- There is frustration regarding how to best balance the public health, emotional and economic effects of managing COVID-19
- Recommended approach is to to do what the leading doctors, scientists and their families personally do, which is largely mask and social distance to help avoid transmitting and being infected by the virus
- Achieving broad adoption of this behavior will be a major cultural change for the U.S.
- There is worry that even with the demand flattening there won’t be enough capacity to care for both COVID-19 and non-COVID-19 patients, especially during flu season
- Long-term solution will be to create immunity, probably using a vaccine
- Near-term solution is to discover and to quickly deploy better antiviral treatments
Americans expect our health care systems to perform well. We get sick or have an accident and generally think that doctors and hospitals will make us better. We trust our providers, who are well-educated and work hard to stay current on best approaches to care for us. And we trust our hospitals to have the facilities, equipment and staff needed to support our physicians.
Of course, we also know that doctors and their hospitals are not miracle workers. We recognize that some diseases like cancer and heart, kidney or liver failure are life-threatening and, despite best efforts, efforts to heal can fail.
However, generally we have confidence that when we interact with our health care delivery system there will be good outcomes.
With this as a backdrop, we grow frustrated – if not impatient – because we do not have the same control over the COVID 19 virus. We do not like hearing that our physicians and scientists are in discovery mode and that they don’t know what the future holds.
We also worry that blunt instruments like stay-at-home directives may create more harm than good, when we consider the many associated economic and emotional costs.
So how do we cope with COVID-19 here in Lee County?
Candidly, my recipe has been to use a “do what I do” approach. By this, I mean I try to find out how health care leadership, doctors, scientists and their families are living their lives and then I copy their modeling behavior.
What have I found? They are all about not becoming infected!
- They are remarkably strict about wearing masks, constantly using sanitizing hand gel, washing their hands and being socially distant.
- They don’t just rinse their hands. Rather, they use lots of lather for 20 seconds which is the Happy Birthday song sung twice.
- They are incredibly careful about touching their mouths, noses and eyes. They try very hard to not touch those parts of their bodies, except after they have washed their hands.
- They worry about contaminating their masks. They will replace or wash them if they suspect there may be virus on them.
- Some apply disinfectant wipes to anything they bring into their homes, or quarantine for a day or so anything items they bring into their homes.
- Some do not go shopping and rather opt for curbside pickup or home delivery.
- They try to not visit individuals who are at high risk like those with chronic illness and/or the aged, for fear of spreading the infection to those who will have a hard time surviving.
- They try to avoid contained spaces like elevators where a sneeze or a cough, even with everybody wearing a mask, creates a high likelihood of exposure to the virus. Instead they use the stairs.
- Travel is limited to must-do trips.
- They avoid restaurants where tables are not socially distant and servers are not masked.
- They substitute phone calls and tele-videos for in-person visits.
- They try to limit their in-person visits to being with people who behave the same way they do.
- They also worry about their immune systems. They try to get enough sleep, eat balanced diets and take vitamins and minerals thought to boost their immunity. They work out. Doctors and scientists have found that infected patients that have stronger immune systems tend to do better.
These doctors, scientists and their families have adopted these ways of avoiding infection because the virus can wreak havoc with a person. It can surely kill. And, it can also permanently damage heart, lung and nervous systems, making a patient chronically ill.
Treating COVID-19 can be a grisly experience, too.
For me, making these behavior changes has taken some discipline. I am a social person. These precautions require me to ask relatives, friends and others sometimes-uncomfortable questions and to make judgements. Frankly, occasionally I disappoint if not altogether offend. I try to not come across as self-righteous but, probably and sadly, I sometimes do.
I really do not feel good about having to constantly be on guard and the social isolation, but it is better than going back to a stay-at-home mandate. Further, it is something I can personally do to help stem the spread and to make a difference.
It would be great if the more social parts of our society could find their way to avoid being albeit unintentional spreaders. Given our culture, broadly accomplishing this behavior change will be difficult. Gatherings are part of what defines us. Hopefully, education and awareness will be enough to motivate behavior change.
I worry that without success in containing the spread, demand for care will grow beyond what the doctors and hospitals can provide. There are limited numbers of beds, equipment and staff. PPE is still hard to come by. Candidly, it would not take much growth of disease to overwhelm our capacity to care.
I also worry that demand for care is relatively low right now and that, come next winter’s flu season when we add flu patients to those sick with COVID -19, we will be in trouble.
This possibility adds to the need for everybody to do their part.
I think the question remains whether the way we are now living our lives is a temporary or permanent change. Said differently, is this masking and social distancing the new normal?
I truly hope we discover an effective vaccine that ideally provides permanent immunity. I know enough about vaccine development to understand that if the scientists and manufacturers are successful, it will be likely well into 2021 before it will be broadly deployed. This suggests that this “do what the doctors and scientists do” behavior will need to continue for quite a while.
With all the attention being paid to COVID-19, we are discovering pathways for treating it. Prescription medications like Remdesivir and dexamethasone seem to be proving effective. Perhaps in advance of a vaccine, we will find an easy to use anti-viral therapy to would allow us to return to the way it used to be.
America is a resilient and tough country. We have always risen to the occasion. We will again here.