JUST STAY HOME

Much has changed in the week since my last post.  Total diagnosed cases of COVID-19 in the United States have gone from less than 5,000 to more then 30,000.  Deaths have risen to over 400.  This growth is not unexpected to the doctors, scientists, and epidemiologists who study viral infections.  This is what happens when a dangerous virus that spreads exponentially is left unchecked. 

In some parts of our country, like New York City, the situation looks grim.  They are speeding towards a time when the number of sick and critical patients may overwhelm the capacity of their healthcare system.  Issues such as shortages of personal protective equipment, also known as PPE, and ventilators seem more likely than not.

But in our local area, the situation is currently different.  We still suffer from a lack of adequate kits to test everyone who should be tested, but that situation is improving.  And because of this lack of testing, exactly where we stand regarding the levels of COVID-19 in our region is hard to say.  At this point, we do not appear to have a lot of disease activity here based on what we see in the hospitals and doctors’ offices.  Arguably, the virus takes longer to spread widely to our rural area in the middle of the country than to large cities on the coasts with international airports and large numbers of travelers.  In Kentucky and Illinois, we also had measures in place such as school closings, business closings, and calls to stop large gatherings relatively early. 

These facts give me hope.  I think it is still possible for us to avoid the type of situation locally that we are seeing in other parts of the country and the world.  We have seen in other locations that mitigation factors such as social distancing, school closings, and orders to shelter in place have been able to significantly reduce the spread of disease.  These measures are most effective when they are put in place early, before the disease becomes widespread.  Our local early actions may have been in place soon enough to make a real difference.  

So, while I am hopeful that we are having a positive effect, our advantage will only last if we remain vigilant.  As healthcare providers we are hard at work to prepare ourselves for what may come.  We are gathering as many tests as possible and developing protocols for the most judicious use of those tests.  We are attempting to eliminate all non-urgent procedures, testing, and office visits to avoid unnecessary exposures to patients and staff and to preserve personal protective equipment. 

Those are the steps we are taking as healthcare workers.  So, what can our nation and you do to help?  A few things top the list of what healthcare workers need right now:

1.  More tests as well as tests that come back more quickly.  Currently test results are not available for up to six days.  This is too long, but turnaround is improving. 
2. More masks and other personal protective equipment.  The shortages are real.  This may be the scariest part of all.  The possibility that healthcare workers will face taking care of highly infectious patients without the proper equipment is unacceptable.  We are told that new supplies will be coming, but no one is certain when or if the quantity will be enough.
3. Treatments for COVID-19.  As of now there is no proven treatment.  There are some early promising possibilities, but we need further study to know if they work and if the benefits are greater than any unforeseen harms.
4. A vaccine.  This is the ultimate need, but one that we know is likely at least 12-18 months away.

These items are likely coming, but they aren’t here yet.  What we need is more time.  And that is something that each and every one of you can give us.  By doing the things that are being asked of you to control the spread of the disease, you can buy us the time that we need to get more tests and more masks.  You can give us time to learn from the experience of others what treatments may work.  You can get us closer to the time that a vaccine is available without overwhelming our local healthcare system first.  So, I ask you to do a few things:

1.  JUST STAY HOME.  This is the most important thing you can do to help control the spread of the virus, protect healthcare workers, and very likely save someone’s life. 
2. DO NOT TRAVEL.  As I said before, we seem to have some advantage locally that we are behind the curve (in a good way) of the virus spreading in our area.  We are doing the things necessary to control the spread by canceling schools, closing businesses, and asking people to stay home.  This could all be undone if people start to travel, such as to Florida for spring break, and bring new exposures into our community.  So, don’t travel.  And if you do travel, self-quarantine for 14 days when you get home whether you show symptoms or not. Those who are infected may not show symptoms and can spread the disease.
3. WASH YOUR HANDS.  Do it. And do it some more. Then do it again.
4. PRACTICE SOCIAL DISTANCING.  Stay at least six feet away from others when you must go out to the grocery or pharmacy.  Do not shake hands.  

In closing, I think we have reason to feel hopeful, especially in our local area.  We have some advantages that other areas of the country and the world do not have.  When making decisions about things that may inconvenience you, please think about your effect on others.  How might your decision affect the safety of doctors, nurses, and other healthcare workers on the front lines?  How might spreading the infection to a family member who is elderly or who has chronic medical conditions affect them?

Think about how you can help yourself. Think about how you can help your family. Think about how you can help your community. Think about how you can help the world.

Just Stay Home!