Covid-19 Missive Four, March 20th

This is Robin Schoenthaler, the cancer-doctor-who-writes-about-Covid. I’ve been asked for updates. I have no good updates. It was such a beautiful spring day but here we are, standing on the cusp of one of the worst events of our lives.

Testing has increased some (more centers, more tests), and now there are many more cases in MA (413 cases, 58 hospitalized and now for the first time, today a death). When I last wrote you on March 14 it was 138 cases. Soon the numbers will be unimaginably high. The China/Italy statistics seem to be holding steady: 15% need hospitalization because the pneumonia is so bad people can’t breathe. Many need ventilators. When dozens (hundreds?) arrive on one day at our hospitals it will be terrible beyond imagining. It will be just like Italy.

The one difference in the US data, however, is that we are seeing more young people die – one study shows 20% of the deaths are in people are in their 30s and 40s. Maybe this is just temporary or maybe it’s us, something about Americans, or population skewing. One study showed that each additional medical problem a person has adds huge risk of severe illness or death. So a person with heart disease and lung disease and diabetes is at much higher risk than somebody with just lung disease.

The one good thing is that American kids are still not obviously getting the disease much or dying from it hardly at all, just like in China. But they are most certainly carriers and can infect others.

Our hospitals are wicked smart. Some of the best minds in medicine are downtown and are in constant contact with doctors in Italy and China and they know what’s ahead and what it has looked like. They are building testing centers, moving doctors and nurses around like chess pieces, cancelling all elective everything (no mammograms, no colonoscopies, no little operations), working like crazy to acquire more protective clothing, having anybody who doesn’t have to touch a patient stay home and work virtually. They are doing everything smart people can think of to learn from others and to mitigate. But still. This virus is so so contagious. It’s like an avalanche.

Today there’s a hundred patients at MGH – several of whom are health care workers – who are being ruled out for Covid, and probably a similar number at the other big hospitals. They can handle it right now because they’re huge and smart and have anticipated this. But in a few weeks?

So STAY HOME, folks. Don’t get this. Don’t overload the system. Don’t be one of those dozens-in-a-day patients clamoring for a ventilator. Being out and about now and physically connected with people is a terrible choice from both a moral and a medical standpoint. Please, please, stay the heck home.

And folks, we’re here for the long-term. Like two months? Three? More? We need to gird our loins and figure out ways to cope with what is essentially a total meltdown of our normal lives. We need to figure out how to model courage and fortitude and flexibility and grit to each other and to our children. We need to remember our grandparents and what they went through and pull it out of our DNA and put it out there.

We need to picture a day some months ahead (July? August?) when we sit at Walden Pond or Lake Winniepesaukee or the Mystic Lakes and we say, “Remember that nightmare? Remember how every single week got worse?”

And then we need to be able to say, “But during that whole long awful period there was this one thing I’m really really proud of – it was when I did this: _____” And then let’s all have something we did during all of this that we can fill in the blank with – something we end up really, really proud we did. It’s our only hope.