The doctor's sons came over for Thanksgiving; yes, it turned out to be a mistake

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Hi, I'm back as Robin-Schoenthaler-the-Boston-cancer-doctor-who-writes-about-Covid.
(And it’s okay with me if you want to share.)
Today I’m going to talk about vaccines and tell a cautionary tale about holiday gatherings.
As we proceed through the start of these dark days of huge increases in cases, hospitalizations, and deaths, a thrill of hope has appeared in the form of vaccines.
So far, the news about the vaccines’ effectiveness is all good but most of the information we’ve gotten has come from press releases. Fortunately, the real data — mountains of data, thousands of pages of data — has been released to FDA scientists and analysts. On Thursday December 10, 2020 — this week! — the FDA’s main advisory committee will meet to review all this data and discuss granting an Emergency Use Authorization (EUA) to Pfizer’s Covid vaccine. You can watch it on YouTube!
On December 17 that same committee will meet to discuss the Moderna vaccine data, and AstraZeneca’s vaccine may well be discussed shortly thereafter. We need all the vaccines we can get so this is awesome, really nothing short of miraculous.
In the meantime, a committee of scientists, patients and ethicists called the Advisory Committee on Immunization Practices (ACIP) has been meeting for months to figure out the order of distribution (aka who should be first in line to get vaccines).

Should it go first to frontline health care workers; older or compromised people in nursing homes and the people who work there; or teachers, bus drivers, meat-packing employees — who? (For now, top priority goes to health care workers and long-term-care residents.)
And while all that is going on, millions of doses of vaccines have already been made — and companies have been working on the syringes, refrigerator boxes, labels, and all the other vaccine accessories we need as well.

The states and the hospitals have known this day was coming, and now it’s almost here. As soon as a vaccine gets their EUA, vaccines will roll out of the manufacturing plants and head our way.

So it’s possible — maybe even probable — that some people will be getting vaccines in their arms the week after next. It’s even possible that, some months later, anybody who wants a Covid vaccine will be able to get one.

But it’s going to take a lot of time and a huge organizational platform. And there will be at least eight billion news stories and Facebook posts about manufacturing glitches and long lines and side effects and conspiracy theories etc etc in the interim.

Speaking of side effects, the short-term side effects of the vaccines have been entirely as expected: sore arms for many, and for some people a day or so of fatigue, body aches, even fever.

These side effects remind me a lot of what we see with the Shingrix (shingles) vaccine — most people do fine but some people definitely have a lousy day. The good news is these kinds of “whole body symptoms” (fever, fatigue, achiness) are showing you your immune system is being activated, which is a good thing.

As for long-term side effects, the researchers have been watching the trial patients for an average of two months after the second shot and so far no ill effects have been observed after the first day or two. Now, watching 70,000 people (Pfizer and Moderna total) is awesome but the important thing will be watching the first three million people, too. And then the next ten million after that.

But we clearly have a light at the end of our tunnel. A long, winding, complicated, eight-billion-Facebook-posts-and-news-articles tunnel, but a light just the same.

Now, I am going to tell you a personal story about my family’s Thanksgiving.
My young adult sons (Kenzie, 24 and Cooper, 21) live nearby and have been wonderfully Covid-conscious from the start of the pandemic. Both kids work and study from their apartments, both have small pods, both have excellent Covid hygiene (particularly with me and anyone who falls into a high-risk group), and both stayed mostly bubbled at home the last two weeks before Thanksgiving.

Because of this, we agreed to have a science-based "as safe as we can make it" Thanksgiving following all the techniques I wrote about in my previous posts. We kept it small, we kept it short, we kept the kitchen-cooking time to a minimum, we kept the windows open and the fans on, we ate dinner in two adjacent rooms with each of us seated about ten feet from each other, and we stayed masked the entire time except when actively putting food in our mouths (I.e., we were masked between servings or when chatting during the meal).

It all went perfectly.

But then, on Saturday morning while I was walking with a friend at the Pope John Paul Park south of Boston, Kenzie texted me saying, ”Sooooo I have bad news.” Half a minute later he sent a second text that read, “I feel horrible.”

I knew instantly what it was — he was sick with Covid. Which meant he had been contagious at Thanksgiving.

It was probably the most terrible moment I’ve ever had as a parent. I bent over on the walkway and I just could not stand up.

All I could think was “Why oh why didn’t we just skip Thanksgiving this year? Why? And now it is too late to stop whatever tsunami is coming our way."

The rest of Kenzie’s texts confirmed my fears: he was sick with a fever and body aches and a headache and he lost his sense of smell and taste and he tested Covid-positive later that day.

It was a very bad day.

This is exactly how Covid spreads: a person, like my beloved son, can have Covid and have no symptoms at all, not a single clue, for several days before getting sick. A person can be contagious, like my beloved son, on Thanksgiving Day and then not get any symptoms at all until Saturday, while his mom is walking in a park.

This is exactly why we were so meticulously careful about our Thanksgiving. We knew it was possible one of us could be that asymptomatic contagious person. Not likely, not even probable. Kenzie had and has no sick contacts. He had only shopped, carefully, at a couple of large stores. All of us had been mostly at home for the previous two weeks.

We had no reason at all to think any of us had already caught Covid, but we couldn’t be sure. So we followed the science and opened the windows and turned on the fans and sat far from each other and masked up pretty much every moment we didn’t have a fork in our mouths.

And as it turned out, the science worked. Coop and I have remained Covid-negative. And asymptomatic. And NEGATIVE. And Kenzie had a rough week but is getting better.

We’re all getting better.

The science worked.

But was it worth it? Was gathering my little family together for some pumpkin pie and whatnot worth it? Was it worth it to have Kenzie feeling what he called “Defcon One Guilt” about potentially exposing us? Was it worth the discomfort of having to tell his contacts they needed to be tested and then go into ten days of quarantine?

Was it worth all the 4:00 am awakenings, the test-result anxiety, the constant texting each other checking on symptoms while living through that first week of absolute uncertainty about how things were going to turn out?

Am I ever going to hold another Thanksgiving in the middle of a global pandemic? Or Christmas?

Absolutely not. No possible way. Not a bit. Not a chance.

And I’m never going back to that Pope John Paul Park place again.
#cancelChristmas #haltHanukkah #wearthemask

So I get your point, but in this case, this is a doctor who has been posting weekly, encouraging people to take COVID seriously and be safe. She shares medical advice--like last week's post was what medicines and health tools to put in your COVID treatment kit. She is re-posted all over my FB feed. And her anecdotal thoughts are usually based on what she is seeing as a doctor right now in Boston.

She has been a strong advocate for not traveling for Thanksgiving, not meeting up indoors, and always wearing a mask. So her story--that they tried to have a safe indoor Thanksgiving, with ventilation and masks and distancing with her immediate family (who quarantined beforehand) and someone had Covid unbeknownst to them with no symptoms--it strikes a cord. And underlines how you can think you're doing everything right and still putting people in danger.

I just don't think it's the same thing as you are arguing against, even though I do agree that anecdotal COVID stories can be annoying!

"Everyone lies."

One or both of those sons - or possibly the good doctor herself - have been regularly attending off da hook brunches in Fort Point and house parties in fancy Cohasset neighborhoods.

It was probably the pod, although it sounds like no one he knew also got sick. Also, shopping isn't 100% safe. If we're indoors with lots of people for more than a few minutes, we're taking a risk even if we're masked. We can't assume everyone else is properly wearing their mask, and toddlers don't have to wear them. We don't know who was there before we got there, coughing or otherwise spreading germs. Aerosols can linger for a while.

If you can afford to have groceries delivered, it makes sense to do it. I try hard to keep all of my indoor errands to 5 minutes or less, and only once or twice a week.

This is a heartening story, though. I was expecting to hear about three sick people and there was only one. Stay home, Stay safe. There's always Zoom to remind you of why you moved away from your relatives.

The reason I ask is that those of us trying to be careful want to know what he did wrong so we don't do the same thing and end up with Covid.

It likely will not ever be known exactly what he did wrong. Years ago, I realized that most catastrophes aren't caused by running a red light (figuratively speaking) but by speeding through a series of yellow lights - so, yes, it's possible they may identify the person he caught it from, but how he caught it is more likely a series of "yellow lights".

Seeking after the "red light" is a classic risk-assessment mistake: trying to identify what someone did wrong in the mistaken belief that if you avoid that one thing, you'll be safe. "He wasn't wearing a helmet; therefore, if I wear a helmet, I am safe." Real life just doesn't work that way.

But that's why it has to be a collective effort. It's not just about doing what you need to do to keep yourself or your family safe, everyone needs to be doing what is needed to keep everyone safe.

It's like driving a car, you can be the best driver in the world but that won't stop some other driver from hitting your car. Yes, you can drive defensively, and your vehicle can have all of the best safety features installed, but sometimes that isn't enough to protect you.

And as someone who basically teaches people how to do relatively hazardous activities in a safe manner, I can anecdotally say that none of us are as careful as we would like to be, or think we have been, all of the time. And sometimes that little lapse is the one that gets you.

When a person is ill or infirm or needs assistance with day to day activities, they don't have the option to be an anti-pod purist.

Exactly. Even having a small pod is not risk free. I have no pod. I simply do not trust people. I hear folks all the time say "Oh yes I'm being very careful"... while they're hanging out with people from outside their household for social reasons.

This is why I refuse to visit my parents for any reason until we get a vaccine. The worry that I would have infected them unknowingly would absolutely destroy my mental health. And then if I actually did infect them, it would haunt me the rest of my life. No thanks.

You are wrong.

From the end of July into October, we had a steady 10-20 deaths per day most days. Over the past month, we've moved into the 30's. Now in the past week, we've gone over 40 a few times.

Cases are up, hospitalizations are up, and deaths, the lagging statistic, are slowly increasing behind them, even as our great medical professionals and scientists continue to decrease mortality through better medical interventions.

And death is far from the only adverse outcome of becoming infected by this virus.