Corona LI. So, what have I learned?

Welcome back! For those of you who have been following, we were talking about what I think I have learned from this Terrible Pandemic, as we enter its third year. I also talked about how great I was feeling. But then I went to four back-to-back meetings, tested negative twice, and four days after the last one, I tested positive.

Fortunately, my symptoms have been mild (thank you, vaccine and boosts) and are pretty much gone, except for being tired. And I don't have time to be tired, so I'm laboring on. I'm seven days out, and I think I'll be fine. I'll let you know if that changes.

If you recall, I am being particularly careful not to say what I think we have learned from this, but rather what I have learned. There are a few reasons for this. Most of all, I would not presume to tell you what you have learned. Secondly, I am leaving out a lot of things that many pundits talk about, such as how we have learned that so many medical professionals are heroes. As are firefighters, police, store workers, and food providers. Or that the study of infection spread and control is essential and underfunded. Or that zoonotic infections pose a gigantic threat to global health. Or that vaccine denial poses a gigantic problem for global health. Or that global health is a thing. Yes, many learned these things. But I already knew them. You probably did as well (because you are very smart).

“But Mole,” you say (I'm listening), “why should we care about what you learned from all this?” That's a pretty good point. I'm not sure. But as the Mole, it is my duty to talk about terrible things and try to make them funny despite how terrible they are. And nothing, to date, has been more terrible that this Terrible Pandemic. Even the current state of my sinuses (just kidding, my sinuses are fine). Okay, so here we go, a few more things that I think I have learned from all of this.

3. Much of what we thought we knew was wrong

Before you become outraged at what I am about to say, let me point out that we knew very little when this pandemic began, and many in public policy tried to do their best and are still trying. I am not talking about the scary clown leaders who immediately declared that we do nothing, and it will all go away ‘like magic.’ I am talking about the serious health officials who took steps to try to mitigate infection rates, morbidities, and deaths.

Many of us may not recall the early days of the pandemic, when we focused on washing our hands, surfaces, and food packaging. It was very difficult to obtain hand sanitizer or even alcohol (and toilet paper, but that was an entirely different story). I still have not learned why TP (the paper, not the pandemic) tends to disappear from store shelves whenever anything bad is about to happen – where I live, this is a common occurrence if the weather people predict a storm. Maybe people think that, like duct tape, TP can be used for so many things. But duct tape doesn't disappear from stores (and hey, duct tape was instrumental in bringing the Apollo 13 astronauts safely home, so I can see why we might want to stock up on duct tape. But TP? It's a mystery). What was I talking about? Oh, right, cleaning hands and surfaces. Of course, washing our hands and disinfecting surfaces is generally good for public health (during the outbreak of the original SARS, the city of Toronto decided to keep elementary school children in school, but had them repeatedly wash their hands before and after each class. They reported a remarkable drop in school absences due to infections in general). But it took us some time to determine that SARS-CoV2 spreads predominantly via aerosol dispersal. Suddenly, scientists who study aerosol dispersal became the equivalent of pop stars (or at least their videos did – I hope their funding, which I suspect was never great, improved, but somehow I doubt it).

So, of course we moved to masking and social distancing, and in many places, stay at home orders. It was obvious that these behaviors greatly limited the spread of disease. Famously, ‘red’ and ‘blue’ regions in my country, which for foolish reasons (I should say stupid reasons) corresponded to ‘won't’ or ‘pretty much always’ wear masks and socially distance, highly correlated with rates of infections and hospitalizations. But now there are data that, in the end, this didn't really matter at the level of public health. Those areas with or without mandates and restrictions ultimately evened out over time in terms of infection rates. I am not saying that wearing a mask and social distancing don't help us avoid infection; what I am saying is that on a population level, it didn't seem to matter whether people were told to or not. (The findings I am talking about probably only relate to districts within my own country, and of course, these findings may change – analysis of public health initiatives and their consequences is tricky science).

We also knew that if we could just get vaccines into arms and therapeutics into clinics and hospitals, we would be okay. Do you remember how thrilled we were that the vaccines seemed to be preventing infection? And how depressing it was when vaccinated people were turning up with infections? Of course, the vaccines have been incredibly good at limiting hospitalizations and deaths (and data out of California, where community testing is routine, easy, and free, showed that the Omicron wave last winter was largely, but not entirely, confined to the unvaccinated). We are now realizing that vaccination may be a yearly thing for the foreseeable future.

We knew, with remarkable certainty (given how little we knew) that following the initial infection, morbidity was a consequence of an over-exuberant inflammatory response. Long term morbidities were similarly due to inflammation. To some extent, this has borne out; of all the off-the-shelf drugs that we thought would improve outcomes, only corticosteroids seemed to work. But on the other hand, we now know that in many cases of ‘long COVID’ the virus sticks around. We don't know why, and we do not entirely understand the consequences.

All I am saying is that in an emergency, and this was certainly a burning garbage fire of an emergency, scientists are not immune to jumping to conclusions. The major difference between scientists and other pundits, as I see it, is that scientists have less trouble admitting that we can be wrong. And now that infection rates are on the rise again (more than 100,000 in my country last week), I'm not sure that anything we have done before is likely to happen again. I'm not even sure that we are going to try.

4. Science thrives on human interaction

Maybe the biggest thing I learned through all of this was how desperately important it is (at least in my lab) that we interact. Our publications took a major hit, our progress took a major hit. Everyone was working hard, but alone, and while things got done, big things didn't happen. By ‘big things’ I mean those ‘aha’ moments that tell us that we are onto something.

And then we started showing up, as conditions permitted, and our lab's science soared. We have several papers coming out that we are very happy about, and several more that are close. It feels like we are back, at least for now. I can only ascribe this to sitting together over a table strewn with data. As I've often said, we are primates. Okay, we don't pick fleas from each others' pelts (okay, I don't, I can't speak for everyone in my lab), but we need to socialize. If we don't, work can still happens, but science? Not so much.

Over the past few weeks, I've attended a number of small, international meetings. They were electric. I'm looking forward to more.

5. We are still not ready for this

SARS-CoV2 continues to evolve. Vaccinated people get it, and get sick. It is not going away, but any precautions that might limit infection are optional. There is a need to explore alternative vaccines and test them, but the impetus is fading (as is the potential market value) and, unless we have major waves in the coming months and vaccines we are willing to test, I worry that it could take years to figure out how to beat this, assuming we even can. We are not ready for this.

And of course, SARS-CoV2 is not the only threat out there. We seem to be doing due diligence on Monkeypox (in this case, should this become a serious threat, I think we know what to do about it. I think), but there are at least 12 more beta-coronaviruses waiting to make the leap to humans, bird flu (yes, this is a very real threat), and who knows what else? And I worry that our experience with COVID-19 quarantines and lockdowns will hinder our ability to respond should a new threat arise. We are not ready.

But I get it. We have had enough of worrying about the current pandemic. We have certainly had enough of me writing about it. So, this will (hopefully) be my very last Corona File. I'll be back to talk about other things that relate to this thing we do, this biomedical research thing. But since this is my last CF, please bear with me for a few more lines. Nobody is making you read it, anyway (but if you are, thank you).

It has been a long ride. When I started the Corona Files, I thought it might be interesting to record thoughts along the way, sort of a diary of the pandemic. At least, I thought it might be interesting for me. I knew that, eventually, we would come through, maybe with changes, maybe not. I'm still not sure that I have changed, or if I have, that it was the Terrible Pandemic – it is always hard to tell. I'm pretty sure that my old worries, bad reviews, trashed grants, projects that don't want to work, have not gone away. I'm also pretty sure that I will be happy to never give a Kazzoom seminar again, and I hope that virtual meetings go away (or at least, become rare).

Here's my sincere hope that you've come through it, too, and that things are looking, well, if not bright, at least no worse than they were before any of this happened. Research is hard, but it beats the hell of trying to do it under a lockdown. Join me, and lift a glass of ‘tea.’ No, it isn't over, but we are moving on.

Here's to moving on.