April 2020 Newsletter – Coronavirus

I published this in the Urban News

Coronavirus, Nursing Homes and Trump’s Complete Failure
Errington C Thompson, MD

It is kind of amazing. It has only been a couple of months, toward the end of December, when China announced that the discovery of a new virus in the city of Wuhan. It was a coronavirus. It was different than SARS, which we saw more than a decade ago. Two weeks later, in the middle of January, China announced the first death secondary to this novel coronavirus (Covid-19).

On January 20, a man in his thirties returned to the US from Wuhan and fell ill with the coronavirus. This man returned to his home in Washington state. By this time, Japan, South Korea, Thailand, and other countries were reporting cases of the coronavirus. Ten days later, on January 30, the World Health Organization declared a global health emergency.

In early February, in Kirkland, Washington, the Life Care Center nursing home seemed to be battling an unusual number of their residents’ contracting what appeared to be the flu. One resident after another got sick, and even after several days, these residents did not seem to be getting better. They were taken to the hospital: one after another died.

As of two weeks ago, 29 of these nursing home residents had died because of the Covid-19. According to a Washington Post article, 30 of the 43 remaining residents have tested positive for the coronavirus. Forty-six of the nursing home’s 180 employees have also tested positive. Which makes us ask, what special precautions did this nursing home take in early February to try to prevent the spread of this virus?

This is a new virus, yet in a very short period of time, we have learned a lot about it. It is a respiratory virus, meaning that it is passed from one human being to another, by mostly coughing and inhaling the virus. We know that it is highly contagious.

Currently we do not have a cure. Supportive treatment works in a lot of patients, but not all: there are many patients who are dying of the Covid-19 virus. We have heard reports of vaccines being developed, but they are not ready yet. We have heard that old drugs like hydroxychloroquine and azithromycin (touted by President Trump) may be useful in treating this virus, but experts have stated that these claims are highly dubious, at best.

One of the great myths that surround this virus is that it attacks only the elderly; this is 100% wrong. The other myth is that only the elderly will die with this virus. This is also wrong. Perfectly healthy, young, active people have contracted this virus, gotten sick, and even died.

It is now the beginning of April 2020. The coronavirus has been detected in all 50 states. Yes, it’s in North Dakota, New Mexico, and here in West Virginia. States all over the nation have enacted “social distancing” in order to try to stem the spread of the virus. All but nine states—all with Republican governors—have mandated “stay-at-home” orders closing countless restaurants and other businesses.

And as of April 3, there were almost 300,000 diagnosed cases of Covid-19, and more than 7,000 deaths from the virus, just in the United States.

Nursing Homes

With everything that has happened at the Kirkland Life Care Center, what precautions have nursing homes enacted? Are these precautions universal?

Nursing homes contain a population uniquely vulnerable to the coronavirus. It would seem reasonable that nursing homes would test every single patient. Then, if the nursing home does not have any patients with the coronavirus, its managers would make sure that the coronavirus never invades the nursing home. They would lock down the nursing home. No visitors who haven’t been tested. All patients coming in would have to be tested: and every new resident must have a negative test before entering the nursing home. All employees would need to be tested, on an ongoing, regular basis.

As far as I know, no nursing home has isolation rooms. Therefore, once a resident tests positive, he or she would need to be moved out of the nursing home immediately.

This is the only way to prevent a nursing home from becoming another Life Care Center. This protocol should be mandated in every state. But, not only has it not been mandated, it is unclear whether anybody is even thinking about it. Instead, as of now, nursing homes are operating under a “Business as Usual” policy.

This is criminal. This lack of thoughtful action is completely unacceptable. We are Americans. We must protect Americans. The only reason I can think of that steps like these haven’t been taken is the power of money, and these steps would cost a lot of money.

A Proactive President
What if Trump had gathered all his top advisors—not Jared Kushner or Steven Miller, but his expert medical advisors—in the situation room as soon as China announced this new Covid-19 virus back in mid-January? What if Trump had listened to his experts and quarantined everyone who tried to enter United States who had visited China in the last two months? What if President Trump had built or commandeered military barracks so as to isolate these quarantined citizens for 14 days? What if Trump had insisted that every American who wanted a Covid-19 test should get one, and worked with Congress to pass funding so that the test was free for every American?

Well, that would have been proactive. If Trump had acted to save American lives, we would now know the real extent of the Covid-19 infection—because millions of Americans would have been tested. This would have taken amazing insight. Moves like this would have saved thousands of lives, thousands, or even tens of thousands, of American lives.

These actions would have taken great forethought. They would have taken a leap of faith. They would have taken a president capable of forethought and faith. These actions are exactly what we needed—and exactly what our president did not undertake.

GREAT presidents are proactive. Unstable presidents tell Americans that the virus is going to go away, soon. Great presidents tell the people the truth. Crazy presidents state that they want to open the country before Easter in order to get the markets going. Great presidents correct themselves when they learn new information. Ignorant presidents make statements not based on medical science or reality, and that actually put people in harm’s way.

Sadly, some Americans believe the president despite his record of false statements, fudging the facts, denying reality, and flat-out lying; as a result, they hope, and even believe, that things are going to get better with this virus today, or tomorrow, or by Easter. This simply is not going to happen.

Don’t believe the president when he and his minions tell us that no one could have known that this virus was going to be so bad. This is not true. The infectious disease community has been talking about this for decades. In fact, this is just like Al Qaeda flying planes into the World Trade Center: Secretary Rice lied to the American people when she said that no one could have imagined using planes as bombs. In fact, our own US intelligence community had already acquired hard drives from Al Qaeda in Southeast Asia that explicitly said that they were planning to use planes as bombs.

The president’s statements—and those of his vice-president and other spokespeople—are the same lie. The infectious disease community have told us that we were vulnerable to a new virus that is highly contagious. They told us that it would take time to develop vaccines. They moved quickly to contain Ebola, MERS and SARS. But this administration did nothing.

Fortunately, two employees of the administration, neither of them appointed by President Trump, have continually told the public the truth. Thank goodness for Dr. Anthony Fauci and Dr. Deborah Birx.

Other nations
South Korea has shown us the way (Germany, too, but it is still early) to flatten the curve of infection—that is to slow the rate of contagion and therefore lower overall infection rates. In late February, South Korea was the epicenter of the coronavirus epidemic; they were seeing 800 to 900 new cases per day. They locked down the country. They tested everyone. They knew the extent of the disease and confronted the problem quickly. Within weeks South Korea saw the number of new cases begin to fall. Now, they are seeing just over 100 new cases per day.

South Korea is the model for how nations should respond to Covid-19. In contrast, the governors of Florida and Texas are models of inaction. The governor of Florida allowed large crowds of college students to party on the beach like it was 1999. It isn’t 1999. It is 2020. Now, students from University of Tampa are testing positive. Forty-four spring breakers from the University of Texas who chartered a plane to Cabo are now testing positive for Covid-19.

A couple of weeks ago my office manager asked me if it was okay for his teenaged son to go bowling. NO! There is no way that bowling is a safe activity.

The coronavirus is here and it is real. We must have thoughtful leadership, or we will have millions of Americans dying of this damn virus. We know we cannot turn to the president for thoughtful leadership, but we can turn to experts like Dr. Fauci and other infectious disease specialists and epidemiologists.

Be safe. Be thoughtful. Wash your hands frequently. Do not get into large crowds. Stay at home. Stay six feet away from other people. Follow good medical advice. This will keep you and your family safe in these difficult times.

Do not gargle with bleach. Do not touch your face. (This is my personal downfall: I touch my face all of the time. I’m trying to break this bad habit.) Above all, do not listen to the president for his “advice.”

Instead, go to the CDC.gov website, which carries basic, accurate, medically sound information about how we all can avoid dying during this epidemic.

There is a Christian hymn that prays for strength for today and hope for tomorrow. This is what we need. Be safe.

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Errington C. Thompson, MD

Dr. Thompson is a surgeon, scholar, full-time sports fan and part-time political activist. He is active in a number of community projects and initiatives. Through medicine, he strives to improve the physical health of all he treats.


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