The Moral Dog’s Owner is a Doctor so the usual provisos that her Opinions are hers only do come tweaked with Medical Knowledge gleaned over three decades and a swine flu pandemic.
The Owner is expecting imminent Covid because of close contact. So apologies for hijacking the Moral Dog’s blog but:
How to defend ourselves against Covid
Covid is a new bug for mankind, and like most new bugs that affect us , it jumped to people from animals. Many human diseases jumped from animals, including measles, the bubonic plague, HIV, ebola, influenza and the common cold.
In the modern world we have four defences against new infections:
- Our Own immune systems. Number one in every way, these are brilliant as we have been developing them for hundreds of thousands of years. They are why we don’t die from every cold or infected insect bite. They have defended the world’s population, as a whole, against plagues and pestilence since long before we had antibiotics and science. They defend us, much of the time, against cancers. They consist of millions of cells primed to recognise pathogens, neutralise them and remember them for the future.
- Immunisation. This piggybacks onto number one. Immunisations merely give our own immune systems advance warning of what may be coming, so that we can prepare. Immunisation is probably medicine’s greatest gift to the world. It has nearly eradicated polio. It eradicated smallpox. It protects against measles, which I and my friends all had in the pre vaccine era (some of us died). It protects against rubella. It protects against meningococcal disease, which was something we all expected to see when I was a junior doctor and now see rarely in the UK. Immunisation is a fabulous public health advance. It is imperfect, as not all immunisations are 100% effective, but it also helps with herd immunity (see below). However for Covid-19 we don’t have a vaccine yet, and if we develop one it won’t be for some time. So we can’t bank on that yet, at least.
- Antibiotics and antivirals. These have saved us from many overwhelming bacterial illnesses and a few viral ones. We don’t have one fr Covid-19 yet, although the search is on, and again we can’t bank on it. We don’t have nearly the range of effective antivirals as we have antibacterials. But it is being worked on, as we need it for those whose immune systems can’t do the job themselves.
- Healthy Group Herd Immunity. Herd immunity means group immunity. It means that if most of a population are immune to a virus, the virus cannot circulate in the population, so those who are not immune to it won’t get it. As a population we use our immune systems to kill the virus so that those whose immune systems are not up to the job don’t need to. Healthy Group Herd immunity allows protection of the vulnerable by the immunity that the healthy majority acquire. A population acquires herd immunity either because they have been vaccinated or because they have had the infection. If we want to use Healthy Group Herd Immunity to protect the vulnerable, however, we cannot just let the virus sweep through us all. This approach only protects the vulnerable if the ‘herd’ who catch the infection are the healthy and strong ones. If 60% of all of us, across the board, young and old, have Covid then at least 1% will die. However, if the strongest 60% of us have Covid, the figure could be very very much lower than that. However, it will still not be zero. Some Healthy People do become sick, including critically sick, and need Critical Care. A very small proportion do die, even with the best care. For this reason Healthy Group Herd Immunity is not a perfect strategy. It would be better to have stopped the virus in its tracks. It would be better to have a vaccine, a treatment or, preferably both. It would be better if the virus had not come. But with the virus still spreading and no vaccine imminent, the best we can do is to slow it down, protect those most likely to die, and do the best we can to ensure that those least likely to die have access to the best the NHS can do.
So what does this mean for me and my Covid?
I am expecting to experience the Virus over the next 2 weeks. I do not regard myself as at risk as I am under 60 and fit, even though having just had surgery is not great. I am not afraid as, statistically, my risk of needing to go to hospital is low, but I know it could happen. After I have had the virus I should be immune to it. I will then be part of the Immune group, effectively a buffer of Protection for those whose Immune Systems are not as good as mine. And as an immune doctor, I’ll be useful as I can’t pass Covid to my patients.
If I weren’t already almost certainly infected, would I hide?
For my own sake, no. As a low risk individual who treats patients it is better to have had it, if I can have it safely. At the time of writing it appears that I can. I would like to be in the group that becomes immune, not the group that is only safe because others are immune, for my own sake too, so that the virus will not make me hide away again. For a doctor this has obvious extra advantages.
For the sake of this community, however, it is still better to delay acquiring it, because it would be better for our population that the virus spreads at medium speed through April and May than at fast speed through March. This would mean that :
- the numbers affected at any one time was less, even though the outbreak lasted longer.
- we won’t all be off work at once.
- the numbers needing hospital at any one time will be less.
- we may know more about possible treatments
- the outbreak would be in the spring and summer, when our NHS acute beds are not so full.
- it seems likely that we can protect the vulnerable more successfully if systems are not overwhelmed
- we will have enough intensive care beds for the critically ill
Why is everyone so frightened?
Older people, whom we love, are at risk. Front line medical staff, who may get a very high level of exposure to multiple patients with the virus, may have worse infections. So we need to protect them.
The best way to do that seems to be by a massive community effort to contain the virus as far as we can, and allowing only those in the healthy group to expose themselves to it by doing essential work. It looks as if the virus will still spread, but we may have some control over where it spreads, and how fast it gets there.
If we do this then there is a good chance that those who have had it will be permanently immune, and those who are not immune but would be at risk won’t have it. The best method we have to stop the pandemic is ourselves.
I have had Covid. It was mild for a week and moderate for a few days. It is now resolved. The Covid diary is here. It proved nothing to be afraid of in a 58 year old who is normally healthy but who, as it happened, had fairly major surgery around the day she caught it.
Don’t be afraid. Our job is to look out for each other, to be socially responsible, to work together and to save the people we can save. For some of us that is going to mean having Covid. Please don’t panic. Only a small percentage of the normally well will need a doctor. And if you do, we will be there for you.
Hergest the Hound
I am a dog of many thoughts.