We Were So, So, So, So Right about COVID

In April, 2020, serendipitously, my high school classmate reached out to me after one of my podcast episodes where I was talking about mask usage. I was incorrect in one of my assumptions with the use of masks and the spread of particles which he pointed out. I then read his blog post about COVID and how it pertained to his home state of Montana and recognized that the way he looked at the pandemic was completely different than most. He came on the show for episode 086 and with today's episode will have been on five times. The perspective Dr. Graham brings to COVID is one with a clear insight about where we will end up. And if you know where you are going, it is much easier to figure out the best way to get there.

COVID Is Endemic

The greatest insight we spoke about way back at the beginning of this pandemic was that this virus, SARS-CoV-2, would become endemic. There was no chance of eradicating it no matter what type of vaccine was developed. The virus would be ubiquitous throughout the world with individuals always having a risk of exposure and infection. There would be no place to run or hide from the virus. And now we have animal reservoirs (animals that can become infected and spread the virus to other animals or humans) which means that even if you miraculously eliminated the virus from every human on the planet, it would pop up again as soon as it found new people who don't have immunity are born or their immunity wanes.

How Do We Approach Endemic Viruses Differently?

Endemicity is the key point to our discussion and one which has broad reaching policy implications. Your approach for controlling the spread of the virus and expectations completely change your strategies. It is why I've personally found the strategies promoted (and currently being promoted at this writing) so frustrating. Our current strategy is pointedly directed at preventing any and all transmissions of SARS-CoV-2. Whether that is using masks, distancing, restrictions on social gatherings, vaccine mandates, travel bans, or economic lockdowns we have been attacking this viral pandemic in exactly the wrong way.

For an endemic virus, we recognize that we will all get infected multiple times throughout our lifetimes. Although we develop lasting T cell immunity to coronaviruses it does not completely prevent infections. That means that people will continue to contract and spread the virus but not get terribly sick. For the vast majority of people, these reinfections will be mild not requiring hospitalization. However, just because you don't require hospitalization it still might be a miserable few days similar to when you get the flu.

If You Promote Masks, Promote Ones That Work

We discussed mitigation measures and the colossal failure of any country, state, or city to successfully stop the spread of COVID-19 with either masks, lockdowns, or distancing. One important point was that we ned to be honest with people and if we are going to force kids to wear masks we should at least have them use masks that have some chance of making a difference. The use of cloth masks is pointless when you have a bunch of kids in an enclosed place for long periods of time. Ultimately, even good N95s probably wouldn't work very well because the kids wouldn't have good seals on them anyway.