Thoughts of a retired physician

  On 4 March, Los Angeles County lifted its indoor mask mandate for covid. This was after California had lifted its state mandate. Margan and I went to REI today for some hiking shoes. We were masked and I estimate that about ½ to ⅔ of the people we saw inside were also masked – leaving a high proportion who were not. The national data and the LA County data all show falling numbers of cases, hospitalizations, and deaths , with numbers among the lowest troughs seen during the pandemic. However, the BA.2 omicron variant represents ever more of the cases seen , likely because it is more transmissible than the BA.1.1 variant and immunity from vaccines and prior infections wanes with time. The WHO reports BA.2 is now the dominant variant worldwide at 85% of isolates sequenced. Wastewater surveillance shows many communities have BA.2 being shed into sewage nationwide.  At the same time, uptake of vaccines has fallen to very low levels in the United States – less than 160,000 doses daily

  Covid cases, hospitalizations, and deaths are at their lowest point in Los Angeles County since July 2021 (727 new cases, 25 new deaths, and 432 current hospitalizations as of 19 March 2022). The masking mandates have pretty much been lifted except for public transit and healthcare facilities. And still. The omicron variant BA.2 is producing surges in Europe . Asia is seeing rising cases. It has been described for several months in Africa where case counts are less precise. BA.2 is perhaps 30 to 50% more transmissible than its cousin BA.1. New York City is experiencing a rise in test positivity and cases of BA.2 in the past 10 to 14 days and is an airplane ride from Los Angeles or any other city for that matter.  The encouraging news is that vaccinations and prior omicron BA.1 infection seems to provide protection against BA.2’s ability to produce severe disease and death. How robust this “immune wall” is and how long it will persist remain objects to study. Experts such as Drs.

  This was a busy week and next week promises the same. Multiple physician appointments (when did medicine become a commodity, I missed that – fortunately). The continued threat of Russian aggression in Ukraine becoming a general war in Europe remains. But at least we had a wonderful Sunday with our two older grandsons, Maxwell and Sebastian at the Los Angeles Zoo. They turned 12 and 9 respectively in February and as you can see, have grown a lot. Sebastian is closing in on our height while Maxwell – well, you can see that we have to look up at him now. My advice to all is enjoy life and family – precious items as time will otherwise stream by.

  Ukraine continues to fight and Putin is now using the standard tactic when his military falters – bludgeoning civilians and screaming ever louder that Ukraine is a danger to Mother Russia. The reality is that Russian military forces have stumbled badly. What in all likelihood was envisioned as a 72-hour war is now approaching 2 weeks and the incompetence of the Russians is beyond astounding. This by no means indicates they will lose, but if they defeat the Ukrainian army and the Ukrainian civilians, they then have to occupy Ukraine, install a puppet government, and face a hostile population and the possibility of an ongoing insurrection.  Phillips P. O’Brien has a cogent post on Twitter worth the read. The oft said phrase about war – amateurs talk tactics, experts talk logistics – is the core of his tweet. It appears obvious that the Russian army has yet to master the science and art of logistics. The stalled convoys have run out of fuel. Troops are being given rations that are year

  On 24 February 2022 Vladimir Putin’s Russia invaded its neighbor, Ukraine, under wicked and false pretenses. After Russian forces surrounded Ukraine on three sides, including its long border with Belarus to the north, Russian armed forces began assaults from air, land, and sea. As I write, now almost 72 hours on (Saturday), the Russian Army is trying to take Kyiv and Kharkiv but meeting determined resistance from the Ukrainian Army – and the Ukrainian people. What will the outcome of this be? Certainly a lot of death and suffering. The Russians claim not to be targeting civilians but there are too many reports of schools, residential areas, and hospitals being struck by a variety of munitions to give much credence to the Russian claims. There have been civilian deaths but no one has released any figures to date. There are videos of Ukrainian troops fighting Russians with antitank weapons from the UK. It appears now that the prime target is Kyiv but despite the force applied by Russia

  A short housekeeping note. I have disabled comments for the moment as they are being spammed for offers for cryptocurrency and casinos from parts unknown. I hope to re-enable them at some point. Last week I opened the subject of how the growing population of humans represents a threat to the survivability of our species because of the increasing degradation of the environment. I will get back to that but today there are two other things at the top of my mind. The first is the crisis in Ukraine brought about by Vladimir Putin. Putin has clearly evolved into the same sort of dangerous autocrat that the world saw too much of in the last century. Russia is now toying with war as a means to extend its influence to the states that separated from Russia when the USSR collapsed. As David Ignatius writes, Putin's rage at NATO is long-standing and his military has improved dramatically over the past two decades. The coziness between Xi Jinping and Putin has also created a powerful bloc

Short post today, lots of other stuff to do. MonteCedro showed a Netflix documentary yesterday called Seaspiracy . Pretty scary in its own way and brings the climate change crisis into focus in a new way. I thought of a book I read a month or so ago, Stranger Than We Can Imagine: Making Sense of the Twentieth Century by John Higgs. In the penultimate chapter, Higgs makes note of what he believes is the least understood of the events of the 20th century. In 1900, the world population stood at 1.6 billion. By the close of the century, it had quadrupled to 6 billion. As I type this, the world population in 2022 stands at over 7.9 billion people. As Higgs points out, our civilization is predicated on increasing consumption. But there is a limit to growth because Earth, the only home our species knows and likely will ever know, is finite. Many years ago in Microbiology 101, we learned what an ever-increasing population of bacteria will do on an agar slant. It looks like this: We are at lea