The Covid Years. A glimmer of hope.

No, it’s not been years.

That’s a gross exaggeration. Although I’m sure to most, it may have felt like so.

It’s been approximately 2 months since our local province had declared a State of Emergency over the COVID affairs, mirroring what’s been going on in much of our “top of mind” developed worlds, give or take a few weeks.

Here, Spring is looming. April was one of the driest, sunniest months on record. We were blessed with such fortunate timing amidst our social distancing orders. With the sun comes hope. With flowers come happiness. Green leafs bring a sense of calmness. Dry pavements brings an invitation to get out and play.

Us humans have a short memory. Both a blessing and a curse. I find even myself, who stay glued to the television set for daily news of the world pandemic, slowly losing sight of the nasty images of overwhelmed hospitals and mass mortalities during some of the “televised” peaks in our worlds. My mind gradually shifted to a level of normalcy. My attention towards the new focus of reopening, of reintegration, of our society and livelihoods.

“I worry that people are going to forget about the risks…”, said my mom.

“Let them forget a little.”, I said. For the time being. Let them have some emotional relieve. Daily stern reminders to be vigilant will mean diluting the key message when we need them to listen again.

And we will need them to listen again real soon. The second wave will come. It’s just biology. Nothing has drastically changed in our fight against the virus. It is still here. It is still circulating. We are still susceptible. Many will still get sick and die.

But perhaps, something HAS changed. It isn’t all the same, is it?

In warp speed, more impressive than I have ever witnessed in medicine, is our increasing knowledge-base of the virus and its complications.

In fact, that is where I’ve heard the term “Covid Years”. In our current battle against COVID, enhanced by an unprecedented scale of international collaboration and experience-sharing via easily accessible social medial channels, one week feels like a year of progress.

The shear volume of data, of observations, of thoughts and novel ideas, have been staggering to date. Overwhelming to be sure. For many of us clinicians, passively surfing through volumes of online updates, podcasts, video conferences, have unfortunately became a favourite pastime in our non-clinical hours. Some might even call it an obsession, or addiction. For we have no sports; what else do we have to distract ourselves with other than, well, more COVID news.

But in my mind, that will became our main salvation going forward.

The light at the end of this dark tunnel isn’t going to be a proven vaccine, or a widespread availability of a successful therapeutic. Not yet. Those would take too long, and if they do come this year, would be prone to such a high degree of “bad science” that I’m not even sure if I should support that notion.

The ongoing angle to fight this battle, to gain and keep an upper hand, will come down to knowledge and preparation.

And our numbers are reflecting that success.

Locally, despite somewhat persistent case numbers, admissions rates and ICU numbers are declining.

Are we humans becoming less vulnerable to the virus? No. We are simply adapting as a population to know how to fight it better.

Perhaps one of the earliest “lessons” in this pandemic, stemming from observations in Wuhan and Italy and early New York, was a call to “intubate early” for severe cases. They crash quickly, we were told.

Suddenly, many COVID patients around the world ended up on ventilators. Just like that, hospital capacities grind to a halt. Death rates rose for those who needed but lacked an ICU bed.

On top of that, widespread worries about aerosolizing the virus into open space forced many clinicians to avoid previously useful “bridging or temporizing” methods, such as high flow oxygen, or BIPAP or CPAP, that has been invaluable in the past for other respiratory struggles. As such, even many “non-COVID” patients who might have benefited from these therapies were denied such interventions, perhaps leading to progression of their non-COVID illnesses. This might be hard to prove, but logically plausible.

But within weeks, the medical field has turned the corner. Progressive observations from NY and other hot spots described a changing of attitudes, that perhaps such “early intubations” were not, in fact, protective, or possibly even detrimental. A new observation, of many “happy hypoxic” patients, dumbfounded clinicians, as they stared at patients with numbers that should not normally be compatible with life but instead lying prone “happily” tapping on their iPhones.

Suddenly, we aren’t rushing to jam tubes down all these people’s throats “to keep them alive” anymore. From a hospital resource point of view, this would have profound positive influences.

Meanwhile, week by week, we are discovering new and unsettling complications of this virus, from unexpected thrombotic events to neurological complications to, for heaven’s sake, serious atypical inflammatory conditions in kids. These unexpected events are truly what makes this virus awful to deal with, in my opinion.

But week by week, we are pulling together as a human race to discover new insights in how to detect and counteract these complications.

As for our collective livelihood, our economy, and our social needs, our path towards reopening and reintegration will not yet be solved by a viable vaccine, but instead be guided by our improving knowledge on the determinants of prevention, identification, and separation of this virus from our society.

There, too, it will be knowledge and preparation that will enable us to get as close to, although no yet to the same level, to our previous normal.  

In popular social media circle, a lot of fuss has been made about the virus “mutating” or “evolving”.

But nobody is talking about the “evolution” of the human race. We, as a whole, integrated by modern technology which allows our collective wisdom to be shared and utilized instantly, has an edge to fight this thing. (Indeed, cloud computing and networking companies aren’t just helping us stay afloat in the stock market, they are also allowing us to keep winning in this fight).

For throughout the summer and come next fall, we are going to need all of this knowledge and preparation to keep fighting.

And for that, together with the sunshine and booming flowers, I am starting to develop a small hint of optimism, that we might just be able to pull it off, vaccine or not.