Dr. Ricardo Maldonado

It almost feels back to normal

In the past several weeks, the Covid-19 census at EAMC has been less than 20 cases on any given day. Three months ago, we had 92 active Covid cases and 20 more who were still hospitalized, but no longer testing positive.

We are still licking our emotional wounds from the brutal third peak. We thank our community for standing up and supporting our local healthcare system during the past 14 months. 

Our country has lost more than 550,000 lives to Covid-19, but lately things appear more manageable and healthcare workers have been able to get a little break. We are definitely closer to normal than we were a year ago or even three months ago, but please know cases are still around and we are not finished with Covid-19. 

The new face of Covid-19

Covid-19 cases and hospitalizations have a new face now. We are not seeing nursing homes patients as often as we did during the first and second peak. 

The number of Covid hospitalizations from the elderly or those with weakened immune systems or other medical problems that we saw in the winter have also been reduced. Instead, the new face of Covid-19 is the younger, healthy individuals.

The average age of an EAMC hospitalized patient with Covid-19 today is 48. Back in January, the average age of a patient hospitalized with Covid-19 was 64. 

We are seeing younger and otherwise healthy patients being hospitalized, and other hospitals in the country are seeing the same. We have even seen a healthy patient in their early 20s that required an ICU stay.

The reason we do not see many elderly patients now is likely because many have been vaccinated. Vaccines are successful because they can help reduce your chances of getting Covid-19, and more importantly, prevent you from getting a serious infection with it. 

We have not seen a single severe case of Covid-19 at EAMC from a person who was fully vaccinated. Besides being vaccinated, another thing many of our elderly are doing is that they are still wearing masks when necessary and taking precautions.

What is the future looking like?

What is ahead? What is going to happen in the next several months? How are we going to enter the second half of 2021? 

To answer that question, we have to understand that natural selection shapes the evolution of a virus. While viruses never sleep, humans always do. Viruses need a host organism (a human, in this case) to reproduce. The only job of a virus is to evade the immune system, create more copies of itself, and spread to other hosts. Characteristics that help a virus do its job tend to be kept from one generation to another.

Covid-19 is an RNA virus (compared to a more stable DNA virus). RNA viruses are more unstable and don’t have a built-in proofreading step in their replication. Mistakes in copying RNA happen frequently and these are called mutations that can have important consequences for us, the hosts. 

SARS-CoV-2 (Covid-19) has been mutating since late 2019 and many variants have been recognized and likely will continue to be recognized in the United States and worldwide. Some of these variants are capable of increased transmission (more contagious) and/or virulence (more dangerous) and/or immune evasion (not protected by current vaccines). It will be very challenging to deal with these variants in the future.

“It takes two to tango”

There are three things we can all do to help stop Covid from continuing to mutate: get vaccinated, wear a mask and avoid crowds. That’s because doing these things decrease transmission. 

If there is no interaction between a susceptible human and the virus, no mutation will take place. It’s like the old saying: “It takes two to tango.” We can slow down transmission, and therefore, mutations. Let’s be smart and responsible and help end this pandemic. Things are getting better, but we aren’t done yet.

The risk of becoming infected with Covid-19, and the potential for severe illness or death, is still there and attacking more younger and healthy people. I urge everyone eligible to be vaccinated against Covid-19 to do so.

Ricardo Maldonado, M.D. is an Infectious Diseases specialist and is the sole practitioner with East Alabama Infectious Disease. He joined the medical staff at EAMC in 2009.  Dr. Maldonado is leading the clinical response to Covid-19 at East Alabama Medical Center.

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