Fact vs. Fiction

Uncle Jack's rainbow

To my Patients and Friends,

There’s not a lot of exciting news this week.  Although it appears increasingly likely that a vaccine may be available to the general public some time in the spring of 2021, the short-term outlook continues to look rather grim.

First, a brief disclaimer

I recognize that it’s inappropriate for me to express political points of view in my role as a physician. That is never my intention; however, as a physician and public health official, it is my responsibility to do everything possible to make sure that my patients and the larger community understand the facts as they relate to Covid-19, which poses a real and present danger to our health as individuals and as a country.  Unfortunately, there is an ever-growing disconnect between the advice being disseminated by certain political leaders and media outlets and that being expressed overwhelmingly by doctors, scientists and public health officials, including the CDC and the public health experts at our leading universities.  It is enormously important that you listen to and heed the advice of the latter group.

A stark contrast

According to Johns Hopkins Bloomberg School of Public Health, “Rwanda has emerged as a leader in controlling the pandemic. In addition to fast implementation of strict lockdowns, Rwanda also has a robust testing and contact tracing program. Testing is widely and freely available, with testing sites being set up along high foot-traffic areas. Rwandan health authorities say that they have converted their widespread HIV testing capabilities for use in COVID-19 testing. They also conduct pooled testing in order to process samples more quickly and return faster results. Police, college students, and healthcare workers have been recruited as contact tracers. In the Rusizi district, a hotspot in the country, people were largely compliant with the strict lockdowns and suspension of travel to and from the area. As a result, within-district mobility has begun to resume while travel in and out of the district is still banned.”

While here in the U.S

Cases of COVID-19 are skyrocketing and we continue to break records daily.  In some states (including Connecticut), appropriate measures have been adopted as per the sound, evidence-based recommendations of scientists and other public health authorities, which has resulted in meaningful regional control over the spread of the coronavirus.  It’s likely that, in these regions, businesses will remain open and schools will be able to reopen in the fall, at least for some period of time.

However, in other states in which leaders have been motivated to discourage the most basic reasonable practices of social distancing and wearing of masks, masses of people are falling ill and hospitals are quickly reaching (and in some cases, exceeding) their capacities.  Very soon, health systems in these regions will be overwhelmed, just as they were in New York when the pandemic first struck.

The difference: in the New York tri-state area, we knew nothing of the virus at the time it arrived on our shores.  But we learned and adapted quickly.  We had sound leadership.  We heeded the scientists.  We stuck to the plan.  We were unified in our mission.  And we halted the spread of the virus.

Contrast this to what’s happening elsewhere in the country.  Even armed with the wisdom gleaned from our early experiences here in the New York area, leaders in these now profoundly-affected regions are failing their citizens.  The results of these failures have been tragic and the situation is going to get much worse before it gets better.  The numbers of people falling ill have already exceeded the capacity for these regions to perform effective contact tracing.  Many state and municipal leaders continue to shun the advice coming from the scientific community.   In neglecting to dispel myths, squelch conspiracy theories and educate the populace, many of our elected leaders are de facto facilitating the spread of COVID-19.  They squabble over whether or not face masks should be required, or even encouraged.  They promote mass gatherings in high-risk areas.  There have been threats to defund schools that don’t open in the fall, even in areas in which cases of COVID-19 are skyrocketing.  Governors are suing mayors who choose caution over recklessness.

Due to this absence of solid, consistent leadership at the highest levels, tens of thousands of Americans have needlessly lost their lives.  It’s a statistical certainty that, had we responded in a more timely, comprehensive and evidence-based fashion early in the course of the pandemic to take meaningful action (that is, to launch a public education campaign based on epidemiological evidence, to ramp up our testing capabilities, to acquire and disseminate adequate PPE supplies to healthcare workers, and to enforce physical distancing measures), countless American lives would have been saved, as was demonstrated in other countries, and it’s likely that we would not have found ourselves in the dire situation in which we now flounder.

Scientists and public health officials are very concerned about what’s to come as the influenza season approaches.  It is likely that what our country has gone through thus far will seem like a dress rehearsal compared to the public health blizzard that’s looming.  Hopefully, our leaders will have learned some lessons in preparedness and are more poised to heed the advice of those to whom they must listen.  But regardless, we can all do our parts as individuals to ensure that Americans behave safely, appropriately and in consideration of their fellow Americans by wearing masks and maintaining physical distancing measures, with or without our leaders’ approval.  This needs to be an ongoing conversation with everyone you may know, particularly those who live in the hardest-hit regions of the country.  Only if we all consistently practice these measures will we stand a chance of halting the spread of COVID-19 as fall and winter approach.  It’s our best and only hope right now, at least until we are finally able to achieve herd immunity with the help of an effective and wildely-administered vaccine sometime early next year 🤞.

And we need to ask more of our leaders.  Because as of now, in contrast to the leadership role we’ve traditionally played on the world stage and despite our extraordinarily deep wells of knowledge and resources, we are failing.  And Rwanda- a struggling Third World nation- is setting the bar.  Shame on us.

That’s all… thanks for listening.  In spite of all this, please continue to be safe, patient, thoughtful and kind.  And please heed the science, wear masks and follow all recommended physical distancing measures.  One way or another, we will get through this.

Have a nice weekend.  I’ll see you soon.

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