to drive home and wait maybe a day or so to get the result. She’d probably test positive, not a false positive, but a true one.  What do we do about that?  Griselda says she doesn’t have a breathing problem.  She’s young enough so she is not “vulnerable.”  What is best practice for a patient with a positive COVID result but no life threatening condition requiring the attention only available at a hospital.  Tylenol for the headache, cough suppressant for the cough, hot tea, chicken soup, plenty of water, plenty of rest.  And what if she doesn’t test positive?  What if this is a normal flu, or even a bad cold?  Would my prescription be different?  No.  Would Griselda still be susceptible to CORONA – 19?  Yes.  Would she need another test to prove her CORONA free?  She would.  And another two days later?  Of course.

“No, Griselda.  Without breathing difficulty, you need have no concern about whether you have it or not.  I wouldn’t tell you to do anything different no matter what.”

“Really, Dr. Cares?  That doesn’t seem to be what they’re saying on the news.”

So, you see?  If a person is tested, that person is discovered to be infected or not.  Now what?  And if everyone in the United States is tested next Monday and the results are improbably reported to the nation in time for supper, does that mean anyone who tested negative is less vulnerable to COVID – 19 on Tuesday?  So on Tuesday, everyone in the nation who doesn’t have COVID- 19, is tested again.  On which of the next days is the testing stopped?  Has there been a report that testing for the virus is a cure for the virus? 

What will stop the virus?  A vaccine, sort of.

 According to a Feb. 21 CDC Morbidity and Mortality Weekly Report,(www.cdc.gov) the current influenza vaccine has been 45% effective overall against 2019-2020 seasonal influenza A and B viruses. 

“Specifically, the flu vaccine has been 50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)pdm09.”

When will a vaccine be available?  Eight months, a year, a year and a half, never?  All are possible answers, even never.  How do we know never? Look at MERS, which officially showed  up on the planet in September of 2012.  It is also a Corona Virus with a 34% fatality rate, far greater than CoV-19.  Well, the work on MERS is on-going and promising.  Scientists have achieved excellent results with mice, not as good with larger animals, and clinical trials are now being conducted, but no vaccine has yet to be approved for people. Then there’s AIDS. How’s the work on the HIV vaccine coming along? 

So I’m going out on a limb here and flatly saying, whether or not testing is widely and easily available will have no clinical effect on the eventual outcome of the epidemic of the novel CORONA – 19 Virus. 

I would be more than interested if any of you all can offer a reasoned argument that suggests I’m wrong.


Responses

  1. I enjoy everything I get from you. I miss seeing you at Best Pond, but I am very pleased to have struck up an excellent friendship with Tim. Cheers!

    • Best Pond is certainly a unique and wonderful place. Tim speaks of you often, fondly. I’m glad you and he are friends. It’s good for Tim to know you. Once this mess is settled, we might try to visit the NW corner. If we do, I’ll give you a call.

  2. I was pondering how to formulate my reponse while hacking my way through 18 holes of golf with the temperature here at 97F. When I got home I found I didn’t have to. This from Bill Gates as reported by CNN (sections deleted):

    “New York (CNN Business)The ability for parts of the United States to safely and effectively begin to lift coronavirus restrictions will depend on the country’s capacity to aggressively test for and trace new cases of the virus, Bill Gates told CNN’s Fareed Zakaria Sunday. . . . Successful reopenings will happen in stages, Gates said, guidance that’s in line with recommendations from many health experts and economists, including the World Health Organization. And will require thinking critically about which elements of society are most essential to get back to work, implementing safety measures as they are reopened and ensuring diagnostic testing and contact tracing are in place to understand the effects that easing restrictions has on the spread of the virus.
    “What we don’t know is, (if) we go slightly back to normal, which activities create the risk of a rebound?” Gates said. “We need to put in place a very dense testing regime so you would detect that rebound going back into exponential growth very quickly and not wait for the ICUs to fill up and there to be a lot of deaths. If you see the hot spot, you kind of understand the activities causing that.”
    In two suggested plans for reopening the US economy, public health experts and economists said that the country would have to perform millions of diagnostic tests each week before restrictions could be safely lifted.
    Gates said Sunday that new testing machines and methods should soon be able to get the United States up to between 400,000 and 500,000 tests per day, though that’s “just barely enough for really doing the tracking.”
    Dr. Anthony Fauci, a member of the White House coronavirus task force, estimated on Saturday that the country is conducting approximately 1.5 million to 2 million Covid-19 tests per week and said it is likely the testing capacity could be doubled within the next several weeks. So far, the United States has only performed (NOTE: should be “performed only . . .”) about 4 million coronavirus tests.
    More states are easing coronavirus restrictions this week, unnerving experts and some local officials
    Gates added: “The key thing about the US, though, this focus on the number of tests understates the cacophony and mistakes we made in the testing system,” including testing shortages, inequality in who can access testing and test results taking longer than 24 hours to reach patients.”

    • Well, with all due respect to Mr. Gates whose products I appreciate and who is a really good person, the “country is conducting approximately 1.5 million to 2 million Covid-19 tests per week.” And each and every test that shows a testee to be negative is, the next day, worthless because the test does not confer immunity. This is a flu that may turn out to be more or less lethal than the flus against which we can be vaccinated each year. The horror of crowded cities cannot be extrapolated to the rest of the country. As populated as Scottsdale, for instance, is, it’s population density is not to be compared in any way with Manhattan’s.

      • OK, cool. By the way, I do not look upon Bill Gates as my guru. I just happened across the article. You say that all negative test are worthless. What about the positive ones? There is tracking, which I’m sure you’ve heard of. Might this procedure not help to isolate those who have the capability to transmit?

      • Interesting. I wonder how the data would change which I don’t mean as dispassionately as it may sound, but the most informative result of “everyone” being tested would be the statistical information epidemiologists gain in understanding more of the dynamics of this brand of Corona. James B. Heath 80 Calle Irena Sedona, AZ 86336

        H 928-282-0537 C 928-821-3603

      • Oh, Jim–I don’t know. I doubt anyone does. Situation: Louis is asymptomatic but has the CV, His doctor is testing all of his patients. Louis tests positive. The network in place (I’ve heard it does exist) interviews Louis and seeks out every person with whom Louis has had contact (mostly golfers at Mountain Brook Golf Course). Each of these persons is tested. Those who test negative can continue to whack away or hand out practice balls. Those who test negative must go into quarantine, the rational being that these positives will, therefore not transmit to others (as does poor Louis, who sinks into a deeper depression and starts thinking of other avenues . . . oh, never mind). Does this inhibit, does it reduce the incidence of the disease? Please don’t ask Donald Trump for the answer.

      • Ooops. Too late. I’ll let you know what he says. Here’s my simple solution for you. Don’t get it!


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