Auld Lang Syne’s melancholy? This go-around it may be a tragic, viral dirge

covidhealthcasualties-300x130As the nation closes out 2020 and months of a raging coronavirus pandemic, will old acquaintances be forgot and never brought to mind?

Covid-19, unchecked, has killed at least 330,000 Americans and almost 19 million of us have been infected with the disease.

Those numbers likely are underestimated. Based on still tallying “excess deaths” in this country — the higher than expected number of fatalities above the norm and likely due to the coronavirus, the truer toll from Covid-19 as of Dec. 16, likely exceeds 377,000.

The virus’ more accepted death toll (~330,000), however, has now claimed the equivalent (or more) of the population of cities like Santa Ana, Calif., Henderson, Nev., Lexington, Ky., or Cincinnati, Ohio.

In mere months, the coronavirus took more lives than battle deaths this country suffered in four years of World War II. More Americans have died of the coronavirus than participated in the Revolutionary, 1812, and Spanish-American wars.

As the Wall Street Journal reported just before the holidays launched:

“The death rate had accelerated in recent months despite regional shutdowns and social-distancing measures enacted around the country. According to a Wall Street Journal analysis of Johns Hopkins data, it took the U.S. roughly four months to reach 200,000 deaths on Sept. 21 from 100,000 fatalities. But it took just two and half months to reach 300,000 deaths.”

Confirmed coronavirus infections soar by the day, as do hospitalizations, with the hot spot of California alone reporting tens of thousands of new cases daily. The Los Angeles Times reported that the holidays will play havoc with disease testing and data for a while but noted:

“The number of cases in California is now on pace to double every 35.7 days, a number used to measure how quickly the virus is spreading.” Los Angeles County, which has the number of people to rank among the 20 most populous states, has reported for days now that all intensive care unit beds are filled, and hospitals have reached the brink in treating the most dire coronavirus cases.

No matter how grim and formidable the data that politicians and public health officials seek to muster to try to persuade Americans to respond differently to the pandemic, especially to heed common sense precautions, the year is ending with a deeply riven nation. Too many people seem to be too ready to forget the coronavirus’ harms, even as the Associated Press reported this:

“This is the deadliest year in U.S. history, with deaths expected to top 3 million for the first time — due mainly to the coronavirus pandemic. Final mortality data for this year will not be available for months. But preliminary numbers suggest that the United States is on track to see more than 3.2 million deaths this year, or at least 400,000 more than in 2019. U.S. deaths increase most years, so some annual rise in fatalities is expected. But the 2020 numbers amount to a jump of about 15% and could go higher once all the deaths from this month are counted.”

PBS interviewed experts examining life expectancy and other fundamental measures of the nation’s well-being reporting that the 2020 data look bad for Americans, particularly as the opioid abuse and drug overdose crisis has worsened during the pandemic and:

“Many of the deaths we’ll see from 2020 may not be directly tied to the coronavirus. While [hundreds of thousands of] Americans have died from the virus … those deaths have been disproportionately felt in black communities and communities of color … Researchers think another factor could be people not seeking medical care. Cancer patients, for instance, might be forgoing treatment out of fear that they might catch Covid-19, and … those conditions could cut short someone’s life in a way that doesn’t result in the coronavirus being entered on their death certificate. An uptick in overdose deaths and a possible increase in suicides could also be ramping up those numbers.”

ProPublica, the Pulitzer Prize-winning investigative news site, said it has scrutinized the terrible toll that the coronavirus has taken on communities of color, and, in particular, among black men, finding:

“While Covid-19 has killed 1 out of every 800 African Americans, a toll that overwhelms the imagination, even more stunning is the deadly efficiency with which it has targeted young black men … One study using data through July found that black people ages 35 to 44 were dying at nine times the rate of white people the same age, though the gap slightly narrowed later in the year. And in an analysis for ProPublica this summer using the only reliable data at the time accounting for age, race, and gender, from Michigan and Georgia, Harvard researcher Tamara Rushovich found that the disparity was greatest in black men.”

A growing body of research has found, separately, that African Americans do not have genetic or inherent susceptibility to the coronavirus, as some experts had feared early on. Instead, because of racial inequities — economic and in health care — black Americans have greater exposure and significantly increased risk of infection. They live in more crowded conditions, have less access to poorer health care, and their economic situations have forced them to keep working — and getting sick and dying — during the pandemic because they are far more likely to hold “essential jobs.”

ProPublica reported that black men also may suffer from what it termed the “John Henry effect,” named after the legendary character who toils against unfair disadvantage — until his determination and strength combine to help kill him. With African Americans, racism, and the coronavirus, ProPublica reported:

“The effort of confronting that machine [of discrimination], day in and day out, compounded over a lifetime, leads to stress so corrosive that it physically changes bodies, causing black men to age quicker, become sicker and die younger than nearly any other U.S. demographic group. Covid-19 is a new gear in an old machine. In interviews about the young men who died from the virus, a portrait emerged of a modern John Henry: hard-working, ambitious, optimistic, and persistent, trying to lift others along with themselves. They were the very people communities would have turned to first to help recover from the pandemic: entrepreneurs who were also employers; confidants like coaches, pastors, and barbers; family men forced into a sandwich generation younger than their white counterparts, because their parents got sick earlier and they had to care for them while raising kids of their own. They were ordinary men. Time and again, it was their fight that was remarkable.”

But equally stunning, at least to doctors, nurses, and public health officials, has been the devil-may-care response to the coronavirus that too many Americans are showing.

President Trump is playing golf and vacationing in Florida as the pandemic infects and kills thousands of Americans each day. He has said little about the disease since his election defeat, and he left the nation’s capital after creating legislative chaos, attacking a giant coronavirus relief and budget bill, and declining to say if he will sign the measure. Vice President Pence, head of the White House coronavirus task force, has defied experts’ guidance about the need for Americans to stay home for the holidays. Pence is vacationing in Vail, Colo., where local officials are blasting him for relaxing while so many across the country struggle and suffer.

As for other Americans, they, too, took to holiday travels, with federal officials reporting the heaviest air traffic in recent days during the whole time of the pandemic. Media reports showed packed shopping malls and retail centers. In Southern California, an actor known mostly for his B-list youthful performances and his public professions of his faith gathered crowds of mask less people to sing Christmas carols — gaining national attention for a protest against coronavirus health restrictions.

Really? In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.

That said, our health care system is in desperate need of support, as it has been under duress for much of 2020 and is being pushed to the brink as the year ends. We do not have limitless medical resources and our skilled health professionals are finite in number and exhausted. Caring for coronavirus patients and assisting their loved ones can be crushing work.

Yes, all the rest of us may be weary of the pandemic and the restrictions it has put on us and our lives. But the melancholy captured Auld Lang Syne should not turn funereal. Millions of Americans already are mourning loved ones, friends, and colleagues lost to the coronavirus, including thousands of courageous health workers (shown above). The battle against the disease will be boosted as vaccines become more widely available and in use.

But we cannot forget our own roles in helping all around us. For the sake of times behind and ahead of us, we need to stay home as much as we can, practice excellent hygiene (especially hand washing), cover our faces, and keep appropriate distances. We need to avoid closed spaces, especially for long periods. And we will need for a time to forego close contacts with others outside our own households.

Looking for a new year’s resolution? Resolve to stay safe, sane, and healthy, so we all can be in a better place — soon — and, maybe toasting at this time next year with zero nostalgia about how good life can be.

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