Should I be worried?
The random texts started weeks ago, but now it’s constant. Friends, colleagues, and loads of fellow parents (especially of college students) are texting me- “Are YOU scared? Is it time to panic? Or is this simply media hype? What do we do about Spring Break? Is Mexico safe? Why the heck is our kid’s university going to online classes? Are you kidding me? We’ve paid a fortune for their education!”
My friends know if they ask me a medical question, I’m going to answer straight up. Along with a side helping of grief if they try to pivot around with pseudoscience. So what CAN I say about COVID19 at this point? I feel like a Magic 8 Ball with answers like “Cannot predict now” or “Ask again later” but the truth is answers are changing every day as we gain new information. Here’s where I’m at today, star date 3.12.20.
Point: I look at the numbers of COVID19 vs Influenza, and constantly wonder what the last decade would have looked like if the media reported daily deaths from flu. The numbers are staggering- the CDC estimates that we’ve had 34 million flu illnesses, 350,000 hospitalizations and 20,000 deaths from the flu THIS SEASON. These numbers FAR outweigh COVID19, so how can COVID19 be scarier than that?
Counterpoint: Unfortunately, while we have antiviral medications AND a flu vaccine shown to reduce the severity and MORTALITY of the flu, for COVID19- we’ve got nothing but “supportive treatment”. What does that mean? Supportive care means ventilators (breathing machines) for those who end up with rapidly progressive lung damage. Thankfully 80% of infections are mild, but for the 20% that are not, this virus is vicious. So maybe the numbers aren’t so bad? Well, here’s the catch: your standard hospital has less than 20 ICU beds (high care beds that include the use of ventilators.) Many have less than 10. What number does it take to overwhelm our hospitals? NOT as high as what you might think. Toss in a “mere” 10, 20 or 30 patients with severe COVID19 requiring ventilation…and boom, your hospital is overwhelmed. PS This is the major fear factor- COVID19 patients needing all the available ventilators. Now consider what happens if you’ve had a terrible motor vehicle accident, or a hip-breaking fall, or a heart attack- and you need surgery with recovery in an ICU- but wait, we have no room. THAT is scary. And it’s happening in Italy and China. How will medical teams decide who “deserves” a ventilator? Not easy choices, and yes, this is cause for worry.
Point: What about our college kids? They’re mostly young and healthy, and thankfully we are not yet seeing severe disease or deaths in their age group. While yes, there is a growing cohort of students who are cancer survivors or type 1 insulin-dependent diabetics or other immune-suppressed individuals, the majority of students are immunologically robust. Meanwhile, universities are steadily jumping on the bandwagon and telling students not to return to campus after Spring Break, noting they will switch to online courses. Wait, WHAT? As a parent, my initial reaction was frankly irritation- we are paying for REAL classes, and how dare they send our healthy, low-risk kids home? And what about the kids who need their work-study jobs to make ends meet, and who don’t have home environments that will support online learning?
Counterpoint: But then…these healthy kids are living in cruise-ship-like tight quarters, and they will surely pass this virus among their ranks with rapid speed, which may not produce symptoms much beyond cold or mild flu-like illness in them. But what about their families? Or the people in their internship or work environments? Or their professors? Or the parent that is undergoing chemo? These healthy kids (including mine) are prime vectors to transmit this virus. Am I losing sleep that COVID19 will kill record numbers of healthy young people? NO. But the buck doesn’t stop there. And I do worry about who else they will infect. Including young pregnant women (and frankly, we have no idea yet what impact this virus will have on growing fetuses.) And so, after I initially agreed with my kid that she COULD stay in her dorm when her university announced the switch to online courses, I realized the greater good (despite inconvenience and significant expense) was that she leave campus and fly home.
Side note: College students- Hello! We see your social media stuffed with memes about online course drinking games and extended spring break parties, and okay, I may have chuckled initially, but come on! I love that you feel invincible, but I honestly worry that your excessive alcoholic partying will cause more injuries, illness and deaths than COVID19 in your age group. Please take a minute to learn or remind yourself of these few tips.
Point: Politics aside, WE NEED MORE TESTS. Right now, we are saving our tests for the severely ill or super-high-risk patients. This means we are not picking up the 80% of people who have infection with mild disease. YES, our numbers are going to skyrocket in the next weeks as we finally have capacity to test more people with mild-moderate disease. But we need to know who has this virus to more effectively reduce its spread!
Counterpoint: Until we have unlimited access to testing, we really shouldn’t have to test EVERYONE with cold symptoms. Please trust your doctors to work within their community to weigh who should or should not be tested at this point, as we are literally rationing these tests to try and help those who have the greatest need.
Point: Tonight, I checked in to a hotel by LAX that is at 20% capacity, though this time of year it is typically overbooked. The staff are fearing for their jobs. The restaurant changed its menu two days ago to streamline the kitchen and has cut back on waitstaff hours. My flight tomorrow has few enough fliers that last minute reservations today for our displaced college students got us A-section boarding passes. I tend to think about COVID19 in regards to life/death, but the ramifications on the economy extend far beyond the travel industry.
Counterpoint: Well… crap, there’s not one. Why? Stock market dips. Service jobs tightening. Entertainment and sports industries counting on “crowds”. And what about the medications produced in China that are now in short supply? Or even the lack of hand sanitizer and toilet paper? Many will suffer. Okay, perhaps if your company makes hand sanitizer or N95 masks, maybe that’s a counterpoint? All flippancy aside, some businesses will do well. But I think it’s time for all us to work together, which means it’s time to cancel OUR family’s fun events and vacations, bring your kid home from college, and order take out instead of dining out. And yes, it’s hard, but let’s “do the next right thing.”
BOTTOM LINE: We’re in uncharted territory. Is it time to worry? YES. Time to panic? Well…that’s never helpful. I prefer to say it’s time to be really AWARE…and it’s absolutely time to ACT. Make the hard choices to “socially distance” your family from crowds, wash your hands (beyond “splash and dash” please- go for the full 20 seconds), and for goodness sake, make sure you got your flu shot this year!