Why You Must Stay The Eff Home

While several of my subscribers are medical types, many are not. And with so much misinformation spreading about, I’d like to provide a clinician’s take on the current pandemic as it relates to those of us in the U.S. This is not meant to scare you, but to help explain why we must flatten the "curve."

Yes, I’m worried

Every day, friends, family, and business contacts ask me what I think about the pandemic. Should we be concerned? Is it really as bad as they say it is? Are you worried about it, Christine?

Yes, I’m extremely worried. But not for the reason you think.

Yes, we should all be very concerned. Which is why we must act now.

We’ve known this was coming. Virologists and epidemiologists have been regularly telling anyone who’d listen that we are overdue for an outbreak like this for some time. So most clinicians are not surprised right now. In fact, you may be shocked or even dismayed by their lack of panic. 

But here’s the thing, we on the front lines of healthcare face risk all of the time. We’re accustomed to taking precautions against communicable disease. We see people dying from influenza every winter. We respect microbes.

And those of us who have provided medical care in developing countries and other resource-scarce environments understand exactly what we’re facing in this country should the current forecast be realized and our medical system become overwhelmed: care rationing. Meaning having to decide who lives and who dies.

It’s happening in Italy right now. With only so many ICU beds and ventilators, not everyone is receiving the care they would under non-pandemic conditions. 

Let me put this in blunt terms

There are only around 170,000 ventilators in the US.* 

In a country of 330,000,000 people. 

A 2011 research article reported that a U.S. pandemic similar to the Spanish Flu of 1918 could result in 1,500,000 patients requiring an ICU bed with 750,000 patients requiring mechanical ventilation.

170k ventilators for the 750k who might need them.

Let that sink in.

Yes, you might astutely say, but not every sick COVID-19 patient is going to need a ventilator at exactly the same time. True. 

But here’s the bombshell…

Those ventilators aren’t just sitting around idle waiting for a sick patient with COVID-19 to come along. Many (at times most) are already in use.

Yep, other life-threatening events will occur while this new Coronavirus spreads like wildfire. People will continue to have heart attacks, strokes, accidents, and other life-threatening events. 

On top of that, many hospitals around the country have been at or near surge capacity all winter due to a record high influenza season.

What this means…

Not only will those who develop severe COVID-19 disease require ICU beds and ventilators, so will those with the “usual” life-threatening conditions. And a shortage of ICU beds and ventilators means that a person having a major heart attack with multiple underlying medical problems may be deemed unlikely to survive and not receive the current standard of care, because there are other people who are very sick but more likely to survive. The aforementioned care rationing. This is called “emergency triage” and is standardly applied during disasters and in battlefields. 

Which is why I don't have time for the “I’m young and healthy” personal defense. You are a potential vector contributing to the spread of this novel Coronavirus to people who WILL get very sick from it. And you’re preventing us from “flattening the curve” and giving ALL sick people life-saving treatment.

Do your part RIGHT NOW to help slow down the spread of SARS-CoV-2, the Coronavirus that causes the infection known as COVID-19.

What you can do

Fortunately, we’re seeing state and municipal bodies take action by closing schools and restaurants, and preventing gatherings. 

But we have a personal responsibility to protect one another by:

1. Social distancing
• This means staying home unless you are required by work or a significant need to leave the house
• Keeping a 6 foot distance between yourself and others if you are out and about.
2. Controlling your mucous
• Don't pick your nose. Please.
• Cough/sneeze into your elbow
• Throw away used tissues immediately
3. Sanitizing the surfaces you touch regularly (counters, knobs, handles, steering wheel of car, TV remote, PHONES)
4. Washing/sanitizing hands (and not just a quick rinse of your palms and fingers, THE WHOLE HAND UP TO THE WRIST!)
• And your permanent hand extension, your PHONE (apparently they are dirtier than toilets)
5. Get your facts directly from the CDC and WHO

This is an unprecedented time in our history. As I write this, Canada’s Prime Minister is announcing that they are closing borders to non-citizens and permanent residents. 

We should not panic, but we must do everything we can to get this pandemic under better control. 

I will be happy to be accused of overreacting should we dodge this bullet.

But sadly, I don’t believe we’re going to.

We also need to take of ourselves and each other

It’s important that we keep ourselves and loved ones as healthy as possible.

• Eat good food. 
• Move your body.
• Get outside into fresh air every day (but keep your distance!). 
• Eat nourishing foods and stay well hydrated.
• Check in with family and friends. Social isolation is difficult.

Try to notice the human good that is emerging: 

• In my home state of Vermont, the distilleries are converting their operations from booze to hand sanitizer production.
• Vermont lawmaker, Mari Cordes, RN, who I’m honored to call a friend, started a FaceBook group to connect people throughout Vermont in order to ensure that people who are ill or quarantined can get essentials brought to them by neighbors (food, medication, firewood, etc). The group has grown to nearly 5000 members in just a few days and now has a global reach. 
• Restaurants are stopping sit-down service, but offering curb-side service, some even giving kids their food for free and accepting barter and “pay what you can.”

It’s an incredibly stressful time. Stay connected over the phone and videoconference. Reach out for support if you need it.

Stay safe and healthy. Be kind to one another. 

I’ll be in touch. 

xo

_{*According to a fact sheet published by the Johns Hopkins Center for Health Security on 2/14/2020, there are approximately 170,000 total ventilators (full-function and partial-function, including 8900 in reserve) in civilian and military hospitals across the U.S.}