Dr. William Brown is a professor of neurology at McMaster University and co-founder of the Infohealth series at the Niagara-on-the-Lake Public Library.  

Dr. William Brown

Special to The Lake Report

Since early this year I have written more than 20 articles on the pandemic, covering everything from the nature of the virus, the short- and long-term consequences of the disease, status of vaccines and antiviral drugs, testing, herd immunity and periodic updates on the status of the pandemic, but none in the last two months.

Why the gap? Mostly, because of fatigue with all things COVID, including the relentless 24/7 coverage from the news media. Some of the latter was excellent but much was repetitive, speculative and even misleading.

Unfortunately, the efforts of highly reliable sources such as the U.S. National Institutes of Health (NIH) and the Centers for Disease Control (CDC) were undermined by cutbacks and dismissive, misrepresentative information from government leaders.

The latter behaviour from those in charge did much to mute the best advice from the professionals and contributed to the recent huge surge in cases in the United States.

But we can’t blame everything on the lack of political leadership – look at Europe these days. The numbers from the U.K. and other parts of Europe are almost as bad as the U.S.

In the face of this pandemic, our behaviour changed. Most locals, perhaps because of age and other factors, became wary of crowds, especially those with people who weren’t familiar.

Orderliness and patience in lineups, dutifully maintaining distances from those around them and wearing face masks became the norm at the post office and other public venues.

Foremost, we learned that COVID-19 is highly transmissible, especially within closed spaces where the virus can hang suspended in the air for hours. So avoiding crowds, especially indoors, keeping our distance from others and wearing masks are very important.

Perhaps the most challenging aspect about COVID-19 has been the age divide. Those under 50 suffer few, if any symptoms. Because the latter group includes students and those working outside the home, they can be unintentional yet potent vectors for transmitting the disease to older members of society who are most at risk for the disease.

Striking the right balance has been very much a moving target between meeting the competing needs to protect those most threatened by COVID-19 , ensuring that students at all levels are able to meet their educational needs with as little disruption as possible and protecting the economy and jobs.

So far, the major financial indices haven’t been hit nearly as much as markets early on expected. For the U.S. economy the saviour has been those high-tech industries that kept businesses connected with one another and their costumers through Zoom and Zoom look-alikes and provided internet entertainment and training resources.

In case you haven’t noticed, the likes of Amazon, Apple, Google and Netflix to name a few, are doing very, very well these days. Good news for investors – but tell that to the many who lost jobs during this pandemic.

For the vulnerable – older age and comorbid conditions – COVID-19 turned out to be a far greater threat than the seasonal flu. The reason is that the disease attacks multiple systems such as the heart, vascular system, coagulation system, kidneys, bowel, brain and respiratory tract, especially the lungs. It took several months for front-line health care workers to realize what a formidable high-risk foe COVID-19 could be.

Even now, there are no truly effective drugs, although remdesivir, dexamethasone and immunoglobulin infusions appear to offer some protection. Fortunately, the mortality rate for those in intensive care on ventilators improved significantly, partly due to dexamethasone but mostly because of improvements in the general management of cases in ICU units more than any specific drug or combination of drugs.

In the past week Pfizer announced that its vaccine proved more than 90 per cent effective in preventing COVID-19. That’s impressive but we need to know a lot more about this and other vaccines to follow. 

For example, just how effective are they for people most at risk, such as those age 50 and up, and how long does the protection last? 

We know the immune systems of older people are less capable of mounting effective immune responses to the virus and that the duration of naturally acquired immune responses may be short at any age – based on evidence that some patients who suffered an initial documented attack from COVID-19 later suffered from a second attack from the virus.

It would be a mistake to let down our guard because we hope and believe an effective vaccine is just around the corner. Hopefully, that will prove to be the case but we’re several months away from access to vaccines and from knowing just how effective and long-lasting such vaccines will prove to be. 

NOTL has managed surprisingly well given the surge of visitors in the summer and fall. But winter will be another matter because most social activities must necessarily move inside, where the virus poses the greatest risk.

What we’ve managed so far – distancing, wearing masks and avoidance of high risk venues – worked and we need to continue the same way probably until late spring or early summer next year when one or hopefully several effective vaccines should be widely available. Keep your fingers crossed that these vaccines will prove as effective for all ages and as long-lasting as the measles vaccine.

In the meantime the best strategy is distancing, wearing masks and avoiding get togethers outside our bubbles, especially inside. My daughter in Alaska tells me that lack of discipline on all three fronts has created a nightmare of outbreaks of COVID-19. 

So be cautious.