Dr. IV Mirus on omicron, masks, and Bob Saget injury

Alex: With the Covid-19 Omicron variant, we saw on New Year’s Eve that the numbers were very bad. Rates were high with many people contracting the virus. We were hitting almost a million cases in one day. Now, cases are down 60% and even Democratic blue states are announcing that they will not have a mask mandate. Some school districts are allowing parents to decide if their children should wear masks. So it now seems that mandates are going down. Can you explain your perspective on where we are currently with the Covid-19 pandemic?

IV: Yes. So, we did predict that the Omicron variant would be rampant, and that did in fact happen. But, fortunately, Omicron itself did not cause serious illness. So that means while many people were hospitalized, most of them were able to recover fine. Right now we’re seeing those numbers go down quickly, which is very fortunate because either people are vaccinated, meaning they have protection against Covid-19, or there’s the chance that they already contracted the virus, so they have a natural immunity against it.

So now as you’re seeing the numbers go down, Covid-19 has been exposed to many people in the U.S. That means we can expect that many people in the U.S. have an immunity of some kind. That allows policymakers and government officials to allow for removing mask mandates. You can see in the states of California and New York, masking policy is changing. But other states such as Texas and Florida never had a mask mandate to begin with. So now, the U.S. is leaving masking as an option, so you can do whatever you feel comfortable with moving forward. That’s the reason it’s been proposed, this big idea that people already have immunity by now, either through the vaccine or through natural immunity by getting sick and recovering fully.

Some others in the medical profession do have some concerns regarding masking and following CDC guidelines. I expect that the CDC will announce more policies this week, detailing more about what to do next. Another concern of many is the idea that if mask mandates end, what will happen if a new variant emerges? Or if numbers start to go up again, will we need to return to a masking policy? Will people be willing to do that? It’s confusing, this back and forth of changing policies. That’s a concern too.

Alex: Now it seems that as numbers go down, we are seeing the word “Endemic”. Can you explain that term, and are we arriving at the point of an endemic?

IV: The theory right now is that Covid-19 will become endemic. And as for what that means, imagine a house, and the whole house is on fire. That’s the pandemic, the whole world is experiencing this virus. Therefore, the whole house is on fire. That’s no good and we don’t want that. An epidemic is different than endemic. An epidemic means that perhaps the house is fine, but there’s still one room on fire, the kitchen for example. It’s not the whole house, just an area, but the kitchen fire is not under control. That’s still bad news. Then you have endemic, which means that perhaps there’s a fire in the fireplace. Not the whole room, nor the whole house, just the fireplace. We have to be careful, and watch the fire to make sure it’s safe. We need to make sure the fire doesn’t spread to the rest of the room and make its way to the kitchen, right? We don’t want an outbreak, in other words the fire spreading from the fireplace. If a fire takes place within the fireplace, we’re fine. So we suspect that will happen with Covid-19. Some areas, whether it be cities or specific areas, may have outbreaks within them, but the hope is that those numbers will stay contained and go back down. That’s why it’s important to keep an eye on the numbers in your area to decide if you should use a mask or not.


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Alex: Now, let’s move to a different topic entirely, although it’s still medical related. Last month, Comedian and Actor Bob Saget passed away. It was revealed that he had a severe fracture on his skull, starting at the back of his head and going all the way to his eye sockets, an orbital fracture. It’s said that this kind of injury is typically associated with a fall from 30 feet or blunt force like a baseball bat. Could you explain from a medical perspective this kind of head injury, and why it can kill someone?

IV: Head injuries are very severe, and can be life threatening. There are different kinds of head trauma involving bleeding. There can be some bleeding inside the brain, which can cause headaches, whether it be from a fall or from forced impact. Then there are other kinds of bleeding if you picture a brain, the skull is the hard bone protecting the brain, right? The problem is pressure. So if you have bleeding outside of the brain, swelling can occur. But the skull isn’t flexible enough to compensate for that. So when there is blood inside the brain, that causes high pressure on your brain.

Alex: Compression of the brain.

IV: Right, exactly. There’s compression on the brain and that is dangerous. Your brain does not like that. Your brain doesn’t have any place for the blood to go. It’s locked inside your skull with no outlet. And that’s a real problem, that pressure. So what happens is your brain undergoes that pressure which can cause different kinds of symptoms. For example, this can cause confusion. You might not be sure of what time or day it is, or where you are. It can cause nausea and vomiting, seizures, or passing out. And really, the only way to solve this is to remove that pressure. So what an emergency doctor like me, or a neurosurgeon would do is make an incision to allow the blood to escape, which relieves that pressure. So you can see how time sensitive this issue is. If you experience a serious head injury, it’s important to seek emergency or medical help. It’s especially high risk if you’re on blood thinner medication, such as Aspirin, Warfarin, there are many different kinds. People tend to know if they’re taking that kind of medication. If you do, you can bleed more and bleed faster so it’s important to be careful. I would advise you not to worry too much because this isn’t common. But if you have these symptoms such as confusion or you’ve passed out after an injury to the head, it’s always a good idea to seek medical help.

When you arrive at the emergency department, what they tend to do is observe you and ask questions for three, maybe four hours to make sure there’s no bleeding. Sometimes they do a CT scan, and they will find bleeding if it’s there. Those are the two main things. If after four or five hours you are feeling fine, you’ll be discharged.

Alex: I appreciate your time!

IV: Of course!

Alex: Thank you, take care!

IV: Stay well!