May, 2020

Covidus Interruptus

By Michael J. Katin, MD

It is unfortunate that there has been extensive criticism of the Wuhan Institute of Virology. After all, they identified the virus right off the bat.

The news has been dominated by coverage of COVID-19, appropriately, and it calls attention to the extreme difficulty for the media to cover more than one topic at a time. Over the past six weeks it appears that turmoil in Venezuela has ceased, there is no longer a civil war in Syria, and there are no more fires in Australia. Oh, and by the way, Asteroid 1998 OR2 missed earth by 3.9 million miles, and Category 5 Cyclone Harold devastated much of Oceania, and nobody knows it. There has, fortunately, been some breakthrough in public access to developments with the Kardashians and the NFL draft was even able to proceed, although in an altered format.

It will still be some time before we return to behavior as we did in the BC era (before COVID-19). Despite the number of persons who recover from this disease, there will continue to be those who have cataclysmic courses especially since there is not a curative treatment as of yet. However, as part of collateral damage, the oncology specialties will be affected in terms of setting back of clinical and laboratory research, delay of diagnoses, delay and interruption of treatment schedules, and creating layers of complications in being able to efficiently run a medical practice. As if that weren't enough, pandemic economic bailout programs will contribute to at least a $3.7 trillion budget deficit this year---which may be balanced by cutbacks in funds for cancer research and practice (alternative payment models, anyone?).

It is anticipated that short-term changes in behavior may not revert rapidly. Handshakes will almost certainly become a thing of the past, with some controversy as to what would be the best form of greeting as a replacement. Plans for commemoration of "Hands Across America " will have to be postponed. Social distancing will be a difficult habit to break and, in addition to provoking a dramatic decrease in the birth rate, will continue the practice of defacing floors, resulting in windfall profits for the colored tape industry and possible confusion among the colorblind (for those in that position, remember that six feet is equal to the lengths of 2 1/2 adult Asian pangolins, Manis pentadactyla , excluding tails, but not of the giant African ground pangolin, Manis gigantea).

Back to business. What scientific advances have been overlooked during this time of sheltering in place and all attention has been directed to treatment and cures for COVID-19? One virus has gotten all the attention, and it's not even an alphavirus. We should have learned that a vaccine for Chikungunya virus, a real alphavirus, passed phase 2 testing and is moving into phase 3. The media in the US don't care too much about Chikungunya since, although there are millions of cases each year, 99.99% occur occur outside this country, and "Chikungunya" is terribly difficult to spell. And speaking of vaccines other than for COVID-19, we should have learned that early in April it was announced that researchers at the University of Missouri were successfully able to treat osteosarcomas in dogs with a vaccine prepared from the patient's own tumor, a discovery that could have important indications for human cancers. We should have learned than NRG Study CC001 demonstrated that minimizing radiation dose to the hippocampus can result in better neurocognitive outcomes after treatment for small cell carcinoma (throwing in memantine as a bonus). None of us may know that in April the NCCN not only up-dated its breast cancer guidelines (3.2020) but also published a policy paper on Impact of State Policy on Access to High-Quality Cancer Care and even gave recognition to the value of research on the gut microbiome! Parenthetically, over the next year state policy decisions will almost certainly make it easier to access a respirator (and maybe even gut microbiome testing} than high-quality cancer care. As if these weren't enough in terms of overlooked scientific milestones in April, it has been revealed that, for the first time, frog fossils have been discovered in Antarctica, indicating that warm, humid conditions existed there 40 million years ago. Or else it hopped off an alien vessel making a temporary landing there. Did anybody notice that the Department of Defense took the opportunity to release videos of UFOs from 2004 and 2015 while everyone was distracted?

It is certainly hoped that life will return somewhat to normal over time and that this column can return to addressing topics that other writers wouldn't touch with a six-foot pole. In the meantime, I would encourage readers to find solace in the uplifting works of Miguel de Unamuno and Emil Cioran, knowing that there is a very reasonable chance that we will finally be back to a January, 2020, lifestyle by May 6, 2022.

BONUS: In honor of Christopher Cross, who is recovering from COVID-19
Bailing (to the tune of Sailing )

Well, the virus spread from state to state, in each town that it reached,
They closed the stores and restaurants and even closed the beach
And everyone was stocking up on masks and gloves and bleach
Aggrieve me!

The jobless claims were heading for the most in history
And government and business saw a diving GDP, so
They made a plan to save what's left of our economy
Naive, me!

Bailing, giving away the money that we don't have
Apply for all the grants and loans
But really it's for free.

Ecstasy, as all the dollars stream
To those who are needy
Every multinational company and university
As you deceive me!

The lockdown was demanded, now small businesses are wrecked
While Harvard, Yale, and Princeton, and the NEA collect
When stores and homes are empty they're not hard to disinfect.
Deep clean me!

Printing money fast as possible is their priority
And after Amtrak and the airlines there's not much for you and me
But if inflation hits then we can use our dollars for TP
Relieve me!

Bailing, giving away the money that we don't have
Might as well include Burisma, and most importantly,
The PRC.

Asteroid JF1 Countdown: Asteroid JF1 will be impacting with or passing by Earth May 6, 2022, which, counting May 6, is 736 days from now. Plenty of time left to stock up on batteries, plywood, and hand sanitizer.

Thanks to Dana Alexander and Randolph Knific for supplying needed perspective.