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THE OTHER SIDE: COVID in the closet

While some want us to believe it’s the end of COVID as we know it, those who confront the virus every day, either fighting it in our hospitals or in our laboratories, and especially those suffering from it, are pretty sure we’re still at the beginning.

With apologies to REM’s “It’s The End of The World As We Know It,” it seems so many Americans, including those in our local, state, and national governments, want and need us to believe it’s the end of COVID as we know it. Along the way, many are dispensing with any sense of a public health emergency. Locally, few people are masking indoors and many are unconvinced of any need to practice social distancing. And there seems to be no real sustained attempt to improve indoor ventilation. People are eating out again as if it’s 1999.

Aside from the heart-breaking cries of those who are victims to COVID’s worst effects, and the great numbers suffering from Long COVID largely without public support, most Americans, once again, have got looking the other way down pat.

It’s not all that surprising that we don’t want to focus on an epidemic we’ve gotten tired of after three years. To many, COVID is a mostly mysterious but remarkably inconvenient virus that may or may not have come from a Chinese lab or, possibly worse, from Chinese bats. As for avoidance, haven’t we become all too used to melting glaciers, erratic and unpredictable and increasingly dangerous weather patterns, massive flooding, ever stronger hurricanes, tornadoes and typhoons, the dreadful droughts, crippling heat, and raging forest fires? Have we just begun to accept that nature grows more threatening by the day yet not wanting to force the necessary changes in our fossil fueled economy? Most recently, daily life for many has been shattered by the devastating earthquakes in Turkey and Syria, yet again mocking the decisions of builders not only to save money by skimping on construction materials and methods, but for building homes on Nature’s fault lines.

Sadly, we Americans have become inured to daily mass murder—living without safe spaces. So is it really surprising that we now seem willing to regard COVID cases, hospitalizations, and deaths as just more disadvantages of contemporary living? Yes, for the moment, cases and hospitalizations seem to be ebbing. But as the New York Times just reported on its Coronavirus Tracker email of February 10, 2023, there were 72 COVID cases in Berkshire County and 5 deaths reported on the day before.

According to the CDC as of February 15, 2023, there were 128 new deaths in the past week in Massachusetts for a total number of 24,029 deaths.

I’ve heard from several local health workers that a significant number of COVID cases—the result of home testing—are never entered into county or state or federal databases. So even if you wanted to keep track of the current state of COVID infections, you wouldn’t be able to.

Unfortunately, the Southern Berkshire Health Collaborative, which serves the Towns of Alford, Great Barrington, Lee, Lenox, Monterey, Mount Washington, New Marlborough, Otis, Sheffield, and Stockbridge seems to have suspended its valuable South Berkshire County COVID-19 Dashboard (the latest edition I could find was from August 26, 2022).

I say unfortunately because there is so much more we need to learn about COVID, so many reasons we need to remain vigilant. And a local, up-to-date accounting of our COVID reality is essential. So too the latest available data from the Great Barrington Board of Health is more than a month old and doesn’t provide any information, including COVID in our wastewater, specific to Great Barrington:

COVID data for Berkshire County from January 1 to January 14, 2023. Graphic courtesy of the Great Barrington Board of Health.

Given the limitations in the COVID data, it is nevertheless striking that the Massachusetts Department of Public Health acknowledges that, as of February 4, 2023, there have been 1,957 reported COVID cases in Great Barrington, or one in more than three people (but less than four). If not you, who of your friends and family?

Massachusetts Department of Public Health COVID Dashboard showing total COVID case counts as of February 4, 2023. Highlighting added. Courtesy of Massachusetts Department of Public Health.

Berkshire Health Systems’ reports on February 9, 2023 that, since March 1, 2020, they have recorded 26,512 positive COVID tests, with 168 unique patients testing positive in the last 14 days.

At her recent appearance before the newly configured Republican-controlled House, CDC Director Rochelle P. Walensky offered this balanced view of the current state of COVID: “Today, the nation is in a different position than when we began our response to this pandemic. The rapid development and deployment of safe, effective, and life-saving COVID-19 vaccines has prevented millions of severe illnesses, hospitalizations, and deaths … As of the week of February 6, hospital admissions have decreased nearly 9 percent from the previous week, total weekly deaths are also down about 9 percent from the previous period, and our COVID-19 Community Levels show that 96 percent of counties have a low or medium level. While these are encouraging trends, with nearly 4,000 deaths from COVID-19 in the last week, we know there is more work to be done ahead … Nearly six million people have been hospitalized, and many more continue to suffer from post-COVID conditions (‘long COVID’). Vaccinations and treatments continue to be the best protection against serious illness and death from COVID-19.” (Emphasis added.)

Thankfully, the CDC isn’t looking away. But, sadly, many institutions are curtailing and/or limiting their efforts at reporting cases, hospitalizations, deaths, and recent trends. I’ve just read that one of the preeminent hosts of accurate information, Johns Hopkins Coronavirus Resource Center will soon be closing its operation—a great loss to us all.

As they explain: “Johns Hopkins University & Medicine plans to cease the Coronavirus Resource Center’s ongoing collection and reporting of COVID-19 data on March 10—three years after the institution embarked on the unprecedented effort of tracking an unfolding pandemic in near real time. The pioneering public service has operated since the novel coronavirus first began spreading globally in January 2020 to provide the public, journalists, and policymakers across the United States and around the world with visualizations of cases and deaths as they were being reported. Johns Hopkins’ comprehensive pandemic data will remain free and accessible to researchers, journalists, and the public for all data reported between Jan. 22, 2020, and March 10, 2023.”

Johns Hopkins helped us all to see what was happening with COVID around the world and here in the United States:

Johns Hopkins Covid Dashboard showing global cases and deaths as of February 10, 2023. Courtesy of Johns Hopkins Coronavirus Resource Center.

By highlighting the increasing numbers of cases and deaths, Johns Hopkins’ COVID dashboard made it impossible to deny the horrifying toll COVID was exacting everywhere around us—almost seven million deaths across the world and 672,622,196 total cases. Within one 28-day period, we lost 131,463 people.

COVID-19 United States cases by county as of February 10, 2023. Courtesy of Johns Hopkins Coronavirus Resource Center.

This recent map offers statistics on those U.S. counties with the highest confirmed cases. For example, Los Angeles County has had 3,682,771 confirmed cases. Miami-Dade County has had 1,532,574 confirmed cases. And New York County has had 591,382 confirmed cases. As for confirmed deaths, Los Angeles County has had 35,132 deaths; Kings County has had 14,169 deaths; Queens County has had 13,376 deaths; and Miami-Dade County has had 12,049 deaths.

People continue to be hospitalized, continue to die, and millions continue to suffer the ravages of Long COVID. Yet, the new Republican Party and their devoted followers seem determined to send us hurtling in reverse to the 1950s, to back alley abortions, to banned books, to the notion of an enemy within—replacing atheistic Russians with Godless Socialistic Democrats.

For many, too much in modern life is uncontrollable. Once black and white, they remember America as simple and predictable and reliable. Today, though, there is too much choice, too many languages, too many colors. “Those” and “them” and “they” all wanting to replace their language, their culture, to occupy their jobs and, most importantly, their preeminence in the social and economic and psychic order.

The undeniable complexity of contemporary life seems to have prompted an unending avalanche of grievance. This most recent Super Bowl offered a glaring example: a Star Spangled Banner sung by a heartland favorite, Chris Stapleton, undone by a halftime show offered by Rhianna, who, though fully clothed and pregnant, managed to balance on a precarious slab high above the football field, while oozing unbridled feminine sexuality. Such a display, no matter how beautifully choreographed, and endorsed, encouraged, and engineered by a corporate marketplace that has made so many, including Rhianna herself, mighty fortunes, predictably prompted fury from the evangelical Right and the Trumpian minority. As Marjorie Taylor Greene put it, “Chris Stapleton just sang the most beautiful National Anthem at the Super Bowl. But we could have gone without the rest of the wokeness.” It seems the woke are people of color and weak empathetic whites.

I suspect the always-outraged—and I’m guessing they see themselves as the real victims here—must have known the gender fluid, gay and lesbian and bisexual folks, and those severely uncomfortable in their apparent sexuality while understandably yearning to transition, have always been with us—in our neighborhoods, our schools, in our homes. But, I imagine, this uncomfortable reality was always accompanied by a constant mutter and a continuing threat that unless they had the good sense to keep themselves undercover, they’d be hounded, shunned or eliminated.

But, these days, they refuse the closet.

There’s that old Scottish saying: “If wishes were horses, beggars would ride.” Unfortunately, there’s a problem with allowing political imperatives and downright fear to shape public health policy. The right wing, the evangelicals, desperately want to believe that one chooses one’s sexuality sort of like how you order your burgers. It’s easier to despise someone’s choice than the inescapable imperatives of the body. Like someone else’s sexuality, COVID doesn’t care if you think you won’t get it, if you’re convinced vaccines aren’t safe, if you really don’t want to get sick. Viruses don’t care. And denial doesn’t work. Our hospitals have been filled by the unvaccinated.

COVID has managed to unleash a large coalition of the anti-science and the anti-vaccination, along with those conspiracy theorists who stalk the World Wide Web deep into the night—those who have managed to convince themselves that Anthony Fauci and unnamed Chinese lab techs and mask-wearing public school teachers are somehow colluding together in a vast assault on American normality. They desperately want to banish COVID to the closet along with the entire LGBTQ+ community. Ironically, they were recently helped along by a White House subject to pressure from several quarters, anxious to promote the ever-expanding economy, and conscience-less politicos like Governor DeSantis, hoping to impress the COVID-weary and anti-vaxers by nailing shut the COVID closet door.

DeSantis’ office released the following press release: “Today, Governor Ron DeSantis announced a common-sense legislative proposal to make permanent COVID-19 freedoms in Florida. This strong pro-freedom, anti-mandate action will permanently protect Floridians from losing their jobs due to COVID-19 vaccine mandates, protects parents’ rights, and institutes additional protections that prevent discrimination based on COVID-19 vaccine status …

“Included in Governor DeSantis’ proposal are first amendment rights guarantees for medical professionals, ensuring no one loses their job or medical license for voicing their professional opinions in Florida. The legislation will safeguard medical professionals from discrimination based on their personal religious views.”

Governor DeSantis’ Prescribe Freedom COVID Policy.

Quite the public relations triumph. In DeSantis’ Florida being intubated in an ICU or suffering 18 months of brain fog, a debilitating lack of energy, and an inability to make a living—not because of a vaccine but as a direct result of Long COVID—is just DeSantis’ way of living free.

As for Washington, D.C., ABC News puts it this way: “The Biden administration will end both the COVID-19 national emergency and public health emergency on May 11 … They began in 2020, soon after the onset of the pandemic … ‘To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19,’ the administration wrote. ‘They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.’”

The World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus recently declared that COVID is “probably at a transition point” and that the risk of COVID-19 global transmission remains high, meaning the virus still qualifies as a Public Health Emergency of International Concern. Due to diagnostics, vaccines, and treatments, however, Dr. Tedros says that the global community is the best position it has been in to fight back against COVID since the start of the pandemic.

Thanks to Twitter, almost from the very beginning of the epidemic, epidemiologists, doctors, and nurses on the front lines have been sharing their knowledge and their experiences in their emergency rooms and the ICUs with COVID. And patients with and victims of COVID have been telling us what it’s like to struggle with the disease, especially Long COVID.

Despite the widespread desire to return to the days before COVID, the virus refuses to stand still, and won’t easily allow us to dispense with it. COVID is changing, mutating, responding to the vaccines and tactics we are employing to fight it. Dr. Jeff Gilchrist, who refers to himself as a “PhD Biomedical researcher, data scientist, and finder of large prime numbers,” recently posted a long series of tweets about what’s happening with our neighbors up north in Ottawa, Ontario. Dr. Gilchrist wrote: “A couple of months ago if you got sick there was a good chance it could have been RSV or Flu that was making you feel ill, or possibly the Omicron BQ.1.1 variant which was rising quickly. Now, RSV is at much lower levels and Flu A is no longer being detected from wastewater samples in Ottawa so it is much less likely you can blame your sniffles, congestion, or fever on those two viruses. There is a virus that is increasing fast in Ontario now, the new XBB.1.5 ‘Kraken’ COVID variant …

“This is a descendant of the XBB.1 recombinant variant which means that it is actually a combination of two different variants BJ.1 and BM.1.1.1 which are both descendants of BA.2. That is why the variant designation starts with ‘X’ for XBB because it is a cross ‘X’ of two different variants. This can happen when someone is infected with two different variants at the same time and while the viruses are copying inside the body recombined to create XBB. The mutations that XBB.1.5 has picked up make it more immune evasive but also bind to ACE2 receptors much better (higher affinity) which the virus uses to enter and infect cells … Looking at the wastewater COVID signal over time, the baseline lows keep getting higher and higher so ever since Omicron BA.1 hit a year ago, we have never gone back to low levels of COVID community transmission and now those minimum transmission levels keep getting higher.” (Emphasis added.)

On January 8, 2023 USA Today wrote, “The newest COVID-19 variant is so contagious that even people who’ve avoided it so far are getting infected and the roughly 80% of Americans who’ve already been infected are likely to catch it again, experts say. Essentially, everyone in the country is at risk for infection now, even if they’re super careful, up to date on vaccines, or have caught it before, said Paula Cannon, a virologist at the University of Southern California.

“‘It’s crazy infectious,’ said Cannon, who is recovering from her first case of COVID-19, caught when she was vacationing over the holidays in her native Britain. ‘All the things that have protected you for the past couple of years, I don’t think are going to protect you against this new crop of variants,’ she said. ‘The number of severe infections and deaths remains relatively low, despite the high level of infections, she said, thanks to vaccinations—and probably—previous infections. But the lack of universal masking means that even people like her, who do wear masks, are vulnerable.”

Using genomic analysis, The Centers for Disease Control (CDC) has been keeping track of the different COVID variants currently infecting Americans. Here’s the CDC Chart as of February 11, 2023:

COVID Variants in the United States for the weeks November 6, 2022 to February 11, 2023. Chart courtesy of the U.S. Centers for Disease Control.

As you can see, XBB.1.5 went from non-detect on November 1, 2022 to 74.7 percent of all COVID variants by February 11, 2023. The XBB.1.5 percentage is noticeably higher—up to 93,6 percent—for our New England region: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont:

COVID Variant Estimates for New England region for the weeks November 6, 2022 to February 11, 2023. Chart courtesy of the U.S. Centers for Disease Control.

USA Today noted: “Its growth is probably due to XBB.1.5’s characteristics—it appears to bind even more tightly to receptors in the human body than its predecessors—as well as human behavior, such as traveling and not masking … ‘It’s a good idea to do what you can to avoid getting infected,’ said Dr. Ziyad Al-Aly, chief of research and development at the VA St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis. It’s still early and there are a lot of unknowns about XBB.1.5, he said. Every infection makes someone vulnerable to a bad course of the disease and to the lingering, miserable symptoms of long COVID, Al-Aly’s research shows. ‘Reinfection buys you additional risk,’ he said.” (Emphasis added.)

One of the great dangers we continue to face is Long COVID. In an article in The Atlantic entitled “Trying to Stop Long COVID Before It Even Starts,” Katherine J. Wu writes: “Three years into the global fight against SARS-CoV-2, the arsenal to combat long COVID remains depressingly bare. Being vaccinated seems to reduce people’s chances of developing the condition, but the only surefire option for avoiding long COVID is to avoid catching the coronavirus at all—a proposition that feels ever more improbable. For anyone who is newly infected, ‘we don’t have any interventions that are known to work,’ says Akiko Iwasaki, an immunologist and long-COVID researcher at Yale.” (Emphasis added.)

Wu makes a compelling case that cramming COVID and Long COVID into the closet makes little sense: “As the world turns its gaze away from the coronavirus pandemic, with country after country declaring the virus ‘endemic’ and allowing crisis-caliber interventions to lapse, long-COVID researchers, patients, and activists worry that even past progress could be undone. The momentum of the past three years now feels bittersweet, they told me, in that it represents what the community might lose. Experts can’t yet say whether the number of long-haulers will continue to increase, or offer a definitive prognosis for those who have been battling the condition for months or years. All that’s clear right now is that, despite America’s current stance on the coronavirus, long COVID is far from being beaten.” (Emphasis added.)

A month later in the February 13, 2023 issue of The Atlantic, she offers a state of the union portrait of Long COVID and makes the compelling case for acknowledging our slow learning curve: “In the early spring of 2020, the condition we now call long COVID didn’t have a name, much less a large community of patient advocates. For the most part, clinicians dismissed its symptoms, and researchers focused on SARS-CoV-2 infections’ short-term effects. Now, as the pandemic approaches the end of its third winter in the Northern Hemisphere, the chronic toll of the coronavirus is much more familiar. Long COVID has been acknowledged by prominent experts, national leaders, and the World Health Organization; the National Institutes of Health has set up a billion-dollar research program to understand how and in whom its symptoms unfurl. Hundreds of long-COVID clinics now freckle the American landscape, offering services in nearly every state; and recent data hint that well-vetted drugs to treat or prevent long COVID may someday be widespread.” (By the way, “Acute and postacute sequelae associated with SARS-CoV-2” denotes the effects of Long COVID.)

An integral part of the COVID Closet Campaign is the action of states and local communities—even nations—to cancel their previous mask mandates. NBC News reported on the decision of New York State health officials to dispense with COVID mask mandates: “State health officials announced on Friday the end of mandated masks and face coverings inside health care facilities as of Feb. 12. The updated guidance, they said, is in line with recommendations from the Centers for Disease Control and Prevention.

“‘The pandemic is not over, yet we are moving to a transition. As we do, and with safe and effective vaccines, treatments, and more, we are able to lift the State’s masking requirement in health care settings as operators now develop and implement their own facility-specific plans, in accordance with federal CDC guidance and the level of transmission in their areas,’ Acting State Health Commissioner Dr. James McDonald said in a statement.”

Their decision impacts New York State hospitals, nursing homes, agencies providing home health care and hospice services, as well as the diagnostic and treatment centers that previously had been required to enforce mask wearing.

On February 10, 2023, NPR weighed in: “There are still hundreds of thousands of COVID cases reported in the U.S. each week, along with a few thousand deaths related to COVID. But with mask mandates a thing of the past and the national emergency health declaration that will expire in May, we are in a new phase of the pandemic.

“Life looks a little more normal here in the U.S. than it did a few years ago, but decisions on how to deal with the virus aren’t over yet. China had a huge increase in cases last month after abandoning its zero COVID policy, and another variant prompted renewed recommendations in some airports. Researchers estimate that more than 65 million people are struggling with the effects of COVID—a disease we still have to learn about. However, masking requirements are being lifted in places like Spain and Germany …

“Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University Medical Center, says he and his wife are still playing it conservatively. He cautions people to stay ‘careful, not carefree … Older persons, people of any age who have a serious underlying illness, heart disease, lung disease, diabetes, if you’re immune compromised,’ Schaffner said, ‘keep wearing that mask.’” (Emphasis added.)

NPR also spoke to Dr. Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco, who says: “While he’s no longer concerned about dying or serious illness, the virus can still knock you out. Wachter watched firsthand as his wife recovered from a bout of long COVID-19. He evaluates it case by case. A small gathering where everyone is vaccinated and windows open may not require one. But sitting on an airplane or in a large, crowded theater might be a good idea to do one. ‘Those places, I’m wearing a mask now, and I suspect I will wear a mask forever,’ Wachter said.”

As for Spain’s mask policy, Reuters reports, “Spain, one of the last countries in Europe to still require people to wear masks on public transport to prevent the spread of COVID-19, will likely lift the obligation on Feb. 7, Health Minister Carolina Darias said on Thursday.

“She said the epidemiological situation in the country was stable and health emergency services had proposed lifting the restriction. Masks will remain mandatory in health facilities … Three years after the first cases of COVID-19 were detected in Europe, masks are only mandatory on all, or some types of public transport, in Spain, Germany, Austria and Greece. Mask wearing on public transport became obligatory in May 2020. Germany is due to lift the rule, which applies to long-distance trains and buses, on Feb. 2. The obligation in Greece is set to expire on Jan. 30.”

According to, “The German health minister has announced that as of February 2, masks will no longer be required on long-distance trains and buses. The regulation was to have been in force until April 7, but the government has decided that it is no longer necessary, as the pandemic situation has subsided.”

It wasn’t until I plunged back into researching the latest developments with COVID that I discovered the work of the John Snow Project. “Members of our editorial group have expertise in epidemiology, immunology, microbiology, clinical practice, and public and global health. Many of the clinicians in the editorial group have spent the past three years treating patients with COVID-19 and are now treating patients suffering from both the acute disease and the long-term consequences of infection.”

They write: “The world is entering its fourth year of living with COVID-19, the disease caused by the SARS-CoV-2 virus. Nearly everyone has had personal experience of catching the virus and many people are living with the lingering effects of illness. Governments around the world have abandoned national policies to curb transmission and have left the management of risks to the individual. ‘Learn to live with it’ and ‘you do you’ individual responsibility are the dominant mantras.

“This individualistic approach to an airborne virus relies on people being armed with knowledge to understand the risks they face and the tools that help mitigate those risks … Three years on the pandemic is still with us but official communication and consequent media coverage has been reduced so that many people have resumed their 2019 lifestyles, largely oblivious to the ongoing risks posed by COVID-19. This information gap comes just as the scientific and medical community is learning more and more about the detrimental long-term effects of SARS-CoV-2 infections.

“Certain political figures might like to pretend COVID-19 no longer poses a risk to public health, but the medical and scientific community and official government organizations such as the WHO, CDC, NHS, UKHSA, EPA and many others are united by a single consensus view. That consensus is: Avoid infection whenever possible.” (Emphasis added.)

New daily COVID cases in the United Kingdom, German, Japan, Canada, and the United States. Chart courtesy of Our World in Data.

You may not be aware of some of the more recent research. Sara Berg, in a column for the American Medical Association (AMA) entitled “What Doctors Wish Patients Knew” addresses the issue of reinfection: “At this point in the pandemic, almost everyone in the U.S. has had COVID-19—whether they know it or not. But something more alarming is happening: A growing number of people are getting reinfected with SARS-CoV-2.”

Berg spoke to two practicing physicians: Rambod A. Rouhbakhsh, MD, a faculty physician and program director at the Forrest General Hospital Family Medicine Residency Program and the Hattiesburg Clinic, and Nancy Crum, MD, an infectious disease physician at Avita Health System in Galion, Ohio.

Sara writes: “‘It can be problematic if you are reinfected,’ Dr. Rouhbakhsh said. ‘We know from a pretty elegant study that was recently published in Nature Medicine that each subsequent COVID infection will increase your risk of developing chronic health issues like diabetes, kidney disease, organ failure and even mental health problems … Such evidence dispels the myth that repeated brushes with the virus are mild and you don’t have to worry about it,’ he added, noting that ‘it is akin to playing Russian roulette.’

“Dr. Crum said. ‘As we went from the Alpha to Delta to Omicron, we have reduced our ability to prevent reinfection and so we can get infected again … There are some viruses—like hepatitis B, for example—that if we get the virus once in our life, we’re protected for the rest of our lives,’ she said. ‘But other viruses, particularly the respiratory viruses like influenza and now SARS-CoV-2, they continue to mutate in a way that we can get those types of viruses over and over again because the strain changes and we aren’t necessarily protected against that new strain.’” (Emphasis added.)

On November 2022, B. Bowe, Y. Xie and Z. Al-Aly published their study “Acute and postacute sequelae associated with SARS-CoV-2 reinfection” in Nature Medicine. They explaim: “There were 443,588 cohort participants with no SARS-CoV-2 reinfection (only a single SARS-CoV-2 infection) and 40,947 participants who had SARS-CoV-2 reinfection (two or more infections) … Among those who had reinfection, 37,997 (92.8 percent) people had two infections, 2,572 (6.3 percent) people had three infections and 378 (0.9 percent) people had four or more infections …”

They found: “Compared to those with no reinfection, those who had reinfection exhibited increased risk and excess burden of all-cause mortality, hospitalization and at least one sequela in the acute and postacute phases of reinfection. The risks and excess burdens of all-cause mortality, hospitalization and at least one sequela during the postacute phase gradually attenuated over time but remained evident even 6 months after …” (Emphasis added.)

A recent January 2023 study entitled “Excess risk for acute myocardial infarction mortality during the COVID-19 pandemic” offers evidence that there has been a noticeable rise in cardiac deaths because of COVID: “The excess mortality seen during the coronavirus 2019 (COVID-19) pandemic has been undeniably profound. In the United States and worldwide, rates of excess mortality due to COVID-19 have been especially elevated for adults aged 65 years or older, males, and racial/ethnic minority groups. Importantly, the measurable total excess in mortality includes deaths attributed to several major non-COVID-19-specific causes. A substantial proportion of these non-COVID-19-specific deaths include cardiovascular deaths due to ischemic heart disease …” (Emphasis added.)

Dr. Céline Gounder, an infectious disease specialist and epidemiologist, commented on CBS News and Twitter that this recent study from Cedars Sinai reveals “the number of heart attack deaths among people 25-44 years old during the first 2 years of the COVID pandemic was 30 percent higher than predicted … Increased rates in heart attack deaths also seen after the emergence of Omicron, which has been thought to cause less severe disease.” (Emphasis added.)

She then answered her own questions: “How does COVID cause heart attacks? COVID causes inflammation & blood clots, which may trigger or accelerate the development of coronary artery disease, including in young people. How can you reduce your risk of heart attack from COVID? – getting vaccinated wearing a mask, especially in indoor public spaces during COVID surges, ventilation & air filtration.”

Finally, a January 18, 2023 article entitled “Multi-organ impairment and long COVID” and published in the Journal of the Royal Society of Medicine examined “the prevalence of organ impairment in long COVID patients at 6 and 12 months after initial symptoms” in a mix of patients in Oxford and London, including “536 individuals (mean age 45 years, 73 percent female, 89 percent white, 32 percent healthcare workers, 13 percent acute COVID-19 hospitalisation … Our interim magnetic resonance imaging (MRI) data in 201 individuals showed mild organ impairment in the heart, lungs, kidneys, liver, pancreas and spleen, with single- and multi-organ impairment in 70 percent and 29 percent, respectively, 4 months after COVID-19.”

I suspect the COVID debate will rage on, along with the controversies over masks mandates, and the continuing need for vaccination. The concerns of some to keep COVID front of mind, to advocate for continuing vigilance, may seem to some an unnecessary and bothersome attempt to limit their freedom of movement, to choose how to live. But it is worth repeating, as NPR recently pointed out, a mind-boggling number of people across the world are living with a COVID that just won’t stay in that closet: “Researchers estimate that more than 65 million people are struggling with the effects of COVID—a disease we still have to learn about.”

According to the folks at the John Snow Project: “COVID-19 has not ‘gone away’ nor is it likely to. The virus mutates rapidly and waning immunity means long-term protection and so-called herd immunity against infection does not seem possible against SARS-CoV-2, the virus that causes COVID-19. Until we have vaccines that are more effective at blocking transmission, or there has been a global effort to eliminate or reduce transmission of SARS-CoV-2, we should expect a relatively high background prevalence of the virus and to be infected or reinfected when our immunity wanes, unless we take steps to mitigate our risks.”

While some want us to believe it’s the end of COVID as we know it, those who confront the virus every day, either fighting it in our hospitals or in our laboratories, and especially those suffering from it, are pretty sure we’re still at the beginning. However much some might want to cram COVID in the closet, that door isn’t ready to be shut.


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