It’s real, it’s here and it’s deadly.
As I write this on Monday afternoon, Kern County Public Health has confirmed at least 12 cases of COVID-19 and is waiting on the results of nearly 300 additional tests. Some of those will come back positive and those people will have infected others, who will in turn have passed it along.
The virus is, in other words, now embedded in the community. And this means that people will die from it: maybe a member of your family, maybe a colleague, maybe a neighbor. I wish that wasn’t true, but the numbers are straightforward: COVID-19 disseminates rapidly, at least two to three persons infected for each carrier, spreading exponentially with each passing day.
Further, the type of pneumonia this virus causes is particularly nasty and thus approximately one in five infected persons will need aggressive medical intervention. And despite every effort, some of those will die. While older persons and those with other medical conditions are more vulnerable, they are not alone. Experts aren’t quite sure why this is the case, but in the United States, we are seeing a higher percentage of healthy 20- to 50-year-olds with severe symptoms, even fatalities.
All of this also means Kern County hospitals will almost certainly become overloaded. It is already happening in New York, Los Angeles and San Francisco, and the stories from Washington’s Evergreen Hospital, near Kirkland’s epicenter, are chilling. Bakersfield is blessed with excellent health care leadership, but there is only so much they can do. If – when – the surge arrives, they will not have enough ventilators, nor enough protective gear for their staff. Nor will they be able to treat other health conditions, including some surgeries and less critical infections.
Italy first started seeing cases a few weeks before the United States. and it has already been forced to make previously unimagined choices. Two weeks ago, physicians had to move away from the ordinary “first come, first served” model, restricting ventilator access to those under 80 who do not have other excluding medical complications. And we are now getting reports that in the harder hit parts of the country, they are reducing that to age 60 and providing only palliative measures to those who do not qualify.
Will our hospitals reach this level of rationing? By this point everyone has heard the phrase, “flattening the curve.” We are past prevention, even likely past containment. Current predictions are that 60 percent to 70 percent of the population will eventually become sickened by COVID-19. Everything now rests on when that happens.
If it comes in a large wave, we will be in the same position as Italy and people who might otherwise have been saved will die. If we can lower the peak, reducing the number of those who at any given time need aggressive medical support, we will save lives. We will also directly protect those on the frontlines – not just nurses, doctors and EMTs, but also respiratory therapists, janitors, cafeteria staff, all those who keep a hospital functioning and who are dependent on increasingly scarce protective gear. Shrinking the wave will give us time to produce more equipment, helping them, who will in turn be able to help us.
I repeat: this is real, it’s here and it’s deadly. It is not a hoax, nor a political plot. It’s a virus, one that doesn’t discriminate based on politics, ethnicity or geography. Anyone can catch it; most of us will. Whether necessary medical resources are available when we do is now totally dependent on our current behavior: will we do what is necessary to flatten the curve?
For most of us, it is not that hard. Avoid large groups. Wash your hands and, where there is no sink, use antiseptic lotion or wipes. If you feel sick, self-isolate. Leave the house only for vital activities. When you do have to go out, try to maintain at least six feet of distance from others. In short, act as if you have the virus and can spread it.
Do that for your sake, but also for those who must work now. We should all be deeply grateful to the first responders, for sure, but also to grocery clerks and stockers, delivery drivers, gas station attendants, bank employees, drug store employees and, yes, the many government and agency employees who are keeping the lights on, clean water running, sewers flowing and traffic lights operating. And while we’re at it, let’s give a shout-out to journalists – those producing this newspaper and staffing all the news sources keeping us informed at this vital time.
The easiest way to show that gratitude: abide by the distancing and hygiene guidelines; accept this for what it is: a medical emergency that, in the end, is up to us to manage.
Christopher Meyers, Ph.D., is the retired director of CSUB’s Kegley Institute of Ethics and has been a hospital ethicist for more than 30 years. The views expressed are his own.