As I write this, one quarter of U.S. adults have been fully vaccinated, while half have had at least one dose. If the vaccines offer us significant protection against the assorted variants in world circulation, there is hope that we may entertain a gradual return to pre-pandemic life once the vast majority of the population has been fully vaccinated. Here in the United States, debates about re-opening businesses and schools still rage, but a pervasive sense of “giving up” also is in the air.

“We’re tired of being under restrictions, and some people are vaccinated, and other people don’t care, so let’s just reopen,” is the rallying cry. No one wants their kids at home anymore; parents are exhausted. “The kids aren’t learning,” complain the parents, and this is partly true. Kids are always learning though; it is the nature of childhood to absorb knowledge and skills. They are learning patience, and closeness to their families, and sacrifice. They are learning that life and people and systems aren’t perfect. Looking back in 20 years, this learning experience may be judged an unexpected benefit even if unwanted now. Perhaps it will inspire these children to fix the problems they saw during this pandemic as they mature into adults, and make this a better world for the rest of us. Yes, home schooling is setting children back educationally, but it is setting the entire generation back equally; they will not be disadvantaged relative to their peers.

We have proof. Children survived the restrictions of the 1918 influenza epidemic, the polio epidemic, and evacuations into the arms of strangers in the English countryside during the London Blitz during WWII and still became productive citizens and went on to have families and good lives. Separations from friends and family and education are undeniably traumatic, but as we often are told during pediatrics rotations, children are resilient. They adapt, and survive and thrive. Thankfully, we are not in a crisis where bombs are falling overhead, or the death rate is astronomical due to the absence of modern medicine, or where the majority of the ill and dead are children. While I do not downplay the serious of the depression and the suicides that are occurring now, the PTSD from those other scenarios would be far worse in aggregate than emotional disturbances brought on by the current pandemic. Simply said, we should be grateful it isn’t worse.

People in some parts of our country have intellectual discussions about which vaccine to take, even as people in other areas are still desperately waiting for their chance to take any vaccine at all. Some people are refusing to take vaccines even when vaccines are available and offered to them. What an embarrassment of riches we have! Consider the rest of the world population, most of which has little access to vaccines. The vaccines that are within reach may not be as effective, or may have been withdrawn over safety concerns, or may be fakes provided by a criminal enterprise. The countries of Western Europe, which one would expect to be organized and orderly, have had surprisingly terrible vaccine rollouts. As a result, there are still national lockdowns in European countries. Consider the situations in Brazil and India, where there are vaccine shortages and poor logistics. COVID variants are burning through these two countries at record paces with case fatalities far in excess of the numbers reported by the governments. Political leaders are holding rallies there with tens of thousands of closely packed, unmasked supporters and encouraging mass religious festivals/superspreader events. Unchecked COVID gives rise to further variants which can then migrate and threaten the rest of the world with more contagious and deadlier disease. Think of the entire continents of Africa and Asia and South America and the many countries therein where access to care and access to vaccines are both poor for the common man. How lucky we have it in comparison!

India has a double mutation variant which is sweeping across the country. Young people in their 20s and 30s are making up the bulk of the inpatient admissions and the dead. Hospitals have been instructed to downplay the numbers of actual COVID related deaths and only report deaths from pneumonia rather than deaths from other COVID complications (PE, MI, CVA, etc.). The crematorium numbers tell the real story; investigative reporting by local newspapers suggest that the actual deaths are likely five to 10x what the government figures state. India’s health system, such as it is, is collapsing. There are no more hospital beds, let alone ICU beds. Patients are dying routinely because the hospitals are out of oxygen. Family members have to travel miles and fill oxygen canisters to bring to the bedside to keep their loved ones alive. Critical drugs are too expensive for the common man to afford; in India, family members must buy the drugs from pharmacies and then hand them to the nurse to administer. If you can’t pay for the drug or fetch the oxygen yourself, your family member dies. If you are the patient and you have no family to fetch/carry/pay for you, you die. It is fee-for-service medicine at its most cruel. Think of how much better we have it. Our system may bankrupt us eventually rather than immediately, but at least our loved ones get the care and medicines they need to save their lives when saving their lives is possible.

Remember that there are people in the rest of the world who would kill for a dose of the Moderna or Pfizer vaccine that some people in the United States have the luxury of refusing. For that matter, people elsewhere in the world might fight tooth and nail for the Johnson and Johnson vaccine, despite the rare reports of blood clots. Believe it or not, we would likely do the same in the same situation. We are in the greatest country in the world, and we need to understand just how good we have it, even in the middle of a global pandemic. This is the modern version of “Finish your dinner. There are children starving in Africa.”

In the case of a sudden drop in aircraft cabin pressure, we are told to put on our own oxygen masks first in order to be better able to help those around you put on their masks. We are a great nation, yes, and part of that greatness comes from our propensity to help the rest of the world. Let us quickly get our house in order. Let us get our population vaccinated and protected, the better to help the rest of the world. Let us appreciate and be thankful for our considerable advantages, and let us keep our guard up: The variants are already here.

Dr. Paranjpe is an ophthalmologist and medical editor of the ACMS Bulletin. She can be reached at reshma_paranjpe@hotmail.com.

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Deval (Reshma) Paranjpe, MD, FACS

Dr. Paranjpe is an ophthalmologist and medical editor of the ACMS Bulletin.