We are now in the midst of the exponential growth stage of this pandemic. During the linear growth, there was a fighting chance to slow the spread. Now, as you may have noticed, the cases are starting  to increase sharply higher rather than chugging along linearly. I actually predicted all of this back in late June with nearly this exact timeline and you can watch that video here.

              So now that we are here, what will happen next? Well, I’m afraid it will likely get pretty ugly before it gets better. But, it will get better. With case numbers escalating, you’re going to see hospitals getting full, lots of serious illness, and a gigantic stress on our medical infrastructure. The curve was flattened until now. After all, that was the entire intention of flattening the curve – decreasing the stress put onto the medical infrastructure and buying us time. Never would flattening the curve make the virus go away.

              Death rates remain low compared to the virus in March/April. I still firmly believe that the virus has mutated to something less lethal (less virulent) and more likely to spread (more pathogenic). That, along with better management, has kept the death rate lower compared to March/April. Because of the sheer numbers, I expect we are likely to see the deaths exceed those from March/April.  We should be careful interpreting those numbers when that dreadful time arrives. Indeed, it will be ugly and those deaths aren’t a lie. However, I also anticipate that the fear from the headlines of the death rate exceeding those from March/April will overpower the logic and statistical fact that the death rate will still be a fraction of the previous lethality of the virus.

              I have personally cared for many COVID-19 patients. Many of them in nursing homes and well into their 90’s. Please hear this: most of them are asymptomatic or minimally symptomatic. Most people will do well. Also please hear this: This virus is not a joke. We don’t know why (yet), but there are some people that are clearly very vulnerable. Diabetes, Lung disease, obesity and race have all been well-established as risk factors. However, this disease can easily kill someone not in those categories. Someday we will learn why, but at this time we just don’t know. This is the reason that we all need to exercise a great deal of caution.

              In a best case scenario, you get COVID and are asymptomatic or minimally symptomatic. In a decent-case scenario, you get COVID and are very, very sick with fevers for several days, crippling fatigue and shortness of breath that may require hospitalization or supplemental oxygen. In a worst case scenario, you get COVID and end up on a ventilator in the ICU and face a life-threatening course.

              With the exponential growth, I’m concerned that holding out for a vaccine may be a pipe dream unless you’re the best of quarantining hermits. I fear that the majority of us get this virus before the vaccine becomes widely available. Then you face the situation mentioned in the paragraph above.

              From the social standpoint of things: you can absolutely count on another shutdown. Please don’t get mad at me about this, but the writing on the wall is very obvious. Governor Dewine gave an ultimatum: make things better in one week or face a shutdown. Given that the incubation time of the virus is anywhere from 2-14 days, this is an unrealistic ultimatum. Even if every single person stayed home, one week is not enough time to see results; the writing is already on the wall. He knows the numbers were only going to increase exponentially over that amount of time and he’s preparing you as a citizen for the bad news ahead of time.

              I’ve had many patients ask me about the future of COVID-19 after we get through all of this. First, let me just say that I think a March 2021 timeframe is realistic for seeing some significant light at the end of the tunnel. By this time, we should either: a) all have had this and have natural immunity (more on this in a second) or b) if you haven’t yet gotten natural immunity, then you’ll likely be in the vaccine camp.

              Many thought leaders feel that SARS-CoV2 (aka coronavirus) will now become endemic. This means it will unfortunately be with us for the rest of our lives. It will mutate and we may need to get a yearly “COVID vaccine” just like one may get a yearly flu shot. However, it’s my belief that with eventual exposure (either natural immunity or through vaccination) to the virus, we will all develop some degree of immunity in the years to come. Yes, you may still get COVID in 2025, but the chance of it killing you will be substantially less than in 2020 because it is no longer novel or new (to your body and immune system).

              So what should you do going forward in the coming days and months? I truly wish I had a better answer but I honestly don’t know. My best advice is to purchase a home pulse oximeter ($20 on Amazon). If you get COVID and your oxygen levels drop below 92%, this can serve as your objective trigger that it is now time to go to the ER ASAP. My other suggestion would be to get the vaccine when it becomes available. Yes, it is true that we don’t know the long-term safety of the vaccine. However, my suspicion is that it is going to be less risky than contracting COVID-19 and potentially dying. The Pfizer vaccine that has recently made the news had over 44,000 people in the trial. These trials are designed to ensure safety and, therefore, I think it is probably safe. I would guess that getting into your vehicle and driving somewhere probably poses more risk than the vaccine and most of us don’t think twice about getting behind the wheel.

              Scary times lie ahead. Godspeed. Spring can’t get here soon enough...