Originally posted on KevinMD.com
In the past month, I find myself going from making videos telling people to stay home to slow the spread of Covid-19, to videos telling patients not to be so terrified of the virus that they die from other serious conditions like MIs and strokes. 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 other direction. I believe we did not effectively convey the actual risk to patients as more data became available, and we now run the real risk of people unnecessarily suffering from the severe consequences of ignoring other serious conditions because of unrealistic fear of Covid-19. Perhaps we did not convey this to our patients because many of us ourselves have not paid attention to the data, but have instead been ruled by our emotions and our wish to protect our patients, our 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 to avoid overwhelming our healthcare system. 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 stay-at-home orders.
We wanted to flatten the curve, we’ve done it in most places. If we want to eradicate the virus, we know in our minds we can’t do that by all of us just staying home for another week or month. 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 had a total of 3 deaths (county population 233,000) since our first case on March 13 (one of whom was a 91 year old with multiple medical problems). Our hospitals are sending healthcare staff home because hospital traffic is so low, 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 doctors on his Strike Force. Social media was ablaze with healthcare workers bashing the state for reopening too soon. I acknowledge that his plan is not perfect and things are not ideal in terms of full restoration of supply chains, but we are in a far better place than we were when this started. If all the data say that we have more than flattened the curve in the state, what reason, other than unfounded fear, do we have for not reopening carefully? I would understand some of the panic, and I would be joining in it, if the governor had announced that we would just 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 then let’s rationally look at the data as the professionals that we are and make decisions for the overall wellbeing of our patients, not just preventing them from getting Covid-19.
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