Hide and Watch
“Hide and watch” is what we have been doing since the beginning of the COVID19 lockdown. It has been little comfort to realize we are “all in this together,” as many people have asserted. Though it may be true, when your income is gone, anxiety accumulates. The battle against the virus has been characterized as a war. It is difficult to get information one can trust in a wartime atmosphere. Hiram W Johnson, a Republican from California, was elected to the United States Senate in 1917. Like most senators seem to do, he stayed there in the Senate until he died in 1945. He is credited with the original truism, “The first casualty when war comes is truth.” It has been variously worded since then by other commentators, but you recognize the sentiment. The information that we get about the pandemic and the current state of it is a mixed bag. In The Grip, our local Griffin news source, the editor has documented her own struggles in getting accurate facts. The information with which we are bombarded is not just fact, however, as it is mixed with emotion, opinion, and political shading. All of this affects how we feel about the future – about our future. The Chinese communist government has lied repeatedly and is still lying about this virus, its nature, the mode of transmission, and the casualty rate. People who speak or attempt to speak the truth in communist China are murdered. The World Health Organization (WHO) has demonstrated a very close relationship with the Chinese government and lied on their behalf. Political correctness distorted everything we saw or heard, since it was “racist” even to discuss the origin, much less the cloud of disinformation perpetrated for political reasons. One presidential candidate tried to brand Pres. Trump as “xenophobic” because he ordered a travel ban from China to protect Americans, but then the candidate thought it over and realized it was the right thing to do. At least he admitted it. As a healthcare provider, I do not base my decisions on emotion, opinion, or politics. I will look to science and cold, hard, verifiable data. I am more comfortable in that arena with clinical and business decisions. So what parameters do we watch in order to understand what is really happening around us? First, every pandemic surges and then subsides. We plot graphs based on the number of cases over time, the number of deaths over time, the number of people recovered over time, the amount of stress in the healthcare system over time, etc., and we look at these graphs for information or comfort. You have seen data presented this way on the television screens for over a month now. We know that death rates lag behind the actual trend in the pandemic. Some people get sick and are still in the hospital as a pandemic subsides. So, following the death rate does not look like a good indicator. The total number of cases can be plotted in a graph over time. This can look frightening, but there are factors in the interpretation that need to be considered. There is lag time between verification of a coronavirus case by lab confirmation and the time that it is reported. Some of the cases being reported are actually old cases that are just now being put into the tally. This makes the total number of cases unreliable as an indicator of where we are in the pandemic. To me, as a non-epidemiologist, the most important indicator to follow is the number of new cases. If new cases being confirmed are on the rise, then the pandemic is still on the upswing, and danger abounds. If the number of new cases is in decline, so is the course of the pandemic. I urge you to look daily at the report from the Georgia Department of Public Health. Put this into your browser and market as a “favorite:” https://dph.georgia.gov/covid-19- daily-status-report. Scroll down to the bottom and look for a bar graph that tells you the number of daily confirmed new cases. If the trend there is favorable, we are on the tail end of the pandemic. Here are the numbers-- new cases and the number of deaths-- from 14 April to today:
Date New Cases Deaths
14 April 843 38
15 April 642 26
16 April 700 35
17 April 597 18
18 April 286 23
19 April 192 31
20 April 330 21
21 April 84 12
22 April 10 1
In just over one week, we have gone from 830 new cases in Georgia down to 10 new cases. The data from this tally lend strong support for Governor Kemp’s decision to begin leading Georgia into Phase 1 of reentry from the isolation of the pandemic. He is following the advice of one of the most reputable epidemiologists in the United States.
To be clear, the virus is still out there. It may even surge some as we relax our strict isolation. But we can go back to work safely if we do it with intelligence and using the right precautions. Social distancing is still appropriate, as is handwashing, use of a mask in public, scrupulous disinfection of the environment, etc. If we do not get our economy gradually and progressively back on track, we will have a different kind of resuscitation ahead of us.
I have been very careful as a doctor and as a small business owner. I have taken precautions to protect my staff, my wife, and myself. I have been concerned like everyone else about what is happening. But I will not let emotions or anxiety make my decisions. I said early on in this crisis that when you are in a fog, you fly on instruments. Science should be our guide, not politics, emotion, or anything else.
So, I stand with my president and my governor: I believe the worst of this storm has passed us, and it is safe to go outside with precautions. Yes, there is some risk. But there is more risk in the destruction of the greatest economy the world has ever seen.
We have bought time by hiding and watching. The curves have flattened, and that has bought time for our healthcare system to adapt and provide world-class care under wartime stress. Hiding and watching has led to the low number of new cases cited above. The data show that this monster is weakened significantly.
I look forward to getting back to work. I miss our patients, my staff, the drama, the laughter, the challenges. We will open Monday.