Covid Diary 2021: You Can Always Get What You (Don’t) Want

Day 1: Thursday, Dec 23: I need to get a COVID test. There are no appointments online in any of the usual retail pharmacy testing sites. I call my clinic and am told they have drive-through testing in 2 locations. I head to the nearest one, where a long line of cars is already waiting. I pull up at the end and wait.

A woman from the testing facility walks down the line of cars, saying something to each of the drivers. She comes to mine. I roll down the window. She says a different location has no wait, and the line I’m in is a 3-hour wait. I decide to pull out of the line and take my chances at the other location. Turns out she is right. There are just a couple of cars ahead of me. When my turn comes, the nurse assistant outside takes my details and directs me to one of the numbered spots in the parking lot. I pull up and wait. Within a couple of minutes, a lab assistant comes over. She is in full protective gear, gloves, mask, and shield included. She confirms my identity one more time and asks me to pull down my mask. She sticks a swab up each nostril, puts the swabs in a container and asks me to confirm my name one more time. I’m done.

***

The news is all about how thousands of flights are cancelled because of staffing shortages and low travel demand. It doesn’t say how much is which, but they’re all due to the spike in COVID cases.

I wouldn’t want to be one of those trying to get home for Christmas, stuck in some airport for hours waiting for a connection to make it home in time.

***

The Omicron mutation seems to be spreading fast, though parts of the country are still grappling with Delta. In NYC, the test positivity has been doubling every three days.?This poses interesting challenges for public health officials.

One of those challenges pertains to the stockpiling of monoclonal antibodies that can be administered intravenously and effectively against the virus. Monoclonal antibodies are lab-grown cells that mimic the defence of natural COVID-19 antibodies. One version is effective against Omicron, but there aren’t enough doses available. Only 50,000 or so. Another version from a different company is effective against Delta, and there are more doses available, some 250,000.

My physician’s website says I could be eligible for monoclonal antibody treatment but cautions that the treatment may not be available. With only 50,000 doses to go around, what are the odds?

A Google search for monoclonal antibodies pops up an ad for a facility within 10 miles of where I live that promises the treatment. It assures us that “90% of all recipients” will be covered by insurance. It doesn’t state what it will cost those that are not covered.

Day 2: Friday, Dec 24: Christmas Eve. The first thing I see when I wake up is a notification on my phone that my test results are ready. The message header reads ”2019 Novel Coronavirus (COVID-19) PCR”. I open it up and – I’ve tested positive. I have COVID. The long, automated message details several risk factors, guidelines for isolation, and what constitutes mild vs. severe symptoms.

We have already made plans to initiate the isolation protocol in the house. The protocol has been activated even before receiving the test results. The family is expected to gather at home for the Christmas holidays. The house is well set up to isolate effectively. Fortunately, no one else in the household would test positive.

***

The world of Covid-19 at-home tests is a vast, confusing maze. There are many FDA-approved tests, most of which are antigen tests. An antigen test?hunts for pieces of coronavirus proteins in the sample. Most rapid home antigen tests work sort of like a pregnancy test — it’s binary. If virus antigens are detected in the sample, you’ve tested positive.

The gold standard for COVID testing is PCR, an abbreviation for Polymerase Chain Reaction. It’s a term straight out of the organic chemistry classes from my undergrad in chemical engineering.

Rapid antigen tests – the most widely used at-home tests - may not conclusively tell you that you don’t have the virus. The PCR tests definitely will.

At-home test kits for both antigen tests and PCR tests kits are sold-out everywhere. The major retail pharmacies have started rationing the sale of at-home tests. PCR tests are more expensive than rapid antigen tests ( $120 vs $30). I finally find a brand of antigen tests online that is FDA-approved and order two. While I’m online, I also see one store with pulse-ox meters in stock, and I pounce on it. It’s the other COVID accessory that’s in short supply. ?

A lingering question over all of this is – what will insurance cover? There’s much confusion, and the Biden administration is supposed to make some policy announcement on this in January. There’s no doubt that there are two pandemics out there today: one for those who can afford access to care and treatment, and another for those who can’t.

Meanwhile, the Omicron wave seems to be ripping across the nation like a tornado, leaving a wreckage of holiday plans in its wake.

Day 3: Saturday, Dec 25: Merry Christmas. Sunny today, high of 44 degrees. No White Christmas this year.

With time on my hands and nothing on my social calendar, I’ve started watching the Beatles documentary Get Back sessions. Peter Jackson has taken some 60 hours of raw footage of the Beatles composing songs for a brand-new album – eventually to become Let it Be – and condensed it to a 3-part documentary, nearly 8 hours in total. It can seem pretty dull and a complete waste of time on the surface. I mean – is there anything left that we don’t know about the Beatles? Apparently, there is. ?

It’s January 1969. London is cold and dreary. It’s a slow and painful start for the documentary, even for a Beatlemaniac like me. ?Not much happens for most of part 1. The songs aren’t coming together. Paul is trying hard to get the creative juices flowing and is visibly frustrated that they are unlikely to meet their goal of coming up with a live performance of brand-new songs at the end of 18 days. The interpersonal dynamics are on full display. John is withdrawn and uninterested, Paul is trying hard not to be the boss, George is feeling stepped on and unappreciated. Ringo just looks on. He says the least. And there’s the inexplicable, creepy presence of Yoko, sitting in close with the band all day long, saying nothing. ?

The documentary would actually turn out to be a fascinating insight into the creative process at work, along with leadership and interpersonal issues that get in the way of any great endeavour. I enjoy watching the little things that make great music what it is. ?(Separately, I watch a YouTube show that breaks down all the guitars used on the Get Back sessions – the Epiphones, Martin D-28s, the lefty Hofner bass with the funky Bassman amp sticker, the Les Pauls and even the Fenders.)?

***

The Christmas season travel is in full swing despite thousands of flight cancellations. Omicron rages on. Over half of all new cases in the U.S are Omicron, over 70% in California. Illinois is a hot spot. DuPage County in IL, where I live, has seen a 97% increase in a 14-day period (Cook County, which includes Chicago, has seen over 195% increase). The national numbers for positive cases among unvaccinated individuals are far above those vaccinated. States with high unvaccinated populations are seeing their healthcare systems overrun by hospitalizations. Meanwhile, the unvaccinated have well and truly dug their heels in.

***

I have been reading Uncontrolled Spread, a book on the experience and lessons from the COVID crisis by Scott Gottlieb, the FDA Commissioner from the Trump administration. A couple of things emerge clearly from the book: 1) genomic sequencing technology has helped us avoid a far bigger catastrophe and saved more lives than we could have if the pandemic had struck just a few years ago. 2) pandemic response readiness is genuinely a national security issue, and when the rubber meets the road, it’s every nation for itself.

One of the interesting challenges of a national pandemic response is the vulnerability of the testing infrastructure to the availability of the lowest-value components.

An example is the nasal swab.

The standard nasal swab used for COVID testing looks like a Qtip. The tip is made of polyester (for a number of reasons, cotton swabs don’t work). Two companies worldwide control the bulk of the supply of these swabs – one is in Italy in the Lombardy region, the other is in Maine on the east coast of the U.S, a 100-year old family business that makes among other things, toothpicks and tongue-depressors. The two companies fiercely protect their market shares and have even sued each other repeatedly over patent infringements.

I am amazed that there can be patent battles over a polyester Qtip. ?

Day 4: Sunday, Dec 26

It’s another sunny day and I’m feeling much better.

I spend most of the morning writing words to a song about coming down with COVID, set to the melody of a popular Stones tune. I’m debating whether I want to record it on the guitar or the ukulele. I’ve surrounded myself with my guitars, my music, and my books to battle through my isolation. I am trying hard not to go stir crazy.

I also battle through part 2 of the Get Back sessions documentary.

***

The Beatles have decided to move out of the cavernous warehouse in Twickenham, where nothing was working out, to EMI studios in central London. The studio gets progressively crammed with gear over the coming days – several pianos, amplifiers, microphones and guitars everywhere. Sandwiches, wine and tea are served constantly. The Beatles are smoking cigarettes non-stop. Seems like they’re going stir crazy too. ?

But the music is slowly coming together. John and Paul agonize for days over whether Sweet Loretta is a Marsh or Mary before eventually landing on Martin (ever wonder why Beatles lyrics always seem effortlessly perfect?). Someone has a question about whether Tucson is in Arizona. Billy Preston has joined them by now and his electric piano transforms the sound instantly.

By day 18 or so, a decision has been made that no outdoor concert is possible to perform the new songs within the schedule available, so the only alternative left for what might be deemed a “public” concert is to do a show on the rooftop of the EMI studio building. There’s footage of the recon trip to the roof. It’s very windy and Beatles hair is flying all around. It all looks very unsafe and dangerous. Questions are raised about whether the roof will bear the load of all the equipment they plan to haul up.

Day 5: Monday, Dec 27

I finish a scheduled video check-in visit with my doctor (the pandemic gave us one important advance in healthcare services – telehealth). My pulse-ox meter shows I’m at healthy O2 saturation levels, so she’s pleased.?She runs through all my symptoms, tells me to stay quarantined till the end of the 10-day period from initial symptoms. Just as the visit wraps up, I look down at my phone and see that The CDC has revised its guidance to 5 days of isolation from 10.?I’m now past day 5 but within the initially planned day 10, with the symptoms nearly gone.

Note to self: Revisit quarantine options soon.

***

Back to the Get Back sessions. I’m well into part 3 now. The Beatles are divided about the rooftop concert and the logical end to the whole project they’ve been working on for the past few weeks. Paul wants to make it into an album. John wants to do a show. George doesn’t want to go on the roof. Ringo does. Personality differences are in full display, yet there are no raised voices. Sound engineer Glyn Johns tries to mediate, assuring them that regardless of the rooftop decision, they have valuable material that will amount to something in the end.

The final 30 minutes of the film is all about the rooftop concert. And what an incredible 30 minutes it is. Jackson has captured the celebratory mood from all the angles offered by the cameras, including the ones on the street level. The hidden camera in the foyer of the EMI building captures the comical moments when the Beatles’ wily crew stall the two constables at the door (both improbably named Ray) looking to stop whatever it was that is disturbing the peace (“look, I’m not threatening you but we’re going to have to make some arrests if it doesn’t stop”).

Up on the roof, The Beatles are unleashing their joy within. The ecstasy of performing their music live is exploding, shining in their eyes, pulsing on their faces. It pours forth from Paul’s trendy 3-piece suit, John’s oversized fur jacket, George’s lime green pants, and Ringo’s red raincoat. Their entire consciousness is locked into each other and this special moment which has been a long time coming. It’s a celebration befitting a grand finale for a great band. In those moments, one can see them relive their time in Hamburg’s Reeperbahn district and Liverpool’s Cavern Club. It’s almost a spiritual experience. Jan 30, 1969. Remember the day.?

***

I have been thinking about how I might have picked up the COVID infection.?Since I generally live a highly secluded life, I conclude I must have picked it up from one of the few people with whom I came in contact in the past week. However, none of them has tested positive as far as I know.

That leaves me with only one other possibility – my visit to the doctor’s office for my annual physical on Dec 21. In fact, my symptoms started appearing almost immediately following that visit.

The irony isn’t lost on me.

Be safe. This isn’t over yet.