Pacing and Podcasts

Pacing and Podcasts

As we passed Memorial Day this year, a vast unplanned experiment was unfolding in the United States and many other nations. After months of lockdown to slow the spread of COVID-19, the push to reopen society and the economy is gaining steam. Here in California, we are seeing a cautious set of strategies to do this. In some other places in the U.S., it seems a lot less cautious. Where are we going and what will happen?




As part of my exercise program under lockdown, I have taken to pacing around our apartment to get my 10,000 steps daily done. I understand there is nothing magic about that number but it represents to me that I have made a reasonable effort on that day. A sort of psychological feel-good. To keep boredom at bay, and at the suggestion of several of my children, I find that listening to podcasts helps pass the time and allows me to understand more of what is happening in the world in the era of coronavirus.




Two podcasts today were truly interesting. Biologist Uri Alon described an interesting possible method to safely restore the economy as work proceeds on finding better therapeutics and a vaccine for COVID-19. Titled A COVID-19 ‘exit’ strategy to end lockdown and reopen the economy, Alon and his colleagues in Israel propose a 14 day cycle composed of 4 days of work interspersed with 10 days of staying at home. Their point is that we understand that after infection, it takes several days to become infectious, and that this cycle would allow for better recognition of cases during the time at home, reducing transmission outside of family units. Not foolproof but it would allow for easier contact tracing and perhaps diminished need for testing, conserving precious public health resources. It may not work for all jobs and industries but the creative thinking here deserves credit. Alon elaborated on how this might even be applicable to industries that work multiple shifts.




I have found that NPR’s Coronavirus Daily Podcast is a truly worthwhile listen. The podcast of 26 May 2020 entitled 99,000 People Dead and a Dire Summer Prediction included a great interview with Dr. Ashish Jha of Harvard’s Global Health Institute. Dr. Jha made a point of how this pandemic still feels unreal to the majority of Americans; unless you know someone who had COVID-19, especially someone who succumbed to the virus. It made me think of the connection between the abstract and the optimistic and the connection between the concrete and the pessimistic. Perhaps the abstraction of what COVID-19 has caused is mirrored in the optimism of people who think this is not really a problem, the “Nobody I know has suffered with this so why worry?” Sadly, our nation’s polarized political state seems to have magnified this as well. The term I think of here is magical thinking. One of the residents where we live contracted and died due to COVID-19. Even without that connection, my career in infectious diseases and epidemiology has long left me a realist to what a pandemic can do. I recommend listening to the full podcast with Dr. Jha’s interview.




Just before I sat down to write this, I read a sobering article by Wan and Johnson in today’s Washington Post. The likelihood is quite high that COVID-19 will become an endemic viral disease that humankind will need to deal with into the future. This would really mean that there will be no return to the exact pre-pandemic past that everyone yearns for. Dr. Barney Graham, deputy director of The Vaccine Research Center at NIH (I had the honor to work with his group on a universal influenza vaccine before I retired) points out that even with a vaccine, we need to think in stages that are measured in years and possibly decades to control SARS-CoV-2.




This is perhaps the most important message for everyone to understand. Currently all the thinking is exceedingly short-term, measured in weeks or months. What is necessary is a long-term plan and long-term leadership. Both are currently lacking. There is no plan in the U.S. at the federal level. We have a president who has totally abrogated a leadership role and in fact seems bored of coronavirus. I have written before on this blog about leadership as well as on my Facebook page. Without federal leadership there will be little long-term progress in dealing with this pandemic.




And the death toll this afternoon has exceeded 100,000.