Rural doctor: I fear what is happening now in Iowa

Greg Cohen: We need to stop pretending the pandemic is over, because it’s not. -promoted by Laura Belin

Seven months ago, I wrote a letter to The Chariton Leader about my experiences with the COVID-19 pandemic — what was going right, what was going wrong, what frustrated me, and how America had responded. Here’s my follow up.

After more than one year, I hugged my children and grandchildren two weeks ago. I hugged my sister and brother in law last week.  Although the COVID-19 pandemic is not over, all of us have finally been vaccinated and we are now reasonably  safe to be together.  It has been the longest year of my life.

For the last year, health care workers and scientists have toiled tirelessly to protect us. Medications have greatly reduced the chances of our being hospitalized, and we have cut the death rate by 70 percent. After a terrible surge this winter, when I diagnosed two to ten people every day with COVID-related illness, I still diagnose people with COVID–19, but far fewer of them. This makes me hopeful we can end this pandemic sooner rather than later.

Unfortunately, I fear what is happening now in Iowa and across America is undermining that work.

States, including Iowa, have relaxed preventive measures, giving people the misperception that the pandemic is over. Too many of us are no longer taking the simple precautions I noted last August: Wash hands frequently, keep at least six feet from others, and wear a mask covering your nose and mouth when around people you don’t live with. And too many are unwilling to get vaccinated.

Six weeks ago, new daily cases in the United States had fallen under 50,000 after peaking at more than 300,000. Since that time, we have fluctuated between 50,000 and 70,000 cases a day. COVID-19 related deaths still exceed 700 a day after peaking at about 4,000.   This is still as high or higher than when I wrote at the peak last summer.  Much of the world is currently experiencing yet another wave that threatens to send this disease spiraling out of control. We must do whatever we can to minimize the number of people who are getting this disease. The more people who get COVID, the more the chance of catching and spreading new and more dangerous variants that partially or totally resist our vaccines and treatments.

Vaccines are our best hope for ending the pandemic and saving lives. We were hoping for one that would be 50 percent effective. But to have come up with two that are 95 percent effective at preventing infection, and three nearly 100 percent effective at preventing severe disease, was extraordinary!

As I write this, we have vaccinated about 100 million Americans. But I still run into so many people — including many who are at high risk for severe disease or death — who won’t take the vaccine.

To help educate and advocate for my patients, I have read extensively to know just how safe and effective are our three FDA-approved vaccines, from Moderna, Pfizer, and Johnson & Johnson. But I spend so much of my day trying to convince people that this is so:

Although the vaccines’ development was unprecedentedly rapid, they resulted from decades of peer-reviewed research and experience using the best techniques to ensure their safety and efficacy. We have been working on developing coronavirus vaccines since the outbreak of SARS in 2000 and MERS in 2003, and have 15 years of finely tuning the messenger RNA technology used in the Pfizer and Moderna vaccines.

Finally, President Trump’s Project Warp Speed worked! Participating companies received government funding up front so they didn’t have to worry about financial failure if their vaccine did not prove effective or safe. They were also permitted to run required test phases side by side instead of completing each separately, submitting data to the CDC, then waiting for their OK to start the next phase.

And yet, I see people who won’t take the vaccine because of irrational fears stoked by misinformation, mistrust, and partisanship. Many are very educated but believe things that just are not true: “Bill Gates put a tracking chip in it.”… “It will make women sterile.” … “It will change my DNA and I won’t be conservative.” … “It will make me a zombie.”

I don’t have enough space to reply to all of those, but here are two: Thousands of vaccinated women have become and stayed pregnant with no noted ill effects. And, it would be seemingly impossible to individually extract each “tracking chip” from the millions of multi-dose vials and insert them into individual doses. (Also, if you have a cell phone or a credit card, you’re already being tracked.)

People tell me friends and family have gotten vaccine side effects that made them very ill. But we know that fewer than 50 percent of those who take the vaccine have any side effects. And the most unpleasant side effects have been brief and treatable. From my perspective, isn’t it far, far worse to let those we love, and possibly ourselves, get this disease and die?

Yes, nearly 50 percent who get COVID-19 experience few, mild, or no symptoms. But 10 percent of those infected end up in the hospital, and 1 percent to 2 percent die. More than half of those who don’t die are still fighting at least one symptom, months later.  Now some of those who got it are getting it again. At least two of my family members have had COVID more than once and have long-term symptoms.

I hear, “We need to let people get this to achieve herd immunity.” First, we never have reached herd immunity with any disease by letting people just get sick. Second, there is no such thing as herd immunity for a disease like this; it has shown itself to be adaptable, and each variant seems more contagious and more deadly. Third, even after more than a year and multiple waves, at least two thirds of us haven’t gotten COVID-19, making most of us still very vulnerable.

The only way for us to achieve anything close to herd immunity from this disease is to do whatever we can to minimize the number of people who are getting it. Vaccinate 85 percent to 90 percent of us so this thing runs out of vulnerable bodies, and use the tools I recommended last August and still strongly recommend: Wear a mask to keep from spreading it; stay at least six feet away from each other; and avoid spending time indoors with people unless all in your group are fully vaccinated. Otherwise, COVID-19 will keep coming at us in waves. The next wave has already begun.

We have suffered about 580,000 dead (nearly 6,000 here in Iowa). Scientists say that if we don’t double down on our efforts, we’re looking at another 100,000 to 200,000 this year.

We need to stop pretending the pandemic is over, because it’s not. It’s getting worse again.

Just like you, I want to take my mask off and get my life back. I am certain we have the tools to do it.

We have to start by talking to each other, convincing each other, educating each other, doing for each other, listening to each other, and learning to trust each other again. We need to trust the people who ought to know the right answers: doctors, scientists, and epidemiologists who have spent their lives serving Americans. This requires making sure everyone has access to the truth, and being willing to accept that truth.

If we, as Americans, get vaccinated when able and conscientiously use the three tools to stem the spread, in just a few short months we could be able to remove our masks, eat in restaurants, go to movies, and hug our family members.

But it isn’t going to happen unless we unite. I know we can do this. So many times in our history, when facing adversity, Americans have banded together and overcome our differences to complete a national mission. If we can summon our common resolve and our belief in our fellow Americans, we will be able to proclaim “mission accomplished” here too.

Dr. Greg Cohen has practiced medicine in Chariton (Lucas County) since 1994. He was named a Distinguished Fellow by the American College of Osteopathic Family Physicians as well as Physician of the Year by the Iowa Osteopathic Medical Association in 2019.

Editor’s note from Laura Belin: Due to sagging demand, Iowa turned down 71 percent of its COVID-19 vaccine allocation last week, Tony Leys reported for the Des Moines Register on May 1. The Iowa Department of Public Health spokesperson “also said 88 of Iowa’s 99 counties have told the state they won’t need part or all of their weekly allocations of vaccine for the week starting May 10.”

Tags: COVID-19

Login or Join to comment and post.