And this gives us a chance to really appreciate what’s important, be thankful for our families, and even reach out to help people who need it. So to actually answer the question, I’m not surprised by it, but the scale is more than we’d ever imagined. After SARS and MERS, we certainly have discussed such scenarios, though typically in hypotheticals [because] it was not spreading to this degree, and we would do testing to know where it is and and doff. And if you are going through the appropriate measures with full PPE for each one of these patients, you will quickly run out... So all the drilling on how to do it right is being thrown out the window, and we’re making up alternatives as we go. and pandemics are on the list of things we consider and prepare for. Just last fall we had a meeting reviewing Ebola and practicing donning and doffing the full PPE with such attention to detail, it would blow people’s minds... like hand sanitizer on the second glove set before pulling the gown from the front, rolling it off the shoulders and arms while keeping exposed surfaces in, then removing it with the outer layer of gloves and placing it in the specific bin in the room designed for doffing, while being observed for error by a colleague whose one and only job it is to observe this process... Now we are actually doing it, but there will be multiple patients in multiple rooms with a highly contagious disease. There will not be a specific room for each patient in which to don
limit exposure... Then those few patients we would have would be much easier to care for. Do you think the U.S. will mirror Italy’s situation? China’s? I think we have the benefit of seeing what happened in Italy and China to guide our response. Our attempts to do social distancing early will hopefully help slow it down here, though there will be questions after the fact about whether we did it early enough. The reports out of Italy have been truly horrifying. I don’t think we know how to minimize the number of medical providers who are getting sick and even dying. I think we will likely have enough resources that we are not making the nightmarish decisions about who can have a ventilator and who is just left to die. But really, verdict is still out on that. Italy has something like a 52% fatality rate in patients over 80, which is because they just don’t have the ventilators for them, so they are put on comfort measures instead of trying to save them. Let’s hope we don’t get to that point. Are there any silver linings to this outbreak and lockdown? To the outbreak? Hell no. This is a nightmare and many people will die. To the lockdown? Maybe some life perspective for people. I think we all get a taste of what real worries are. You can already see it in how people are barely complaining about being stuck at home (other than in the form of funny memes) and major life events being canceled or postponed – graduations, proms, weddings – it’s a good check on us when our lives are so wrapped up in the minutia. And this gives us a chance to really appreciate what’s important,
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April 2020
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