April 2021—“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
I thought of this Winston Churchill quote when I, along with many others, received my first COVID-19 vaccine in December. Unfortunately, this country would go on to experience a second peak. My counterparts in other countries remind me of their third peak. Still, we are well along in the end of the beginning.
By the time this column reaches you in mid-April, COVID-19 metrics will have changed, and I believe will be better. This is being written in early March and positive indicators are abundant. Testing availability has increased substantially. In the U.S., reported new daily infections have fallen significantly from their peak in January, while more than 10 percent of the public is now fully vaccinated against the virus. President Biden just announced that by May 1 he expects that all American adults will be eligible to receive the vaccine.
“Give us the tools, and we will finish the job.”
Churchill aimed that comment at the U.S. Congress and the public in 1941, before our country entered World War II. I have personally, without shame, used this when talking with the FDA, the Department of Health and Human Services, and members of Congress as well as their staffs. In the pandemic, this has been our plea from the start: Give us the tools—consumables, reagents, platforms—and we will give you the answers. Those answers will be reliable, accurate, and timely enough to maximally benefit our patients.
While supplies are less scarce than they were last year, we are still not where we want to be. In a CAP survey of members conducted in February, we found that 45 percent of labs were still struggling to get adequate reagents and 30 percent were struggling to get enough consumables. A full year into the pandemic, we have yet to meet the goal of making enough accurate, local testing available for all who need it.
The new American Rescue Plan, which was just signed into law, includes funding for exactly that. Nearly $50 billion has been set aside for diagnosing and tracing SARS-CoV-2 infections and for purchasing and distributing test supplies. This support is desperately needed and will be much appreciated by our members across this country. I am anxiously awaiting the funds.
“Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
Not Churchill: That is the First Amendment. Every word in the amendment is important. The second phrase is why I am allowed to write this column. Today I am focused on the last phrase. This phrase guarantees us the right to go before our members of Congress to identify our needs, to lobby for more testing supplies so we can take care of our patients, and to draw attention to our economic situation so that we can afford to continue practicing medicine. In my opinion, the CAP does this better than any other pathology organization. This petitioning of the government to redress our grievances has been particularly important in the time of COVID-19. They are, ultimately, the grievances of our patients.
Victors write the history books.
While it has been attributed to Churchill, and he used it on more than one occasion, it is actually an adage that has been around since at least the 19th century. It is relevant today. One day in the not-too-distant future, we will come out on top over this virus. When we do, we will be the victors. I hope we remember the pandemic history that got us there. It is always dangerous to rewrite history. This rewriting, or selective remembrance, does allow for future celebrations, but it also causes us to forget our mistakes rather than learn from them.
Our history should include what we needed to do, what we should have done but did not, and what we did to best take care of our patients. We should never forget the lessons of this experience. Examples include the building up of our Strategic National Stockpile so we do not ever again find ourselves short of PPE, critical hospital equipment, and laboratory supplies. We must own our responsibility to tell this story correctly and without bias so that decades from now our future members will know what worked, what we did well, and what we did not.
Some members disagree with me, but I do not see a scenario in which SARS-CoV-2 is eradicated, particularly in view of animal vectors. Also, global availability of vaccines and the reluctance of some to take the vaccine will continue to be a problem. COVID-19 will become endemic and will be with us for a long time, in one form or another. But we will beat the virus back, controlling it with vaccines and herd immunity to keep its numbers down as much as possible. Still, members of the CAP and the laboratories we direct will continue to be called upon to answer the most fundamental question of all: Does my patient have COVID-19 or not?
Dr. Godbey welcomes communication from CAP members. Write to him at president@cap.org.