One month ago, I made a video telling people to stay home to slow the spread of COVID-19. Today I’m making a video telling people to not stay home with life-threatening symptoms of other diseases. This is because patients are now more terrified of getting the virus than dying of a heart attack or stroke. I fear that I, and other physicians, in our efforts to warn people about the dangers of COVID-19 may have caused the pendulum to swing too far in the opposite direction. I believe we did not effectively convey the actual risk to patients as more data became available. We now run into the real possibility of people unnecessarily suffering from the severe consequences of ignoring other serious conditions by overestimating the risk of COVID-19. Perhaps we did not convey this to our patients because many of us ourselves have not paid objective attention to the real data, but have instead been ruled by our emotions and our wishes to protect our patients, loved ones, and ourselves at all cost.
In the beginning, when we had so little data and were faced with the possibility of unimaginable mortality and morbidity from a novel respiratory virus with no treatments or vaccines, it was prudent to take all possible precautions, including shutting down the nation to flatten the curve and wait for data. But now, after we have done exactly that, many of us seem to have forgotten the original purpose of stay-at-home and shelter-in-place orders. Most now want to keep these orders in place for prolonged periods, long after the curve has been flattened, to stop the virus, and not just slow it down. We all know in our minds that we cannot stop this virus until we have an effective vaccine, good treatments for early disease, and massive testing, but many of us are following our hearts in wanting to somehow eliminate or nearly eliminate this virus with extended stay-at-home orders.
We wanted to flatten the curve, and we’ve done that in most places. If we want to eradicate the virus, we know in our minds we can’t do that simply by all of us staying home for another week or two. That would take several months to possibly even years, and none of us can or need to stay at home for years given what we already know about how this virus behaves.
Smith County, Texas, where I live, has a population of 233,000. We had a total of 3 deaths since our first case on March 13, one of whom was a 91 year old with multiple medical problems. Our hospitals are sending health care staff home because admissions are so low, and there is no danger of acute shortages of ICU beds, vents, or PPE. So I was surprised to see so many physicians react with hate and rage to the Texas governor introducing a reasonable and cautious plan to reopen the state in measured phases while taking all social distancing precautions to ensure that we do not overwhelm our system as we reopen. This was despite him taking pains to repeatedly stress that his actions were guided by a team of doctors on his Strike Force. Social media was ablaze with health care workers bashing the state for reopening too soon. I acknowledge that his plan is not perfect, and things are not ideal in terms of the full restoration of PPE supply chains, but we are in a far better place than we were when all this started. If the data say that we have more than flattened the curve in the state, what reason do we have for not reopening carefully? I would understand some of the outrage if the governor had announced that we would simply open everything up all at once and go back to life as usual, but he did not.
So let’s take a step back, acknowledge our fears as human beings, and rationally look at the data as the professionals that we are. Let’s make decisions for the overall wellbeing of our patients and not focus exclusively on COVID-19 prevention.
Sue Royappa is an internal medicine physician.
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