COVID Conversations: Weekly Update

Air Travel, Vaccines, Antibodies, and the End of Quarantine

Disclaimer: the tone of these updates is candid and sometimes irreverent. COVID is a sensitive subject, so opt-in or out at your own discretion. This update does not constitute medical advice.

COVID Convos, where as usual, I tell it to you straight. No sugar coating, no BS, and sometimes no tact.

When will it be safe to indulge in air travel again?

This is a great question that a number of people have asked, so I decided to investigate. Being a good reporter I booked a flight to learn firsthand, and now 2 flights, 3 airports, and 3000 miles later, I can update you on the status of air travel.

First, the good news: Parking is really easy at the airport. You don’t have to cruise the economy parking lot for 20 minutes looking for a spot as there are plenty, although despite being uncrowded, the TSA still manages to maintain long lines. Hand sanitizer stations are abundant and seem well supplied. Everything, including the airplane, has benefited from enhanced cleaning. Oh, and if you fly Southwest, your boarding number doesn’t matter so much anymore, because no one is getting stuck in a middle seat. Even though the airport lounges are closed, you will feel First Class when you are not elbow-to-elbow with your neighbors on board.

But there’s also the bad news: any hard surface in the terminal or on the plane could be sheltering virus. Also, despite mandatory mask rules, compliance is mediocre. And even when the airline leaves every other seat empty, that’s still only 2 feet of distancing from your neighbor. Oh, and snack service is mostly curtailed, and alcohol (which I believe kills viruses!) is no longer available in the air.

About the masks: In the air, passengers were good about wearing masks, but in the airport, folks got lazy. I’d love to think that everyone who took their mask off had a medical reason to do so, or was under age 2, but no. To be clear, everyone had a mask but a lot were being worn on the chin or hanging off one ear; I’d put appropriate usage at about 60%. It appeared that the groups with the worst compliance were kids under 15, adults over 50, and those who are obese. I guess this makes sense because those groups are probably the ones least comfortable wearing masks for various reasons, but it’s also bad news because 2 of those 3 groups would see the most benefit from mask use.

Other reasons I saw to not use a mask? Eating, talking on a phone, or napping. Oh, and a final thought: wearing a mask over the mouth but not covering the nose was a popular style. But because the nose is one of the best routes to spread and receive viruses, what you’re saying to people around you is “I care enough to wear a mask, but I don’t care if it actually protects me or you.” It’s kind of like going on a Tinder blind date and only halfway wearing a condom.

(Update: Now that I’ve traveled both east and west across the country on 4 separate planes, I am ready to render my final opinion…I don’t think that air travel is safe for the masses at this point. I recommend limiting airport exposure and thinking carefully about the pros and cons of air travel before casually booking a flight. (Fwiw, United and American are back to 100% fully packed flights. Alaska and JetBlue are socially distanced only to the end of July. Delta and Southwest will be at ~60% capacity until September.)

When will we have a vaccine that works?

It depends on how you define “works.” Works, like works 100%? Or works, like the current flu vaccine that’s 50–70% effective? I’m cautiously optimistic on this subject. We may have some sort of vaccine this coming winter, but it will be largely experimental and not completely effective. There are 125+ companies trying to be the first to bring a vaccine to market because of the immense profit potential, but “first” does not equal “best.” There are a lot of challenges to producing a vaccine that is 100% effective, so early on we may need to settle for a shot that is imperfect, but better than nothing.

Fortunately, studies have shown that there is an effective preventive treatment already available: face masks! Marks are not quite 100% effective, but they are pretty darn good. A mask is affordable, available without a prescription, and has very minimal side effects.

True, in previous COVID Convos I’ve pushed back against facemasks a bit. People still wear them wrong. I still think it’s pointless to wear one outside*. And I’d much rather be living in Iceland where facemasks were not needed because these were so good at test and trace.

But I’m a realist, and I’ve seen how bad we are at tracing positive contacts.** We live in a country with some stubborn people who may not care about your health as you do. And I also know that asymptomatic people can shed virus, but that a mask cuts transmission down significantly. Thus, I’m a fan of masks.

*the virus needs droplets to survive, and the droplets dry out very quickly outside.

**I took care of a COVID patient who ended up dying, and I’m still waiting to be officially notified by the health department of my exposure to a positive case. I only know because someone broke HIPPA to alert me.

I have a nurse friend that had COVID back near the beginning of the pandemic. She had symptoms and a positive test and everything. Last week her employer started offering antibody tests, and her result came back negative. What’s up with that?

Thanks for sharing this store. As discussed in previous COVID Convos, antibody tests are so inaccurate as to be pointless outside of the research environment and now some insurers are pushing back against paying for these tests. Personally, I am not signing myself up to pay out of pocket to get poked with a needle to obtain an inaccurate result that will not change anything in my life. (That’s a run-on sentence and just my humble opinion)

But you don’t have to believe me, here’s an article about the new study in Nature Medicine.

When will be done with quarantine?

Phase 1, 2, 3, etc… There is a lot of debate about when we will be able to relax these measures, and our politicians seem to be choosing dates by party affiliation, not science.

Really though, meaningful quarantine was over weeks ago. I’m aware that this is me ranting, but effective quarantine only works when everyone participates, and lots of people stopped participating a while back. Look at the headlines from last week: One church in LaGrande decided to get together and they ruined things for many people in that community. Crowds gathered indoors for a political rally. And large groups continue to protest together night after night.

If you wear a facemask, you’re probably safe to gather in small groups again and you might as well, because others are doing it. I’m throwing my hands up and shrugging. Whether or not the politicians agree, the people have spoken: quarantine is over.

Upcoming in COVID Convos:

Playgrounds, Drug Prices, Hotspots, Where you will/won’t catch COVID, and the Future of Healthcare

To unsubscribe, reply to this email. To sign someone up for COVID Conversations, direct them to opt-in through the bot

Doctor, Reader, Thinker

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store