Memories can be a magic elixir. So a simple question posed years ago to my elderly great-aunt led to a remarkable transformation. Thin, tired and in failing health, she sat up and animatedly answered this:
What is the first historical event you remember?
On Nov. 11, 1918, church bells around the world pealed forth to mark the end of World War I. The chimes rang out in London, Paris and across the United States, including in Aunt Mary Margaret's hometown of Cedar Rapids, Iowa. Prayers uttered aloud, happy tears, and dancing on porches accompanied the joyous cacophony. Mary Margaret was only 7 at the time, but eight decades later she could effortlessly bring the euphoria to life.
At the COVID-19 pandemic's beginning, I found myself recalling that long-ago conversation and hoping for a bells-ring-out moment to mark our ordeal's end. That yearning has long since yielded to weary resignation that there likely won't be a day when total victory is declared and the world is COVID-free. While the virus may become more of a manageable threat like influenza at some point, vigilance is the new reality.
Among the reasons: the virus's vast spread. And, what the omicron variant's arrival reveals not only about our medical arsenal's limitations but about this pathogen's ability to leverage human fallibility. Specifically, when there are large numbers of people unvaccinated voluntarily or because they don't have access to the shots, the virus capitalizes on this to evolve, with the current omicron surge a chilling reminder of what can happen.
"We will see more Greek letters,'' said Dr. David Hilden at a Twin Cities forum on Tuesday. Hilden, Hennepin Healthcare's vice president of medical affairs, was referring to the nomenclature in use to designate emerging variants of concern.
Not all the new variants will be more dangerous, but there is that potential. "The honest-to-goodness truth is yes, we're going to have COVID-19 well beyond the year 2019 for which it is named,'' Hilden said, adding that it is "nearly impossible for us to eradicate."
For the time being, that probably means more of the same: Surges that can disrupt life, with quieter spans when life feels like it did pre-COVID, and timely actions taken to protect our families.
That includes vaccinating and boosting. And being ready to mask up again temporarily, switching over to remote work if possible, and putting other mitigation measures back in place when conditions warrant, like those the current omicron wave requires.
So to all asking "When will this be over?" the answer remains frustratingly elusive.
"The absolute truth of the matter is no one knows,'' said Mayo Clinic infectious disease and vaccine specialist Dr. Gregory Poland. "There are no rules for this sort of thing."
Checking COVID 'weather'
Continued uncertainty is tough to hear. Resilience has run dry in this grim winter of omicron. Even those who have stepped up to mask, test, vaccinate, forgo travel and educate their children in this era of distance learning have COVID battle fatigue.
It's tempting to throw up your hands, but that's not the answer. It's likely to get you infected and potentially stress the health care system. You've made it this far — keep going. The world needs responsible people.
As someone who began writing about the pandemic in early February 2020 and has covered it nonstop, I've begun thinking of it in weather terms. It's helpful for coping with a future that does not include an "all clear" signal.
Here in the Midwest, we understand tornadoes' destructive power. Yet we don't spend our summer hunkered down in fear. Instead, we're aware of the conditions that can spawn severe storms and adjust. We go to the lake, picnics or baseball games and scan the sky, tune in the National Weather Service and take action if needed.
The same strategy works for the ongoing viral circulation. Thankfully, COVID forecasts are now available. Mayo Clinic offers one for free, pinpointing hot spots and predicting future ones. It's easy to use and can be checked as quickly as a weather app. Hopefully there will be more long stretches of pleasant weather, but it's important to understand that things can change and stay on top of it.
Minnesota's unprecedented tornadoes in December are a reminder that personal experience or beliefs are no substitute for predictive expertise. Someone doing their own research might have scoffed at weather warnings last month. No tornadoes had ever been recorded here in December.
The conclusion that there's a very, very low risk of being injured by a tornado in Minnesota at this time of year remains correct. And yet only a fool would have relied on that instead of taking cover as the storms bore down, spawning 20 tornadoes across the southern part of the state.
There's a lesson there for needing and heeding COVID experts.
Bright spots elusive
I did go looking for bright spots as I wrote this. They're not plentiful.
A recent news story offered a tantalizing possibility. "Scientists at the Walter Reed Army Institute of Research expect to announce that they have developed a vaccine that is effective against COVID-19 and all its variants, even Omicron, as well as previous SARS-origin viruses that have killed millions of people worldwide,'' reported Defense One last month.
That the military is developing a vaccine makes sense. A pathogen that can swiftly lay troops low is a national security threat. A vaccine effective against all variants, couldn't that be a game-changer?
The disappointing answer is "probably not," and we have only ourselves to blame.
Mayo's Poland is a leading vaccine expert and past president of the nation's Defense Health Board. He's followed the Walter Reed effort. He's also researching another vaccine.
Poland wished "godspeed" to the Army researchers, but cautioned that their vaccine is in very early stages of testing. Human trials could also be challenging because of the need to test it in unvaccinated people. Most people in the United States and Europe willing to be vaccinated already have been, necessitating finding volunteers further afield, which could slow progress.
But even if Poland or others could develop the perfect vaccine, there's a still a big problem. Far too many are simply unwilling to get vaccinated. Vaccines are plentiful and free in the United States. So are boosters. Yet just 67% of those eligible are considered fully vaccinated. Just 39% of those fully vaccinated are boosted.
With so many unprotected, that leaves what Poland calls a large "reservoir" for the virus to keep churning, develop new variants and outpace efforts to control it. Adding to this concern: the vast parts of the world, mainly in less developed countries, where so many have not had access to the shots.
Another complicating factor in controlling or eradicating COVID: the virus's spread in wildlife. One study found "more than 80% of the white-tailed deer sampled in Iowa between December 2020 and January 2021 tested positive." That could create another pathway for viral variants "that may prove a threat to wildlife and, possibly, to humans."
Thankfully, the vaccines continue to confer strong protection against severe COVID. We will need them for generations. "Your and my great-great-great-great grandchildren will be getting coronavirus vaccines," Poland said. "A) because we now have the technology but more importantly, B) because of the way we've handled this pandemic."
Acknowledge 'new normal'
Checking the Mayo Clinic COVID forecast does deliver some encouragement. Minnesota's omicron surge is predicted to peak this coming week and decline swiftly. Omicron's frightening spread could leave many with naturally acquired protection from COVID.
Does that translate into the pandemic's "end," meaning a shift from crisis to better control of the virus? It's a subject of debate, but it hinges partly how long that immunity lasts. Durability so far has not been encouraging. And of course, there are many other factors critical to moving out of crisis mode. Foremost: dropping caseloads and easing pressure on hospital capacity.
My own checklist also includes: testing that's cheap and abundant, wider availability of Paxlovid and other treatments, and vaccine eligibility for kids under 5. They are the only group not yet eligible for the shots, the most potent weapon against the virus. There's no moving on when little ones lack this vital protection.
The University of Minnesota's Michael Osterholm is among the medical experts calling for a "national strategy for a new normal.'' Among the sensible action items: setting benchmarks for when illness caused by COVID and other winter respiratory pathogens triggers mitigation recommendations.
Just formally acknowledging that there must be a "new normal" would be immensely helpful, too. The world has changed. It's time to make peace with that — smartly — and it doesn't mean throwing caution to the wind.
Jill Burcum is a Star Tribune editorial writer and a two-time Pulitzer Prize finalist. She writes about health care and other topics.
