Category: Commentary

By Robert Lehman, MD

Do you happen to know this person I’ll call DD?  To DD, stop signs are merely a suggestion.  It is okay to go through the intersection after the light turns red because the other cars will probably delay before starting.  Only a loser merges when they see the merge sign; DD will race up the outside lane until the lane ends and make others stop so that DD can get into traffic.  DD never follows the speed limit stating “there are plenty of cars going faster than me.”  And DD has never clicked with seat belt laws.  When asked, DD admits to a couple of fender benders, but nothing serious and says, “I never was hurt.”

DD never considers the pain, anguish, and lost income time for the other people in the fender bender.  And when the big one does happen, DD has not considered who is paying the hundreds of thousands of dollars in ER and other hospital charges, the death or permanent injury that might be inflicted on someone else, or the life-long effects that DD’s death or permanent injury will have on DD’s family and friends.

About now you are wondering, “Doc, what does this have to do with me?”

I won’t tell you how many Covid-19 strains exist right now.  I don’t want you afraid to leave your room.  However, there are 4 predominant strains actively causing illness right now, and they are all just a little different from each other.  I will bet that everyone reading this knows of someone who has been ill with Covid in the past few weeks.  And yes, most of those basically had just major cold symptoms.  But there are still people being hospitalized and dying from Covid-19.

You remember those vaccines we had roughly 2 years ago?  Those vaccines won’t work on these strains.  And do you recall that seriously ill people were being treated using monoclonal antibodies for Covid?  Well, you guessed it, those monoclonal antibodies do not work on the current active strains.  And don’t count on the Paxlovid you have heard about; its effectiveness is quickly dropping.  It might help on some of the current strains, but not on others. 

Hold that thought as I bring up two other potentially major concerns.

RSV is a respiratory virus that we have been following now for 60+ years.  It is a serious player in the hospitalization and death of persons over 60, and a deadly serious concern with newborns and infants.  That said, it is a common cause of cold-like symptoms in children, and unlike virtually all other viruses, having the illness does not seem to provide any immunity against getting it again after a few months.  The reason you might hear about it now is that FINALLY the code has been cracked to be able to develop a vaccine for this.  The vaccine was just approved a few months ago and is now available to adults over 60, pregnant women between 32 and 36 weeks pregnant, babies up to 8 months old entering their first RSV season, and infants 8-19 months at high risk of severe infection.   When is RSV season?  October-April.  Which is why I am bring this up now.  There is no treatment for RSV.

So, October to April.  Does that sound familiar?  It should – that is the “normal” flu season.  Flu is not a major player “yet” at the time I am writing this, but it is out there and just getting started.

If you are paying attention, I am telling you that there aren’t any good treatments for the current Covid strains, there is no treatment for severe RSV, and you already know that most of the treatments for the flu don’t work either. 

Thus, my profession recommendation is DON’T GET ONE OF THESE!  Unless you have been in a coma for the past 3+ years, you know how to try to prevent getting one of these.  First, get your vaccination.  If you are 60 or over, that means 3 shots right now.  [Jo and I got ours last week.]  All vaccines seem to take about a month for maximum effect, and you want these on board before the infections rates are higher, which also seems to coincide with the holiday season.  And of course, always wash your hands before you touch your face, and wash your hands after you have touched your face before touching anyone or anything else. I know it is hard particularly those of us with military history but stop the handshakes until Spring.  Try waving or if you must, a fist or elbow bump.  And if you forget and shake someone’s hand, then head for the sink or at least use hand sanitizer. 

And don’t be like DD.  If you feel like you might have a cold coming on, THEN STAY HOME. Going out in public when you suspected you might have something might cause the hospitalization or death of someone else.

Lastly before someone asks, what about masks?  You know that the flu is spread by respiratory droplets both in the air and after they land on surfaces (like tabletops).  RSV stands for Respiratory Syncytial Virus, and it is spread with respiratory droplets just like the flu.  And although the droplets in the air might not be as much a player with Covid as direct touch, masks clearly help with all of these.  If (or when) the rate of these disease start increasing this winter, you will definitely have to wear a mask to visit medical care.  Right now, there isn’t a high enough risk to recommend routine wearing of masks — but stay tuned for further developments.  However, the discussion of masks is for people without any symptoms, who feel fine.  If you have any suggestion of symptoms, put a mask on when in public as well as try to avoid being out in public.