Opening Safely

With many states starting to reopen businesses and activities that have been restricted, I wanted to update everyone on where things stand in our community in regard to COVID-19 and what actions we should be taking from this point forward. 

The good news first.  By all indications the level of COVID-19 disease in our local community as of May 21st remains low.  As I mentioned in an earlier post, I was hopeful that if we took reasonable actions as a community that we could avoid a large spike in cases that were being experienced elsewhere.  Thanks to the hard work and sacrifice of many, that has been accomplished to this point.  Rates of new positive cases and hospitalizations are on the decline.  While we remember those who have been ill and those that we have lost, we are also thankful knowing that it could have been significantly worse if aggressive early actions had not been taken.

So, what happens now?  While things currently look promising, we are far from out of the woods.  All data would indicate that only a very small percentage of our population has had COVID-19 and therefore most of us are still at risk.  The virus will continue to circulate and infect susceptible people.  It could possibly slow in the Summer and return in the Fall, but it most certainly will still be around.  As we move beyond a time of “lockdown”, we need to look towards the next phase with a plan in place.  We need to look to open safely, with policies such as those recommended here by a group of bipartisan health policy experts.

While we open up our communities to some degree and get a little more sense of “normal” in our lives, it is very important that we do this in a smart and cautious way.  While we all would like to get back to our normal activities this summer, I think many of us also look ahead to the Fall.  We wonder about schools and the school-based activities such as sports that come along with it.  It is important to keep in mind that what we do now will have a lot to do with what life looks like in August.  The declines that we see in positive cases and hospitalizations now are due to the actions that were taken over the last two months.  Without the significant mitigating efforts that have been in place, the situation would be much worse. Likewise, things that we get wrong now won’t show up for a few weeks.  And the difficult thing about a virus like this is that once you notice more people showing up at the ER sick, you are already behind the curve.  We need to be vigilant about certain steps we can take to minimize outbreaks.  So, what are those measures that we need to focus on as we reopen?

Avoid large group gatherings.  The problem with large gatherings is that one person can potentially infect multiple people at the same time.  When the virus is spreading without social distancing and other measures, we know on average that each infected person passes it to 2-3 others.  (And remember, you could be contagious for several days prior to symptoms).  Those people can then pass it to 2-3 more people each, and that is how we get exponential growth. But if you are in a group of 20-30 people, then one infected person can infect many.  Now instead of two new people being unknowingly infected and spreading the virus, you may have 10-20 new people spreading the virus.  In one example from a choir practice in Washington state, one symptomatic person among 60 others at a 2.5-hour choir practice led to 52 other people becoming ill.  Among these 3 were hospitalized and 2 died.  Avoiding large gatherings reduces this risk of large outbreaks.

Wear a mask or face covering when you are unable to maintain physical distancing.  This one has been confusing.  Initially everyone was told to save the masks for the healthcare workers, and that masks probably don’t help anyway.  We now recognize that masks may well be an effective measure that allows us to open up our society to a larger degree without increasing spread.  Remember, the primary reason for the mask is to protect others if you are infected, possibly without any symptoms.  Wearing a mask in public is a sign that you care about the health of others. It also shows that you are willing to do your part to protect those that are more vulnerable in our community.

Minimize unnecessary travel, especially to high risk areas.  The situation in our local area is currently improving, but that is not the same everywhere.  Some areas of the country are still seeing increased cases, including other parts of Kentucky.  Recommendations for what you can do safely here do not necessarily hold true elsewhere.  Guidelines from the CDC continue to recommend travel only for essential purposes.  Control that has been obtained in one area can be quickly lost by importing new cases from other areas.  Most Americans agreed with stopping travel from China and other countries with high levels of disease early in the pandemic.  Now those high-risk areas are other places in the United States.

Stay home if you are sick.  This one will always be true.   If you are sick, even if you think it is something other than COVID, please stay home.

I think that if you keep these basic precautions in mind, then you can start to resume more activities.  Small gatherings of friends and family held outdoors with adequate distancing should be safe.  Playing golf in small groups without sharing carts should be low risk.  Sitting outside to eat at a downtown restaurant sounds great to me.  Going for a walk, run, or bike ride will be good for your physical and mental health.  Just remember the basic ideas that outside is always safer than inside, smaller gatherings are safer than larger ones, and prolonged close contact in a closed space is probably the highest risk type of activity.

While you start to enjoy a loosening of restrictions along with some better weather, we will continue to work to ensure that everything is being done to maintain the health of our patients and the community.  In this next phase of the pandemic we need to be testing more people, staying on top of new cases or small outbreaks, and monitoring for a change in the situation that requires a change in our behaviors and activities.  What I ask of you is that you trust and listen to the doctors and public health experts as new information becomes available.  I can promise you that none of us like being stuck at home, avoiding friends, and missing out on life any more than you do.  We want life back to “normal” like everyone else.  But we also understand the facts behind the disease. We know that it is serious, highly contagious, and not likely to disappear anytime soon.  Let’s all do our part to make the best of this situation and to make sure that we #OpenSafely.

Posted in

Ryan Frazine, MD

11 Comments

  1. Bob Lingle on May 22, 2020 at 1:38 pm

    Right on. The best explanation I have seen or read.

  2. Charles and Suzanne Alexander on May 22, 2020 at 2:05 pm

    Thanks and keep ‘em coming!

  3. Glen Titsworth on May 22, 2020 at 2:56 pm

    Thank you for this commentary

    • Cindy on May 24, 2020 at 11:39 pm

      Thanks!

  4. Fowler Black on May 22, 2020 at 4:08 pm

    Always grateful for your professional perspective, Dr. Frazine! Thank you for this blog post!

  5. Dale and Frances Mittendorf on May 22, 2020 at 4:31 pm

    Dale and I thank you very much for your comments. They are always welcomed and very informative.

  6. David Deem on May 22, 2020 at 5:33 pm

    Thanks Ryan, for reasoned , insightful guidance!

  7. Judy wilson on May 22, 2020 at 8:52 pm

    Thanks for keeping us updated.

  8. James Prine on May 24, 2020 at 1:10 am

    Great advice from a true professional. Thanks to you and your staff.

  9. William T Knight on May 25, 2020 at 12:21 am

    THANKS FOR LATEST UPDATE DR. FRAZINE. KEEP THE UPDATES COMING.
    THANKS TIMMY

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