Facing the coronavirus with facts, not fear
Scott Strome
Dr. Scott Strome is the Robert Kaplan Executive Dean of the College of Medicine and vice chancellor for clinical affairs at the University of Tennessee Health Science Center.
The news seems consistently negative – more cases of COVID-19 in our community, more COVID-19-related hospital admissions, and overwhelming anxiety that our hospitals may not be able to accommodate the rapid influx of COVID-19 patients.
These biologic concerns are amplified by the politicization of COVID-19, leading people to wonder what is fact and what is fiction and feel that all roads are pointing to the common denominator of fear.
Amplifying these concerns are recent events that have forced us to look in the mirror – as individuals, as neighborhoods, and as a society – and, all too often, we don’t and shouldn’t like what we see.
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How do we move forward? First, let us deal exclusively with fact.
Fact: The reported daily COVID-19 numbers often represent the aggregate of several days of testing due to laboratory backlogs. This means that while we see days with alarmingly high numbers of cases, we must focus on the overall trends – trends that demonstrate the acceleration of this disease is rapid, but not as precipitous as might be suggested by viewing a single data point.
Fact: While the numbers of COVID-19-related hospitalizations definitely are increasing, we still have hospital and intensive care beds available – and even more can be mobilized if there is a need throughout the region.
For example, beds can be mobilized by reducing elective surgical procedures. In addition, new beds can be mobilized at sites like Le Bonheur Children’s Hospital. Indeed, Le Bonheur, a University of Tennessee Health Science Center partner hospital predominantly staffed by UTHSC faculty, has set aside a floor of its 12-story tower to care for young adults if area hospitals need additional capacity. Because children seem to be less severely affected by the virus, Le Bonheur has worked to train pediatric staff who can serve in areas of greatest need on how to care for young adults. While this may not be the usual focus of a children’s hospital, UTHSC and Le Bonheur stand ready to leverage their close partnership to care for our community in unprecedented ways.
Contributing to concerns regarding the availability of beds for COVID-19-positive patients are the limited team members available to care for these patients. Take comfort in the knowledge that the UTHSC, in collaboration with city, county and state officials and the Army Corps of Engineers, have built an incredible field hospital – run by UTHSC faculty – that is available should we exceed the surge capacity of our existing infrastructure.
Fact: We, as medical professionals, are getting better at treating COVID-19 infections. This is the result of shared experiences resulting in changed treatment paradigms and access to drugs – such as Remdesivir, convalescent plasma and steroids – that are thought to improve outcomes. In addition, on the very near horizon lie innovative clinical studies designed to prevent and treat the disease. The UTHSC College of Medicine, in close collaboration with partners like Le Bonheur and Regional One Health, will bring such studies to our community. Open collaborations like these form the foundation of truly excellent academic medical centers and help position Memphis as a national leader in the fight against COVID-19.
As we celebrate reduced COVID-19-associated death rates, we must recognize that the ages of hospitalized COVID-19-positive patients are declining. Some of our improved outcomes are attributable to the fact that we are treating these younger patients who have fewer additional health issues – patients who can and should have inherently better outcomes.
However, the idea that young people who get the disease will be fine is simply that: an idea, not a fact. While it appears that many younger individuals may not suffer short-term consequences of COVID-19 infection, we need to acknowledge the fact that we will not understand the long-term consequences of COVID-19 infections for years, if not decades to come. This merits or possibly mandates caution. Furthermore, we also need to acknowledge that even if many younger patients never develop COVID-19-related complications, they are primary vectors for disease transmission to the most vulnerable in our society – the elderly, the sick, and the people who lack access to care.
Final fact – not so much a fact as a thought: All life-threatening diseases are associated with fear and hardship, symptoms which not only affect the patient but also friends, families and communities. As physicians, we are given the unique privilege to see the positive and unanticipated consequences of illness – the incredible resiliency of the human spirit, the mending of interpersonal relationships and the reinvigoration of community bonds.
As we face the trying times ahead, take solace in the fact that these unanticipated consequences of illness are every bit as real as the diseases themselves, and that, if fostered, they will allow us to emerge from this crisis with a clearer perspective and a renewed sense of purpose.
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