I’ve been reading a lot of posts expressing disappointment with the way that COVID-19 has been covered in the media and worry about the economic consequences of prolonged social distancing. This is long, and you might not care, but here’s my perspective as a former ICU nurse that witnessed many deaths, a nurse anesthetist who is dealing with both the administrative headaches that go with dealing with this disaster and taking airway call where my sole responsibility is intubating COVID-19 patients throughout the hospital, and the husband of a cancer surgeon.
Like many in health care, my wife and I have spent countless hours obsessively studying and discussing the available medical data and the direct experiences of other health care providers. Please take the time to read my take. Spoiler alert, the media is not being too alarmist, and we’re gonna have to suck it up and deal with the financial and personal ramifications of social distancing. Here’s why:
I believe the mortality rate directly attributable to COVID-19 would be less than reported if we had the ability to test everyone in the world and subsequently retest at regular intervals to accurately calculate the number of deaths out of all the people who eventually test positive—but that will never happen so we’ll never know for sure. And that’s not the point anyway. We’re definitely all going to die, and none of us know when death will come. But that’s not the point either. I’d bet there aren’t many people who’d subscribe to the “if it’s my time, it’s my time” philosophy if they knew their death—or the death of their loved one—was preventable. That’s why we, as a society, believe in the utility of laws to discourage actions that will result in unnecessary death. To shirk the seriousness of this virus or abandon widespread social distancing measures would result in tens of thousands of preventable deaths. Probably more. Even if you quarantine all “at-risk” people and let everyone else go about their business. Why?
The reason why is that there are plenty of young, healthy people who’ve gotten sick enough from this virus to go to the hospital, to need a ventilator, and, for a few, to die. And there are even more not-so-young/healthy-ish people that aren’t “at-risk” but are more vulnerable than people in their 20s. And you’d have to be living under a rock not to have read about the potential lethality of this virus for the elderly and chronically sick. When you’re dealing with a highly contagious virus that you can spread for days without realizing it, A LOT of people will get sick—that’s a given—and it will happen in a very short period of time. That’s not a good thing.
Under normal circumstances, our hospitals stay pretty full with people having babies, recovering from bad car wrecks, receiving treatment for heart attacks, organ failure, and strokes, etc. Our health care system is not equipped for a massive influx of patients whose hospital stay will likely be 1 to 3 weeks. So, when we run out of hospital beds or ventilators or health care providers lost to illness (for what it’s worth, health care providers constitute a significant proportion of the positive cases and deaths) or the masks/gowns/gloves/filters that are supposed to keep health care workers and non-COVID patients safe, a lot of people will die unnecessarily for lack of access to standard care.
Already, patients with heart attacks and cancer are being managed differently than normal (suboptimally) because of the strain on the system. People with less urgent medical issues are often not being treated at all. Absent a quick, easy, reliable treatment for COVID-19 or an effective and safe vaccine, the only tool we have to mitigate the strain on our health care system is social distancing. It sucks, and it’s hitting the economy hard. Many people live hand to mouth and now find themselves without the income to get by—and $1,200 only goes so far. But I don’t want to volunteer to die for the sake of the economy, and I don’t think you would either—nor would many of your family or friends. The only volunteer I’m aware of is the Lieutenant Governor of Texas, although I’d imagine he’d be leading a pretty sparse parade of volunteers. I regress. The point is this: someone you love is going to die a preventable death if we don’t lock it down for the foreseeable future.
A lot of people have died already. A lot more are going to die. And if you’ve never seen someone who’s scared and gasping for air or dying without a loved one by their side, it’s an awful thing to witness, and I hope you never have to. We can’t stop all the deaths, but we can stop most unnecessary deaths if we all do our part and ride this out from the comfort of our couches. Let’s take this as an opportunity to come together as families, friends, and communities to support one another during this difficult time. Be patient, be generous, do your best to live the golden rule, and we’ll get through this together.
Christopher J. D. Patton is a nurse anesthetist.
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