Metaphors and analogies abound when trying to communicate risk and scale of things that are not familiar to us. Yesterday, I heard an interview with Dr. Michael Osterholm of the University of Minnesota Center for Infectious Disease Research and Policy. Dr. Osterholm is famous for using a baseball analogy to describe where we are with the COVID-19 pandemic. Yesterday, he said, “We're at the bottom of the fourth or the top of the fifth inning,” meaning that we're only at best about halfway through this ordeal.
I have had a different metaphor come to mind for this stage of the COVID-19 pandemic—the false summit.
I have a colleague who is a mountaineer. He has climbed the highest mountains on four different continents—seeking the Seven Summits. When I was 15, I also had the opportunity to summit a mountain, Mt. Rainier (elevation 14,410 feet) outside Seattle. Mountaineering is an endeavor that can be done as an individual (see Reinhold Messner) but is more commonly done in groups, or at least with a guide.
Mt Rainier, from nps.gov
While it's unlikely that someone may die while mountaineering, that risk is always there. Mt. Rainier is covered with glaciers. The most treacherous aspects of walking over glaciers is encountering a crevasse—an opening in the ice that can be dozens or even hundreds of feet deep. Tumbling into a crevasse is a good way to break a limb—or even your neck.
Photo: nps.gov
To reduce the risk of falling into a crevasse, we roped up in teams of five. We were trained to stop (or arrest) a fall by immediately dropping into a three point stance with our spike (crampon) covered boots and our using our ice axe as the third point. If anyone of us should slip on a slope, or even worse, fall into a crevasse, the others could prevent the fall by securing ourselves to the ice and snow. We relied on each other to keep each other safe. It took protective equipment, training to use that equipment, and trust in our fellow climbers to reach the summit with a modicum of safety.
As we set out from Camp Muir (elevation 10,000 ft) and started our summit ascent in the very early hours of the morning, while the snow and ice was still firm, not yet warmed by the sun, I remember one of our guides say, “Don’t get bummed out about a false summit.” Beyond the obvious challenges of cold, altitude and physical fortitude, one of the biggest challenges of mountaineering is mental. Keep putting one foot in front of another. As I climbed, and especially as the morning wore on, and I was getting tired, I spotted an outcropping of rock in the distance. As this climb was in the pre-GPS days (1976, to be exact), I was certain we were near the summit. We had already traveled so far! As we arrived at the outcropping, I saw that it was just a ledge, and we still had a lot higher to climb to get to the summit. My hopes were dashed that we were done. More slogging! Eventually we reached the summit, a volcanic caldera, long quiet. The reward was the 360 degree vista. In the distance, we could see Mt. St. Helens—also a quiet volcano, or so we thought!
With the coming approval and distributions of vaccines for COVID-19 at our doorstep, I fear that we are reaching a false summit on our way to the top. The administration of the first doses of vaccine will not be the summit of our journey. We still have many feet of mountain ahead of us. As vaccines are administered to the most vulnerable and front line health workers, it will not stop the deaths of people now in our ICUs, and won’t stop the many transmission events occurring in the community. It will take weeks for the first doses of vaccine to induce protective immunity, and months before enough doses are administered to put a dent in transmission. Those hoping for a knockout punch to start the New Year will have hopes dashed.
So it’s time to keep putting on our gear (masks), rope up, and keep each other safe as we climb this mountain. We will get there!