This is the second of what I anticipate will be a weekly update on life during the greatest pandemic in over a century. Because it's clear that's what we'll be living through for the next several months, at least.
The overall story of the last week has been the exponential rise in cases in the US, accompanied by a growing knowledge about the virus and consensus regarding the severity of the pandemic. "Social distancing" is now a universal phrase, and the resultant anxiety has palpably seeped deeper into the collective consciousness.
According to reports, many in Britain are in a state of shock as prime minister Boris Johnson, Prince Charles, and several high-ranking ministers have contracted the virus. Elsewhere, Italy and Spain are continuing to struggle with what is hoped is the peak of the pandemic's first wave. India has completely shut everyone inside for 21 days in hopes of avoiding additional stress on its fragile healthcare system. China, on the other hand, has relaxed some of its restrictions as new cases have plummeted, at least initially.
The sober, wartime mentality was punctured earlier in the week by Donald Trump's relapse into denialism, claiming that he thought the country would be back to work by Easter. Which is less than three weeks away. And which would clearly be catastrophic. His insatiable lust for a return of the bull market of his first three years in office has served to only derange his already-catastrophically-impaired decision-making capacity.
This is mainly mentioned to highlight the utter lack of leadership at the federal level. We are all starting to pay an incalculably steep cost for raising such an incompetent, narcissistic, and irresponsible human being to the office of president. We don't need a great leader. We just need someone who has the basic level of competence to set the right tone for the nation, consult with experts to make some big important decisions, and delegate serious policy-making to competent people.
A correlate with Nazi Germany comes to mind. Not Trump to Hitler (necessarily), but rather how loyalty was elevated above competence in placing people in power, resulting in a cast of fools trying to making decisions and utterly failing every step of the way. Unfortunately, that's all we've seen the past 2 months from this administration, and all we can expect to see until a new administration hopefully takes power next January.
A silver lining is that half of the states have taken bold steps to stem the pandemic. Though this may be slowing the progress in more rural areas and in a few cities like San Francisco, it clearly has been insufficient in most cities. A week ago, Italy was shocking the world with its 25,000 cases. Today, the US has over 120,000-- 52,000 in New York alone, with skyrocketing numbers in New Jersey, New Orleans, Chicago, Detroit, and elsewhere.
As expected, reports out of New York in the last couple days have started to mirror those coming out of Italy from the previous week. Because of New York's size, the situation has not yet gotten as dire as Italy, but I am certain I will be stating a different case a week from now, when the US will be closer to a million cases and New York in the hundreds of thousands.
Locally, North Carolina just topped 1,000 cases, over half of which are in Charlotte and Raleigh-Durham. Those areas are on shelter-at-home, while the rest of the state will be starting that on Monday at 5pm. Watauga County sits at just 5 cases, and we have yet to see any inpatient cases or local transmission outside of a single household. Watauga Medical Center has barred all visitors except for spouses of delivering mothers and family members of dying patients. All staff are being temperature screened on our way into the hospital each shift. Policies are in place and the COVID ICU and intermediate units are up and running. I am personally caring for the COVID rule-out patients this week, and have been encouraged at the rapid pace of change. After weeks of preparation, we are nearly as ready as we can be, excepting the continued lack of rapid COVID-19 testing capability-- which is by far our greatest limitation in terms of caring for possible COVID patients and conserving PPE (personal protective equipment). If reports are to be believed, responsibility for this lack rests squarely at the feet of the FDA, which delayed all testing development for the entire month of February. But no matter who is responsible, heads should roll. My job and the job of thousands of healthcare providers is markedly more difficult without rapid testing capability. And most importantly, patient care is suffering, even before we have any actual COVID patients in the hospital.
The dark clouds continue to gather, and the rain has started to fall. But the silver linings remain. Distributed work (ie working from home), a beautiful concept, is starting to see its day in the sun. Service industries are being painfully disrupted, but much will rise from the ashes. People are having to be more intentional about staying connected. And the world is starting to see the value of competent leadership... and the steep price that must be paid where it is lacking in trying times.
Stay calm and self-isolate on.
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