Struggling With Uncertainty
Last updated 5/4/2020 at 1:37pm
When 2020 rang in four months ago, we assumed it would be much like 2019. We were certain that we would probably have jobs and that if we ate right and exercised, we would be healthy. We were fairly certain of our future.
That certainty has now vanished. The uncertainty ranges from the immediate to the long-term. When we shop, we wonder if the person near us or the cashier has COVID-19. We wonder if there is going to be any toilet paper available. If we have loved ones in “hot spots” who are elderly or immuno-compromised, who work as doctors, nurses and first responders, or who work in tight quarters such as meat-packing plants, we wonder if they will get sick and die. We wonder how long we will have our jobs.
Longer-term, we wonder how long local businesses can remain closed and still survive, how long our personal finances can sustain us, how long will the food supply remain fully intact, how long will it be until routine medical visits will become routine again and even relatively mundane matters, such as how long before we can get a professional hair cut. In every aspect of lives, from the personal to the general, COVID-19 has created medical, economic, educational, social and political uncertainty.
There is even much uncertainty related to the disease itself. Scientists know the genomic construction of the novel coronavirus, but the list of symptoms keeps expanding as does the list of organs it affects. We do not really know how many people have been infected, how many have recovered and how many have died. We don’t know if people can become immune and if they do, how long their immunity lasts. We do not know how long it will be until COVID-19 is “controlled” or even know precisely what “controlled” means.
People want certainty. As a result, we tend to seek certainly where it may not exist. The latest example is the “positive news” from a large clinical test of remdesivir. In a clinical trial of more than 1,000 patients, remdesivir appeared to reduce the recovery time for patients from 15 days to 11 days. Hoping for a cure, some have grasped on to this drug as a “game changer.”
However, the specific information from the study has not been released nor has the study been peer reviewed. The impact on the fatality rate also was statistically insignificant, and some medical specialists question why that outcome was dropped from being a primary outcome of the trial.
Dr. Michele Barry, a global health expert at Stanford University, told The New York Times, “It is unusual to call a drug the ‘standard of care’ until peer review of data and publication, and before studies have shown benefit in mortality.”
“Getting out of the hospital early is useful, but it’s not a game-changer,” Steven Nissen, a Cleveland Clinic cardiologist and expert clinical investigator told The Washington Post.
Medicinally, there have been no silver bullets regarding COVID-19 and while remdesivir may significantly reduce recovery times it apparently is not the answer to the COVID-19 riddle.
Dealing with COVID-19 is like running a race over unfamiliar terrain with an unknown finish line. It is physically, mentally and emotionally enervating.
For the vast majority of Americans born since World War II, we have never faced such uncertainty. The Cuban Missile Crisis was an existential threat, but it was resolved in a matter of weeks.
Yet, for most of history, humans have lived with uncertainty. For centuries people did not know when or what they would have to eat. Diseases killed millions who had no idea of what killed them. Even during World War II, there were more than 52,000 Army Air Force accidents that claimed more than 14,000 lives. These stateside accidents were not part of combat. For centuries, uncertainty was the norm.
We understand the uncertainty caused by COVID-19 is greatest for those who have had to make the greatest changes. For those of us living where infections are few and have the capability to work from home, the uncertainty is much more palatable than for those living where the rates of infection are higher, or those who take care of the ill, or those who have lost their jobs, or those who have had to close their businesses. The more fortunate should help the less fortunate.
In the meantime, we should remember that those who handle uncertainty best are not overwhelmed by it but make thoughtful, informed decisions and focus on the things they can control.