Coronavirus: If the United States was my patient

Coronavirus: If the United States was my patient

Seven weeks later, as we approach the patient’s birthday – July 4 – I thought it would be a good time to check in and see how the patient does.

It turns out that the answer is: it’s not good at all.

In fact, with daily infection rates breaking records in many days over the past two weeks, we are undoubtedly worse off today than anywhere else in the pandemic. Think about it: This week, 15 states saw the highest average in seven days and the country is seeing about 50,000 new cases a day. We have less than 5% of the world’s population, but about 25% of corona cases and deaths. Several states, including Texas and Arizona, are on the verge of recently contracting patients from the hospital.

As a doctor, I am disappointed. I think the deterioration of our patient should not have happened and there were many unnecessary mistakes.

I really thought we would have a different conversation in the country at this point. I thought that together with the fireworks, we were celebrating the progress we have made so far. Instead, I must tell the patient, “The infection has returned in retaliation. It has spread and is in danger of spiraling out of control in certain parts of your body.”

And I’m worried – I’m worried that we will get to the point where the existing treatments we have, the drugs we carry in our small black bag, will no longer be effective and we will have to resort to the big guns, the most aggressive measures.

But at the same time, I still have some hope. we still have some time to change the situation, to restart our medicine, to take it faithfully – but we can’t waste another minute.

The best care, the best advice

“If the country, like the human body, became ill or infected, it would have to seek better medical guidance and follow it, as hard as it could be,” I wrote in May.

Well, throughout the disease, this patient had the advantage of excellent medical care. This country hosts some of the most creative minds, the best doctors and the most experienced public health workers in the world. And, along with equally talented international researchers, they took action to try to decipher the genetic makeup of the virus, learn how it spreads and how to alleviate this spread, discovering all the ways in which the disease manifests itself, calculating how to treat it together. and desperately trying to develop a vaccine that will prevent new cases of infection in the future.

However, a few weeks after a doctor’s order, our patient – our country – chose to turn his back on the advice of these health experts. He didn’t like what the doctors were saying and stopped taking the prescription drugs because they were unpleasant.

Some of the recipes, such as social removal and the restriction of our daily activities, were bad and difficult to swallow. Others, such as the face mask, created a little physical discomfort and a lot of political friction. And the most aggressive drug of all, home-ordered orders caused mass layoffs that had never been seen before in many areas of the economy and the decline had just skyrocketed. In other words, very real pain.

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But difficult, as it was to put the patient in a medically induced coma with the orders to stay at home, in order to control the infection, it seemed to have worked.

When I first wrote the piece, shortly before Remembrance Day, at the time of another national holiday, it seemed that the patient was moving in the right direction. Infection rates have dropped significantly in some of the worst-hit areas, such as Michigan, Massachusetts and New York, and have remained stable in much of the country.

Discontinue treatment very soon

I was worried about stopping the drug too early – and that’s exactly what happened.

The patient came out of the medically induced coma very quickly and chaotically, with each condition doing its own thing. Some states reopened immediately, while infection rates rise (I see Georgia), while other states and some cities expected a little more. However, few, if any, states met all the so-called “gate criteria” for the opening of the White House and the CDC.

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In addition to the action very soon, these new openings were often accompanied by a violation of rules, a lack of social distance and a growing refusal to wear masks by a strong minority. We’ve all seen the photos full of beaches, full of bars, protests in favor of the opening and presidential press conferences with officials behind the podium, and a few, if any, wearing masks.

It’s like our patient just got up after waking up and said, “It was a weird nightmare. I’m glad it’s over,” before he got out of bed and walked out of the hospital. But the infection was still simmering beneath the surface.

Like Cassandra, the predictions were ignored

Since then, a health expert after a health expert has tried to remind us that this pandemic has not disappeared. Not only that, he will be here with us for the foreseeable future. But there is no unifying directive or action plan from the White House. States respond independently of each other. And so the patient continued to do his business, often ignoring the risk.

People in parts of the country continued to have no social distance, and the war on mask wear became even more vocal and well-established, with the President, his vice president and other elected officials refusing to shape the very behavior recommended by health experts. : Wear a mask and stay 6 feet away. For some time, the rulers of some states, including Arizona and Texas, have even prevented local officials from issuing mask orders in their cities and counties.

However, thanks to a slight concern about the alarming increase in cases, we may have reached a turning point last week. Nearly two dozen states have halted or reopened efforts to reopen. The rulers of a handful of waiting states – including Texas, Oregon, Pennsylvania and Kansas – have issued mask orders. Some in the GOP and the vice president began wearing a mask. Even President Trump recently said it was “all about masks.” And a government health expert after a government health expert – including Dr. Anthony Faucchi and Dr. Deborah Bix, Dr. mask. Embrace universal face covers.

It’s too late;

As I have said many times, this corona is not durable and because of this, small spoons of medicine can go a long way. It doesn’t travel much, so staying 6 or 10 meters away can help. With good air circulation, it disperses quickly, so don’t concentrate indoors. And wear a mask – that’s great. Studies have shown that it can reduce transmission to others while protecting the user. Even bandanas and even paper surgical masks work better than nothing.

In fact, researchers at the Institute for Measurement and Health Assessment at the University of Washington say that if 95% of people wear masks, about 24,000 lives could be saved in October.

If we can get our patient to follow these small steps – these tried and true public health measures that have worked in places like South Korea – the number of daily infections can be slowly reduced to manageable levels. And then we can start restricting efforts, such as detecting contacts and isolating potentially infected people.

But we are not yet at this stage, and it is not possible to talk about reducing the virus when there are 50,000 or 10,000 new infections a day. To do that, we need to bring the country closer to one in a million people infected a day. That’s more than 300 new infections a day – not 50,000.

And that brings me to another point: We need more testing, no less. It is the only way to see the patient’s condition, to see if the infection subsides or spreads. Tests in many parts of the country are still difficult to do. Test data is sometimes incomplete and results are slow to arrive. And now that more people want to be tested, test sites on some of the new hotspots are full, with large lines. This will further increase the wait for the results as the laboratories try to continue. We need massive access to a quick, easy and inexpensive test that can work in minutes, not days, so tests can be done more easily and results returned faster.

Things will get worse before they get better

Make no mistake, the patient will feel worse in the next few days until the medicine starts working, until the public health measures that are applied again have the opportunity to do their job. And the patient may still require aggressive treatment in some places – we may see some parts of the country being partially closed again.

In the spring, everyone made great personal and financial sacrifices trying to normalize the curve. No one wants to lose that progress and no one wants to go back to the coma.

But we must now act, as a nation, indivisible and with a guiding voice. This would be a wonderful birthday present for our patient.

Andrea Kane contributed to this story.

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