I recently rejoined Facebook after deactivating my account over two years ago. I did not return because I missed the memes or pictures of friends, but as part of my civic duty. Now, more than ever, our friends and families need to hear from trusted medical professionals about what lies ahead. As a radiologist who screens the increasing volume of chest x-rays being ordered through the emergency room, I diagnosed my first case of COVID-19 pneumonia Friday night; but I know there is much more for me to do.
Back on social media, I’m reminded why popular internet videos that rack up hundreds of millions of views in a matter of days are called “viral.” Of course, it’s no coincidence that the term “viral” comes from the fast spread of diseases like COVID-19. Information is the only thing spreading faster than the coronavirus, and at the same time our most significant defense against it, for now.
Cases of COVID-19 will double every four to six days in the absence of interventions. If your city has two cases now, they may have dozens by next week. Right now, our number of confirmed cases are artificially low due a significant lack of testing, orders of magnitude behind some countries like South Korea that has tested ten times more people than the United States, despite having less than one-sixth its population. A long incubation period and asymptomatic transmission further disguise the gravity of the situation, as we may unwittingly transmit the virus to others.
Like many in my field, I have watched the COVID-19 story unfold with angst over the past three weeks, shortly after there was suspicion of community spread in the United States. Unfortunately, the pandemic scenarios that public health experts have feared are becoming a reality in countries like Italy and Iran, where the situation continues to worsen, ventilators are becoming scarce, and doctors are forced to make the unthinkable moral choice between saving a 45-year-old or a 75-year-old.
The CDC, other public health agencies, and many media outlets have disseminated useful information to the public about hand washing and social distancing, but we still haven’t been confronted with the massive challenges that may await us in the coming weeks. Recent polling demonstrates that many Americans are still unaware of the significance of this crisis.
And despite the guidelines, my daily interactions with friends and family have been troubling. It is routinely clear to me that many are under informed, and at worst, misinformed. They still think that this invisible threat won’t impact them, and that worries me; for my elderly family members, for those with weakened immune systems, and for the millions of healthcare workers who will be battling this on the front lines.
Some of this is understandable. It is very easy to be swayed into complacency by the absence of, or low number of confirmed infections in one’s known circles. School closures, cancellations of public events, travel restrictions — all for something we can’t even see or fully feel yet seems irrational. I get why some are dismissing this as “hype.” But those in the healthcare field know that we cannot afford to be complacent.
While closures and cancellations get all the press and attention, it is the collective action and responsibility of all Americans that is ultimately our best defense.
Hospitals are not designed for pandemics, our supplies of personal protective equipment, intensive care beds, and ventilators are finite. However, unbeknownst to most of the public, hospital systems throughout the country have spent the past few weeks undergoing extraordinary planning and preparation efforts in anticipation of what is coming; it is all hands on deck for a battle against a once-a-century (hopefully) foe. Countless meetings, first in person, and then remotely as social distancing became more imperative, have occurred and are ongoing. Daily updates regarding policies and protocols are now commonplace. While some hospital systems, like those in Washington State and New York are already seeing resources stressed by increased volumes of patients, the rest of us wait.
Many of us chose the field of health care to make an impact on the lives of others through caring for, treating, or curing those in need. Many of us get a chance to do just that every day. Despite those daily efforts, the next few weeks may very well offer each one of us an opportunity to save the lives of more people than we could hope to save for the rest of our careers. But this is not just true within hospitals, and you do not have to be a healthcare worker to save lives.
While closures and cancellations get all the press and attention, it is the collective action and responsibility of all Americans that is ultimately our best defense. Having entered a phase of exponential growth, everyone now has the power to prevent additional transmissions and slow the spread of disease in the weeks and months to come. This will help disperse the surge of patients our hospitals face over time, allowing doctors and nurses to provide quality care to the many people in need.
Every one of you can do your part to help educate the public. People trust their friends, so use that trust wisely and help make a positive impact. DO listen to the public health experts’ recommendations. DO dispel misinformation –- this is NOT the flu. DO convey appropriate caution and seriousness. DO explain the benefits of social distancing and hand hygiene. DO make it easier for seniors to stay at home. DO cooperate with the efforts of local businesses and governments. DON’T share unverified or unsourced material (this weekend an email hoax caused at risk people to go out and panic shop for supplies). DON’T incite panic.
We are all in this together, we all have loved ones at risk, and there is no opting out. The threat we are facing does not care about beliefs, race or status; we will all succeed together, or we will all fail together. I have seen the best of Americans in response to national emergencies, and I know that we have the capacity for unprecedented strength and resilience in crisis.
If we are successful, our best efforts will ultimately look like an overreaction, and that is the irony of trying to stifle a pandemic. You cannot be too careful.
Joseph Cavallo is a postdoctoral fellow and clinical instructor, second year student at Yale School of Management, Yale Radiology and Biomedical Imaging.