Conway McLean, DPM, Journal columnist

Although difficult to imagine a short 24 months ago, the COVID-19 pandemic has changed our lives irrevocably. It continues to dominate the headlines, altering supply lines, phone lines, even the “chalk lines.” In many parts of the country, ‘COVID Fatigue’ has set in, people slipping into the old routines. Many businesses no longer require mask use since those vaccinated didn’t need them. Many never felt the need to mask.

As of this summer, there have been more than 180 million reported cases of this novel viral infection. Nearly 4 million people have died from COVID-19. Current transmission rates in Europe are of grave concern and new cases are nearing record levels. World health authorities continue to stress the role of immunization as a global public-health goal for preventing, containing and stopping transmission of SARS-CoV-2 (the virus causing COVID-19). Yet many Americans still question the presence of a pandemic, choosing to believe otherwise, crediting less reputable sources of information.

Physicians are seeing surging numbers of new cases. Some regions have been particularly hard hit. Hospitalizations due to COVID have set a record in Minnesota. With record numbers of new cases being reached, hospitals are more than 90% full in Buffalo, where they have gone so far as to reinstitute a mask mandate for indoor public spaces.

It’s getting harder to gauge the state of the pandemic though since many vaccinated individuals have been infected with COVID-19 but never reported it due to minimal symptoms. The United Kingdom experienced some of this last summer. The Delta variant caused a record increase in new cases, but deaths levelled out quickly due to the number of vaccinated people. The vaccinated can die from COVID-19, but they do so far less often.

Interestingly, in those parts of the world where vaccination rates are higher, the numbers of new cases identified are still high. What’s different is the number of hospitalizations and deaths in those vaccinated as compared to the unvaccinated. Vaccines have been miraculously effective in preventing severe illness, but they don’t stop transmission.

In combination with the high number of people who are not getting vaccinated and the high transmission rate of some new variations of the virus, it appears unlikely vaccines will ever be able to stop the spread of COVID in the way they did for measles. And what of the many debilitating outcomes associated with COVID-19? The data shows that more people who are unvaccinated have severe outcomes due to COVID-19 versus people who are fully vaccinated

The latest variant, termed Omicron, originated in South Africa. The United States has restricted travel from these regions attempting to contain the contagion, but the first case of the Omicron variant has already been identified here. The response of the UK has been to test everyone coming in, isolate all contacts via social tracing, promote boosters, and again, re-institute compulsory face masks in most public places. Experts are clear; these efforts will not stop Omicron cases from circulating. If a virus is good at spreading, then eventually it will slip through.

Omicron’s genetic profile has raised concerns, but definitive data takes time to collate and assimilate. Some sources claim it infects younger children more readily than prior versions. There are concerns the vaccines may not be as effective since it appears to be the most heavily mutated version yet. Covid vaccines were designed using the original strain from China and so may not be as effective. Arriving at a definitive picture of how the Omicron variant behaves and what it can do will take time and effort.

The latest news dominating the headlines concerns the  two new antiviral drugs slated for release. These are not vaccine’s, taken to prevent a viral infection, but are administered to newly-diagnosed COVID patients. Both are expensive compared to vaccines and questions have been raised about the modest benefits. Only one has received FDA approval and just barely did so. These two drugs have been found to reduce hospitalization and death in clinical trials but need to be given within days of infection. This means communities need to have widespread access to testing for the therapies to make an impact. This is not the case in most parts of the country.

Officials from the Centers for Disease Control stated for the first time they no longer consider ‘herd immunity’ a goal for COVID-19. Unfortunately, we are not going to be able to make the COVID pandemic functionally disappear because not enough people have gotten vaccinated. The reservoir of unvaccinated individuals is large enough to prevent control of the coronavirus pandemic. And the high number of cases of COVID-19 recently seen increases the risk of further mutations (like the Omicron). The more it spreads, the more chance it has to mutate.

The recent uptick in the number of new hospitalizations nationally appears to be largely due to the unvaccinated. Estimates from over the summer reveal nearly 300,000 preventable cases of COVID-19: the hospitalized are generally not vaccinated, leading to these unnecessary hospitalizations. This naturally includes all the associated costs to our already overburdened healthcare system, not to mention the impact of these illnesses on families, communities, and the economy.

Opinions vary on what the best direction for U.S. public health policy is. In the face of Omicron and its rapid spread, there has been a shift in response by the European Union. They are recommending booster doses for all adult individuals. Or, should we focus on pushing as much vaccine to the developing world as possible? Supporting vaccination efforts for highly vulnerable populations may be our best way to protect the world.

It appears unlikely that better information to those not yet vaccinated will change things. How much more information do people need to know that the vaccine is a safe, effective way to stay out of the hospital. Check with CDC for accurate, scientifically-based information. The accepted science to date is that a COVID-19 infection can make you extremely sick, kill you, or, more likely, cause debilitating symptoms for years to come. The vaccine gives you a sore arm.

As long as COVID is raging across the globe, new variants can continue to evolve and emerge. Some new variants could well be capable of reinfecting people who have had COVID before. Or it could be significantly more deadly. A few European countries have made vaccination mandatory, an actual law. This isn’t likely in the U.S. But some would consider it unpatriotic to not get vaccinated since you are willingly endangering the lives of your fellow Americans, your neighbors, your family. This is not a political issue; it’s just good medicine, plain and simple.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula. Dr. McLean’s practice, Superior Foot and Ankle Centers, has offices in Marquette and Escanaba, and now the Keweenaw following the recent addition of an office in L’Anse. McLean has lectured internationally, and written dozens of articles on wound care, surgery and diabetic foot medicine. He is board certified in surgery, wound care, and lower extremity biomechanics.