Monday, October 5, 2020

Who Is To Blame?

The guts of this post were originally written a couple of months ago and it has gotten close to release several times since - yet for any number of reasons I postponed publication.  With the recent whirlwind of ever-changing circumstances I figured now is as good as any time.  

Besides, it is easily adapted to the circumstances of this present moment in time.
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By now you have likely heard that the toll as a consequence of Covid has exceeded 210,000 dead.  

That is a really big number.   

How big you ask?  

It is three times the number of service member deaths in Vietnam.  

It is the equivalent of the entire population of Salt Lake City Utah being snuffed-out.  

It is the highest per-capita death toll in all but twelve other countries.  

It is the largest death count in the entire world. 

The fact that it all happened in the space of only nine months makes it a big deal.

The most protected man on the planet - our President - has been hospitalized after contracting the virus.  That makes this an even bigger deal.  

The fact that President Trump was so recklessly cavalier about the severity of the pandemic makes this cluster of health crisis and economic train wreck a huge deal.  

Anything that could go wrong has gone wrong.

I want to be perfectly clear - Donald Trump is not to blame for causing Covid.  Moreover, I wish the president a speedy and uncomplicated recovery.  

That said, Donald Trump is responsible for having so fragile an ego that he refused to level with me and everyone else about the severity of this pandemic all the way back to January, February and March of this year.  Feel free to read my trail of documentation of his insipid dismissals of the growing crisis. 

He lied.  

He is incapable of telling the truth even when it is in his own best interests to do so. Sure, he and his apologists will insists he did not want to cause a panic.  Guess what?  Americans don't panic.  To suggest otherwise is silly.  And as a consequence of his willful blindness Donald Trump has the blood of my countrymen on his hands.  It didn't have to get this bad.  Yet those unsettling facts are not the purpose of this post. 

An acquaintance of mine ascribes to the notion that Covid is not at all as deadly as it appears to be. He will blithely suggest it is like seasonal influenza (which can be deadly) or the common cold. He will tell you (without the benefit of a medical degree) that when people die as a consequence of contracting Covid it is the result of comorbidity or an underlying medical condition. And that it is exceedingly rare for Covid to be the sole cause of death.  

His implication is that the dead are somehow to blame for having cancer, heart disease, diabetes, chronic kidney disease or some other pre-existing condition resulting from heredity, advanced- age or whatever.  It is their own damn fault - not that of Covid.
  
He will insist they would have died anyway.  

He is correct in that regard - it is a fact that we're all going to die.  It is also factual that virtually all disease impacts are compounded by comorbidity factors.  And to the extent you can make any medical issue less deadly you can extend life-expectancy.  Which is good for those of us with families, grandchildren, plans for a righteously-rewarding retirement, a wish to travel, extending a working career or volunteerism. 

It is also good policy to not be youthfully smug, recklessly invincible and mockingly prideful.  When you choose to dance with the Schadenfreude Devil you do so at your own peril.  Just ask the President.  But I digress. 

Getting back to the Covid thing is the reality that some exposed to the virus do not become infected. Some people who become infected get very sick while others get only a brief fever and cough – or no symptoms at all.  Some people die.

We have learned that middle-aged and older individuals are more likely to become infected,  are far more likely to suffer symptoms, to be hospitalized and to die. Nevertheless, the therapeutics have improved as we learn more about this virus and fewer deaths result from contracting the contagion today than did as few as nine months ago.  This is major medical progress in a short period of time.  Yet this only addresses fatality statistics.

Severe Covid-19 is driven not just by viral damage to cells but occasionally a whirlwind of inflammation that harms the cardio-pulmonary system, along with other organs and the immune system. It would appear that middle-aged and older individuals are more vulnerable to this storm of complications than younger people. You don’t necessarily have to die from Covid – you can simply be seriously compromised as a consequence of exposure.  

What we do not yet know is if these non-fatal complications to an otherwise healthy individual are a temporary or permanent disability.  Of course death is permanent - my point is that it isn't solely about mortality - plenty more additional bad medical stuff can result.  That is called morbidity.  Not to mention the high cost of immediate and ongoing future care.  Stuff like that drives-up healthcare costs for everyone.

So here we are. Donald Trump is in the hospital as a consequence of his known comorbidity factors - namely age and obesity.  He's receiving first rate care and I hope he emerges from this experience healthy and maybe inclined to show some empathy for the millions of unemployed (and consequently uninsured) individuals of our nation.  If I were a White House advisor I would suggest a healthy display of civility and humility.  Decorum and decency could win the election for Trump.  Alas, this is a low probability event.  Besides, nobody listens to me.

And even though we continue to learn more about the new (novel) virus we do not yet know what we do not know.  Speaking for myself the last thing I’m going to do is eschew my primary care doc’s advice for that of some smartass.

The Missus and I have no known serious, underlying chronic medical issues; nevertheless, we do share a common comorbidity over-which we have no control – namely age. We are in our sixties and seventies.

We're OK with our agedness and fully accept and embrace the blame for making it to this point in our lives.  And just like wearing a seat belt and using sunblock we'll continue to conduct ourselves responsibly.   

Taking responsibility for stuff still counts for something.  

Pass it along....


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