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The White House and Governor Herbert Need to Listen to Our Doctors About the Coronavirus
We understand that economic pain carries its own public health consequences. But the White House's plan to relax isolation efforts by Easter is premature, counter to all scientific evidence, and will only magnify and prolong both the human and economic losses. Relaxing conditions must be strictly a medical decision, made by medical experts, not a political decision made by politicians.
As defenders of individual and public health, we urge our colleagues and the public to proclaim any policy that sacrifices lives for an economic resurgence to be morally repugnant, and must be resolutely condemned. Together we can push back against this. Please join us!
Dear Governor Herbert and President Trump,
As physicians, healthcare workers and residents of our communities we feel compelled to publicly weigh in on the coronavirus pandemic gripping the nation. How our country responds in the next few months will have long term consequences not only within our borders, but worldwide. Because our nation failed to act aggressively when we had the chance, we now have no choice but a virtual nationwide lockdown, as other countries have recently done.
Given that, we are shocked to hear that President Trump, in the name of reviving the economy, is suggesting the opposite--abandoning our national containment strategy as early as Easter. We join other medical professionals in warning that such a move will be catastrophic, a death sentence to hundreds of thousands of Americans, perhaps even millions.
This threat is not comparable to that from seasonal flu or with the number of fatalities of auto accidents, which President Trump used for comparison. The mathematics of exponential growth tell a different story.
On a typical year, the first person with the flu can infect 1.3 people. After ten transmissions, that one person can infect 14 people. Because of much greater infectivity, the first person with COVID-19 can infect nearly 3 people. That difference seems small initially, but after ten transmissions, that one person can infect 59,000 other people--a dramatically different outcome. Because of that mathematical reality, world experts in infectious disease and epidemiology estimate that anywhere from 40-70% of the world’s population will become infected with the virus within a year if a strict containment strategy is not adopted. The rate of growth of the pandemic in the US is now greater than in any other country.
Because of that extreme infectivity, vigilant, nationwide separation of human beings from each other must be continued to suppress the outbreak. It only takes a few states, a few cities, even a few individuals who flaunt isolation and social distancing to completely undermine the success that we would otherwise accrue from universal cooperation. As Bill Gates says, that’s why there is no “middle ground” in mitigation.
The elderly and those with pre-existing medical conditions are at increased risk. Their immune systems and lung capacities are diminished, both of which predispose them to poor outcomes. Nonetheless, young people can become seriously ill and die. Nearly 40% of patients ill enough to require hospitalization in the US are between the age of 20 and 54. Half of COVID-19 patients in ICUs are under 65. As of March 25, in Lombardy, Italy, 1,600 patients in their ICUs were 30 yrs old and younger. Furthermore, the disease can leave survivors with residual organ damage and shortened life expectancies.
A shortage of ventilators has received a great deal of media attention. But ventilators are the last hope to save patients. Because of the unique virulence of this virus, patients sick enough to require a ventilator face a mortality rate of well over 60%, even with a ventilator.
Healthcare workers are at even greater risk than the public. Sick and dying health care workers obviously decrease our ability to respond to the crisis. Moreover, infected workers then make hospitals breeding grounds for more infection, adding fuel to the fire.
In many large cities our healthcare system is already overwhelmed. Patients in New York are now dying so quickly, in such large numbers, that some never make it from the emergency rooms to the ICUs. Refrigerated trucks are being used as temporary morgues. Relaxing containment strategies by Easter, or prematurely at any time, will cause the healthcare system to collapse, and medical care will have to be rationed. Such a move would ignite massive morbidity and mortality, far beyond what we would have otherwise endured, and prolong the duration of the pandemic not just domestically, but globally.
We understand that economic pain carries its own public health consequences. But relaxing isolation efforts prematurely will only magnify and prolong both the human and economic losses. Relaxing conditions must be strictly a medical decision, made by medical experts, not a political decision made by politicians.
As defenders of individual and public health, we urge our colleagues and the public to proclaim any policy that sacrifices lives for an economic resurgence to be morally repugnant, and must be resolutely condemned.
Sincerely,
Brian Moench MD - Board President Utah Physicians for a Healthy Environment
Park Willis MD, FACP - Board Vice-President Utah Physicians for a Healthy Environment
Richard Kanner MD - Board Member Utah Physicians for a Healthy Environment
Kirtly Jones MD - Board Member Utah Physicians for a Healthy Environment
John Macfarlane MD - Board Member Utah Physicians for a Healthy Environment
Sara Johnson MD - Board Member Utah Physicians for a Healthy Environment
Edward Thomas Nelson MD - Emergency Medicine Physician
Courtney Henley MD
Chris G Cowley MD
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