Oh, friends. You thought we were done with COVID, didn’t you? Or that, between vaccinations and so-called acquired immunity, we had largely tamed the snarly, spiky beast?
Maybe the truth is somewhere in between. After all, life for most of us has had to keep moving, and maybe the best we can hope for is that the Tough Mudder race of life we are thrashing around in is not like the recent one in Sonoma, CA, where bacterial infections sickened hundreds of mudder toughers.
Most of these races go off without a mass-infectious hitch, similarly to how most who catch COVID-19 will not become long haulers. But, the nature of mud is to contain microbes, harmful and otherwise, and so whether it’s COVID or Tough Mudder, you’re always playing with proverbial fire.
Cases are up, good people
CNN posted this article on Friday: It seems like everyone has Covid-19. Here’s why this wave is probably worse than official data suggests.
Also, chew on these facts, gleaned both from the People’s CDC (they do a weekly COVID-19 “weather” report) and from my life:
· Wastewater detection of the virus is currently the only way to track cases, since the CDC stopped tracking PCR test results. And cases have clearly been on the rise since July:
· Hospitalizations were up 22% last week over the week before
· I have heard about at least five people within the last few weeks who caught COVID either for the first time or again. One was wearing an N95 mask when she caught it at a local store. At least two others I know of also took precautions but were around unmasked others.
All of this tells me that whatever strains are circulating right now seem quite contagious and fast spreading. It is unknown yet whether they are also more virulent. Scientists are trying to figure that stuff out now.
Eric Topol, MD, who in the Ground Truths newsletter on Substack provides frequent analysis of COVID-19 variants as well as Long COVID, had this to say last week:
…the fact that the inexorable evolution of the virus continues—to find new hosts and repeat hosts—cannot be ignored. If this isn’t “the one” it ought to signify that “the one” is still yet to come. If it never shows up, that’s great. But you sure don’t want to bet on that. All of us wish this was behind us, but it’s not. Facing that fact this virus, in one version or another, will be with us for many years to come, rather than denialism and complacency, is critical.
Dr. Topol thinks there’s no reason for alarm just yet, but he’s also a realist, and he has said the pandemic isn’t over yet.
You sure don’t want to bet on that
A lot of long haulers have been angered and frustrated by all the talk of the pandemic being over. It’s painful to see so many people trying to move on when we are still mired in a maze of debilitating symptoms, a medical system that doesn’t much know what to do for us, slow AF research, and disability safety nets that are insufficient and aren’t accessible to most of us.
It also particularly stings because we know too much. Most of us can still remember when we were healthy and didn’t believe we’d be the ones to get taken down by a “measly” respiratory virus. And how it only took a few airborne droplets to completely upend our lives. And how, since COVID isn’t over, a few droplets could take our healthy loved ones down still.
Yesterday, I got a note in Facebook Messenger from a college friend thanking me for my posts and information because he got COVID last year and hasn’t recovered. He’s now a long hauler. These kinds of messages break my heart because again, I know too much, and I don’t wish the experience on anyone. There was a time when 1-2 people a week were sliding into my DMs with the same sort of message, either pertaining to themselves or to someone they love. That pace has slowed, but it hasn’t stopped, and that should be enough to give pause.
As should this: most of us have had COVID-19 at least once, but for those who have had it two times or more, the data appear to show a:
Two times increased risk of death
Three times increased risk of hospitalization
Two times increased risk of long COVID and chronic fatigue
Three times increased risk of heart issues and blood clotting disorders
To drive home my point about risk even further, here's a reply I left to a doctor’s comment on a Substack thread this week. I’ve bolded and italicized the points I want to draw your attention to:
I’m a 2020 long hauler. Given the physical toll long COVID has taken on my overall health and all that I have lost (my 25 year career and virtually all of my pastimes), I submit to you this: even if your risks for this illness are less than what they were in 2020, what level of risk are you comfortable with if the costs are as high as they are with long COVID? In other words, if in 2020, a person infected had a 20% chance of their life being upended due to LC, but in 2023 that risk was 10% or even 5%, should it matter really if the risk is still a life upended?
I understand that until you’ve lived through this particular brand of hell, you can’t really wrap your head around just how life altering it is. But a mild acute infection turned me from a healthy, active 44yo at the height of my career to a physically and cognitively disabled 48yo with no job and a shit ton of debt.
This is still happening to people, even if it’s happening less. Keep masking, doc…or you may be forced to tell people that you used to be a doc.
While I want to shout from the rooftops that everyone should be concerned about such high-stakes risks, ultimately I can only provide information and my hot take and hope folks take heed. I do hear from a few friends here and there that their public precautions re: COVID are because they think of me, or because they do not want what I have, or because they do not want to bring the virus home to their elderly or immune-compromised so-and-so.* And that’s all I suppose I can hope for, besides looking out for myself.
*sadly, we learned years ago in this pandemic that appealing to people’s better natures to protect the hordes of unfamiliar fellow man did not work.
🎶 “Les yeux sans visage” 🎶
So, I am back to being eyes without a face in every public setting again (Billy says you’ve “got no human grace” and that you’re “such a human waste,” and while that may have been true of the dame he wrote the song about, it’s not true in this instance. Masking is an act of abundant grace toward other humans, an act that signals that you matter and that others matter.)
I had relaxed my masking in large, airy indoor spaces such as grocery stores. I only went to restaurants at off-peak times and only larger restaurants at that. But for the time being, I have canceled the few indoor social plans I had, and I’ve let others know that I’m waiting a month or so to reassess before making more plans. I am among the immune-compromised now, and, if I haven’t said this enough, I know too much. I do not want to inflame my already fired up immune system any further.
Bringing this in for a landing
In the words of Charles Darwin:
“It is not the strongest of the species that survive, nor the most intelligent, but the ones most responsive to change.”
I want you to survive and thrive, my friends. I hope you will consider taking even minimal precautions to protect yourselves and your loved ones right now. The People’s CDC has a great page on masking if you need a reminder about the most effective masks. And if you do catch COVID again, please call your doctor and get Paxlovid (not just for the elderly or immune-compromised anymore), which will lower your risk of severe and Long COVID.
Stay safe, my dearies (and stick around for the After-party below).
🥳 The After-party 🥳
Announcements, links to articles and studies, recommendations and shout-outs, and miscellany joy and/or tomfoolery.
🎶Baldy (a.k.a. best husband ever) loves this Billy Idol song, and as he has been known to tell our sibkids, he “was cool before all you fuckers were born.” Be cool like him and do not skip over this classic.
(For some reason, I can’t embed it, so go here to see the original video for Eyes Without a Face).
What’s your favorite Billy Idol song? Will you be upping your mask or social distancing game? I’m here for any and all thoughts on these matters. Comment below.
🩺🧑🏽⚕️Stumbled upon this great resource to help folks find a Long COVID-friendly doc: The Long COVID Doctor Map
🧠 If you liked my post last week on recovery and the brain believing what you tell it, here’s a short on Detaching from Your Own Thinking by Dan Buglio of Pain Free You.
🍑 In other health related Substack news,Michael Estrin posted the hilarious and well-written I Had a Colonoscopy. Here’s My Review in his newsletter Situation Normal. Whether or not you’re a colonoscopy virgin, there are laughs here for all.
🧘🏻♀️Another Substacker, Louise Burn, wrote in her newsletter Underachieving Overachiever about taking a break from writing her Substack in On accepting when the timing isn’t right. For those of you who read my post on pacing, you’ll appreciate her post. I admire her for getting in touch with what her body needs – this shit isn’t easy!
🐐 Lastly, it’s THE GOAT.
No, not that GOAT. This one 👇🏼👇🏼👇🏼
Still stunned to be back, Simone Biles is the national champion again 🥇
🐈⬛💩 But GOATS aren’t CATS, so here’s this week’s Cat Dump



There are definitely more positive cases these days, but I am not seeing many more masks. Your piece is encouraging me to put mine back on!
Yes, I have noticed the uptick. I already mask up at doctor's appointments and for public transportation. Will be redonning ye olde mask when I go to Trader Joe's and other grocery excursions.
Fave Billy Idol song: "Neuromancer" from his Cyberpunk album. Very underrated album on the whole.