p Dr. Dennis Y. Fong, M.D.
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Covid Advice #25 (08/31/2022):
Why Still Mask-Social Distance?

- from Dr. Dennis Fong -

Covid is here to stay for years, but we need to live happy, social lives, we need to have our masks off and see each other's smiles when we socialize with friends and family and when we meet with people for business and work.

So what's there to worry about with Covid? The media has stopped reporting on it. The CDC has stopped tracking it. And far fewer people are dying from it.

Well, quite bsides death or long Covid, both of which by the way I still see in my patients even with Omicron, it's the silent long term complications of Covid that worry me. It is established by a large population study (1.25 million U.S. persons, Taquet et al, Lancet Aug 2022) that with the original Covid, an excess of 1.2% of people over 65 get dementia after 2 years. Rush Universitity's studies suggest that heart disease and diabetes are also silent consequences of Covid. An autopsy study of people who have had Covid (Stein et al, Nature Dec 2022) found that the virus goes into all body organs, some organs more often and others less, but almost all brains have had Covid virus in them.

Of course, unlike long Covid, these longer trem consequences are all silent. Therefore they can only be discovered by large population studies comparing those who haven't had Covid with those who have. Now that almost everyone has had Covid, such consequences may only be discoverable by historical comparison studies of large populations. Very expensive and will take some years for enough data to become available.

The optimistic (or reckless depending on your point of view) argument is that Omicron is milder and therefore may not cause those things. The pessimistic (or prudent) argument is that Omicron is only milder and less lethal because it doesn't go as much into the heart and lung, but stays in the head, and therefore there may be a lot more virus that attack the brain.

At any rate, Covid is here to stay, and for some years to come we won't know if we get silent long term problems from it. So to be prudent when continuing to live a happy social life, I have established for myself the following habits. And I ask my friends and associates to do this when they want to be with me. Not only am I resisting social pressure, but also I am hoping to set a trend.

  1. When with people indoors and we can't have our masks on, like drinking or eating, or in business or work meetings where we need to see each other's facial expressions:
    • I keep a distance of 5 to 6 feet from mouth to mouth.
    • I try to have a HEPA filter turned on nearby.
    • With restaurants, I call ahead and see if I could have a server who will wear a mask.
    • In restaurants, I try to do outdoor seating.
    • When inoors in a restaurant, I keep a distance of 2 empty chairs away from the next person sitting on the same side of the table, and if sitting across from the table, also 2 empty chairs down the table across from me.
  2. When I cannot social distance with people, I keep a mask on.
    • In stores I keep a mask on.
    • On airplanes I keep a mask on.
    • On airplanes I drink out of the side of my mask through a straw.
    • On long airplane trips when I have to take off my mask to eat, I get a sandwich and I go into the bathroom to eat it.

By the way, in hindsight, I think that all the lockdowns from 2020 on in this country were wrong, did nothing to stop the pandemic, caused lots of needless bankruptcies, social isolation and misery, and created widespread anger at the very mention of preventing Covid. Masks and social distancing should have been stressed, not lockdowns instituted.

At any rate, I think I will be resisting social pressure and doing masking and social distancing for years to come, until large population, probably historical, studies prove that Covid never had or longer has those silent long term consequences.

By the way, the new Covid vaccine is coming out soon, I think everyone should get his/hers.

This is especially so for Asians, since Asian Americans who get Covid die 3.1 times as much as white Americans from Covid (Yan et al, Journal Genl Int Med Nov 2021). Why? ACE2 receptors are the doorways through which Covid enters cells, and studies show that Asians have a lot more ACE2 receptors on their cells.

Wish you happiness and healthf!

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