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Tuesday, Nov. 16, 2021

Covid-Wise

Seven Lessons Learned About Covid in 2021

The whole concept of scientific inquiry revolves around learning as you go. Scientific inquiry proposes a hypothesis and then tests this hypothesis. Science informs policy decisions, but it is disingenuous when politicians say they “only follow the science.” All decision-making with COVID-19 also includes political, economic and social components. The lessons learned through the pandemic provide context to help us make better decisions in the future. In 2021 we learned … COVID vaccines are effective and safe. The vaccines reduce transmission, severity of illness, hospitalization and death from COVID. The benefits are most significant in those with the greatest risk from the virus, especially the elderly, overweight, immunocompromised and pregnant. The probability of vaccinated adults or unvaccinated children getting severely ill with COVID is in the one in 100,000 range.

Over six billion doses of COVID vaccine have been given worldwide with no long-term adverse effects yet identified. At this time, there has been no negative impact on fertility or reproduction. Long-term safety and efficacy of vaccines in children remain to be determined pending current trials.

Natural immunity and vaccine immunity are both effective immunity. An extensive study from Israel noted natural immunity was as effective or more effective in preventing symptomatic infections, hospitalizations and deaths from COVID-19. Billions around the world have natural immunity from COVID-19.

We now have proven excellent outpatient treatments that get less attention than they deserve. Studies on vitamin D, zinc, Remdesivir, monoclonal antibodies like Regeneron and the new oral drug Molnupiravir have shown over 50% reductions in severe COVID illness when given in the outpatient setting. Other treatments with great promise are currently in trials.

Vaccine mandates remain very controversial and contentious. Those who favor a mandate believe they will reduce the transmission and severity of COVID illness and increase the vaccination rate. Those who oppose are often hesitant because they already have natural immunity and/or believe government mandates are an overreach of government power in their personal health decisions. Many are concerned about the added impact of more losses of an already depleted workforce. Essentially every sector in our country has employment issues. Maybe none as significant as in health care.

We have learned the hard way the importance of in-school learning. The education loss of our children is already greater than one year, with the most significant loss in those furthest behind and most disadvantaged. Child and adolescent physical and sexual abuse, substance abuse, anxiety, depression and suicidal ideation have all increased. This year we will exceed all previous records of opioid use and suicides in children and adolescents.

COVID-19 has a natural history of surges. Currently, Louisiana and other Southern states have a steep downward trajectory of cases and hospitalizations, with the opposite upward surge occurring in many Northern states. We are at the point of making decisions about dialing specific preventive measures down based on the low current level of viral spread. Using this information as context, masking mandates and quarantines become less a necessity in our schools.

Our expectations must be realistic. It is important that we all understand this virus is too transmissible to disappear. We must avoid unrealistic expectations and avoid adding “new solutions” to try to attain the unattainable goal of eradication of the virus. Our goal must be to make COVID endemic, to manage the disease with safe and effective vaccines, considerable natural immunity and very promising new therapeutics. As we do, we engage the COVID pandemic more on our terms.

The recognition of safe and effective vaccines and treatments, open schools and businesses, and crowded football stadiums let us envision the end of the stranglehold of COVID on our lives. As we take advantage of what we learn, there are indications we are getting closer to the time when COVID-19 will not be the prime decision-maker in our lives. It is a time we all want to see – regardless of our age, gender or political beliefs.

Before the pandemic, we had long departed from the biblical wisdom to respect those with different opinions. Agree to disagree is rarely practiced today. More than any other time in my lifetime, people with political or policy differences replace tolerance with threats and too often treat each other with disrespect. This departure from civility has created more fear, anxiety, isolation and hopelessness.

Proverbs 24:14 states, “Know also that wisdom is like honey for you: if you find it, there is a future hope for you and your hope will not be cut off.” We will be better if we learn as we go, remain flexible as circumstances unfold, and remain respectful of others.

The death of Colin Powell reminds us again of the attributes of a great man and reminds us of the indomitable spirit of America. He wrote, “Believe in America with all your heart, soul and mind.

Remember, it remains the ‘last best hope on Earth’.” As we think about these things, we can change our anxiety and fear to confidence and hope.

Dr. Phillip Rozeman is a practicing cardiologist. He is former board chair of the Greater Shreveport Chamber, Shreveport Medical Society, and has been honored as a recipient of the John Miciotto Lifetime Healthcare Achievement Award.

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