COVID-19 update with Dr. Benjamin Marcum

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Myth 14: We should be afraid.

Yesterday, I took my wife to HEB and, while she was in the store, I was waiting in the car (right now shopping is not a family event, y’all).  I was watching the people in the parking lot go in and out and load their vehicles and wash their hands.  On almost every face were etched the lines of stress that we have all been feeling.  I could see worry that they won’t be vigilant enough to avoid infection, worry that others who were doing their shopping might not take the same amount of precaution, worry that we might have to continue this way for months.  Indeed, even shopping at the grocery store raises our collective stress level and the amount of cortisol (stress hormone) dripping off the shoppers and flowing through the HEB parking lot seemed to coalesce into river of anxiety and fear.  

I saw various levels of preoccupation, some seemed to be relaxed, were not wearing masks, maybe had some hand sanitizer, maybe didn’t.  Others wore masks without gloves, gloves without masks, or both (see my previous post about gloves – not sure they help much).  Some, very obviously, were avoiding each other while others seemed much more lax.  I saw masks worn tight on the faces or sagging below the nose.  I saw people try to touch their faces, only to be reminded by their masks not to do it.  Or, sometimes the itchy nose was just too much and a few people reached inside their masks to provide relief from the torment.  

The Coronavirus has clearly affected every individual on the planet, some more so than others.  Either you know someone infected, have been infected yourself or you simply have drastically changed the way you live.  Warnings of the virulence, mortality rates, contagion and the pleas to stay home and do what we can to spread the infection have robbed us of interpersonal connection and replaced that blessing with many other emotions.  Chief among them, woefully, is fear.  Fear of loss of life.  Fear of loss of economic stability, fear that we may not be able to recover from the devastation that has befallen our world.  We are afraid that this purgatory will continue through the summer and into the fall as herd immunity builds painstakingly slow while we do everything we can not to overwhelm our medical resources.  We are afraid our elected officials might make a misstep (they are human after all, and are dealing with intense pressures and uncertainties about our futures on our behalf – please pray for them).  The potential for fear is immense because innumerable uncertainties pervade our perceptions of our collective future.  It can be paralyzing.  

But, we must not allow that.  Our human nature can propel us toward fear and it takes concentrated personal effort to overcome that natural bent.  The antidote for fear is truth – chiefly, the truth that the virus can be avoided.  I detailed previously how a cloth mask – even a bandanna, can remind you not to touch your face.  It will not stop respiratory droplets suspended in the air, but if you avoid being in a small enclosed space with an infected person for more than 15-30 minutes it is unlikely that the virus will transmit this way.  By far the most likely mode of transition is to touch a contaminated surface and then touch your face.  Alcohol containing solutions, bleach water, soap and water, will kill the virus.  If you will clean surfaces and your hands with these solutions (maybe not bleach on your hands – but it’s perfect for surfaces) and avoid touching your face with possibly contaminated hands, there is a very good chance you will avoid infection.  You can go to the grocery store and follow distancing precautions, touch as few surfaces as possible, wear a mask to remind you not to touch your face, and protect yourself – no matter what the shopper who parks next to you does.  

If you do get infected, remember 98 out 100 people will survive.  Those are great odds for the individual.  Not great odds for a population because of the high rate of infection if we are all exposed.  So, the fewer overall infections we have, the fewer deaths.  Empowering ourselves with the knowledge above can limit the spread and preserve life.  You have the power to preserve life!

As I mentioned above, infection with the virus and your ability to survive it is not the only fear.  The economic uncertainty is almost as frightful as the thought of being infected.  The unemployment rate has skyrocketed and there is not an end in sight as epidemiologists are uncertain exactly how long the virus will pose a significant threat. Remember, baby science – still learning about this disease and science takes time to establish certainty.  Our elected officials are balancing life vs economic stability.  As a doctor, obviously, my focus is biology.  But I am not insensitive to economy.  I am, after all, one of the physician owners at our clinic.  We are very concerned about the wellbeing of our employees (physical and economic).  We have been seeing 50-60% of the normal number of patients at the clinic – including virtual visits.  It takes about that many patients just to pay the bills.  There is not much left over to take home after that.  Fortunately, the Federal Government has provided some much needed relief for the short term that will mitigate the negative effect.  But this is not a long-term solution.  The government can’t print money fast enough to overcome a continued shut down of our once bustling economy.  As a physician, I may be tempted to think, “Shut it all down! Save as many lives as possible! Who cares about the economy!”  Business may be tempted to say, “Only 2 out of 100 people die.  Let the virus go through the population and build herd immunity as fast as possible and we should just take our chances.  After all, shutting down the economy will cause loss of life, also.”   You can see that an absolutist stance on either side of this argument is incorrect.  Life vs economy, much as complete liberty vs life saving community ordinance, must strike a delicate balance.  Favor a locked down economy too much and we may cause unnecessarily severe long term damage to our economic stability – which will in turn cause loss of life.  Favor economy too much and relax regulations and we will definitely have too many people infected at once and have an unnecessarily high death toll – which will cause more fear and further damage the economy.  Whose responsibility is it to strike and enforce this balance?  Your elected officials.  And I don’t envy them. 

Governor Abbott, County Judge Campos and the Commissioners, and Mayor Svien and City Council, must listen to economic and medical experts and balance both sides of the argument, all the while walking the tightrope between the two and do what they can to prevent loss of life and, simultaneously, prevent economic meltdown.  We are between a rock and a hard place, put here by an unknowing, unthinking pathogen that has one purpose and cares not whether we live or prosper.  So what do we do?  How do we combat the fear of falling too far one way or the other?  We’ll count on our American creativity.  The smartest scientific minds are working tirelessly on understanding this disease and developing a solution.  There is tremendous economic advantage to doing so, as well, so that the incentive to find solutions is immense.  I’m thankful for that.  The federal government has moved swiftly to buy us some time.  They have been creative when incentivizing businesses to keep employees on the payroll and avoid worsening the strain on the unemployment system.  Governor Abbott has formed a commission exploring a potential timeline of when Texas can get back to business.  No official Texas timeline has been given yet – apparently that will be forthcoming next week.  Dr. Fauci, immunologist and adviser to the Federal Government, has said that as early as May some sectors of the economy may relax and get back to work.  I believe our elected officials have heard us.  I know our local leaders have actively sought advice from many, not just one, members of the medical community as I have been part of those discussions.  They have also turned a listening ear to the concerns of our economic leaders.  Many, many, smart people with a deep understanding of what is at stake are acting on your behalf and I have confidence in them locally, statewide and nationally.  

We are finding our way during a once in a lifetime crisis.  Much like our parents and grandparents experiences during World War II, we cannot predict the future.  We don’t know when it will end.  We do know this crisis will not last half a decade nor will the death toll be so high as was the case in the war.  After WWII, our country enjoyed a period of economic boom, driven by advances in technology, philosophy, sociology.  Coronavirus has robbed us from gathering, it has robbed our sense of physical and economic security.  But it has refocused us.  We think less selfishly.  We are thinking of new ways to connect and support our neighbors’ businesses.  We are innovating in pharmacology, virology and immunology.  Some of the most beautiful art has been created during these short weeks.  (Who knew Zoom Concerts were a thing?)  Trivial self serving desires seem much less important than slowing down, hugging your children, taking a walk, enjoying the spring that is unfolding around us.  We pay closer attention to the beauty.  

It’s Easter Sunday and my family and I worshiped at home with the help of Passion City Church and First Baptist Church, Stephenville.  We heard many messages this morning.  While school, sports, dance, our citywide egg hunt and countless other events have been cancelled, we remembered that because of Jesus, death is cancelled.  It has lost its sting.  We did not wake up this morning and scurry around to get ready for church and hustle to be there on time (yep we are always late and it drives my wife crazy).  We woke up and looked out at the freshly cleansed air after the rain, drank in the sun and the green and the smells of spring.  We enjoyed breakfast with our children and reminded ourselves that they are, in fact, a blessing (even though we were NOT cut out for homeschooling – I’m amazed at those of you who are.)  Like any crisis, this one is fraught with uncertainty and the potential for fear looms and you may not feel you can see past it.  But there are blessings here, too.  There is truth.  There is knowledge.  There is innovation.  There is hope.  There is Jesus.

Happy Easter, neighbors,
BAM

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