Dr. Klotman’s Week 132 COVID update is here. The central idea this week is that while the pandemic is not over, the world’s attention has turned to other things – like economies, education, and a return to pre-pandemic behaviors. As for COVID per se, case numbers, hospitalizations, and deaths are steadily decreasing. Still, ~3000 Americans are still dying of COVID every week – nothing to sneeze at (sorry, bad pun). Most are unvaccinated, and they tend to be a bit younger than the folks who were dying in 2000-2001.
On the medical front, clinicians are focused on the chronic syndromes inflicted by SARS-CoV-2 infection – namely, “long COVID.” About 20% of folks infected with the virus experience symptoms that last a month or longer. The possible causes are: 1) persistent, low-grade infection, 2) immune system activation that causes self-injury even after the viral infection has been eliminated, 3) micro-emboli caused by viral or immune activation of the clotting system cascade. With regard to the first of these, I read a medical item today that reported that corona virus replication can take place in adipose tissue – serving as a reservoir of virus in obese patients.
An old Rheumatology mentor of mine used to say that when you find dozens of treatments for a single disease it probably means that none of them work all that well; this was during the heyday of NSAID drug development. After practicing medicine for decades, I can see the wisdom of his aphorism. In a similar way, I would suggest that when we have multiple proposed causes for a novel illness, it most likely means that we don’t understand the illness well enough to explain it. AIDS in the 1980s was a good example of this principle. Long COVID may be the contemporary example of the same conjecture.
My (unsolicited) advice to you is that if you are 70+, you should get all the COVID vaccines and boosters, and try to live as normal a life as you can. Associate freely with folks who you know to be fully vaccinated, otherwise wear a mask around folks whose vaccination status you do not know. Avoid crowded places – that goes double in the Winter months. Be safe!