Reopening our country

“If you want to be wrong, predict how a virus will behave”

A few of the facts about the 2019 coronavirus

  • Most coronavirus cases are mild or asymptomatic.
  • The “curve” in the United States is starting to “flatten.”
  • Social distancing and face coverings work.
  • Each year, 40,000 deaths in the United States are caused by the flu.
  • The top three known risk factors are age, weight, and prior heart disease (known or unknown).
  • The number of SARS-COV 2 cases in the United States continues to climb.

The three phases of this pandemic

I break this pandemic into three distinct phases. The first is what we all have been living through for the past few months known as shelter in place. There are different extremes of this phase as we saw displayed across the world, but the bottom line is people are limited from interacting with one another.

I will get to phase two in a minute, so let’s skip to the last phase. Phase three is when life feels more like it did before we started phase one. General interaction with people is acceptable, we can look forward to large gatherings, and travel is generally unrestricted. This phase will begin when we have a combination of adequate testing, medications, and a vaccine. We are all hoping to start phase three before the end of 2020, but if I am realistic, it will likely be 2021.

So that leaves phase two, the reopening of our country. To me, this is the most challenging phase of the three. Phase two is the transition between being sheltered in place and being able to move around without worry and restriction. Based on your health risks, you will need to decide how much you want to interact with others. You will need to wear a mask when you are in public, continue to follow social distancing guidelines, and be hyper-focused on hygiene. Large gatherings like sports and concerts will be unlikely, and you will have to decide if going to a wedding, funeral, or graduation is worth the risk of contracting coronavirus. My concern is that our attempt at phase two will be more like a New Year’s resolution. People will do great for a month or two, and then slowly, old habits will start to creep back in. If we treat phase two like most people treat a New Year’s resolution, we are surely going to have to take a step backward.

My opinion on reopening the country

I am optimistic as businesses begin to reopen. However, this isn’t a time for us to let down our guard. In fact, it is time for people to be more careful. I know we are all anxious to get back to life before COVID-19. But as we open the doors again, we need to be careful not to open the doors too widely. As I explained above, we are not ready to move into phase three!

Most of the public (some estimates are as high as 98%) will get exposed to the coronavirus and do just fine. That is why when we talk about the public at large, I am ok with slowly reopening the country. I feel we have to start to open back up if we ever want to get over the pandemic. It is the only way to begin to build up herd immunity in our country. But we all must understand this will come at a cost, and I don’t mean dollars and cents.

Look at the numbers. The United States averages 40,000 deaths from the flu in a year. We have already seen 70,000 people die in 4 months from the SARS-CoV 2 virus, with numbers climbing daily. At this rate, I expect the final death toll in the United States to be well over 3x what we see from the flu which will surpass the annual number of deaths we see from diabetes, strokes, and Alzheimer’s disease.

Final thoughts

At this point in 2020, the coronavirus can not be stopped. Our best defense is to shelter in place or get comfortable wearing a mask, substitute elbow bumps for handshakes, and stand in line to get into Home Depot. The hope is we will have what we need to move to phase three in the near future, hopefully, sooner than later. Until then, we will refer to 2019 as the good old days.

Stay healthy,

Nelson X. Simmons, MD

Comments
  • Can we expect to catch a higher number of other viruses after a strict shelter in place for an extended time period?

  • I was very interested and anxious to hear your perspective. We respect you and trust your judgment. We are impressed by how hard you strive to increase and update your knowledge and skills. As uncomfortable and inconvenient as masks, gloves, and social distancing are, we are committed to do whatever it takes to protect ourselves and loved ones.

  • Thank you for describing a more reasonable set of expectations! This virus is not going away any time soon. Act safely and purposefully in the meantime.

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