COVID - 19: Lessons Learned So Far

Ready for covid post it note.

A respected scientist, Dr. Anthony Fauci, explained earlier in the week of this column’s writing that we are perhaps half-way through the most challenging part of the COVID-19 pandemic in the U.S. Also at the writing of this column, our president is convalescing from the virus infection in the White House after being discharged from Walter Reed Hospital. By the time you read this, the November 3 election will have occurred. With the election over, my intent is to be apolitical in this column and present some important lessons that the pandemic has taught us about it (the disease) and our response to it.

COVID-19 is Indiscriminate

Although there is no question that the virus has sickened and killed more people in the lower economic stratum, it has shown that it can even come into the White House and afflict many who inhabit including the president.  As has been pointed out multiple times, this virus spreads easily and does not care whether you are rich or poor, young or old, male or female. Certainly older people with comorbidities are more likely to die, but everyone who is exposed to it has a good chance of getting it.

Preventive Measures are Effective

There is now ample data to show that simple measures can prevent or slow the spread of COVID-19. The wearing of masks, washing of hands, avoiding large crowds, meeting outside when public gatherings must occur, and staying 6 feet away from others are the most effective methods to prevent the spread of the virus.  This is indisputable science.  For example SC DHEC reported that communities that mandated mask wearing had reductions in new infections compared to communities that did not have these mandates.1

Experimental Therapies Abound but there is no Cure

When the president was sent to Walter Reed he was given a dizzying array of therapeutically different approaches to the disease. He was given Remdesivir that has proven useful in other RNA virus diseases and been shown to be helpful in COVID-19. He was given the steroid, dexamethasone that dampens the inflammatory response to many diseases, and he was given a mono=clonal antibody that is not released or approved for treatment of COVID-19. Surely he received many other medicines and oxygen to improve his hemoglobin saturation, impaired by the lung involvement of COVID-19. In short, being the president he got care not available to the average American – and he seems to be recovering especially well considering his other health risk factors like age and weight.  Despite recent presidential tweets there is still no cure for this disease and there is no vaccine to prevent it yet.

Hospitalization is Important for the Ill

Fortunately many people who contract the disease do not require hospitalization. The president had significant “desaturation” or lowered blood oxygen levels due to lung involvement. When people suffer this severe complication hospitalization is required and often intensive care even in some cases endotracheal intubation with ventilators assisting the impaired breathing.  Most people who are hospitalized in the U.S. survive, but over 200,000 have died.

The U.S. Leads the World in Infections and Deaths by Population

It is a hard, cold fact that the U.S. leads the world in disease and death when the total population is taken into account. In a country with so much wealth, so many fine medical facilities, the world’s biggest healthcare research community (private and public,) and with the world envied National Institutes of Health and Centers for Disease Control and Prevention – the question is why.

Failed Leadership

The fundamental problem seems to be that CDC and president failed the public when we needed them most. A series of miss-steps early at CDC regarding testing and advice on wearing masks was compounded and greatly amplified by a White House that chose to downplay the seriousness of the pandemic so as not to scare the nation.  When has our country and its citizens ever failed to rise up to face a crisis or common enemy? However, worse than minimizing the threat, the standard protocols for disease prevention were decried by the White House in rhetoric that totally transformed a common disease threat to us all and we became divided - the disease political – Republican vs Democrat, state vs national, free choice vs scientific advice, and on and on. This disease is not nor should it be viewed as a political issue. It is a national public health issue that requires Democrats and Republicans to work together to help us remain healthy. It calls for a single strategy that may have different facets, but still a single clearly articulated approach. At the beginning of this pandemic in this country people would have been eager to ban together to combat the virus if a clear winning strategy had even been provided from the person elected to lead us in times of peril. It is not too late for the president to again unite our country against the common foe, COVID-19. That is the clearest lesson among the many.

Reference

  1. DHEC study shows mask ordinances continue to slow SC coronavirus cases. Post and Courier https://www.postandcourier.com/health/covid19/dhec-study-shows-mask-ordinances-continue-to-slow-sc-coronavirus-cases/article_4dbce148-f9d6-11ea-90af-3718fb487b58.html. Published 2020. Accessed October 10, 2020.