As a pathologist on the frontlines of the COVID-19 pandemic, Dr. Zachary Grimes has seen the immediate impact a novel virus can have on a city, state and country. More than 400,000 Americans have died as a result of the virus, and that number continues to grow.
While the virus is given as cause of death for those individuals, Grimes said it is an oversimplification to blame the virus alone with every case.
“I gave a talk recently to [Pocahontas Memorial Hospital] and one of the things that I stressed is, if you look at the demographic of patients who have contracted the disease and who had really bad outcomes, a lot of these patients had underlying health conditions that are very similar to the underlying health conditions that we see every day in rural America – like in Pocahontas County,” he said.
“I think that’s very important because one of the mysteries behind the disease is why is it some people get it and they’re asymptomatic; other patients get it – they get some mild symptoms,” he continued. “Then there are some patients who get the disease and they have very bad outcomes, and those patients obviously pass away. So looking at the commonality of those patients, what you see is that a lot of these patients have underlying high blood pressure; they have underlying kidney disease; heart disease. Some of these patients have underlying lung disease, and those are really the maladies that we see facing rural America today.”
With that information in mind, Grimes said it is possible to look at certain demographics and try to help prevent those individuals from contracting the disease – with social distancing, wearing PPE and a vaccine.
“The best cure is prevention of any disease,” he said.
The ways to prevent passing on the virus may seem simple – wear a mask, keep a distance of at least six feet between you and others and get vaccinated – but there are still many out there who don’t agree with or follow these guidelines.
“There seem to be some people who have a mistrust, I guess, in wearing a mask, or people who have a mistrust in the vaccine,” Grimes said. “You can’t have mistrust in both. You have to choose which one you want to do, but not doing both – it’s not going to fare well for you.”
As someone who has been in the center of the pandemic for nearly a year, Grimes finds it a little disheartening that there are still individuals – including here in his beloved Pocahontas County – who don’t wear masks in public and are not as concerned about the virus as they should be, in his opinion.
“To be honest with you, it is frustrating,” he said. “It’s kind of a slap in the face that there are healthcare workers who are working around the clock, fighting this disease and because you don’t see it every day, you don’t think it’s that big of a threat.
“It’s kind of hard to say you love your neighbor and, yet, you do nothing to try to protect them,” he added.
This past summer, Grimes took two months off from work and returned to Pocahontas County where he saw several instances of individuals not taking the pandemic seriously, and it drove him to speak up and explain the reason behind the guidelines.
“I was really exhausted, and I was waiting for my transition between being a resident and being an attending, and I came back home,” he said. “You would see people that you grew up with who would blatantly refuse to wear a mask or follow the social guidelines put out there by very intelligent people.”
Once the number of COVID-19 cases in the county rose, Grimes said he was happy to see that residents were taking the guidelines more seriously.
“I think it changed some people’s views,” he said. “I think when they realized they knew some people who were dying from the disease and that it was no longer this abstract thing that was happening, they took more serious thought to it.
“A mask is not a sign of weakness – it’s a sign you care about something.”
The vaccine is currently making its rounds in the country and while there are some who think it came out in a rush, Grimes said the science of today has made it possible to create a vaccine faster than in the past.
Grimes looked at the way the public has reacted to the vaccine rollout and compared it to a popular children’s tale.
“We didn’t invent the story of Goldilocks for no reason,” he said. “There are always going to be people who say something is too hot and something is too cold. The story of Goldilocks is nothing more than human psychology. There are always going to be three types of people – too hot, too cold and the in-between.
“I think that’s kind of what we see here – that there are all these conflicting sides – but I think the thing that people need to understand is that science and public policy, when they work together, can create miracles like we saw with this vaccine production.”
Looking at history, Grimes sees many similarities in the COVID-19 pandemic and the 1918 Spanish Flu pandemic. Although there is not an accurate number of deaths due to lack of death certificates, an estimated 50 million people perished worldwide from the disease. Of those, approximately 675,000 were Americans.
“It was a disease that circulated in the population for about two years before it kind of changed its course,” he said. “There was a book by [Daniel] Defoe [A Journal of the Plague Year] written in the Middle Ages during the plague. If you look at the way in which people in London dealt with the plague, it’s very similar to the way we saw it in New York.
“People who had the resources left the city for the countryside,” he continued. “The people who didn’t have the resources were left in the city with the disease, so I really think while they are very different diseases and the way they effect people are different, the way in which we responded, unfortunately – which means we haven’t learned that much – has been the same.”
While we can learn from our history, there are some things that cannot be predicted by comparing today’s pandemic with those of times gone by.
“The thing about COVID-19 that I think is important for people to understand is we don’t know the long term sequelae of the disease – or the long term impact that disease may have on you,” Grimes said. “We call these patients long haulers, like tractor trailer long haulers because some people get the disease and they have persistent effects because of it.”
While there are individuals who will bounce back with no lingering effects of the virus, Grimes said there will be instances where people will have long term health issues, possibly for the rest of their lives.
The long term effects of the pandemic and virus are not isolated to just those who had the virus. It will affect everyone and in many aspects of their lives.
There is a push to get back to normal, but to Grimes, we have to find a new normal in which we address many of the issues brought to light during the pandemic.
“I want us to get back to normal, but I also want us to focus on the underlying problems that got us here to begin with,” he said. “Healthcare inequality in the United States. Everything was in place really for it to be the perfect pandemic in terms of a virus. You had people who were very sick in the nation because of healthcare inequality and socioeconomic divisions and it allowed the virus to take a stronghold here in the United States.
“One thing I think the virus has done is that it’s taking every little boogeyman that we’ve put in the closet and it’s brought out the boogeyman,” he added. “It’s exposed every problem that we have – whether that’s healthcare inequality or the lack of high speed internet to teach students from home.”
While it has been obvious in Pocahontas County for years that internet speed is incredibly lacking, it took the pandemic forcing students to learn remotely and virtually to make us realize just how bad the internet service is countywide.
“These are issues we’ve kind of put on the side burner for years – like the lack of high speed internet in rural America because we haven’t had to really push for something like that. We took for granted that we can put a kid on a school bus and take them to school, and they’ll learn. Then this pandemic comes and we realize that we don’t have the infrastructure to help students get an education.
“The healthcare system also had some setbacks. The nation’s healthcare providers and facilities reacted swiftly and have done a fantastic job of handling the pandemic, but there are so many patients with other issues that had to be put on hold because they were not a top priority.
“The longer we allow this virus to take place, other amenities or other conditions are going to go unchecked,” Grimes said. “It’s costing, not only people dying from COVID, but people are also dying from other preventable diseases because they can’t get access to their primary care physician or a specialist anymore. If you make an appointment with a lung doctor right now, the wait list is incredibly long. That’s the thing that we really need to understand.”
Another issue close to Grimes’ heart is the long term effects of the pandemic on the healthcare providers themselves. The emotional strain and fatigue they have gone through since the beginning of 2020 has yet to catch up to them, but once they return to a regular schedule, those issues will catch up.
“I think people need to understand that we do take the healthcare – the doctors, the nurses, the orderlies, the aides – for granted because it’s going to burn out people over time,” he said. “This is not going to be sustainable working at this pace. I think right now we’re not seeing it because we’re so busy and so that suppresses it.
“The pandemic may be over sometime in the future, but the long term consequences are going to be with us for a long time.”
“I understand that in rural America, and rural West Virginia, people’s livelihoods are being turned upside down with it – businesses, school events – but, I think, unless we work collectively, we’re not going to get this virus under control,” he said. “You have to make sacrifices and those short term sacrifices will get us back to the way of life that we want.
“It will just take some time.”