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Health Matters: The global consequences of the pandemic

Conway McLean, DPM, Journal columnist

Everything is back to normal, isn’t it? More and more, it seems that way. During a recent day of shopping (more than one store), I noticed mask use was rare. Social distancing is clearly a thing of the past. Did we survive the pandemic? Did you know that is a Greek term, pan meaning “all” and demos equating to “people.” It is the term designated for when epidemics are growing in multiple countries and continents at the same time.

The number of hospitalizations, as a measure of severity of a Covid infection, is down. But the totals are daunting; we have not won this war. As evidence, let it be noted a milestone has been reached, a testament to the battle so many have waged with this virus. One million Americans have died as a result of Covid-19.

Entering the third year of this pandemic, Covid-19 has become the third leading cause of death among Americans, trailing heart disease and cancer. Families across America have been profoundly affected. A quarter of a million kids have lost a parent to this disease, many have lost both. Globally, the data concerning the number of deaths has been difficult to determine. Many countries have been reticent to provide accurate numbers, or they simply don’t know, with third world countries often without the infrastructure to say.

The World Health Organization (WHO) has been attempting to track and organize this information, gathered from various sources throughout the world. What exactly should be totaled? Because of gaps in data received globally, determining the number of excess deaths in a calendar year is the best measure of the overall mortality caused by a pandemic. This term refers to the difference between the number of people who died in one of these two calendar years versus the number expected if the pandemic had not occurred.

This measure of excess deaths, as calculated by the WHO, varies dramatically from the number of deaths that were reported by most countries. This determination appears to offer a more accurate gauge of the total impact of the pandemic worldwide. This new research by the World Health Organization is considered the most accurate picture to date of the total number of people who died because of the COVID-19 illness.

The results were staggering, revealing 15 million more people died during the pandemic than would have in normal times. There have been 82 million cases of the illness reported in the U.S. since the start of the pandemic. And the data submitted by some countries regarding their death toll has been especially inaccurate, raising eyebrows of interested parties around the world. For example, in Mexico, the excess death toll was twice that of their estimates. The number of excess deaths was 8 times higher than the official number in Pakistan.

Due to the size of the populations, as well as numerous other factors, one third of the excess deaths globally occurred in India. Their official estimates are one tenth of the number of excess deaths. But that isn’t the only country where COVID deaths were under-reported. In Egypt, excess deaths were approximately 12 times greater than the official Covid toll. Understandably, part of this disparity has likely been a desire to paint a positive picture of that administration’s handling of the pandemic.

The financial consequences of the COVID pandemic may not be known for years. It directly affected the production side of the global economy by disrupting the supply chain. Factory closures in China, inadequate supplies of the raw ingredients for many essential antibiotics and drugs in India, all led to problems with supplies worldwide. Estimates for the total loss in gross domestic product, the oft quoted GDP, ranged from modest, 280 billion dollars, to a mind-blowing 9.2 trillion, according to various projected scenarios.

Another long term consequence of the pandemic is the appropriately-titled “Long Covid” a condition we do not (yet) understand. These people develop chronic and persistent symptoms of all sorts, from brain fog to fatigue, headaches, dizziness, shortness of breath, and others. We can make some generalizations about who is more likely to get this protracted condition, the risks increasing with greater age and body mass index, or of the female gender.

But even a mild SARS-CoV-2 infection can cause long Covid, so getting vaccinated is not a guarantee of not getting this chronic illness. But it is now clear vaccination reduces greatly the likelihood of getting “long hauler,” a primary explanation for the reduction in hospitalizations despite a recent increase in cases. Vaccination remains our only means of prevention against viral infections, whether it is polio, measles, or COVID-19. It’s just good science. And it has been for decades.

The pandemic continues, regardless of our hopes and prayers, ignoring it as best we may. Hundreds die every day while thousands will experience the challenges of long COVID. The short or long term effects on our culture, our society, on humanity itself, likely won’t be known for decades. But it is a safe bet they are going to be dramatic.

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.

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