Thoughts of a retired physician

On 25 June, the United States recorded 41,113 new cases of COVID-19, bringing the total nationally to over 2.4 million. In a press briefing that day, CDC Director Robert Redfield stated that there are probably ten times as many cases that have not been diagnosed . If true, that means 25 million Americans have been infected with SARS-CoV-2 since the onset of the pandemic almost six months ago. That number may astonish those who are unfamiliar with infectious disease epidemiology but it is in line with what we know thus far about this virus and its spread. The White House Coronavirus Task Force held a briefing today (26 June) , its first in many weeks. As usual, the show was led by a politician, Vice President Pence, who is one of the more able people to spread happy talk in ages. Neither he nor Alex Azar, Secretary of HHS, had anything useful to say to my mind. It was more of the usual drivel that we have become accustomed to, sycophantic praise of Dear Leader Trump and focus on what th

Where does one begin with the sad tale of a Trump rally in Tulsa, Oklahoma? Yesterday, at the BOK Arena, Trump appeared at what was supposed to be an oversubscribed rally with a million tickets distributed and plans for both an indoor event and an outdoor event in front of throngs of his MAGA cult. In the middle of the COVID-19 pandemic the idea of an indoor event with thousands of unmasked people, yelling, screaming, and cheering was (and is) an epidemiologist’s nightmare. In the wake of the murder of George Floyd and the overwhelming response that Black Lives do Matter, the added complexities of such an event made its reality even more fraught. So, what did we see? First, the crowd size was gratifyingly much less than the Trump campaign predicted. In an arena that could hold over 19,000 people, only 6,600 people showed up. Photos and videos of the crowd showed the expected: almost all white people, many older, almost everyone costumed in MAGA paraphernalia (hats, shirts, flags, etc.

I have been interested in pandemic disease for many years. When I did my infectious disease fellowship at Naval Medical Center San Diego in the early 1980s, I remember one of my peers presented a seminar on bubonic plague. While he used the medical literature in the seminar, he based it on the chapter about the Black Death in Barbara Tuchman’s book A Distant Mirror: The Calamitous 14th Century . That inspired me to find that book and read it. Then to find other books about the Black Death, then cholera, yellow fever, influenza, HIV, and on and on. I had a conversation about the history of these diseases with a junior colleague 25 or so years ago; he indicated he never read any of the books and had no interest in them. I chalked it up to intellectual incuriosity. This year the world has been convulsed with another pandemic. I had hoped never to experience such an event but Mother Nature had other plans. Although retired, my wife and I have followed the pandemic closely. I read Michiko T

One of the (perhaps) silver linings in the COVID-19 pandemic and the stay-at-home life is time to read. I have been reading more than usual over the past three months and remain thankful for my own library as well as public libraries. The Amazon Kindle has been great. After finishing a book the other evening, I scrolled through my Kindle library and came upon a book I have read in the past, The Glory and the Dream: A Narrative History of America, 1932-1972 by William Manchester . First published in 1974, I remembered it as a good read and a then-contemporary social history, so I opted to open it and re-read it now. The prologue is titled Rock Bottom and tells the story of the Bonus Army in  1932. If you Google “Bonus Army” you will bring up many links . Basically, World War I veterans were promised in 1924 a bonus, to be paid in 1945. The onset of the Great Depression found many of these men destitute, starving, and desperate. Thousands of them marched to Washington, D.C. to ask the g

Stop Worshiping Treason The American Civil War began over 159 years ago. The secession of the slave states was quickly followed by armed conflict. While the first clash at Bull Run has been described as more like two armed mobs colliding, it heralded almost four long years of death and mayhem that cost 750,000 lives on both sides. It must never be forgotten that the invocation of disunion and rejection of the Constitution was driven by the Confederacy’s wish to be a slave-holding nation, with whites as the supreme race. It also must be remembered that the many officers of the U.S. Army who “went South” were performing an act of treason in doing so, turning their backs on their oath to protect and defend the Constitution against all enemies, foreign and domestic. They became enemies of that very Constitution by this choice. The outcome of the Civil War from a military standpoint was clear. The Confederacy lost. While Lincoln had stated his intent to provide pardon and amnesty after the

Trump Must Go - Racism Must Go For the past several days I have been watching closely the results of the horrific conjunction of events that have occurred in my lifetime. As 2020 began, there was at least hope that the United States and the world might emerge at its end a better nation. By that, I mean Trump and his corrupt cult, once known as the Republican Party, were voted out of power and a more reasonable attempt could be made to repair the Hadean mess this man has caused.  Then came COVID-19. With a totally incompetent response to the pandemic at the federal level, the case count today is 1,867,620 with 107,979 dead in the United States -- and rising. The best current hope we have is for either an effective treatment or prophylactic medication to be found (intravenous remdesivir has some activity but is no panacea ) or for a safe, effective vaccine with reasonable durability of immunity. We are all aware of where we are currently: states and cities in varying levels of lockdown

Protest and Pandemics As the world continues to struggle with COVID-19 with its health and economic impacts, a white police officer in Minneapolis chose to kill an unarmed black man who was thought to be passing a counterfeit bill. The video of the death of George Floyd will remain indelibly etched into the minds of all for years to come. Protests against this act of overt police brutality swiftly followed, first in the Twin Cities and then across the United States and now the world. It appears that elements, either outside groups or among the protestors, have decided to make the protests bloody and fiery. At this time it is unclear who the instigators of violence are. There are signs on social media and in photos and videos of the protests that outside elements from the right-wing have decided this is an opportune time to seed further chaos in our society. It will require time and a full set of investigations, including forensic investigations of social media posts, to ascertain whe