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Pandemic recovery won't happen overnight

RUSSELL HILL • Jun 23, 2020 at 6:00 PM

Editor’s note: Emergency room physician Dr. Russell Hill is on the front lines locally of the fight against COVID-19. In the following column he writes about the effectiveness of taking common sense precautions in the fight against the virus and cautions against returning to business as usual. 

Shutdowns and shelter orders due to COVID-19 are loosening up across the country. The curve has been flattened and concerns about “systems overload” have largely dissipated.

Social distancing, hand washing, and widespread use of face masks have worked! But complete recovery will not occur overnight. We know more now about transmission of the coronavirus than we did a few months ago and what we know will help us control its spread and minimize its impact if we remain vigilant. Right now, that is a big “if.”

In an attempt to reclaim a sense of normalcy and restart their local economies, many states are ratcheting down their public health warning levels. But the coronavirus has not gone away and flareups are occurring in states that are going too fast by letting personal preferences overrule public health.

NEW CASES EVERY DAY

As of Friday, June 19, Tennessee has had 515 people die from COVID-19, six more from the previous day. As of Friday, 2,239 persons have been hospitalized in our state with 29 more hospitalizations since yesterday. We see new cases every day in the region.

Historically, warmer weather makes transmissions of viruses like this novel coronavirus more difficult. It doesn’t spread as easily in heavier, warmer air. In addition, people are typically outdoors more in the summer months and congregate less in bars, churches and public places where the virus is more easily spread. Consequently, social distancing occurs somewhat naturally in the summer months when the virus is more sluggish and transmission is more difficult.

Parades, festivals, weddings, funerals and similar activities all work against these natural social distancing summer trends, however. When people are congregating, shaking hands, hugging, and standing close to each other to express either congratulations or condolences, the virus can still spread easily.

Sometimes public health warnings are overlooked or ignored so relatives can mingle at special family events. Recently, a group of 16 friends in Florida met up for a birthday celebration at a local pub. Within days, all 16 tested positive for COVID-19. No one wanted to miss the party. It turned out to be less festive than expected.

PRECAUTIONS CAN SAVE LIVES

Quarantine fatigue, cabin fever, boredom — whatever you call it — combined with a diminishing threat can lead to complacency. But it is a mistake to think the crisis is over and the threat gone. The coronavirus can still be spread easily enough among us if we ignore precautions. Social distancing, wearing masks, washing our hands and avoiding touching our face may get tiresome but it saves lives.

“When can we get back to normal, doctor?” many people ask me. I don't know. No one does. So I tell patients and neighbors, “this is the new normal.”

For now, this is what normal looks like: masks, social distancing, frequent hand washing. Despite the more than 100,000 deaths in the country, such measures have made a huge difference. It may seem that all the precautions and advice has been overblown, and in many ways that is the point. It could be worse. A lot worse. And it's not over quite yet. One epidemiologist compared our current status to a baseball game: we’re only in the bottom half of the second inning. We have a long way to go to beat this thing.

Another way to think of the time we are in right now is like driving through a school zone. When we see school zone signs, we automatically slow down. Children could be near. We are cautious and careful. Even when late for work or an appointment, almost universally people slow down in a school zone. Although driving 20 mph might be inconvenient, we just don’t want to take a chance we might be overlooking a child.

Right now, we are in a school zone-like time period. It is not “business as usual.” We need to exercise caution for the safety of others. Going from lockdown to ignoring health warnings is like going 70 mph and switching on cruise control in a school zone. It poses risks for others, not just ourselves.

Following well-known precautions may be inconvenient, but abandoning them creates risks of pocket COVID-19 outbreaks and second wave infections, hospitalizations, and deaths for the most vulnerable. Nobody wants that in either a school zone or a pandemic.

RISKY INDOOR GATHERINGS

The greatest risk right now of a local COVID outbreak is likely from large indoor gatherings. Too many people too close together increases the likelihood of inadvertent transmission. Because people without symptoms can still spread the virus, no one really knows who may be a carrier standing next to them. Coughing, sneezing, and gleeking all spread droplets from saliva. Even normal speech can spread droplets carrying the virus.

The National Institute of Health did a study last month and used lasers to track droplets of saliva from people simply saying “Stay Healthy.” They found that anywhere between 200-350 microscopic droplets came out of people’s mouths after saying just these two words. In addition, these droplets traveled several feet and lingered in the air for 3-5 minutes. Yikes! Simply wearing a face mask can stop the spread of these droplets that may carry the coronavirus.

COVID-19 cases in the United States have recently surged. Big cities are reinstituting mandatory face masks. Yet, many people tire from a feeling that the government is overprescribing what they should do. But precautions are more about public health and safety than about politics. In a school zone, we give up “the need for speed” principally because we are watching out for others. It's common courtesy, it's the right thing to do, it’s our new normal for now.

Wearing a face mask, maintaining social distance, avoiding large groups — especially indoors — frequently are still the best practices for protecting our neighbors and communities. They are simple and easy to do. No doubt we can all agree to sacrifice a little personal comfort for the benefit of each other. Love your neighbor: Wear a mask and stay apart.

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