A COVID-19 update
The pandemic is currently the worst it has ever been. Hospital ICU’s around the country are near capacity. Doctors, nurses and other healthcare providers are hitting the wall and about to burn out. We can use arenas and build new spaces to treat the ill in makeshift hospitals, but we can’t build new healthcare providers. We are currently in a “Red Alert” world emergency. With this being the season for the regular flu, too, this will be a tough winter and probably the worst time of the pandemic. We need to be tough and intelligent. If we can do this for just a few more months, the future is optimistic.
- 56 million people infected
- 1.4 million deaths worldwide to date
The surge is sweeping the world with another wave that is as bad if not worse than the original infection. Many countries around the world are now considering variations of complete shut-downs, again.
- There are 12 million cases of COVID infection.
- There are 255,000 dead.
The United States has 4% of the world’s population, but almost 22% of COVID infections. What we are doing and have done is not working.
There are several problems. First, we are a vast country, an association of 50 states, all of which are proudly independent and rarely like being told what to do. The other problem is that there has been no national leadership on the pandemic. It has become a political issue rather than a public health problem.
The withholding of information and providing misleading and untruthful information by the administration is atrocious. The current administration’s ignorance, incompetence and indifference have put tens of thousands of lives at risk, including hundreds of people in the White House staff and secret service.
We are at war. It is a world war against the pandemic. Can you imagine if we were at a military world war and our president did not meet with the generals for five months?
President Trump has not met with the COVID task force for five months and, to date, the president refuses to provide information on the pandemic to the Biden transition team.
There are over 1,000 dying every day in the U.S. That is 42 Americans dying every hour. Since the infection numbers are going up, so will the death count in time.
It took three months for the first 1,000,000 people to become infected. We had 1,000,000 people infected this past week alone. The pandemic is entirely out of control. Many states are reinstituting special measures on citizens and business to limit and control the pandemic.
- 225,000 infections
- 3,000 dead
In fact, one-day last week alone 8,700 people tested positive in one day in Minnesota. Positive tests, hospitalizations and deaths are all increasing in Minnesota.
There are 179 vaccines currently in production. We are developing vaccines at an unprecedented rate. Three essential considerations in developing a vaccine are:
- Safety profile
- Long-lasting protection
- Effectiveness in the elderly
There are three types of vaccines:
- Genetically engineered
Two genetically engineered vaccines have proven more than 90% effective and are ready for human use.
One is from Pfizer/BioNTech, and the other is fromModerna.Dr. Fauci supports both of these and says they are a huge step in winning the COVID-19 war.
These vaccines use genetically constructed mRNA that carries the instructions for making copies of the target (spike) proteins, like the “S-proteins.” When human cells make these foreign proteins, it can cause the immune system to respond to the virus. The advantage of this type of vaccine is that no dangerous virus must be used or handled at all.
The companies say they should have 30 to 50 million doses ready by year’s end. Front-line health care workers should be getting the vaccine starting the end of December 2020. At-risk individuals will be next, and the general population should begin getting vaccinated around April 2021.
Additional considerations include that the vaccines must be stored at very cold temperatures (Pfizer’s at -75 degrees, Moderna at -20 degrees), so this will make distribution challenging. Also, people will need two doses about 2-4 weeks apart.
The U.S. government has purchased the initial dosages, and they will be provided free to all. This is excellent news. The better news is that there are 777 more vaccines in development!
There is another new genetically engineered-like vaccine in development. Scientists are constructing monoclonal antibodies, much like the medicines touted in many T.V. commercials to treat psoriasis.
These antibodies will attach to the spike proteins of COVID and assist the body to rid them faster. This is much like the antibodies found in the plasma of patients who have recovered, but available in more extensive and limitless supplies. These may not be used to prevent infections but will be part of a treatment program for infected patients.
The wearing of masks is still the most cost-effective way to block the spread of the virus. Combine this with appropriate distancing and handwashing, and we have an excellent program until the vaccinations are in effect.
Doctors are now learning that wearing a mask is protective for the wearer and prevents others around the wearer, a double benefit. Some ignorant people have tried to make this a political issue. It is not. It is a public health issue.
As Dr. Julius Butler said, “Wearing a mask is not a political statement, it is an I.Q. test.” Wear a mask anytime you are not at home.
Due to experience, several new medications, and a better idea of how the virus spreads and behaves, we are much better at treating Covid-infected patients, but the number of deaths continue to climb. For a list of testing sites and options Google: “Free COVID-19 Community Testing Sites Minnesota”.
We acknowledge that wearing masks and social distancing are frustrating and inconvenient. I would say that dying or killing your friends and/relatives is much more so. Yes, we are all ‘pandemic-fatigued’. If you are feeling sad, blue or suicidal, please call the national suicide prevention hotline at 800-273-TALK. We need to realize that no matter how much we wish to return to normal and celebrate the holidays with family, we need to be smart and hold on a few more months until the vaccines are working. Minimize exposure to loved ones, especially those ‘at-risk’. Let’s push back 2020 holiday celebrations to July 4th next year.
I would suggest that the government immediately pass a financial support bill that allows all businesses to stay open and gives all citizens enough financial resources to pay all obligations for 3-4 months. Zero financial pain for citizens or businesses in America. Interest rates are at an all-time low. We are at war.
Drastic measures must be taken, because what we have done until now has not worked. The term “shut-down” is too politically charged. It is not an off/on switch; instead, it is more of a dimmer switch. We need to dim most things and keep the essentials open for just a few more months until the vaccines are in place.
The future of winning the pandemic war is exceptionally optimistic. Let’s all be tough for 3-4 months. Wear masks, social distance, and limit exposures. We will win the COVID war in 2021.
Finally, remember, vaccines won’t win the war; vaccinations will. Get vaccinated when it is your turn.
Charles E. Crutchfield III, MD is a board-certified dermatologist and clinical professor of dermatology at the University of Minnesota Medical School and a Benedict Distinguished Visiting Professor of biology at Carleton College. He also has a private practice, Crutchfield Dermatology in Eagan, MN.
He received his MD and Master’s Degree in molecular biology and
genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Minnesota Medicine recognized Dr. Crutchfield as one of the 100 Most Influential Healthcare Leaders in Minnesota. Dr. Crutchfield specializes in
skin-of-color and has been selected by physicians and nurses as one of the leading dermatologists in Minnesota for the past 18 years.
He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations and president of the Minnesota Association of Black Physicians. He can be reached at CrutchfieldDermatology.com or by calling 651-209-3600.