"What Would You Do?" A pandemic question we all should answer.
It’s a question we doctors get asked all the time, particularly when it comes to medical issues: “What would you do if you were me?”
The COVID 19 pandemic has been confusing for most people because of the way the information has evolved in real time. At first, it was “over there,” in China and then in Italy, and the American people generally stuck their collective heads in the sand under the misguided idea that it somehow was not really going to impact us. Then, there were outbreaks in Washington State and New York City, and the rest of us breathed a sigh of relief that we weren’t in those places. When hotspots erupted in places like New Orleans, Detroit and Albany, Georgia, we all thought, “Hmm, what’s going on?” And the WHO and the CDC first told us that masks weren’t necessary and then decided that they were, based on emerging research. There were some drugs that seemed to work and others that didn’t, and the curtain was pulled back so that the whole ongoing trial-and-error nature of medical research was exposed to anyone and everyone who wished to see it, which is something the general public is not used to seeing: “Behold, the Great Oz!” (but not Dr. Mehmet Oz, though, who has thankfully gone largely silent during all of this).
And now the virus has come here in earnest. Local numbers of cases are spiking, and COVID 19 hospitalizations have quadrupled in Savannah during the last month. We have a local mask mandate but not a county-wide or statewide one. But yet everyone still went to Tybee over the July 4 weekend, and restaurants remain open for in-room dining. You can get a tattoo, have your hair done in a salon or party in a bar and nobody can stop you—and there’s toilet paper in the grocery store again, lots of it, and not just the off brands.
No wonder everyone is confused.
Here are the facts: The number of COVID 19 cases in the Coastal Health District is, indeed, on an exponential rise. Chatham County, which is the demographic epicenter of that district, saw a recent 68% increase in COVID 19 cases over a single week. Glynn County was up 123% over the same period and Effingham was up 60%. As of this writing, the three Savannah hospitals have over 110 COVID 19 inpatients. That’s double the maximum number we saw here during the prior local peak in the pandemic back in April. The hospitalization data drive home the point that the increased local caseload is not merely due to increased testing.
So let’s be clear about one thing: Locally, we are in the worst phase of the COVID 19 pandemic right now.
That’s why Savannah Mayor Van Johnson appropriately initiated a local mask-wearing mandate. He looked at the local data and made that decision based on science, not politics--something that our county and state governments should have also already done. The same upward trend in cases that we are seeing in coastal Georgia is happening throughout the state, although at a slightly less intense level. The state set a record for new COVID 19 diagnoses on July 10, with 4,484 new cases statewide, and we have more Georgia patients hospitalized with COVID 19 right now than we ever have before.
So now that we’ve established that the current spike in COVID 19 is real, and not some product of social media manipulation or a political football that is being tossed about, what would I be willing to do, or not do, in the current situation? It’s a question that I get asked every day—and rightfully so.
Here’s What I Won’t Do
· I’m not going to a bar. One admission here: I don’t drink very much, and the bar scene has never really been my thing. But bars are typically closed in, crowded spaces—ideal spreading ground for COVID-19. And alcohol use does not lend itself well to social distancing. So no bars for me, not for a while.
· I’m not eating indoors in a restaurant. Almost every documented super-spreader event, in which one person infected scores of others, has been indoors in a crowded setting. I love eating out—my wife and I usually do so at least twice a week—but I have not eaten a meal inside a restaurant since March, and I won’t be doing that anytime soon. One caveat: Outdoor dining, with appropriate social distancing, is probably fine—and takeout is okay, too. We’ve done lots of takeout since the pandemic began, and we try to support our local restaurants when we do so. They need, and deserve, our help.
· I’m not going to any indoor gathering of more than 10 people. This is for the same reason as the above—and includes weddings, funerals, indoor concerts, movies in public theaters or social engagements of any sort. This sort of thing is COVID -19’s dream environment, and I’m not going to be a part of into it. I personally know of at least two local outbreaks which started with indoor house parties among young people who frankly should have known better.
· I’m not working out in a gym. People huffing and puffing in an enclosed space as they work out are simply spewing viral particles into an aerosolized viral soup for the rest of the establishment’s patrons to breathe. Outdoors exercise with appropriate social distancing is fine—but no amount of sanitization can make indoor workouts safe.
Here’s what I will do
· Exercise outdoors. Transmission of COVID 19 outdoors is much more difficult. Individual athletic activities like biking, running and walking are likely fine when done outdoors with appropriate social distancing. One caveat: I’m not running in a road race with a bunch of other people. That’s asking too much.
· Wear a mask when in public. I’ve said this before, and I’ll say it again: If you want our local businesses to stay open, wear a mask when you are out. Most of the transmission of COVID 19 is airborne. Universal mask-wearing alone can be very effective in slowing viral spread. This is common sense—but published data back it up.
· Get seen by my doctor, if I need to. In March at the outset of the pandemic, our medical practice shut down for everything except emergencies for two months. During that time, we developed protocols for social distancing, disinfection and screening patients and staff members at the door which have allowed for a safe working environment for both patients and staff. What we eventually realized was that the COVID 19 pandemic was not going away anytime soon—and patients’ medical needs were not going away, either. People need to see their doctors. As a result, we started seeing elective patients and doing elective procedures again with appropriate safeguards in place. Everyone in our practice has been wearing masks all day for months. When we do procedures, we operate under the presumption that anyone we see might have COVID-19, and we are wearing full personal protective gear. Patients who are very high risk are offered the opportunity for a telemedicine visit, so they don’t need to come into the office at all. The result? We’ve not had one patient or employee contract COVID 19 in our office to date. Most other local physician and dental practices have had similar experiences. Because of consistent attention to this sort of detail, you are almost certainly far more protected going into your doctor’s office than you are going into any retail establishment.
The End Game: Listening to science—and the benefits of common courtesy
The COVID 19 pandemic has torn apart much of the social fabric of our society. It has profoundly disrupted many of the things we all enjoy, from live concerts and sporting events to evenings eating out in a restaurant with friends. It has crippled many industries, sickened millions, and has killed over 560,000 people worldwide—including 137,000 in the U.S.
But we can, and will, overcome it.
Numerous vaccine trials are ongoing—and the preliminary results are very promising. We are making advances every day in our understanding of how to treat the disease’s myriad complications. At some point in the next year or so, things will get better and we will return to some version of normal.
Here’s what we cannot afford to do: We should not, and indeed cannot, simply expect to wish normalcy into existence. This is the mistake that was made with the premature economic reopening earlier this spring, and we are all now reaping the bitter harvest of that strategic error in decision-making. To be clear, “normal” is happening anytime soon. If hospital capacity is stretched further, bars and in-room dining in restaurants may soon be forced to close once again. There may not even be a college football season this year. As Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases said earlier this year, “You don’t set the timetable. The virus sets the timetable.”
But if we continue to be vigilant, to engage in social distancing and wear masks in public, we will all get through this—and can prevent illness and death among the people we care about.
If I had one request I could make of the public, it would be this one: Let’s all engage in a little common sense. Listen to scientists, instead of politicians, when it comes to matters of science. And let’s not always be so selfish. Almost every major religion espouses some version of the Golden Rule, saying that we should all “Do unto others as we should have them do unto you.”
You see, no matter what some people out there may think, it’s not merely about you.
At the end of the day, it’s really about all of us.