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Tuesday, Jan. 11, 2022

Back To The Future: Looking Forward Three Months

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A year of education loss, Omicron and irrational fears

When we are in the midst of a surge of the COVID virus, it is hard to think about the possibility of the epidemic’s end, but we should. It is very transmissible and less virulent. The Omicron variant will likely be important in shortening the length of the epidemic. A long-held wisdom is to begin with the end in mind. The truth is a major unanswered question in this epidemic: “When does the epidemic end and how does it end?” We must first accept the end of the pandemic will not be the eradication of the virus. Any strategy based on this goal is doomed to failure. We must avoid unrealistic expectations and avoid adding “new solutions” that only extend the pandemic to try to obtain the unobtainable goal of eradicating the virus.

Instead, the goal is to stop the epidemic by managing the disease. Safe and effective vaccines, considerable natural immunity and very promising therapeutics will have an even greater impact soon. This virus will not likely be the dominant force in our lives too much longer.

Before Omicron, our state leaders had started to think ahead with the addition of a local option on managing COVID quarantines in our school as well as a local option on mask use. Quarantines are the most significant driver of education loss because of excess student absences, even though the vast majority of quarantined students don’t contract COVID. As for masks, they make communication and learning very difficult. Reducing quarantines and mask usage are steps toward a return to normalcy. COVID-19 has a natural history of surges and evolving variants like other viruses. This is not new to science and is predictable, especially when we observe the impact on other countries affected by specific variants. The recent Omicron variant is highly infectious but less likely to cause severe disease and hospitalizations. As seen in South Africa and Scotland, the infection curve will rapidly increase and then decrease just as quickly. Experts predict the surge will likely be over by the spring.

Along with the already considerable population immunity from vaccines and natural immunity, Omicron will affect millions more — a vast majority with upper respiratory symptoms and fewer with lifethreatening pneumonia of previous variants. When the surge of Omicron is over, our population immunity will be substantially heightened. As far as children who have light-years lower risk from the original COVID, the chance of healthy children having severe health consequences from the Omicron variant will be very small.

The pandemic has resulted in a greater than one year education loss, with the greatest loss in those furthest behind and most disadvantaged. Our schools in the past have been a safety net for children. Child and adolescent physical and sexual abuse, substance abuse, anxiety, depression and suicidal ideation have all increased during the pandemic. This year we will exceed all previous records of opioid use and suicides in adolescents.

With this in mind, we need to reconsider the benefits and risks of each of the prevention strategies on a regular basis in our schools. Since each of these strategies brings with it significant disruption and unintended consequences, considering the reversal of restrictions is just as important as the initiation of restrictions. Since the natural history of viral surges is predictable, we should be dialing masks, quarantines and social distancing up and down depending on the viral load of the local community. Right now, we dial up before the surge. We should be ready to dial down quickly in the early spring after Omicron.

Before World War II, Franklin Roosevelt said, “The only thing we have to fear is fear itself.” COVID-19 continues to induce fear and justifiably so. This is the rational fear soldiers experience before going into battle.

What we have to avoid is irrational fear. The Salem Witch Trials in the 17th century and Germany in the 1930s and ‘40s are examples. The Germans’ irrational fear of Jews led to the unique evil of the Holocaust. As for COVID, we can’t let our natural rational fear turn irrational. We should look forward, not backward. We need to reach normalcy as fast as we can and be ready to make up for the loss to our children.

Early in the pandemic, there was great fear of the unknown. It was rational fear. Now we have much greater knowledge, vaccines and therapeutics but seem to continue to hold on to the same fear level. Like President Roosevelt, our leaders should help us overcome fear as we get back to normalcy in our schools and our lives.

Dr. Phillip Rozeman is a practicing cardiologist. He is a past recipient of the John Miciotto Healthcare Lifetime Achievement Award and recent Northwest Louisiana Medical Society Distinguished Service Award.

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