I want to address some misguided perceptions regarding COVID-19, the healthcare system, and the state of our nation (though most of my comments will be Texas specific since I have not kept up with government mandates and such in other states).
*Of note, views stated below do not necessarily reflect those of my hospital or employer.
>deep breath<
Here it goes:
1. Hydroxychloroquine (HCQ) has NOT been proven to be a miracle drug in the prevention or treatment of COVID-19.
Also, while the safety profile of HCQ shows it’s a relatively safe medication, that is ONLY the case in a subset of patients without certain other medical issues. For some, this medication could literally KILL them by causing an abnormal heart rhythm. In medicine, we largely follow EVIDENCE BASED MEDICINE (EBM) meaning that therapies and tests have to be put through appropriately large and appropriately structured trials in order to be deemed safe/appropriate for widespread use. Practicing outside of EBM can mean loss of your patient’s life, loss of your medical license and very large funds in a malpractice suit and leave physicians without a leg to stand on. Plus, it’s the best way we have to know that what we are doing for our patients is FIRSTLY not going to do harm and SECONDLY going to provide some benefit. We take an oath upon completion of medical school when earning our MD/DO that states “First, do no harm”. The evidence for HCQ shows SOME very small, relatively weak studies saying it MIGHT help (mostly in theory, maybe some in practice) but there are also some small studies showing NO BENEFIT. As such, we truly don’t know if it helps. It might and we might just not have the powerful studies needed to show this or it may do nothing at all. But it also is not completely safe for anyone and everyone to use. So PLEASE stop begging for this medication. Other people NEED it for their chronic illnesses for which there is already strong evidence for its efficacy.
2. COVID-19 was NOT blown out of proportion.
The risk from the virus when it arrived to the US was very real and very high. We DID NOT have our hospital systems set up to handle the cases coming our way if we continued as we were. Ask Seattle, NYC, New Orleans, or Detroit. Their hospitals were functioning BEYOND their normal capacity. They increased their ICU beds and ventilators THREE HUNDRED PERCENT (300%) to adjust for influx of critically ill patients. And with their increase, they were STILL completely full in their ICUs using all ventilators at their disposal and still holding admitted patients in the ER for days on end waiting for beds for open up. It’s true that no one was refused care due to lack of resources. It’s true that no 2 people had to share ventilators. But that is because of actions put into place to adjust to the influx. The danger of COVID-19 was NOT it’s death rate. In fact, the PERCENTAGE of deaths compared to other similar viruses has actually been dramatically lower in COVID-19 than others. The issue was how QUICKLY everyone would need healthcare and maximum support with the resources at hand. If the hospitals in the cities listed above hadn’t made changes to their structure, we most definitely would have seen increase in deaths across the board and our systems would have ABSOLUTELY been overrun and overwhelmed. Just because we adjusted well and didn’t have scenes like Italy doesn’t mean it was never a threat to begin with. It means we acted early and dramatically to PREVENT having scenes like Italy. We learned from their healthcare teams to lessen our blow.
3. The Stay Home orders were not pointless.
The idea behind staying home and distancing was to FLATTEN THE CURVE (meaning the disease may be around longer but less people will be sick at the same time, allowing for resources to be available for those who need it). Guess what? It worked. We HAVE flattened the curve. It did EXACTLY what it was supposed to do. This ties into my next point…
4. The hospitals are not overrun/full, so now healthcare workers are being decreased in shifts/pay and being furloughed.
Now, let me preface this by saying I am NOT referring to Seattle, NYC, New Orleans, or Detroit. Those areas have been quite burdened and their volume is large and their patients are very ill. However, the rest of the country has seen a dramatic drop in ER visits–50% to be more accurate. While we are grateful everyone has done their part in staying home, we also understand that a decrease in volume like that is highly detrimental to the hospital system. The hospital can NOT continue to pay employees as it always has when its revenue is less than half what it once was. It’s simple math. Like it or not, hospitals are not independently wealthy and function just like other businesses out there. Money in has to be greater than money out to keep doors open. If we don’t take action now, hospitals will be CLOSING THEIR DOORS (possibly permanently) in 3-6 months. And while I can’t speak specifically for other businesses outside of healthcare, I feel it’s safe to assume many of them are in the same boat.
So what am I suggesting? (Here come my opinions)
It’s time to wisely start opening back up businesses and starting the process of returning to normal. Our communities need it. I’m not saying we instantly go back to how things were overnight but I think we start with a well thought out process. Maybe it’s letting businesses go back to normal first with certain safety measures in place and, if all goes well over a couple of weeks, schools and other gatherings can also open back up. I don’t know the solution here, but at least in Texas and in other parts of the country where the virus has not wreaked havoc, it’s TIME.
If we don’t act soon, we won’t have communities to return to when this is over.
Our communities need us and we need them.
It’s time to start the process of recovery.
