Wise words from my local county health officer. I have all the respect in the world for him and our county health department. He's also an ER doc:
Eric Yazel, MD
Daily dose of calm. Everything old is new again. We have come full circle to one of the very first posts. It feels like we have divided into two camps again. The 'end of the human race is upon us' camp and the 'this is all a hoax and conspiracy' crowd. What if I told you the real answer, as with most polarizing issues, probably lands in the middle? Is COVID surging in parts of the country, overwhelming ICU's and eating up hospital resources. Yes, it is. Are there a lot of other areas of the country that are being hit but are able to meet the need with solid response plans and good resource utilization? Sure there are. And are there parts of the country that are relatively unaffected? Yep. Hospitals are overwhelmed. Hospitals are empty and furloughing people. Wait, what? How can this be? Can a place be full and empty at the same time? Yep. ICU's in a lot of areas are overflowing and running low on vents, but wings of regular floor beds run empty. ER's are running at about 2/3 the patient volume they normally see. But the acuity is often higher with more unstable acutely ill patients than normal. How can you see meat packing plants with hundreds of cases while at the same time people living in the same household eating together, playing together, sleeping together who don't transmit it? That can't really be happening right? We have seen recommendations that are not based on a gold standard, but on supply chain issues. We all need N95 masks. Just healthcare professionals need them. Surgical masks are acceptable unless doing something high risk. Cloth masks are probably ok. Hell, use a bandanna if you need to. We hear people are dying at an alarming rate. We hear majority of people have no symptoms. Some healthcare workers are having mental health crises because of the psychological toll from what they are seeing. Some healthcare workers are saying this is an over-dramatized fabrication. Someone has to be lying right? Nope. All of us in the medical field are having vastly different experiences depending on specialty and geographic location. You can see how some of these scenarios lead to conflicting statements and general confusion. And I would love to sit here and point the finger at a lot of you who have spent your quarantine time going down rabbit holes and propagating conspiracy theories. A lot of you have been sitting in front of the computer like Pigman from PCU doing his TV thesis (more bonus points for this one) becoming amateur public health experts. It's a true shame that right when they need us the most, the general public seems to be losing trust in the medical profession . And some of that is confirmation bias. People tend to believe things that are consistent with their own existing beliefs. But to place the full blame there isn't fair or the entire truth. The medical profession needs to shoulder their portion of the blame as well. And it's for a simple reason, the inability to use 3 simple words: I don't know. COVID-19 has been one huge mess of gray areas and contradictions. And in our hurry to appear competent and in control, a lot of medical experts have given advice that isn't based on sound data. In our sprint to be cutting edge, we have rushed into treatments that aren't evidence based and have eventually shown little efficacy. There wasn't ill intent. This was a time when our country needed us most, and the pressure to rapidly meet the challenge was almost insurmountable. So what's that mean for the next challenge: opening back up? I'll get this out there right now. I don't know. Will we see a resurgence? If so, what will it look like? Again, I don't know. I have no qualms saying this. But my dad always told me when that's the case, always rely on common sense. And that's exactly what we will do. We will re-open in a cautious, data driven, step-wise approach. It won't be a linear path. I am sure there will be new 'hot spots' pop up. We will probably have missteps and take a step back here and there. But we WILL do everything we can every single day to make progress and keep the general public safe as we do so. Let's come back together, realize we have a common goal and believe in each other again. We will beat this. Together. Be smart. Make good decisions. Stay home.