It’s okay if you think people are overreacting to Corona Virus. Please Read:

By Dr. Jason Persoff, CU School of Medicine

Sunday, 3/8/2020

This is written by a Colorado ER doc; it is long, but informative and yes, you can share.

Well, it’s been an interesting week. For those who don’t know me, I’m a hospital medicine physician and the Assistant Director of Emergency Preparedness for the University of Colorado Hospital. We are still very much in containment mode (isolating patients w/ COVID, quarantining persons of interest), but there are hallmarks that this will likely be in a different phase in the next week or two. For now, the increase numbers continue to be correlated in part with increased testing and in part due to real time increase in disease burden. I think the key message here is that containment will be unlikely, and we’ll enter mitigation: treating the most sick with most people quarantining at home. I do think it is reasonable to assume that COVID will be a global pandemic. Now the question becomes: how do we deal with that?

That brings us to the term social distancing. This is a pretty serious issue that is a stage above mandatory quarantine. Social distancing means, essentially, no unnecessary public gathering. We’re seeing ideas of this begin to pop up with the NBA and Olympics. I think others are coming. We’re already seeing self-selection in this direction with canceled conferences, canceled airline flights, and self-imposed canceled vacations.

What makes me the saddest at this time is how truly financially and socially devastating this could become and is becoming. Some of this is driven by hype, but truly I believe all the extreme measures–be it canceling SxSW or closing University of Washington–may help in spreading **out** the disease. Why would that be a good thing? A trickle of cases over a longer period of time means a better opportunity for us in healthcare not to be overwhelmed.

As an insider in our hospital’s emergency response, I can tell you that this past week has proven to be really draining. Long days and lots of meetings with multiple successes and failures at dealing with this disease. We’re getting on top of it, but this disease is just beginning. We’re still ramping up.

The most startling information to come out of China from the WHO is the abysmal rate of oxygen needs for patients. Five percent of patients end up on ventilators whereas 15 percent require oxygen for the 3-6 weeks it takes to recover. That’s an unprecedented burden on the healthcare system. We are simply not able to take a head-on hit if these numbers remain accurate–but over time, we could handle a sustained surge better.

Think about being out of work for 3-6 weeks on oxygen and you get a better perspective why I have concerns about the wherewithal of the financial system. I feel very sad for people whose lives depend on working day-to-day–this is going to hurt for a while and so that brings us to not panicking.

Okay, so what if we are facing a pandemic. First off, and I beg you to heed this, if you fall ill with fevers and a cough DO NOT GO OUT until the fevers have been gone at least 24-48 hours. I don’t want you to get me sick and you don’t want to sicken anyone else. Sorry, no going to work or socializing–self-quarantine. Oh, not because you have COVID, but because I don’t want any of the other types of illnesses out there either. What has been staggering to me is how many cases are tied to people who were ill not being mindful of others and going to their events anyway.

Second, if you have persistent fevers and are worried about COVID, contact your local health department for guidance. Do NOT go to the hospital unless you are gravely ill or can’t breathe. We’re not going to test you just because you want reassurance you are COVID-free. The most common types of respiratory illnesses remain far more prevalent right now, so you probably have them rather than COVID: flu, RSV, human metapneumovirus, etc.

Third, STOP PANIC BUYING. Hand sanitizer is a good idea, but you don’t need a 36 month supply. Don’t be an asshole–stock up but leave some for others. I can’t even imagine why people need 14 months’ worth of toilet paper, btw. Again, be reasonable. If you don’t panic buy, the manufacturers should be able to keep up.

Fourth, start contingency planning. It turns out most travel insurance policies don’t cover epidemics. Anticipate that most businesses may be running at 85% capacity at their worst, so be courteous and patient with everyone. Be flexible with your job–you may need to help keep operations running meaning changes in your schedule–and you may need that time yourself, so be generous. Hold off on purchasing trips for a month or so to see how we’re doing then.

Fifth, masks aren’t going to protect you. Your biggest enemy is your own face. We touch it on average >40 times an hour. Learn to be mindful of this. We believe, other than getting sneezed or coughed on, hand-to-face contact is a main mode of transmission. So, begin to learn when you do this. Do you know that most people unconsciously sniff their hands within two minutes of shaking hands with someone? Crazy but true: therefore, stop shaking hands and bump elbows or feet. Wearing a face mask will not prevent you from your own habits.

Sixth, don’t visit with ill friends. Hospitals, including ours, are severely restricting ALL visitors at this time, and even more stringently for patients who may have COVID. Facetime and video messaging is the way to go.

Seventh, keep reminding yourself that this is going to last a while. Don’t sprint, slow down. Make haste slowly. Don’t spread panic, deal with the numbers as they become available. The current numbers on the Johns Hopkins site show that China appears to be reaching a sustained plateau of cases, but it’s not dropping off yet. Were that to apply elsewhere, we have months to go.

Eighth–have hope. I do. And I’m in the thick of things. We’re all in this together and we’ll muddle through. Things may not look like we want them to look for a while, but this will pass. The virus will mutate, the vaccine will come out, a medicine may work, whatever happens this will change. This isn’t forever even if it feels like it. We’ve made it through 9/11–we made it through 2007. Be at peace that this is happening. Be practical but caring. Believe in the future…


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