The current situation: In Windham and Tolland counties there are still a small number of cases that have been reported. Undoubtedly there are many more. I have seen estimates stating that for every case that is identified, there may be 100 more that have not been included in the count.

It has become very clear that unlike Influenza, which tends to present with a common pattern of symptoms, COVID-19 can present with a wide-variety of symptoms alone or in combination. While it still appears to be true that the vast majority of cases occur with no or very mild symptoms, there are some very unusual presentations, some of which can lead to death. MIS-C (for Multi-inflammatory syndrome – Coronavirus) is in the news now, with the occurrence of rare cases with cardiac and/or gastrointestinal or other severe inflammatory reactions in children and young adults.

Despite a lot of research and investigation, the science on COVID-19 is not complete, and many important questions remain unanswered:
— the availability of testing is still too limited
— the quality of available testing is variable, and the results are difficult to interpret. Unfortunately, neither a positive nor a negative test result may not always be true
–if antibody tests show the existence of antibodies, and that result is accurate, we still do not know whether this means that the person tested is immune

There are many other questions.

The Next Few Weeks: Northeastern Connecticut, while so-far having relatively few cases, may see a more rapid rise in the next few weeks. At least this is the projection from public health authorities, and our levels of caution should be high.

The “re-opening”: In the United States as a whole, public health officials are warning that it is too early yet to consider a broad-scale reopening. In more rural areas, a cautious resumption of “normal” activity may work out, but in more population-dense areas the risk for a “2nd wave” is higher. In my opinion, caution is advised, especially in Northeastern Connecticut and other more rural areas.

For a good discussion of some of the risks, see Erin Bromage’s blog post.

Alternatively, it is important to realize that the closing of much of our economy has created a huge amount of suffering in large portions of society. Furthermore, the suffering is not equally shared by all. There is much to think about here, and there are many important decisions that we need to make, individually and collectively, to emerge from this crisis and create a healthier environment. Much has been written about this. A column by David Brooks in yesterday’s New York Times is worth reading in this regard.

In general, I am not advising any changes from my prior recommendations. Influenza cases have dramatically declined across the country, and for those of you taking Influenzinum, you can stop.

I will continue to post from time-to-time.