The U.S. National Institutes of Health has issued the final version of its Covid-19 Treatment Guidelines, perhaps the most influential reference work of its kind for SARS-CoV-2 since its humble beginnings four years ago.
It’s hard to believe it has only been four years, as it feels more like four centuries have passed, but in the spring of 2020, people were downing hydroxychloroquine and hoarding livestock store supplies of ivermectin when there was not any proof that either of these drugs worked against infection by what we then called the novel coronavirus and, soon thereafter, there were studies that conclusively showed that a placebo would have greater efficacy.
The NIH saw fit to convene a panel of 40 experts and the result was an august series of guidelines. A view of the archives is a tribute to human ingenuity and how quickly scientific knowledge and technological progress evolved in the initial years of what was only declared to be a pandemic four years ago on March 11, 2020.
An online archive of the guidance will remain online August and, going forward, it will be a variety of physicians’ groups who typically fill the role of stewards of best-practice guidance including the American College of Physicians and the Infectious Diseases Society of America that will be the keepers of SARS-CoV-2 treatment guidelines.
With all this, it’s important that we don’t throw away the baby with the bath water and forget the lessons of the past four years. It’s still common sense to avoid crowded spaces, practice preventative medicine, continue good hygiene including frequent handwashing, avoid poorly ventilated places, and spend more time outdoors.
It’s been a long time since people were wiping the mail and lettuce leaves with disinfectant and we’ve learnt quite a bit in the interim. Let’s hope it sticks.
Keep in mind that, even with a significant drop in cases and deaths, in the period January 8 through February 4, 2024, there were over 503,000 new cases and at least 10,000 new fatalities reported.
Finally, and it isn’t even close to the first time I’ve repeated this: “It ain’t over until the fat lady sings.”
For the curious, this phrase apparently was first uttered many decades ago, perhaps by multiple people at various times in the twentieth century, but Samuel Goldwyn is said to have explained to a friend how to know when an opera is actually over by saying, “Just remember, it ain’t really over ‘til the fat lady sings.” The first known reference in the media appeared in the Dallas Morning News on March 10, 1976, in a sports-related article quoting Texas Tech sports information director Ralph Carpenter as saying, “the opera ain’t over until the fat lady sings” with reference to a basketball tournament. The Yale Book of Quotations seems to confirm Carpenter as the originator of the phrase, even though he probably wasn’t.
As for me, I had always imagined it was something Groucho Marx would have said.
Nonetheless, the colloquialism “It ain’t over until the fat lady sings” implies that one should not presume or pretend to know the outcome of an event that ostensibly is still in progress.
It’s typically invoked at such time when it appears that said event is possibly nearing its conclusion and meant as a caveat against assuming that the current state of affairs is a foregone conclusion and, hence, irreversible.
The phrase clearly has its origins in opera, where sopranos are known for being plus sized, to put it politely. Some attribute the phrase’s beginnings to the Wagner opera cycle “Der Ring des Nibelungen” where in “Götterdämmerung,” the Valkyrie Brünnhilde, traditionally portrayed by an amply endowed soprano, in her farewell scene – which has a duration of approximately 20 minutes – sings about the end of the world, or at least the world of the Norse gods.
This is not to be confused, however, with what Yogi Berra famously said, namely “It ain’t over ‘till it’s over.” Berra actually never uttered those exact words and it appears that the then former majority leader of the Connecticut State Senate and future U.S. senator Joe Lieberman, at the time a candidate for state attorney general, summed up the race for that position in 1982 by invoking Berra’s name thusly: “As Yogi Berra said, ‘it ain’t over till it’s over.”
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