Crozet Annals of Medicine: The Bell is Tolling

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The virus is coming for me. Again. 

I had vowed not to write anymore about the pandemic, but COVID-19 has circled the globe yet again, mutated in Africa and is threatening the U.S. again with now a fourth wave of pandemic. 

The new variant has been dubbed Omicron after the Greek letter O. (A side benefit of the pandemic is we are all learning our Greek alphabet.) Incidentally, two Greek letters were skipped, Nu (N) and Xi (X). Apparently, the WHO, which is in charge of naming these things, felt Nu would be confused with new, and Xi, being the surname of the authoritarian president of China, was felt to be culturally and politically insensitive. This leaves only nine Greek letters left for any future, inevitable variants. I am sure we will all learn these letters eventually. 

It is not clear how much danger Omicron poses here in the U.S. and especially for those fully vaccinated and boosted. Time will tell. In the meantime, several things have become clear. 

1) Covid is now endemic. It will not go away.

2) We are beyond prevention. But we can mitigate the risk considerably. More on that later. 

3) We are all in this together. By we I mean every citizen on the planet. The reason this variant was allowed to circulate long enough to mutate up to thirty ways was because almost nobody in Africa is vaccinated. We have to change this, if only to protect ourselves from future mutations. 

Vaccination rates in southern Africa are only 3%. This is not due to vaccine hesitancy. They simply cannot afford mass inoculations like we have been able to do here in the U.S. Much of the developing world is in the same straits. Regrettably, even though we can afford to vaccinate all our citizens, our vaccination rate is only 60%.

4) The rich nations of the world must vaccinate the poor nations of the world. It is in everyone’s best interests to cooperate to tame this thing. This is true of most of the other pressing problems the world faces. 

John Donne, the English poet anticipated this time when he wrote “For Whom the Bell Tolls” in 1623.

For Whom the Bell Tolls
No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thine own
Or of thine friends were.
Each man’s death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.

So, how are we to live now in the time of endemic Covid?

We should not go back to lockdowns and travel bans and school closures. We have to live in the face of this danger, but we have to mitigate this danger. Since none of us are islands, we must work to protect each other. We have a social and moral obligation to wear masks when gathered indoors and we have a social and moral obligation to maintain social distancing indoors. We have a social and moral obligation to get fully vaccinated and boosted as soon as possible. While we don’t know yet how protective the vaccines are against Omicron, the likelihood is that they are going to be far better than nothing, especially after a booster.   

Most importantly we have a social and moral and practical obligation to vaccinate the world. It will ultimately protect all of us. No one wants to be a clod washed away by the sea. The bell is tolling. 

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