survival of the fittest and reopening Archives

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Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group

Richard Novak, MD is a Stanford physician board certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
emailrjnov@yahoo.com

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In Charles Darwin’s book On the Origin of Species he theorized that organisms best adjusted to the environment are the most successful in surviving and reproducing. In the Great Reopening after the COVID pandemic of 2020 we will see Darwinism in action.

The five basic pillars of safe reopening are eloquently described by Harvard surgeon Atul Gawande in his article “Amid the Pandemic, a Regimen for Reentry” in the May 13, 2020 edition of The New Yorker. They are:

Wearing masks.
Social distancing to 6 feet away or greater.
Frequent handwashing and avoiding touching your face.
Screening individuals for COVID symptoms, or better yet screening individuals with the nasal swab test.
Culture. If a population understands 1-4 above and collectively adheres to these behaviors, reopening will be as safe as possible.

I awoke this Memorial Day morning to television videos showing groups of mask-less people in certain states across America enjoying the holiday weekend by walking shoulder to shoulder on beaches and boardwalks, malls pools, and parks.

The five tenets above were blatantly ignored. I was aghast. Why? Denial is at play. “I deny the risk of COVID” people were out in public.

These individuals convinced themselves that the virus threat is not real, and that COVID-19 was some boogieman that invaded New York City like Godzilla in a B-movie. Protesters around America have raged against coronavirus restrictions and governments that administer them.

Protesters around America have been toting guns and waving “Don’t tread on me” flags.

What will happen to reopening without individuals following the five rules above? Asymptomatic carriers will pass the virus on to others. Multiple others. And what will happen to these others? Pursuant to what we’ve learned in these past months, roughly 80% of their contacts will have no significant symptoms. If these contacts also go to beaches, parks, boardwalks, pools, and malls without social distancing or masks, they will pass the virus on as well.

Five percent of those who newly contract the virus from the “I deny the risk of COVID” individuals will get very sick, and approximately 1% of the newly infected individuals will die. Ironically, young healthy “I deny the risk of COVID” people will probably not die, but one percent of those who were ignorant enough to stand within 6 feet of them will die. Survival of the fittest? Yes. Individuals who ignore points 1-5 above will find that death will follow their actions. If you choose to ignore points 1-5 above, you and your genes stand a higher chance of following the dinosaurs and the wooly mammoths into the abyss of extinction.

What if you’re not ignorant and you follow points 1-5 above? One of my colleagues is a University of California at San Francisco MD-PhD virologist and immunologist. He confirms that the five points above will keep reopening safe. He’s highly educated and careful in his behaviors. We were standing outside in an open space, and not only was he keeping greater than 6 feet of distance away from me, he repeatedly maneuvered to stand upwind of me so that any water vapor that I exhaled would be carried away from him rather than in his direction.

Are PhDs and MDs more likely to follow 1-5 above? I don’t have any data, but my guess is “yes.” Are less educated people and people who don’t read the news more likely to be “I deny the risk of COVID” individuals? Again I don’t have any data, but my guess is “yes.” You don’t need a graduate degree to observe points 1-5 above, you only need common sense. If you see a group of people who are within less than six feet of each other without wearing masks, you need to avoid them at all costs. Will less adaptive genes like the ones who ignore the risk of catching COVID die out? Only time will tell.

Unfortunately Darwinism will not be limited to killing off the “I deny the risk of COVID” individuals. People with health risk factors such advanced age, diabetes, obesity, and hypertension, and elderly people crowded together indoors in nursing homes are also at high risk of dying from COVID-19. These deaths will be a different kind of Darwinism, a survival of the fittest based on preexisting physical ailments.

The Great Reopening of 2020 can be very safe. Be smart. Reopen with glee, enjoy the great outdoors, hang out with friends, and walk in beautiful settings, but don’t pretend that the masks, the 6-foot distancing, and the hand hygiene are fairy tales.

They aren’t.