Am I Living?

We were stepping out for the second time foray into the restaurant world and perhaps a sliver of normalcy. We were joining a friend from Conway who despite an immune suppressing disease and being a little bit older, she was ready to get out of the house and so where we! Our community has a mandatory mask requirement which you can remove once seated at your dining room table. Our waiter walks up and attempts to pleasantly converse while frequently tugging at a paper mask that looked like it once had a surgical background. While we placed our order his nagging mask kept falling from his ear and he would hastily put it back on while picking up plates to prepare for our first course. “Germ Alert, Germ Alert!” kept flashing with a bright red light in my head. I smiled inwardly at my overactive imagination.

“Liz, are you ok with staying?” I said in worry for her health and more importantly her sense of comfort. With her brawny laugh and a great big smile, she says, “If I am meant to get that Corona Virus, well so be it. This is my first dinner out and I want to treasure it. That is the Liz I know, strong, determined, wise!

It is difficult right now to know who to trust or what to believe when it comes to this virus and the Panic-demic it has caused. Conspiracy, Political Motivations, Financial Gains, Power Mongering make it ripe for an action movie perhaps played by Liam Neeson or Tom Cruise or perhaps Sandra Oh as Eve from the series Killing Eve (my guilty pleasure show). 

The reality is that THIS IS OUR LIFE and we don’t know who to believe. Through my work in Rwanda I have had a great appreciation for the work of the World Health Organization. However, the management of the virus has made me think twice about ANY medical recommendations outside of randomized controlled studies that do take great time and many patients before you can identify a statistical benefit that outweighs any potential harm. 

For example, the following statements have been reported by the WHO:

“Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus.” You can find additional information here.

Coinciding with this on January 20^th, a Chinese official confirmed the evidence of human-to-human transmission. It was a week later that the Director of WHO, Dr. Tedros Adhanom Ghebreyesus, visited China and while praising the Chinese Communist Regime for its response to the virus he also declared the spread of the virus a global health emergency. It was six weeks later that it was finally called a pandemic. While we can’t change the past, we have to surmise that with accurate information in December and January a different future we may have had. Perhaps the Chinese New Year Celebration may have been delayed rather than sending potentially infected individuals to the world.

Panic seemed to ensue after these events as pictures of Northern Italy were distributed to the rest of the world and early models predicted the deaths of millions. Fear was instilled and he who controls fear, in fact, controls the hearts and minds of people. Faulty scientific data had the WHO, the FDA, and the CDC recommending a medication or measure and then reversing that recommendation.  Ibuprofen thought to make patients worse and acetaminophen products fly off the shelf. Ibuprofen was thought to make you sicker until, well it wasn’t.

Hydroxychloroquine and Azithromycin was mandated in countries upon the basis of faulty data in small trials and then tweeted to the world and it became the standard of care. Then a 180 degree occurred and it was rejected, not allowed, and trials were stopped. Some clinicians continue to use it with passionate belief that it makes a difference if used early. Other medications such as Remdesivir and Convalescent Plasma have had mixed results but are still being studied in various studies and are used in “compassionate use” cases for those that are very ill. 

Personally, the most promising information that I have read and been following is how critical care specialists are changing their approach to how they care for those with COVID 19 and significant pulmonary disease. By using innovative approaches with oxygen delivery and avoidance of ventilator placement they are seeing a significant reduction in mortality in ICU patients. Again enforcing the belief that the doctor-patient relationship at the bedside is the most crucial and provides the greatest information.

As vaccination options become available, I believe there will be those who choose not to get vaccinated for fear of potential complications. I believe much like the flu vaccine which requires a yearly shot I would expect this to be a destination for COVID 19. Influenza A and B vaccines change yearly in response to the genetic adaptation of the virus. With COVID 19 already displaying unusual features, genetic adaptation over time seems a true possibility. For those that are traditionally against vaccines of any type, I pray that we as a society still allow the individual to have their freedom of choice. 

And with that I shall tell you my biggest fear. My biggest fear is that our global world shall live in fear and we let our freedoms slip slowly away until history describes a time when people once lived together, worked together, played together, went to concerts and movies together, worshipped together and traveled together. Institutions with frail information will be our guides. We learn to trust no one. 

In that future time we will have forgotten the words of Dr. Vicktor Frankl, Nazi Concentration Camp Survivor: “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” 

I think back to that dinner with Liz. She was a woman not living with fear. She was a woman living with faith and a great sense of humor. She was getting ready to head out West and meet some friends in a place that is not so calm now. Liz is a woman living. I am a woman living. Join us in living and if you have a question about what I have written, feel free to sign up and email me. I promise to do the best I can at answering it. 

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I chose this photo because my husband and I traveled to New Zealand a couple of years ago. This is living for us and I trust we will get back there one day!