From the Desk of Dr. Louis M. Weiner

So, here we are: 2022, still living in the time of coronavirus. Omicron is having its way, predictably, with the world, and with the United States in particular. Remarkably, DC has risen to the unenviable position of being the leading or second-leading SARS-CoV-2 hot spot in the U.S. since my last blog in mid-December. Viral chaos is everywhere. While most infected people are more inconvenienced than desperately ill, the impact of this pandemic wave on our society is profound. Effective vaccination clearly mitigates disease severity, though it certainly does not prevent breakthrough infections. Our university’s functions are constrained, the hospital is challenged by people admitted for COVID (the vast majority of severely ill people are unvaccinated) or admitted for something else, but with COVID as well. Because so many health care workers have tested positive, staffing shortages compound the challenges. Primary and secondary schools are beset by chaotic responses.

We console ourselves by stating (or perhaps hoping) that the infections will cause comparatively minor illnesses, and that this wave may be relatively short lived. Of course, we don’t know yet what will follow this wave — calm waters, or another series of storms? Herd immunity, or variants that evade immunity? A return to “normal,” or a new normality dominated by mitigation strategies? I don’t know, and while I can spin a hopeful scenario, I don’t know that I can plan for one just yet.

At some point, we need to devise better ways as a society to address this emerging, serious endemic, which is punctuated by quasi-pandemic episodes. How do we keep schools open so we can keep society functioning? Is the goal to prevent infections or to minimize their impacts? What measures can we take to minimize illnesses as opposed to infections when the causative agents are highly infectious viruses? What are the roles of vaccines in that context? What responsibilities, if any, do those who choose to refuse vaccinations have with respect to the allocations of health care resources? What is the role of government, and of its public health components, in devising national rules of the road in the face of public health emergencies posed by communicable diseases? And, of course, the bottom line: At what point does the greater good have precedence over individual freedom in this context? These are complicated problems — in some cases the solutions are obvious but difficult to implement due a lack of political consensus, while other questions have no obvious answers.

For what it is worth (as I have no authority in that regard), I am leaning toward favoring approaches to minimize the severity of COVID-related illnesses while maintaining normal societal functions as much as possible. Decisive moves in that regard probably must wait until the Omicron wave has crested and receded. Quite clearly, vaccines should be important components of any effective strategy. I received my Pfizer booster in late September, and hope I will be eligible for my next booster no later than March. We shall see.

In the meantime, work continues, though I am home more than I would like to be. I saw patients on Thursday, and also presented some our lab’s work at the Immunotherapy Working Group meeting. Fortunately, laboratory research can readily continue, as it is intrinsically socially distanced as long as people exercise good judgment. And that is my reminder to all of us to stay safe and be well.

Have a good week.

Lou

The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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