A prescription for the coronavirus
For the past six months, I have been taking the sick calls for the nearly 200 staff of our health center in Santa Fe. As the medical director, I felt it was the only way we could catch potential cases of COVID-19 as early as possible, and our employees could receive quick testing and the best guidance about how to keep themselves and their families safe.
After advising hundreds of patients and staff, I have seen what a shape-shifting chameleon this virus can be. It mimics allergies, migraines or even food poisoning, often starting with just a headache, nausea or maybe a slight runny nose or scratchy throat. Researchers are working to unravel the mystery of how the same virus can appear innocuous or even asymptomatic in some, but crushing, chronic and even fatal in others.
Likewise, we are learning more every day about how the virus is transmitted. It took a few weeks into the pandemic to understand the importance of mask-wearing. For months, public health experts erroneously underplayed the significance of aerosolized transmission, especially from asymptomatic individuals. At the same time, based on our knowledge of other coronaviruses, we overemphasized the potential contagiousness from surfaces and the need for decontamination of
objects we touch and use.
In the best of circumstances, advising the public about a deadly virus at the same time medical and public health professionals are still learning about it would be a herculean task. These are not the best of circumstances. The pandemic arrived on our shores during a time when we had a leader who does not believe in science, a fractured mass media where people can pick and choose their own convenient “reality,” a social media that amplifies unfounded conspiracy theories and a vacuum where there should be trusted national public health leaders expressing a consistent, evidence-based message.
As we know, nature abhors a vacuum, so misinformation floods into the void, and most of us have no measure to separate the truth from the lies. In the face of this chaos, our fears are amplified. We cling to erroneous beliefs like security blankets, and our misapprehensions solidify into convictions when we find them substantiated by others. The miasma of misinformation is so pervasive that doctors have reported severely ill hospitalized patients going to their graves believing they were misdiagnosed. On the other end of the spectrum are those who obsessively sterilize every piece of mail and never leave the house at all, even for safe activities like taking a walk outside.
In our fragmented society, it’s easy to stay comfortably ensconced in our respective bubbles, listening to our self-reinforcing echo chambers. We look to our social group to find concurrence with our convictions. In a recent Daily Show segment, Jason Klepper interviewed an attendee at a pro-Trump rally. Klepper asked what would make the man wear a mask. He replied, “I would wear one if all these people were also wearing one” as he swept his arm toward the mostly mask-less crown. A friend who was recently in Taiwan told me his taxi driver wondered why Americans don’t wear masks when it seems like such a simple way to protect your community. How many lives would have been saved if there had been early and unified support of mask-wearing from all our political leaders? Instead, many governors and President Donald Trump framed it as a personal choice, one which they publicly eschewed. Confusing mixed messages from our leaders are a primary reason we have lost over a quarter-million lives to the pandemic.
We are at the doorstep of a new phase of the pandemic. At least two very effective vaccines will be approved soon, and at-risk New Mexicans likely will start receiving them before the end of the month. President-elect Joe Biden already has appointed competent and intelligent experts to lead the Centers for Disease Control and Prevention and the Department of Health and Human Services. He has a comprehensive plan for pandemic response, but its success depends on the mental calculations of Republican senators and governors. Do they care more about preventing illness and death or about preventing any appearance of accomplishment for the new administration? Time will tell, but past experience is not encouraging.
As we watch the death toll hit new records every day, much of the damage seems irreversible, but there is hope. The very effective and safe vaccines that are being deployed will stop the fatalities, relieve our exhausted hospital and health care workers, and get us all back to hugging our families and friends again. Vaccine rollout success will depend heavily on clear, consistent and transparent information, disseminated from trusted leaders and aligned with the best evidence and public health directives. The mass media must act more responsibly to ensure their messages are fact-based and avoid sensationalistic clickbait. Finally, national and state governments must collaborate to support local health care providers to distribute the vaccine as quickly as possible.
Many have compared our moment in history to World War II, and in fact, we recently passed a gruesome milestone. U.S. fatalities from COVID-19 have surpassed all U.S. soldier deaths from that war. The tremendous difference between the two crises is that during those war times, our trusted leaders and the mass media were all singing from the same hymnal. We put aside differences and asked what sacrifices we could make for the common good. What would a similar response look like today? What if the media and the politicians of all stripes put aside individual political goals in favor of a coordinated, evidence-based response? We have the road map. What will it take for us to follow it? Let us hope it’s not another quarter-million deaths.