COVID-19 update with Dr. Benjamin Marcum

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Myth 11: People aren’t taking this seriously

We doctors and even some elected public officials are starting to notice many people think we are the social distancing police.  We are bombarded by, “Did you see how many cars were in front of such and such house,” or “I went shopping and whole families are walking around the store,” and the like.  It is true, these activities do unnecessarily increase the risk of spreading the virus.  But for the most part, Texas has taken note and made a difference.  With the help of the Institute of Health Metrics and Evaluation, I can prove it.  Here is the link to the website.  https://covid19.healthdata.org/united-states-of-america 

On March 29th I posted a link on Facebook to this site that projected cases of Covid-19 in Texas would definitely overrun the number of available ICU beds and ventilators when the number of cases peaked in late April or early May.  This week, the data has been updated taking into account the success we have had with social distancing and it is much more favorable.  Though the US as a whole is set to need more ICU beds than we have available, just looking at Texas, if the current trend continues, we will be able to accommodate the number of ICU admissions we will have.  

When you open the link above, it shows the graph for the US.  Click the drop down and go to Texas.  You can see how many total admissions are expected and how many ICU admissions and ventilators will be required.  At the peak, the guys and gals at University of Washington who created this model project that Texas will have 712 ICU admissions and we have over 2000 ICU beds available statewide.  

But, Erath County, this is not time to relax the pressure we have put on this virus.  It is time to double down.  I want to point you to another projection tool for a closer look at exactly where we are in our county.  Check out https://covidactnow.org/.  This is another projection model created by epidemiologists and supported and endorsed by many scholars from Universities all over the country.  It takes into account the efficacy of social distancing, county and city regulatory practices and even the compliance with such recommendations by the county’s citizens.  You can search for Erath County and see the data.  The first message you will see is that more aggressive action is needed in Erath County to prevent total exhaustion of our medical resources.  Two curves are illustrated on the interactive graph.  The orange curve represents our following a stay at home order with lax compliance – meaning taking your family and lingering in the grocery store, shopping for unnecessary items in stores that you don’t need to go to, allowing your teenagers to hang out (illegally) at the skate park even though the park is closed, going over to a friend’s house for dinner etc.  If we are lax with our social distancing discipline they project over 200 hospitalizations at one time before the end of June.  Rember, we have 38 general hospital beds in Stephenville.  THR Stephenville is approved by hospital regulatory authorities for 90 beds but we do not currently have the capability to put up and staff more than 38 beds.  You might notice the dotted line on the graph where the creators of this model assume generously that we will be able to increase our capacity to 81 beds.  This is unrealistic.  THR currently has no plans to increase the number of general hospital beds at our local hospital.  This is not because of money or a lack of desire or willingness on behalf of THR.  It is simply due to limitations of staffing and resources available.  Where will we put the extra 162 patients that will require hospitalization at the end of June?  Who will care for them?  This disastrous scenario will cause unnecessary loss of life.  We MUST DO WHAT WE CAN to avoid this scenario.

The blue peak is how many hospitalizations are expected if we follow strict social distancing and practice good stay at home discipline.  We will require less than 20 hospitalizations at the peak.  We can handle this number without danger of unnecessarily increased mortality.  This means that every decision you make affects all of our futures.  The only difference between the two curves is what you and I choose to do.  We can choose to go out for non essential reasons and increase the slope of the graph to approach the orange mountain we have to climb or you can sacrifice your personal agenda for the sake of your neighbors and send one family member to the store, get in, get out, not linger, etc. Practice strict social distancing and we can turn that orange mountain into a lovely baby blue barely perceptible slope that we can overcome with minimal loss of life.  

We have just barely ventured into the woods, here.  NYC, New Orleans, Seattle, and, in fact, most of the US are ahead of Erath County on the timeline.  We have 11 positive cases that are confirmed via testing in Erath County.  Make no mistake, there are more.  We have tested 200 people at SMSC and other locations have tested a handful of others.  There are 43,000 residents of our county.  No question many of those as of yet untested residents are infected.  Also, families of those who are positive and quarantining are possibly infected as well.  If I had to guess based on my experience and understanding of the epidemiology of this virus, I’d say there are 3-4 other people who are infected for every 1 positive test.  So, based on my unscientific but educated guess, 11 positives likely means there are 30-40 total in Erath County.  And that number WILL rise.  We will not be able to identify every positive case, we just don’t have the capacity for testing.  

Based on the IHME site, the interventions we have put in place have made a dent.  You can see on the graph that the dotted lines are projections but the shaded areas illustrate that true numbers could be much higher or much lower.  It all depends on what YOU DO.  Every choice you make about leaving your home will either increased the number of cases we have in Erath County or decrease them.  You have the ability to change our collective experience with Covid-19.  If your neighbor practices strict stay at home and social distancing discipline and you choose to remain lax in your practices, you have undone the sacrifice of your neighbor.  Don’t be responsible for contributing to the exhaustion of our medical resources.  They are finite.  38 regular hospital beds.  5 ICU beds.  4 ventilators.  THR, city and medical leaders in your community are working to piece together a contingency plan for patients 39, 40, 41 and on… but please don’t make us go there.  The quality of medical care will rapidly deteriorate the more sick people we have at one time.  We doctors, business leaders and elected officials cannot prevent this catastrophe on our own, we need your help to do so.  It is encouraging to see that some of our efforts have nudged the numbers the right way.  Buckle down.  Continue to apply the pressure.  We are winning, but we haven’t won, yet. 

Love requires personal sacrifice,
BAM

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