• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    COVID-19 Update June 21, 2020: Happy Summer Solstice, In Praise of Dr. Amy Acton, a Day in Texas

    By Dr. Arthur Lavin

    Glossary

    • Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
    • Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
    • SARS-CoV-2– the specific name of the new coronavirus
    • COVID-19-the name of the illness that the new coronavirus is causing
    • Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
    • Epidemic– a sudden burst of an illness that comes and goes over a limited time
    • Pandemic– an epidemic that bursts across the world not just one region
    • Spreadability– how contagious is the disease, how many people will end up infected
    • Symptoms– the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
      • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
      • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
    • Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
    • Mask– a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
    • Respirator–  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
    • Personal Protective Equipment (PPE)– PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
    • Ventilator– a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
    • Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
    • Antibody Test– (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.

    Spreadability

    The world is featuring a number of trends of the SARS-CoV-2 virus spreading:

    Happy Summer Solstice

    As I write this post we are in the summer solstice, for everyone North of the Equator (winter solstice for everyone South).  The actual moment will come at 5:43 PM , Eastern time zone on June 20.  This means from 5:43 AM Saturday to 5:43 AM Sunday, again Eastern time, there will be the most hours of daylight for all of us North of the Equator.  Tonight will be our latest sun-down of the year.

    This moment settles the question we held our breath to know the answer to in March, April, and May- will COVID-19 go away when summer arrives?  We now know, the answer is no, for it is spreading just fine, even with the most light, even with the most heat.  It is not seasonal, meaning that we cannot plan on being safe because it is summer.

    A Split US

    Part of the nation right now is seeing COVID-19 decline.  Fortunately for those of us here, Ohio is enjoying a respite.  This is of interest, because Ohio is open, people are gathering, a large number are throwing caution to the wind, and yet our cases are low.  As of June 17, across all the hospitals of the entire UH system, only 49 people had COVID-19, a low number.   This does not mean that we are out of danger, only that the virus is not transmitting right now.

    Part of the nation is seeing COVID-19 raging.  We know this is happening across the South and West with AZ, TX, and FL noted prominently.

    45 Nations have Substantially Stopped the Spread

    The MIT scientist at www.endcoronavirus.org currently counts 45 countries that have brought the number of new cases each day close to zero.

    These nations are on every continent there are nations except N America, and include many democracies.

    69 Nations have Failed to Stop the Spread to any Meaningful Degree

    The same MIT scientist counts 69 nations where the number of cases has not been meaningfully reduced, or is climbing.

    In Praise of Dr. Amy Acton

    For those who are not familiar with Dr. Amy Acton, she was the Director of the Ohio Department of Health when the COVID-19 Pandemic hit Ohio.

    As noted above, Ohio has experienced low levels of infection.  The success of Ohio has been largely credited to its decisions to close schools and businesses early, a plan built squarely in sound science, which was explained and put into practice through the work of Dr. Amy Acton.  Dr. Action is indeed a scientist of public health, trained and certified as such, and has devoted her career to the laudable notion that science can save lives.

    She has.

    We give credit to Governor Mike DeWine, who decided to begin his response to the COVID-19 Pandemic by following, very carefully, the best that public science knows about how to cut down on lives lost by epidemics, which is to say, but following the advice of Dr. Amy Acton.  The result is that Ohio is routinely recognized across the nation as one of the most thoughtful, effective states in responding to the threat of this Pandemic.

    In any normal time, this work by Dr. Amy Acton would be rewarded.  And in many ways it has been.  She has received not only the confidence of our Governor, but led the way in fashioning policy.  She has been praised around the nation and the world.   The vast majority of people who live in Ohio, including this doctor, remain profoundly grateful to her.

    But not everyone.

    A very dangerous group of people decided that the idea of sparing Ohio from the worst of the pandemic was an outrage, and took their protest to her front lawn.   Not only did they disagree, they were agents of hate, who rally around the thrill of threatening groups with violent death, including people of color and Jews.   They gathered on her lawn, chanting anti-Semitic chants, threatening her life.   She had to have constant security.

    Further, right-wing business owners upset that their businesses were affected by efforts to keep Ohio alive, began to sue her for loss of business.

    Threats to her life, on her lawn, lawsuits launched likely played some part in her recent resignation as Director of Ohio’s Department of Health.  If so, what a tragedy that our state, protected by her efforts, her knowledge, and the wisdom it took centuries for humanity to earn, were so dangerously rejected.

    So at this moment, when we are enjoying a lull, which hopefully will last, from the tragedies of the COVID-19 Pandemic, we pause to say thank you to Dr. Amy Acton and the wisdom she translated into  actions.  And to note with some dread the forces that have been allowed to push her wisdom away from us, and threaten her with harm.

    A Day in Texas

    Just a few days ago was Juneteenth, which became a holiday to celebrate on June 19, 1865, in Texas.  Some people have been asking me about the meaning of Juneteenth and since my Mom is from Houston, and my Dad’s Mom is from Galveston, it made sense to share what I know.

    On December 24, 1860, soon after the Election of 1860, the state of South Carolina’s legislature voted to leave the United States for the express purpose of securing the practice of enslaving many of its people in perpetuity.   Lincoln would not be sworn in until March of 1861, but from this time through April 12, when South Carolina fired the first shots in the Civil War to protect slavery, Lincoln did all he could to make the war about restoring the Union, not ending slavery.   Even when it became clear he had to issue an Emancipation Proclamation, on January 1, 1863, he was careful to only free slaves in territory still ruled by the Confederacy.  It had no impact on slavery in lands already conquered by the North by that day.

    So, on that New Year’s Day of 1863, no slaves were freed.  The 3.5 million Americans enslaved in territory still ruled by the Confederacy would not be freed until a Union Army conquered their land and set them free.  As the North did conquer areas of the South, those slaves were freed.

    A great many of Americans enslaved were freed on April 9, 1865, almost exactly 4 years after Fort Sumter began the War.  This was the day Lee surrendered to Grant at Appomattox.  All areas ruled by armies loyal to Lee surrendered that day too, and across those lands Americans were freed of slavery.   But not all the Confederacy gave up on April 9.

    Texas clung to enslaving people, even after Grant surrendered and its slaves remained shackled for another 2 months and 10 days.  It is around June 19 now, imagine or feel how long ago April 9 is to you now.  What was Texas thinking?  The whole Confederacy lay in defeat, loss by Texas to the North was guaranteed.  But this was the draw of being able to enslave another fellow human, they couldn’t give it up.  Not until the Union Army walked into Texas on June 18th, at Galveston.  General Gilbert Granger issued an order the next day, June 19, that ended slavery in Texas.  This is the moment celebrated by Juneteenth.

    Six months or more later in December 1865, slavery in all of the United States ended when the nation ratified the Thirteenth Amendment, on December 6.   In Texas, slavery’s end was not formally adopted until its Supreme Court said so in 1874, probably while my Dad’s Mom’s family had moved to Galveston.

    BOTTOM LINES

    1. We are in the summer solstice, enjoy the warm weather, the many more hours of sunlight.  But unfortunately, the summer does not bring any real break or end to COVID-19
    2. The world is in a mixed range of risk for this illness.   In the US, Ohio joins a number of states with numbers of cases dropping, but many states are seeing serious surges.  Just so across the world with Africa and South America and India in serious outbreaks, much of Europe and SE Asia in decline.
    3. Here in Ohio, credit must be given to Dr. Amy Acton, until recently our lauded Director of Health.  Her wisdom and care for our lives was met by vicious threats on her lawn and lawsuits.  We applaud her thoughtfulness, we decry the threats to her health.  She demonstrates the power of science to heal, and the power of madness to harm.
    4. Speaking of madness, June 19, or Juneteenth marks a celebration of ending of slavery in America, a monumental step that has yet to be completed.

    To safe and happy summer!

    To your health,
    Dr. Arthur Lavin

     

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