Living in the Here and Now With COVID-19
Posted July 29, 2020
Step outside. Listen to the wind in the trees. See the sunshine bounce off the lake. Gaze at our proud mountains, which yield nothing to the weight of the world around us.
You could almost believe there’s no virus out there.
But make no mistake - COVID-19 is here, and we must remain vigilant. How can you stay safe, while still finding ways to enjoy your life? We talked to some local physicians about where we are in this pandemic, what we know about the virus and what we can expect for the foreseeable future.
Where We Are and What We Know
Six months in, we’ve learned a lot about a virus that has upended virtually every aspect of life on our planet. We’ve learned that, though there’s concern about aerosol transmission (tiny droplets expelled when you sigh or laugh), the virus appears to be more easily spread through larger respiratory droplets, which are expelled when you cough or sneeze.
We know that infected people can transmit the disease up to two days before they develop symptoms.
We also know that there are many – as yet to be determined how many – who never develop symptoms, but are capable of infecting others. “It’s a sneaky virus,” says Cindy Noyes, MD, infectious disease expert at UVM Health Network’s University of Vermont Medical Center. “We still have a lot to learn.”
Which brings us to what we don’t know. We don’t know why some people get really sick, others have very mild symptoms, and still others are asymptomatic. We can’t predict early in a person’s disease whether they will become severely ill.
Further, there are elements of mystery to this virus: Why do some people lose their sense of taste and smell? Why do men tend to become sicker than women? Why are children largely spared severe disease?
At a time fraught with the desire for certainty, we’ve had a front-row seat to the uncertainties of scientific inquiry – and this has created a degree of wariness. “Researchers expect science to evolve,” says Tim Lahey, MD, MMSc, an infectious disease expert at UVM Medical Center. “They can roll with the punches. But for the public, changing information and guidelines can undermine trust.”
"The truth is that this is exactly what good science looks like – trial and error, steps forward and back. People should be comforted by what we are seeing here: a healthy and robust inquiry process.”
It may be healthy, but no one’s enjoying it. And people are struggling to figure out how to manage their lives against the backdrop of the evolving information.
“The uncertainty is unquestionably the hardest part for people,” says Natasha Withers, DO, primary care specialist at UVM Health Network’s Porter Medical Center. “Not having control over the situation, not knowing what’s coming next – it’s been tough for many of us.”
Here in our region, the COVID-19 pandemic has been fairly well-controlled because people have generally followed the guidelines set forth by the experts. The majority of us understand that wearing masks, physically distancing, washing our hands and avoiding touching our faces are four simple behaviors that, taken individually and collectively, will help reduce the spread of COVID-19. Says Dr. Noyes, “People here tend to look out for their neighbors. They understand the importance of being civic-minded. We can’t say it enough: wearing a mask is the best way to look out for your health and the health of others.”
But as we all know, changing your behavior – and sustaining those changes throughout the day – is not easy. “Human beings are deeply habitual creatures,” says Dr. Lahey. “It’s really hard to change habits! One of the biggest challenges with this virus is that my personal habits affect your safety.”
To make the new changes of habit we all have to get used to stick, Dr. Lahey suggests using clinical approaches to changing habits. “You can’t quit smoking or lose weight if doing so destroys your quality of life. New habits need to be livable and even enjoyable.” In that spirit, Dr. Lahey wants people to wear a mask and participate in physical distancing, while still seeing friends and participating in the fun summer activities they enjoy. “Even if we have to get used to wearing a mask, we can all still have great quality of life in the era of COVID-19.”
For many of us, adhering to the guidelines also means that we are constantly called upon to make calculations about our everyday activities. What do we feel comfortable doing? How do we enjoy time with people who we feel are more lax? When do we just say “no, I’m not comfortable with that?”
Underlying all of this is each person’s tolerance for risk – and of courses we all know, there is no risk-free existence. “To function in this world,” says Dr. Lahey, “you have to be able to disregard some risk – otherwise you wouldn’t leave your house. So, we’re not saying take your risk to zero. We’re saying, find a livable life that reduces risk, but where there’s some joy. It’s up to each of us to find that balance.”
And, when you don’t feel comfortable doing something, it’s okay to say no.
Right now, as we look ahead cautiously to the fall and winter, there is a lot of trepidation about a potential second wave of illness. Keith Collins, MD, an infectious disease expert at UVM Health Network’s Champlain Valley Physicians Hospital, feels that a second wave is inevitable. “And when fall comes and we’re dealing with the flu, respiratory illness and COVID, I worry that things could be tough.” Dr. Withers points out that this potential scenario means getting your flu shot even more important.
"On the bright side, if there is a second wave, we have more effective treatments. We know that steroids can help save lives and Remdesivir can shorten severe illness, and we have convalescent plasma (plasma from people who have had COVID-19 and recovered). I’m hopeful that means we will be in a better place during a second wave.”
Framing people’s expectations around when this will all end is also very important. A vaccine – when it does arrive – won’t provide an instant return to normalcy, says Dr. Noyes. It will be another tool in our toolkit, which, along with increasingly better treatments and physical distancing, will bring us closer to life as we knew it. “We are not returning to the way our regular lives anytime soon,” she says. “But we can still do the things we love to do, with modifications.”
Dr. Collins agrees. “I think when we first started this, we thought it would be a sprint – now we’re realizing it’s a marathon, and it’s difficult because we all have some COVID fatigue. We have to just accept that this is our norm for now, and that we have to keep doing our part.”
And that means: wear a mask, physically distance, wash your hands and remember to avoid touching your face.
Together, we’ll get there.
Six months into life with the coronavirus, we continue to seek a sense of certainty. We need to make decisions about work, school, and how we minimize our risks as we live our lives in our “new normal.” The UVM Health Network is committed to providing trusted information through an ongoing initiative, Spread Facts, Not COVID-19. Connect with us on social and stay tuned here, and in HealthSource as we bust myths, answer your questions and share the latest guidance you need to know now. #spreadfactsnotCOVID19