I’m writing this letter in the hopes that by voicing my opinion as an emergency room medical practitioner, I will inspire you to resume aggressive social distancing practices which are critical to the well being of this community.
I work in a local hospital with hands-on experience treating COVID19 patients. This is the second letter I am sending out for the benefit of the community after working with many COVID-19 patients – watching several patients deteriorate in a matter of hours, listening to their lungs getting worse, and seeing more critical patients in weeks than I normally do in months.
As you all know, we are in the midst of a devastating pandemic that has infected at least 1.3 million Americans, and killed over 80,000. There are several factors that make this disease so dangerous. First, it is highly contagious. We know based on how fast it spread, and we also do not fully understand how it spreads. Second, it is a very deadly virus. Yes, worse for elderly or those with comorbid conditions, but I have seen with my own eyes both younger and healthier individuals who were taken by this disease. We have no vaccine yet. There are as of yet no definite treatments. Some of the medicines that were initially used have proven worthless, but a couple of antivirals show some small benefit- but not enough to be a true treatment regimen yet. My point is to remind everyone that in this respect nothing has changed. We have no way to prevent or treat it medically. Antibody testing exists, but we have no proof that it will provide immunity. We also believe that there are multiple strains of the virus, so even if someone has immunity, he may contract another strain.
What prompted me to write this is my fear that the virus will resurge and we will wind up back at square one, with the numbers of ill and dying going up again. The reason I worry now is based on what I see and hear. I was pleased and relieved that most of the community took the severity of this illness seriously, and people were truly keeping to themselves, staying home, etc. Unfortunately, the last two weeks I have noticed a big change. Looking out the window, I now see children playing with other family’s children. I see many more cars – people are going places too often. I see walkers, bikers, and joggers, many of them in groups. The CDC is still recommending masks, and I see barely anyone with masks on outside. I know there are once again outdoor minyanim and rumor has it that the inside minyanim are coming back shortly, which is a much higher risk of transmission.
I am not the only one concerned that the virus will resurge. Dr Anthony Fauci, head of National Institute of Allergy and Infectious Diseases just made a statement to Congress, mirroring nearly exactly what I have suggested. I have provided links and resources for much of what I am saying at the end of this statement.
Please don’t be lulled into a false sense of security that the risk is over. The federal government hasn’t even said that we meet criteria yet to decrease social distancing, but even if they would, I believe, as do many other medical practitioners, that this will lead to a quick resurgence and Chas veshalom more deaths.
So what is the plan, if we wait – when do we go back, we can’t do this forever? Think of it this way. There’s a surgery for skin cancer known as Mohs surgery. They remove a section of the skin and send it for pathology testing during the operation. If there is any sign of unhealthy tissue, they go back and remove more, then send it back to pathology, and so on, until they get a sample with clean margins. If they don’t continue this, the disease will just spread again and the whole surgery was a waste. This is the answer here. We need clean margins. We need to wait until there are no new COVID19 cases, and then wait for a few weeks for our “clean margins”, and only then go back safely to our daily lives.
To be blunt: if you knew that reopening would lead to 100 deaths in Lakewood would you do it? What about 50? 10? 5? How about one? Is it worth starting up too early if one community member dies? What if it’s a member of your family Chas veshalom? I believe that risk is very likely if we drop the distancing now. I hope I’m wrong, I will be happy to be wrong, but what if I’m right? Are there serious problems we face while in social distancing? Absolutely. Do I have the solution to all these problems? No. When a man runs out of a blazing fire in his house, he grabs his family and gets out even as all his worldly possessions burn, and he worries about it later. He has problems later, but at least they’re all alive.
Sincerely, An Anonymous Local Medical Practitioner *
*Previously there were those who questioned my submitting this anonymously. As I mentioned before, due to restrictions from my workplace, I am unable to give my name. I’m sure some people will get hung up on that, and I can’t force you to believe that I am who I say I am. I can only give you my word that it’s the truth.
LINKS TO SOME RELIABLE SOURCES
FEEDBACK TO SOME QUESTIONS THAT HAVE COME MY WAY
Wouldn’t we have all been exposed by family members and gotten immunity by now? A logical point. As I mentioned, there are at least two known strains and there are theories that there are more, and that the virus can mutate, so immunity may not help much. We also don’t know how long the virus can last in our systems. I had patients who reported symptoms for more than 4 weeks. I saw studies that people could remain contagious for up to 6 weeks after symptoms are gone. And the final point is that we just don’t know enough about it yet. It has defied many of the rules we knew, so we can’t assume.
Why trust doctors, they seem to be getting it all wrong and admit to not knowing anything about this? Kind of silly, but the part that’s true is – we don’t fully understand it. So here’s a mashal. When computers (or typewriters) came out and someone asked a Rav if it’s a problem to use them on Chol Hamoed. The Rav would admit he knew nothing about the computer, but he still knew Halacha, so he was still in the best position to figure it out and advise. The medical profession doesn’t know COVID19, though we are learning on the job, but we know the human body and how to treat it. Finally, I ask this person who posed this question: if he or his loved one stopped breathing due to COVID19, Chas Veshalom, would he stay home because the doctors don’t know anything? No. He’ll be running to the hospital just like everyone else.
What about the financial crisis, we just can’t keep this up forever- people need to get back to work? A mashal I thought of to help explain the situation in my mind: a right handed artist who makes his living drawing, contracts a serious infection in his right hand. He is told by doctors that this infection is life threatening and can not be cured with antibiotics alone. There is a slight chance that it will work, but if they risk waiting, he will likely become septic and die. The recommended treatment is to amputate his right hand. He complains that this will ruin his ability to work, he won’t survive. And there is a small chance that he will recover without it. The doctor tells him that he still advises the surgery because without it he will probably die. Yes, he will ruin his livelihood, but what good is that if he’s dead? He will stay alive with the surgery, and then work on a new plan of how to make a living. Yes. There is a real financial crisis developing, but there is a greater and more urgent crisis of a deadly pandemic, which is why we started the social distancing in the first place, knowing full well that it would cause financial hardship. We need to wait until it is clearly safe, and then pick up the pieces of the financial mess.
What about the mental and psychological impact? People “can’t take it anymore”? I think we need to be logical. I am aware of this problem, another side effect of the virus, much like the financial issue. But again, the priority is to stop the virus spread and resurgence. The psychological impact must be worked through and dealt with in ways other than introducing the risk of transmission. I saw a post about people bringing back their cleaning help, with comments including that they need it for mental health. This is a very serious risk, especially having them walking around your home for hours a day. Is the cleaning problem real? Sure, it is hard, I’m not trying to minimize, but again that’s a problem that has to be figured out in another way.