How do you land a fighter jet with no wheels, no tail hook, and one engine onto an aircraft carrier moving at 14 knots? Top Gun Maverick! If you have yet to see this, think about watching it. It's an exciting story about highly skilled people with incredible bravado who risk their lives serving us. But there is more: it's about innovative problem-solving, taking responsibility, teamwork, and friendship. So how do you land that jet on the tarmac of a moving boat? Your friends and your coworkers catch you with a big old net on the tarmac and then put the fire out around you. And then you celebrate life! And so it is with our lives. We have family, friends, and coworkers, and if we cultivate and celebrate these important relationships with kindness and respect, they are there for us and we are there for them.

COVID update:

• XXB is a variant on the rise in the northeast and continues to be very contagious. The flu and RSV are slowing, at least for now.
• If you have had the COVID-19 primary series plus one booster, you will likely have a mild course if you get infected.
• A history of a COVID-19 infection plus the primary series plus one booster gives you hybrid immunity of an uncertain duration. You are not bulletproof but if you contract COVID, it most likely will be mild.
• It still appears that the original mRNA vaccines, consisting of the original series plus one booster, have continued to reduce hospitalization, respiratory failure and death.
• China has a real problem: 5,000 to 10,000 deaths per day. Their vaccine, Sinopharm, was given to a fraction of their population and was marginally effective.
• The CDC has decided that travelers from China must have a negative PCR test within 48 hours before departure.
• Vinay Prasad, MD, is a Professor of Medicine and Epidemiology at USF. Here is his latest published piece which speaks to poor decision-making at the CDC.
• The CDC has still not approved the Protein Subunit Vaccine (PSV) for anyone who wants it as a booster.
• This is what Dr. Paul Offit had to say about the Novavax (PSV) vaccine this summer. I contacted him last week and this non-mRNA vaccine still needs to come to his committee.
• The antiviral Paxlovid is very available but careful thought needs to be given before prescribing it due to drug interactions, GI side effects and high rebound rate (5 to 20%).
• Paxlovid does have a role for vulnerable elderly patients as those with poorly controlled diabetes, heart or lung disease or those with immunodeficiencies.

What is this life all about? We are a speck of existence in the universe. But something must hold us together and make things relevant. Are we part of something bigger? Are there multiple universes? And if there are, what is beyond that?

There are times, for a fleeting microsecond, that I think I am close to understanding how everything fits together; it tends to happen at joyful times, it's odd and it's very evanescent. Einstein spent the last 30 years of his life working to understand this. He tried to construct the Unified Field Theory. He got stuck because he could not accept the randomness proposed by his friend, Niels Bohr, who conceived the Quantum Theory. So, yes, Einstein was human and experienced the backfire effect. He dug his heels in and focused on finding forces that explained how it all works. Einstein died at 75 of a ruptured aortic aneurysm, with math notes and a pencil on his nightstand.

On a musical note: Better Days by Goo Goo Dolls. Life is messy. The new year is a time to look for better days. And if you feel broken in some way, it's okay to ask for help.

On a lighter note: Get outside and enjoy the simple pleasures.

As a reminder, I'm no longer sending out daily updates and instead, I'm updating you periodically. I continue to enjoy writing these updates. Initially, these were only sent to my patients, however, I've been humbled to learn that, through social media, these writings have been forwarded and re-forwarded to many. This has brought me great joy to know that this simple act of sharing facts, thoughts, opinions, and hopes has touched you in some way. Hopefully I've been able to reassure you, maybe make you smile and laugh, soothe your worries, and comfort you. And maybe, just maybe, I've helped you to be in the moment!

Reach out. Stay connected. Stay home. Save lives. The power of one. Be well.

Feel free to forward this on: spread the word, not the virus.

HAO

24/7

Harry Oken, M.D.

Adjunct Professor of Medicine

University of Maryland, School of Medicine

Office 410-910-7500

Fax   410-910-2310 

Cell   443-324-0823