A Charlie Brown Life

The whole world seems to be conspiring against me. I am just asking for a little help for ONCE in my life! - Charlie Brown

There was a man in the land of Uz, whose name was Job; and that man was perfect and upright, and one that feared God, and eschewed evil.

Job and His Friends, Ilya Repin

God is life, and life is God.  In talking or reading about life and God, I like to replace the word “God” for the word “life”, and vice versa.  Simple phrases like, “I love life” become “I love God”, or “life is hard” becomes “God is hard.”  This seemed to be the case with the Hebrew god of the Old Testament.  Cain experienced that life, or God, for some unknown reason does not always accept our sacrifices, and we are not always rewarded for our efforts.  He therefore became bitter and slew his perfect brother who seemed to have all the breaks, whose sacrifice was accepted and rewarded.

Job was also a man who offered his best efforts, and his sacrifices also seemed to be rejected, as he suffered the death of family, loss of fortune, rotting skin and stench, and was betrayed by friends.  Yet he remained true to God and life, and was rewarded in the end for his perseverance.  

My favorite comic strip as a kid was Peanuts.  It was always the main feature on the front page of the color Sunday comics.  Those kids with big round heads and their ridiculous human-like dog provided more than just humor.  It was much deeper, and the main character, Charlie Brown, is reminiscent of an ancient archetype. 

In addition to the comic strip, Charlie Brown was the central figure of subsequent TV shows and movies.  Most recently released was The Peanuts Movie in 2015.  It is a fun and silly cartoon which pays pleasant homage to every major Peanuts theme.  I found this movie to be one of the most moving pieces of cinema art I have seen in recent years.

The decades of comic strips portrays Charlie Brown as desperately trying his best to succeed, and to make the right sacrifices while staying true to his friends. Yet no matter how many times he tries, he fails, and not only that, but he is hurled to the ground so hard that he is knocked senseless.  His baseball experience is classic. With great determination and hope, he stands on the pitcher’s mound.  One last pitch will strike out the batter, and win the game.  He hurls his best fast ball, and it comes back at him like a cannon ball, line drive and hurls him into the air, all of his clothes flying off, and he slams into the ground in a dizzy stupor.  A similar thing happens when he tried to fly kites.

Most famous of his fails, come with his attempts to kick a football. He trusts his “friend” Lucy to hold the ball for him, and despite being betrayed by her countless times before, he always trusts her again.  This time he will do it, he will kick the ball through the goal.  Lucy has promised she will hold the ball this time.  This time she will be true.  As his hopes mount, you share his optimism, you believe he will actually kick the ball this time.  And then he runs, full of determination and perfect hope, and as he puts all of his speed and swing into the kick, Lucy again moves the ball, another betrayal.  Charlie Brown once again flies into the air, and crashes hard into the ground, laid out on his back, dizzy and reeling, confused and dejected. Then Lucy stands over him again and pronounces the great philosophical concept he has just learned.

Betrayal

The Peanuts Movie continues with the theme of Charlie Brown failing over and over again.  Yet he always succeeds at continuing to hope, at not becoming bitter, and at being true to principles of good character, namely friendship, honesty, kindness, and determination to keep trying.  

Toward the end of the movie, Charlie Brown has a very important personal mission to fulfill.  He has a special pencil that he is to return to the girl of his dreams, the famous “Little Red-haired Girl.  He has a huge crush on her, and this has caused such self-consciousness and fear, that up until that moment he has not succeeded in finding the courage to approach her.  She is about to leave on the a bus for summer camp, and this is Chuck’s last chance to return the pencil and speak his heart to her.  

Laying between Charlie Brown and the bus is an amusement park, filled with school kids having the times of their lives, oblivious to the desperate need of Charlie Brown.  It is a gulf he must cross.  As he navigates this uncaring world of amusement seekers, everything seems to go wrong.  He is blocked, tripped, trapped, or misdirected at every possible turn.  

At the final turn, he is blocked again by an ice cream truck and all the other children who in their glee have run to it, creating an impassible barrier between him and the red-haired girl. Hope is all but dead, and he utters, “The whole world seems to be conspiring against me. I am just asking for a little help for ONCE in my life!”  Unexpected help does come and literally lifts up Charlie Brown and delivers him with a few bumps and bruises along the way.

When I first saw this movie with my family years ago, I sobbed at that moment in the movie, and my kids didn’t understand why I would be crying at a cartoon.  I understood what it meant, that God would lift us and grant a miracle, but that miracle still would deliver some bumps and bruises. I also knew that my miracle would not be the kind I was hoping for.

At that time, my late wife Julie, had two years to live.  I knew she as dying, and I was trying to hope for a miracle, “for once in my life.”  The looked for miracle, the one that I prayed for, didn’t come, and the rest of the world didn’t care, they were happy and eating ice cream.  Or, that is how it seemed for a time as I allowed bitterness in.  Yet many in the world did care, and showed our family great love in action, and came to my rescue. A miracle of caring people.  

I am no Charlie Brown. My character has not always been 100% steady. My sacrifices have mostly paid off. Life and God have been merciful. The tragic loss of my wife was a bitter experience and is still a hard trial for me. I hope to never experience anything like it again, but there is a good chance I will experience other tragedies. Life is hard at times and still, I love life.

Sooner or later most of us will experience a portion of the Charlie Brown life.  Our sacrifices won’t be good enough, and life will not give us the success we think we have earned, or the love we think we deserve.  The world can seem especially lonely, with few that care about anything but their own amusement.  Then what.  Do we withdraw, stop trying, too tired to hope again?  Do we become bitter and full of contempt for others? 

Job, like Charlie Brown, may be a mythical character, yet mythical characters have deep truths they are representing.  Truths about the power of faith, hope and love.  Truths that a divine power will redeem and lift us in the end.  Until that end comes, Charlie Brown, as Job, is a pretty good model of persistence, to keep working and keep hoping, to keep trying to live a virtuous life, to keep trying to reach out to others and to be a friend.

Philosophers and Friends, A Charlie Brown Christmas

The creator of Peanuts, Charles Schulz, was a religious and spiritual man, who often included overt christian themes in his cartoons.  He passed away 15 years before the release of The Peanuts Movie, yet it was an amazing reproduction of his ideas and ideology.  

Schulz made it a point to emphasize the true meaning of Christmas in the 1965 TV cartoon, A Charlie Brown Christmas, by having Linus read the account of Jesus’ birth from the King James Version of the New Testament:

And there were in the same country shepherds abiding in the field, keeping watch over their flock by night.

And, lo, the angel of the Lord came upon them, and the glory of the Lord shone round about them: and they were sore afraid.

And the angel said unto them, Fear not: for, behold, I bring you good tidings of great joy, which shall be to all people.

For unto you is born this day in the city of David a Saviour, which is Christ the Lord.

And this shall be a sign unto you; Ye shall find the babe wrapped in swaddling clothes, lying in a manger. 

And suddenly there was with the angel a multitude of the heavenly host praising God, and saying,

Glory to God in the highest, and on earth peace, good will toward men. 

Christians believe that Christ has the power to redeem the sinner.  In The Peanuts Movie there is also the message that God will, in the end, lift the suffering soul who is trying in earnest.  It is the Job story.  I don’t know how intentional Schulz was in modeling Charlie Brown after the Job archetype, but he apparently understood Job, who uttered, “And though after my skin worms destroy this body, yet in my flesh shall I see God.”

Merry Christmas

The Birth of Jesus Christ, Carl Bloch

“I Am” -Sleeping Out Under Stars

Sleeping out on a moonless, clear, summer night is an awe inspiring experience. Sleep out with your kids and look up at the stars and talk, or just lie in silence and let your mind wonder. I still remember remember as a kid asking deep questions about the origins of the universe, as I gazed deep into the Milky Way one night…

There was no moon. There were no lights except the stars. In the country there were no nearby streetlights. Occasionally a car would pass down the country road and send shadows of trees dancing through the yard and on the house. Then darkness except for stars. 

The warm day of work in the hayfields had given way to the cool of the night, just cool enough to lie in a light sleeping bag on the back lawn, surrounded by hay and wheat fields, teaming with chirping insects. Faintly the occasional trickle of water was heard as it would eddy in the irrigation ditch 100 feet away. 

The air was full of fragrance, with cool, fresh-cut hay dominating. There was also the smell of grass and of a wet garden with tomato plants and corn. Lilies and a clump of mint planted by the house added sweetness to it all. To the farm boy it was all ambience for a curious mind. 

The Big Dipper was easy to see, even the Little Dipper, all seven stars could be clearly seen, so clear was that night. The Milky Way was cutting diagonally through the sky from southwest to north. Yes it was milky, but the boys mind saw stars in that haze, and the haze became billions of tiny glittery specks in his mind. He was lost in that space, and he wondered. 

“How did it all come to be?”

The 13 year old brain comprehended less than he would at 55, but thought more clearly. For the first time in his life he wondered about the real beginning. “Was there a creator? Who was the creator's creator? Who was the creator that created the creator’s creator…”

Suddenly he felt sick, dizzy and empty all together at that question. “Why?” That was a strange feeling; a very unpleasant, strange, confounded feeling. 

“Where did the matter come from?  How could it have a beginning?  If there was a beginning to matter, before matter there would be…nothing. Impossible!  Matter can’t come from nothing.”

The only thing that made any sense was that nothing should exist, only that idea would make with his mind stop reeling in confounded stupor. Yet here he was! He was real, and so were the noisy crickets, the water, lilies, corn, grass and the hay he would be bucking at 5 AM. 

“I AM!” 

The boy gazed at the billions of stars, inhaled the sweet, cool night air, and slept.

In the Moses story there is a point when Moses asked God for His name, “And God said unto Moses, I AM THAT I AM”. This may also be translated, “I AM THE EXISTING ONE.” No matter what we think we know, whether atheists or believers in God, there is one thing we truly know. We exist!

Remember the Fallen Heroes

If today you haven't shown any acknowledgment for these heroes, then shame on you. Pull your head out of the sands of entitlement and grasp the reality that your gift of freedom is sustained through the blood of those who can't spend this holiday making fun memories with their families. -William Legge, USAF, retired.

Into the Jaws of Death, Omaha Beach, June 6, 1944

I lost the woman I loved to a long and tortuous death due to an incurable and slow growing cancer.  Her one aspiration in life was to be a mother, and she threw all of her efforts into educating, nurturing, feeding and playing with her children.  She left behind seven. She wailed and mourned through the months she was dying and leaving them, but she raised happy children who felt love, and a desire to live free.

Every day I memorialize her and shed a tear.  I shall visit her grave this weekend, and the grave of my father and mother, and her father and mother.  Yet, Memorial Day is not for her.  It is not for victims of any disease.  

Congressional leaders have petitioned the President to order flags flown at half-mast for COVID-19 victims.  The President agreed to this kind gesture, but not on Memorial Day.  He stated that the flags would be flown at half-mast on that day to honor our fallen military dead.  Hurray!  Remember that, Memorial Day is a day to honor those who have bled to death in securing our freedoms.  

Very few of us know or can comprehend the horrors of battle, which cause stout-hearted men to defecate in their pants.  The closest most will come to understand these horrors, is by watching the first 20 minutes of Saving Private Ryan, and it is just a small taste.  If you have never done this, you need to.  I will be watching it again with my teenage boys this weekend. 

I recently read an article in Politico which talked about “good things” that would hopefully come about due to COVID-19.  One of those “good things” was a shift in patriotism, away from honoring military members, and more toward honoring medical personnel and small business owners. 

This angered me as a veteran, and as a medical person and small business owner.  I was angered at the ignorance that trivialized patriotic honor, the ignorance of the warriors sacrifice, and it felt like an assault against those that defend American freedom. 

I do not deserve patriotic honor, though I am willing to accept it as a veteran out of respect for other veterans and fallen heroes who do deserve that honor.  I do not deserve that same patriotic honor by virtue of being a doctor or small business owner.  

I am grateful for my plumber as I am my doctor. Nurses, civil engineers and plumbers are all noble parts of a process that keeps us healthy. I have clean water and waste disposal which keep me from getting sick. My home builder provided me with shelter to keep me safe. All were paid, but they all gave real service too.

Every American who works to provide for his or her family, who gives good service, and values freedom deserves honor; but don’t confuse their sacrifices with those that have died defending that freedom.  Those who stood against the enemy in the horrors of combat, and spilt their blood deserve a more sacred honor, a truly patriotic honor.  They are the ones that deserve every flag at half-mast.

My inspiration to write today, came from a Facebook post many years ago.  William Legge is an Air Force friend who wrote this scathing rebuke of those of us who only see Memorial Day as a fun day to make memories with family.  Here is a portion of what he wrote: 

My son came home from class confused stating he was taught Memorial Day was a holiday to celebrate all who ever died. WRONG. It is a day for "remembering the men and women who died while serving in the military." Do NOT dilute the respect due for their sacrifice by including remembrances for those who did not 'give all' for our nation. Pick any other day of the year to remember your civilian dead, but on this day YOU yourself hang the flag in your yard in remembrance, YOU bend a knee to give a prayer of support for those Gold Star families, and YOU visit the grave of a fallen hero to pay respect. Their final resting places are easy to find -- Google 'national cemetery.'  If today you haven't shown any acknowledgment for these heroes, then shame on you. Pull your head out of the sands of entitlement and grasp the reality that your gift of freedom is sustained through the blood of those who can't spend this holiday making fun memories with their families. -William Legge, USAF, retired.

Become Resilient and Immune to Colds, Flu and COVID

The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.  -William Osler

Jenny was sick and tired of bringing her 8 year old son Blake to the clinic.  He really wasn’t there as often as she felt, just their third visit this winter, but Jenny was frustrated and exclaimed:

“He is always sick!  He has no energy.  He is grumpy all the time.  He eats alright, I mean, not the best, but OK.  Is there something we can give him?  Is there something wrong with his immune system? He gets headaches, stomachaches, and he often has a sore throat!  It takes him forever to get over a cold!”  

A thorough history and exam were completed and a few common tests were done.  Blake did have decreased immunity and resilience, but was an otherwise healthy kid.  His immune function would appear normal on all tests.  There was just one simple thing he was lacking that would make all the difference when restored.  Sleep!

Immunity and Resilience

Immunity is just part of being resilient.  The body also needs to repair itself once injured by infection, stress or any other injury.  Both the ability to quickly repair oneself, and immunity, make one resilient to infections.

Sleep, Not Just Rest

Blake was getting about 8 hours of sleep each night, at least 2 hours short of what he needed for his age.  Adequate sleep varies with age, most of us are not getting enough.  Toddlers and preschools may need to sleep 12-14 hours in a day, including naps. Young school age children need 10-11 hours. Older grade school children 10 hours, and teens should get 9 hours. Some days more sleep may be needed to recover from the physical stress of sports, work or illness.

In our current culture of staying up late, usually on electronic devices/screens, most of us lack sleep.  The devices also make us wake up more in the night, and wake up earlier in the morning.  Here are steps you can take to get a good nights sleep.

1. Stay on a routine schedule, same time each night.  Kids and adults both thrive with routine.  Do the same routine each night as you prepare to sleep.  If Blake needs 10 hours of sleep, and needs to wake up at 7 AM, bedtime should be 8 PM.  That gives him an hour to prepare for bed; bath, get jammies on, brush teeth, have a story and get in bed 30 minutes before 9 PM.  Don’t blow it on the weekends.  If your bedtime is 10PM Sunday through Thursday, it shouldn’t be later than 11PM on Friday and Saturday, even though you can sleep in the next day.

2. NO smart phones or other screens in the bedroom.  A child’s room should always be free of digital electronic devices.  Same for teens, and probably you too.  Use an alarm clock so you don’t have to have your phone by your bed.

3. No screens when you first wake up.  If you or your child is used to watching TV or reading emails first thing in the morning, your brain will trigger an early wake up time.  (Remember as a kid waking up at 6 AM to watch Saturday morning cartoons, even though you stayed up late watching a Friday night movie?)  Kids should avoid screen time before school.

4. Stay active and exercise each day to help you sleep better.  

Vitamins, do you really need them?

The word “vitamin” is a contraction of “vital amines”.  So yes, they are vital and absolutely needed for function and repair of your body, and without them you would die.  During the age of ships and sail, half of the sailors on some ships died from scurvy because of lack of vitamin C.  In the late 1700’s they began taking lemon juice or other fruit with them which completely prevented the scurvy.

Vitamin C, D, Zinc and other vitamins and minerals are needed to repair the body.  In recent years it has been very popular to take large doses of vitamins and minerals to increase immunity.  It is not clear that taking supplements beyond what someone gets from a balanced diet is really a boost to immunity.

We love to take pills.  It makes us feel like we are taking action, and it is easier than exercise, eating right and going to bed early.  But the best source for vitamins and minerals are good foods.  They contain healthy substances we may not even know of.  So remember to “eat your vitamins”.  

I don’t object to taking supplemental vitamins, it isn’t a bad idea in reasonable doses, and I take them at times.  But taking them will never compensate for a bad diet or lack of adequate sleep.

Food, Eating Your Vitamins

You get the best vitamins when you eat the best food.  We haven’t proven that large supplemental doses of vitamin C, D or zinc prevent colds, but we do get health benefits from eating vegetables (I am partial to tomatoes and greens) and fresh fruit, (especially citrus and berries.)  I do like to eat extra veggies and fruit when I am sick, if nothing else I am mentally encouraged by doing so. I just feel better and should do it all the time.  I confess to taking some extra Vitamin C when I have a cold, even though I can’t prove it works.

We eat many foods that are bad for us, such as sugar, sweets, fat, smoked food, grilled food and excess food. Poor eating increases our risk of obesity, cancer and heart disease, which decreases our resiliency.

Eating healthy may not directly increase your immunity in the short term, but in the long term changing to a healthy diet will increase your over all health, and will make your body more resilient to infectious diseases.  Deciding to eat salad this week instead of burgers probably will not prevent me from getting COVID-19 today, but eating right and controlling weight will help me not get as sick with COVID-19 or other illness in the future.  

Stay Physically Active

Stress is bad for your immunity.  Exercise relieves stress.  Staying active throughout the most of the day, and daily exercise will help you fight infections.  It will also help prevent obesity and other health problems that put you at risk for complications of COVID-19.  However, high levels of exercise in ultra athletic pursuits may weaken your immunity.  So if you are training for a marathon make sure you put your body in the repair shop and get extra sleep!  

Stay Away From Sick People

Stay away from strangers who have a cough and fever. When you can, keep your distance from family members who have cough or fever.  If your children are sick, don’t let them climb into bed with you.  Don’t let a child with a cough or fever play with other children. 

Stay Socially Active

We are social creatures, and social connection and human touch help increase feel good chemicals in our brain and body.  Depression is not good for our physical resilience, and physical isolation for too long increases our risk for depression.  Social distancing may be a necessary evil for now, but it is not a good long term strategy for optimal health.  

Exposure in some degree to people and the viruses we live with is needed to maintain optimal immunity, to acquire immunity.  We should always avoid prolonged exposure, or large doses of viruses, by avoiding people who are coughing or have a fever.  Also, follow current guidelines for social distancing until no longer required.  Eventually we will need to start touching again and have meaningful physical and social interactions with others.  

Vaccines are Vital

Vaccines that are currently used for routine childhood vaccination are safe and effective. Everyone has to discover on their own whether or not to vaccinate. There is no question that vaccines are the greatest healthcare invention of all time, responsible for saving more lives than all other medications put together, and much more safe than other medications.

Vaccines prevent meningitis, whooping cough, pneumonia, tetanus, measles, and hepatitis to name a few. Polio and small pox have been essentially eliminated because of vaccines.

Yearly flu vaccines help protect against differing strains of influenza, and also help to cross protect against other strains. Each year’s flu vaccine may help boost the vaccines effectiveness from prior years.

If you don’t vaccinate and you feel safe because you and you family are healthy, remember that you are healthy in part because of the efforts of those around you. If there were no vaccines, you would see people close to you die of vaccine preventable disease. If you don’t vaccinate, consider looking into the issue more, and discuss vaccines with your health provider. Simply put, they save lives!

Sleep Works

Jenny was skeptical that sleep would help Blake.  It wasn’t the first time we had had that discussion, but she decided to give it a try.  I ran into her couple of months later, and she told me that Blake was a new kid.  He was happy, not the grumpy, ornery, fatigued child she had known.  And best of all, he was no longer sick.  

War of the Worlds and COVID-19

The opinions in this article in no way constitute personal medical advice. Any symptoms of illness you are experiencing should be taken to your local health care professionals.

“The War of the Worlds” is a fictional story by H.G. Wells written over a century ago.  It tells of Martian invasion, in which highly evolved aliens invaded earth in their tripod machines.  The Martians were technologically advanced but physically weak.  Our military technology was no match for theirs, and they massacred us.  

When all hope was lost, the Martians all died from infection by earth’s microorganisms.  The Martians had not coevolved with earth’s germs, and thus they were not fit for planet earth, and it destroyed them.  

Isolation and Weak Immunity

In the history of the world, the most isolated people have been the most devastated by infectious diseases when finally exposed to the infectious diseases of the larger world.  Prolonged isolation prevents evolving or acquired immunity and thereby lessens our immunity.  It is estimated that infectious diseases such as small pox, measles and influenza introduced by European colonization killed over 80% of the relatively isolated native population in The New World.   

The 1918 Spanish Flu spread over the planet and killed an estimated 50 million people, with the greatest mortality rates occurring in isolated communities.  The small isolated village of Okak, Labrador lost 204 of its 263 villagers due to the flu. 

In the Pacific, islands that were more isolated had greater mortality rates due to the Spanish Flu. Mortality rate on isolated Samoa was 22%, while the less isolated Hawaii was 0.4 %. Studies of Spanish Flu on isolated islands found that people that had already had contact with the outside world, and been exposed to many different respiratory pathogens, experienced less disease and less mortality. 

Infections with many different respiratory viruses prime and train the immune system to fight other respiratory viruses, including the new viruses and the more deadly viruses.  

Camp Funston, at Fort Riley, Kansas, during the 1918 Spanish flu pandemic

Recent studies have shown that as adults isolate themselves and age, they loose much of their immunity they once had, that might have otherwise protected them against respiratory viruses. Adults infected with common cold viruses are less likely to become ill if they are more socially connected.   

Why are Children Protected Against COVID-19 

Novel coronavirus that emerged in 2019 was named SARS CoV-2, and the disease it produced is called COVID-19. From here on I will simply use the term COVID-19 to mean both SARS CoV-2 and the disease it produces. As of April 2020, only 1.7 % of positive cases in the US are in people under 18 years. Children that do test positive also have more mild symptoms than adults.

Modern children get many more viral infections than adults.  Their physical activities, social habits, daycare and school attendance expose them constantly to infectious organisms.  Yet most of the time they get much less sick than older adults, despite the more frequent infections.  Respiratory Syncytial Virus (RSV) is a common cause of hospital stays in children, but deaths in Children from RSV are uncommon in the US, about 100-500 per year according to the CDC.  Among older adults deaths from RSV are more common, 14,000 annually in the US.  

Frequent viral infections and vaccines in children “train” the immune system to be more effective against a variety of different and new viruses.  Exposure and subsequent immunity to one type of virus helps protect against other similar viruses.  This is called cross immunity and is why influenza vaccine for one strain still helps to protect against other influenza strains.  

There are many strains of coronavirus.  Children are often getting exposed to and infected by these coronaviruses.  The high rate of exposure to these coronaviruses, and the ensuing trained immunity and cross immunity, is partially what protects children from COVID-19.  Other factors such as better overall health, and better regulated immune responses also greatly help the young not get as sick with COVID-19.  

Vaccines and Waining Immunity

Developing an effective vaccine would be the best possible solution for COVID-19, and there is hope.  It may take 18 months, if not years, to develop an effective coronavirus vaccine, and some doubt it will ever be possible.

Immunity to respiratory viruses wains over time, sometimes rapidly. That is one reason why we get flu shots every year (the other is that prevalent strains change from year to year). 

Coronavirus immunity seems to wain quickly in some people.  Some people may have already become ill with COVID-19 more than once. Coronavirus immunity may require either recurring infections or recurring immunizations to maintain.

Vaccines need to be safe and must go through extensive trials to ensure that they are effective and safe. Attempts to develop RSV vaccines have failed for 60 years. The initial vaccine for RSV was not only ineffective but caused a worsening of the disease in some. Our current vaccines for influenza are very safe and very effective with decades of development behind them.

Long term isolation and decreasing the overall exposure to respiratory viruses can result in waining immunity.  What duration of isolation will cause this to happen?  One year, five years or ten years?  It is relative; the longer we go without boosting immunity, the less immune we become. 

COVID-19 is here to stay.  There is a high probability that most of us will eventually get infected.  If that happens before a vaccine is ready, we will have to rely on our natural immunity. If we continue to practice isolation and social distancing for too long, will we and our children become less resilient to COVID-19, and other viruses?

Life in a Bubble

The consequences of living in isolation are incalculable. Loneliness, senility, earlier death in the elderly or those on hospice, depression, anxiety, suicide, decreased intellect, crime, homicide, joblessness, hunger, poverty, loss of fortunes, loss of small savings yet everything for some, loss of funds for humanitarian projects, children becoming obese, all of us becoming obese, diabetes, domestic violence, divorce, screen dependence, alcoholism, drug use, poor fitness, heart disease, emergence of vaccine preventable diseases, and death.

A good argument can be made that more people could die because of our responses to COVID-19 eventually, than from COVID-19 itself. No-one will ever know. No accurate models can be constructed either way.

Cancer patients are really in a conundrum. On one hand they are at very high risk of complications from COVID-19. On the other hand they are very dependent on the contact of medical personal and family members. In many centers they have to go to their appointments and treatments alone. They sometimes fear they are stepping into COVID soup when they enter a health care facility. They are often deeply afraid to be alone without that spouse or friend who typically helps them. My dear wife died of cancer, and I can’t imagine having been denied entrance into the cancer center to be with her and support her. Yet I would also be afraid of her being exposed to someone who was ill.

The poor and elderly are struggling in all ways. They suffer more from COVID-19 infection, but they also suffer more from the fallout of isolation.

We are willing to sacrifice much to save lives. It speaks well of humanity. We are sacrificing extended family relations, helping neighbors, making new friends, dinner parties, drinks with buddies, kind expressions, seeing smiles, handshakes, hugs, human connection, and real romance. There are educational and economic sacrifices: college classes, jobs, and business relations. We are not lifting others out of poverty, supporting the struggling street vendor or local small business. What happened to community service and freedom to assemble? People are very willing to sacrifice fun activities like group fitness classes, big races, sporting events, amusement parks, going to the beach, travel to new places, and the museum, but we miss kids at the playground, kids in a classroom, kids visiting grandparents with hugs, being with dying loved-ones, and holding a spouse’s hand when she is informed of terminal cancer. We are sacrificing mental health, physical fitness, cardiac health, joint health, and immunity, even skipping vaccinations.

Containment and Quarantine

Total containment of COVID-19 is unlikely.  COVID-19 is here to stay and will continue to spike off and on for unforeseeable years to come. We are now a global community and new highly contagious respiratory viruses spread to every nation. The spread is not anyones fault. No matter what, there were going to be hot spots in places like New York City where larger numbers of people were circulating the virus before anyone knew it was there, but we love to find someone to blame, the officials at CDC, the WHO, or whatever government official we despise. I believe they are all trying to do their best.

Quarantine is not what you think.  It is not what most of you are doing.  Quarantine is the isolation of people who have a disease, who have been exposed to a disease, or who have returned from a place where a disease is prevalent.  It is proper to use the word “isolation” when referring to isolating someone who has a known infection, and using the word “quarantine” to refer to isolating someone who may have been exposed. Quarantine or isolation of someone infected with COVID-19 is very smart.  State officials impose temporary quarantine/isolation of symptomatic people known to have COVID-19, high risk travelers, or others who have known exposure.

Ordering the isolation of all healthy individuals from each other regardless of exposure is not quarantine. Isolation of everyone will slow the spread of COVID-19, but it will not make it go away, and the cost is unmeasurable.

What Does it Mean to “Flatten the Curve”

In simple terms, to flatten the curve of an outbreak means to slow down the rate of spread.  It doesn’t mean decreasing the total number of cases, or the number of deaths, though it could have that effect.  In theory the same number of people may get the disease, the same number may die, but it will be spread over a longer time period, and delay disease and death for many.

Esther Kim@k_thosandCarl T. Bergstrom@CT_Bergstrom / CC BY

Some would argue that the longer we stretch out that curve the better, and maybe a vaccine will be developed, maybe better treatments. Maybe being able to manage the disease in a controlled manner will lead to fewer deaths.  

Others would argue that isolation for too long could result in declines in mental health which would result in more death. A vaccine for COVID-19 may take years or decades to produce, if ever. Prolonged isolation could cause a decline in immunity and result in even more severe cases, not just to COVID-19 but to many viruses. Fallout from economic decline and social-political turmoil would also result in more death.  

Living with Germs

We need to live with germs, and become immune.  We knew this pandemic was coming, and have been talking about it for decades.  We didn’t know what virus it would be, but we knew we were overdue for something like this.

If we could magically wipe out all human respiratory viruses, new ones would eventually continue to evolve from animal hosts and infect us. If we didn’t evolve to live with the viruses, they might infect us with devastating effects because we would lack acquired and cross immunity.  

Immunization rates are rapidly dropping already as people fear coming in for wellness visits.  Will we see a whooping cough outbreak? Will meningitis cases increase again? Absolutely, yes and yes if we don’t increase vaccination rates again. All deaths are tragic, but bacterial meningitis in a child should really scare you. It is over a thousand times more deadly than COVID-19 in children, and survivors usually have permanent brain damage such as severe intellectual disability, deafness, or seizures.

Vaccines, clean water and good sanitation are the biggest three measures preventing disease, and are responsible for billions of saved lives.  Vaccines have resulted in the elimination of Polio and small pox.  We should absolutely practice these examples of the best ways to live in a world of germs and survive.  

“Vaccination against polio began with the Salk vaccine in 1955. In 1952, nearly 3,000 people had died from polio and children in “iron lungs” populated wards in most hospitals. By 1991, however, the disease had been eradicated in the Western hemisphere.” - The U.S. Food and Drug Administration / Public domain

Hope and Advise

The most important additional advice I can give to all my family and patients is to go to bed early. That is the very best way to keep your immune system strong in the short term and it should be emphasized more. Exercise, social connection and healthy eating habits also strengthen immunity.

Wash your hands before you touch your face or after you touch something contaminated. Stay away from anyone who has a cough or fever.

I estimate that I have had over 50 thousand encounters of patients with respiratory infections over my career. I have seen that people have very complex lives, and human well being is more complicated than simply stopping one respiratory virus.

Children are suffering in many ways: anxiety, depression, domestic violence, poverty, poor social skills, poor learning, obesity, lack of sleep, and declining resilience to infections. Those with the fewest resources are suffering the most. They need to go back to school in a way that encourages optimal learning and socialization without barriers to developing friendship. They also need to develop immunity.

If a vaccine is developed I will be the first to celebrate, but I don’t think hinging our hopes on that, and delaying our return to living in a way for optimal health should be extended for long. We are already seeing much suffering from our isolation policies that I believe will exceed our suffering from direct COVID-19 infection.

A Question

My writing is biased by my self interests and ideology. Ideology blinds and biases everyone, especially those that don’t recognize it in themselves. I know in some ways I will error, but I am trying to see a much bigger picture. The scientific community is full of ideologues producing biased research and coming to biased conclusions. Their conjectures are more often wrong than they are right.

I look to my colleagues and other highly learned and humble experts to help sort this out. I expect them to be broadminded and farsighted, to consider all aspects of human wellness, and to recognize their own biases, and not be blinded by ideology.

I would ask them this question again, “What are the long term consequences of isolation on our physical and mental health, and what effect will long-term physical isolation and social distancing have on our future ability to be resilient and immune to all types of illness.”

Further Reading:

Pacific islands which escaped the 1918–1919 influenza pandemic and their subsequent mortality experiences

Epidemiological isolation causing variable mortality in Island populations during the 1918–1920 influenza pandemic

The 1918 Spanish Flu

Is COVID-19 receiving ADE from other coronaviruses?

Will children reveal their secret? The coronavirus dilemma

Social Ties and Susceptibility to the Common Cold

COVID-19 (coronavirus) vaccine: Get the facts

Can We Really Develop a Safe, Effective Coronavirus Vaccine?

You’re Likely to Get the Coronavirus

The Untold Toll — The Pandemic’s Effects on Patients without Covid-19

The Unequal Cost of Social Distancing