If the US was my patient: not ready to celebrate

In mid-MayIf America was my patient“I’m wondering what would happen if the United States were a living human being ill with an ongoing infection.

Seven weeks later, when it was time to approach the patient’s birthday (4th of July), I thought it was a good time to check in and see what the patient was doing.

The answer is: It doesn’t work at all.

In fact, today’s daily infection rates have been breaking records for the past few weeks, making it definitely worse today than at any point in the early days of a pandemic. Consider: This week has the highest average of 7 days in 15 states, with about 50,000 new cases per day in the country. Less than 5% of the world’s population, but about 25% of coronavirus cases and deaths. Several states, including Texas and Arizona, are on the verge of overwhelming hospital capacity with recently infected patients.

As a doctor I am frustrated. I felt the deterioration of my patient did not have to occur and there were many unforced errors.

At this point, I really thought I could have another conversation in this country. I thought I would celebrate the progress so far with the fireworks. Instead, I told the patient, “The infection is back with revenge. It spreads and becomes out of control in some parts of your body.”

And I’m worried — the existing treatments we have, the drugs we have in our little black bag are no longer effective and we will have to resort to big guns, more aggressive Measures.

But at the same time, I still have hope. We still have some time to change the situation, restart the drug and take it faithfully, but we can’t afford to waste another minute.

Best care, best advice

“Even if the country becomes sick or infected like the human body, we should seek the best medical guidance and adhere to it as closely as possible,” I wrote back in May.

Well, through illness, this patient has benefited from good medical care. The country is home to the world’s most creative minds, the best doctors, and the most experienced public health officials. And they act together with similarly talented international researchers, trying to decipher the genetic makeup of the virus, learning how it spreads and how it mitigates, and Has discovered all the ways in which they appear and figured out how to treat them and is desperately trying to develop a vaccine that prevents new cases of symptoms and future infections.

But a few weeks after following the doctor’s instructions, our patient, our country, chose to turn away from the advice of these health professionals. I didn’t like what the doctor was saying, so I stopped taking the prescription because it didn’t suit my taste.

Some of the prescriptions that put us at a social distance or reduce our daily activities were tasty and difficult to swallow. In addition, wearing face masks caused physical discomfort and political friction. And the most aggressive drug of all, home order, caused unprecedented mass layoffs across many sectors of the economy, from which fallout spilled out. That is a very real pain.

However, it seemed to work because it was difficult to put the patient into a medically induced coma with a home care order to control the infection.

When I first wrote this work, just before Memorial Day, another national holiday, the patient seemed to be moving in the right direction. Infection rates have fallen sharply in some of the most affected areas, including Michigan, Massachusetts, and New York, and have remained stable in most of the country.

Stop treatment immediately

I was worried about stopping the drug prematurely at the time-that’s exactly what happened.

The patient was taken out of a medically-induced coma too quickly and disorderly, and every state was doing its own thing. Some states were reopened soon, but the prevalence was rising (Georgia). Other states and some cities wait a little longer. But if there are states that meet all of the so-called “gating criteria” for resumption set by the White House and the CDC, that is rare.

In addition to acting too quickly, these restarts were often accompanied by outbreaks of rules, lack of social distance, and increased refusal to wear masks by noisy minorities. We’ve all seen pictures of a packed beach, crowded bars, protests in favor of the reopening, and a few presidential press conferences, even with masks, with officials gathering behind the podium.

It’s like our patients just shrugged and said after waking up. “It was a strange nightmare. It’s nice before I jump out of bed and out of the hospital.” But the infection was still smoldering subsurface.

Like Cassandra, the prediction was ignored

Since then, health experts have tried to remind us that this pandemic has not disappeared one after another. Not only that, we are with us for a foreseeable future. However, there is no unified directive or action plan from the White House. The states respond independently of each other. Therefore, the patient continued to work without realizing the danger.

Some people in the country did not maintain a social distance, and the war on wearing masks became louder and more established. The president, his vice president, and other elected authorities refused to model the very behavior that health professionals recommend: wear a mask, 6 feet away. For some time, governors of several states, including Arizona and Texas, even prevented local authorities from enacting mask orders within their cities and counties.

But it may have come to a turning point this week last week, thanks to a surprising increase in cases. Approximately 24 states have suspended or rolled back work. Several holdout state governors, including Texas, Oregon, Pennsylvania, and Kansas, have issued mask orders. Part of GOP And the Vice President began wearing masks. Even President Trump recentlyAll for mask.. There are also government health experts following government health experts, such as Dr. Anthony Fauci and Dr. Deborah Birx of the White House Coronavirus Task Force, Dr. Robert Redfield of CDC and Alex Azar of Health and Welfare. I repeated the same idea and put on a mask. Accept universal face covers.

Is it too late?

As I have repeatedly said, this coronavirus is not strong, so a small spoonful of medicine can go a long way. It doesn’t travel far, so staying 6 or 10 feet away helps. Please do not gather in the room because the air circulation is good and the dispersion is fast. And wear a mask—it’s a big one. Studies have shown that you can protect your wearer while reducing transmission to others. Even bandanas, even paper surgical masks, work better than nothing.

In fact, a modeler at the University of Washington’s Institute of Health Metrics and Assessment says that 95% of people wearing masks could save about 24,000 lives by October.

If we were able to stick to these small steps to our patients, these proven public health measures that have worked in places like Korea, the number of daily infections could be slowly reduced to manageable levels. I will. You can then begin containment efforts, such as tracking contacts and isolating potentially infected people.

But it’s not at that stage yet. Also, when the number of new infections per day reaches 50,000 or 10,000, it becomes impossible to talk about containment of the virus. To do this, we need to get closer to a country that affects one in one million people a day. This is more than 300 new infections a day, not 50,000.

And that brings me another point: we need more testing. This is the only way to check the patient’s condition and see if the infection is receding or spreading. Testing in many parts of the country is still difficult. Sometimes the test lacks components and results arrive late. And now that more and more people want to be tested, some new hotspot test sites are crowded in long queues. This adds even more waiting for results as the lab is nervous to catch up. Tests are easier to run and results are returned faster because you need to have a large amount of access to fast, easy and cheap tests that can get results in minutes instead of days.

The situation gets worse before it gets better

Undoubtedly, patients will get worse in the coming days until the drug begins to work. Until the public health measures being implemented again have the opportunity to do their job. And patients may still need aggressive treatment in some places — we may also see certain parts of the country once again partially closed.

In the spring, everyone sacrificed both personally and economically when trying to flatten a curve. No one wants to lose that progress, and no one wants to go back into a coma again.

But now, as a nation, we must be inseparable and act in one leading voice. It will be a great birthday gift for our patients.