The New York Times has started printing articles about lifting the shelter in place orders and allowing life to resume. Wouldn’t it be great if it was just two more weeks of this? I can almost imagine a swift economic recovery as businesses re-open, jobs are restored…. but the pandemic isn’t almost over. If we pretend we can return to normal in a few weeks, if people simply go back to their lives, more people will die. Our health care system will be overwhelmed, doctors everywhere will face the conditions NY has been dealing with.
I’m baffled, frankly, that these articles seem to be primary right now. Why aren’t we hearing about changes in testing capacity? Why aren’t we seeing coordinated efforts to ensure adequate PPE? Why isn’t the focus on which treatments are keeping people alive?
I don’t know when it will be reasonable to allow a partial return to normal. But a few things are clear:
- Requirements in Sonoma county to wear masks have been made with trepidation. The fear is that people will think its safe to go out if they have a mask on. It’s not. Does it help, probably. Does it prevent transmission of Coronavirus? No.
- Experts in public health, pandemics, virology, and medicine, all agree that, in order for it to be reasonable to lift the shelter in place restrictions, we need 4 things:
- Adequate fast testing. Everyone with symptoms, everyone who is exposed to a person who tests positive needs to be able to get tested and get results quickly. A lab developed a 15 minute test – do you think you could get it if you developed a cough?
- Adequate protective gear for health care workers. Health care workers make up something like 11% of those with COVID-19. They have to be protected better. And scientists still need to understand transmission better. Its not as if every single doctor or healthcare worker that has developed COVID-19 was working without any protective gear – right?
- Medical Facilities have to feel confident in the number of beds, ventilators, and employees. They can’t be planning to move obstetric doctors into intensive care wards and urologists into primary care cough clinics. They have to have enough beds to care for those that get sick, and enough doctors, nurses, PA’s, MA’s, pharmacists, lab techs, cafeteria workers, administrators, janitors, and other support staff to keep the facility functioning and to care for patients. If we plan to continue the trend of health care workers getting COVID-19 we also need a second line of workers for when the first fall.
- We have to have consistently, less cases diagnosed daily for at least a week. But if people can’t get tests, and then when the do they can’t get fast results, then we can’t be convinced that we have less cases. What if 150,000 people are simply waiting for their test results? No new diagnoses? What if 200,000 people are afraid to go to the doctor for fear of getting sick but they need to be tested?
I’m not advocating staying home till we have a vaccination. I’m writing these words with deep humility. I don’t know when we should lift restrictions, how gradually, or how we should assess the results of any change to restrictions. I certainly don’t have answers for how to manage the terrible destruction that staying at home is causing to our economy.
But I think it’s important to realize that just because we don’t have answers, doesn’t mean we should lift restrictions.
Just because staying at home is causing damage to our economy and to so many people’s lives, doesn’t mean we should lift restrictions.
Just because we in California are currently being successful at preventing the horrors NY is experiencing, successfully flattening the curve, does not mean we should lift restrictions.
I just read a thoughtful article in the Atlantic called Our Pandemic Summer, that discusses in depth some of these questions – it’s worth your time.
Today I saw a tweet from the WHO organization with requirements for lifting restrictions. We haven’t met them yet. You can read about them in this NPR article.
We are not in a battle that can be won swiftly. We are facing something unprecedented. Let’s not move quickly out of fear, ignorance, frustration or worse boredom. We need to stay focused on testing, treatment, protection of our health care workers, and minimizing the number of people who get sick at the same time. Trying to fix the problem of returning life to normal, before addressing management of the Coronavirus is like putting a bandaid on a broken ankle so you can resume your 5K run.