Q: So what do you make of the data? What do you make of where we are right now?
A: If you compare this August to last August, we are going up, but we’re starting at about a quarter of the level of where we were last August around the same time last year. So that’s good news. The bad news is it’s going up. But starting from a lower foothill, if you will. So we can anticipate that the numbers will continue to go up because of the nature of respiratory viruses as it gets cooler and drier.
It’s been a little strange with just this incredible heat, because it has sequestered people inside more than before. And I think when you get clustering people inside, you do tend to get some upticks as well. So it may mean that we’ve already seen some of the surge that we would typically see as people are returning to school and sequestering indoors more.
Q: So we’re in the foothills of an upward curve. Do we have any way of knowing, is it possible we’re on the way up to another Everest?
A: I think it’s really, it’s really hard to say.
First of all, the testing data is just not there. We don’t have that kind of granular data. Home testing doesn’t get reported even if it is getting done. And it’s getting done a lot less than it was in the past. After the public health emergency ended, just accessing these things has become challenging and expensive. (NOTE to readers: Test kits can be accessed at no charge; see this link here.)
But you know, I just don’t think we know whether or not we’re climbing up to a level like that. I would say that there is this notion — and I will describe it as that, it’s been proven wrong in the past — that as as you get increased transmissibility of the virus, which we may be seeing, you may get lower pathogenicity (or severity) as well. So while there may be more cases out there, they may not be cases that are leading to as much severe illness or hospitalization. But this is a novel virus. And I think there’s an interesting point to be made there. When something is novel, it just may behave in ways that we haven’t seen before.
I think we have to be really careful about buying into this notion that increased transmissibility, leads to decreased pathogenicity. It’s been true with other viruses in the past, and maybe it’s ultimately true with this virus as well, but I think maybe we’re just in the early phases of this virus, still even three years in the lifecycle overall of the virus and how it’s going to affect humanity. We’re still very much in the early days.
Q: That is a stunning take, because I think most of us feel like we’ve been through the Battle of the Bulge and we now know what it’s like.
A: Yeah. Look, I think that there’s another argument there, which is that you know, we do have a fair amount of immunity out there as well. The larger point for most people is then, what is their existing immunity going to provide for them? What does it mean about the booster shots?
There’s obviously a lot more cases than have been reported out there, because you’re getting totally disparate families and countries that had no connection with each other. You’re getting people with no history of travel — that are testing positive. So that that clearly means there’s a fair amount of community spread.
Q: You’re a surgeon. And you know what it’s like to practice in a hospital. What are you hearing? What are the concerns that anybody who cares about the health care facilities in our world would be having right now?
A: I was operating all day yesterday for example. There are there almost entire teams of surgical professionals who are out with COVID right now. So I am seeing an impact of COVID. The numbers are still really low. But when you get certain targeted demographics of people getting COVID like an entire surgical team, that has a significant impact on on our community overall.
Q: Are we possibly back on the path to another constriction of health care services because our resources are are decreasing again?
A: I don’t think so, thankfully. At least not at this point.
Especially places like Grady, with AMC (Wellstar Atlanta Medical Center) closing and you’ve already got a decrease in accessing certain — just primary care, prenatal care, things like that. Thankfully, we’re not at the point where people should be putting any of that stuff off.
Q: When it comes to shortages of hospital staff, and especially hospitals filling up, you do not have the dread that we’re heading into another January of 2021?
A: I don’t right now. I do think the XBB variant-focused vaccine booster (which is expected to arrive in September) will provide an added layer of protection, especially for those who are at high risk. So between the immunity, and starting at a lower amplitude, and then obviously there’s infection acquired immunity out there — those two things I think, probably ease my dread a bit.
When we came in and heard that COVID was affecting these surgical teams, it was a little bit of this flicker of, ‘Is this a here-we-go-again? Or is this more of a one-off?’ But it’s not surprising where people are out (of the office) because they’re doing the right thing by going into isolation via the whole protocol. I think that there’s a real emphasis on making sure it’s something that does not lead to those sweeping problems that we saw in the past.
Q: What are your thoughts are on what people should do now?
A: (Gupta mentioned the updated vaccines both for COVID-19 and for flu and for RSV, if you’re eligible. But his most emphatic piece of advice was to take action if you might be getting sick.)
You should stay home if you’re sick. Which sounds like a really obvious thing. But if you think of the impact on society, overall of that one action, I think that could greatly, greatly diminish the ferociousness of any future surges.