COVID-19 update with Dr. Benjamin Marcum

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It seems appropriate to write to you again, Erath County.  On the heels of 5 new cases and a double exposure to our clinic, clearly COVID 19 is with us to stay. Over 100,000 people have died in the United States.  That’s a packed AT&T stadium – to standing room only – of people who were alive at Christmas and are now gone. To dispel some misinformation about death rates in the US here are some unmassaged factual statistics.  1,790,172 people have been tested and 104,381 people have died.  That is a case death rate of 5.8%.  Availability of testing has skyrocketed and random population testing has begun.  So this reported death rate, while still not exact, is approaching the true infection death rate with every passing day.  These people died despite the availability of all life saving measures available for treatment.  To date, in the US, there has not been a significant shortage of medical resources for treatment.  They died in spite of our best efforts. 
Many more will die.  There will be continual outbreaks.  That’s what epidemics do, they look for unexposed hosts and infect them if we let them.  

In August of 2005, Hurricane Katrina slammed into the coast over Southern Louisiana.  Lake Pontchartrain greedily gobbled the fat raindrops, burgeoning and raging against the levee protecting the vulnerable city of New Orleans.  The potential energy of the vast inland lake soon overwhelmed the levee and inundated the hapless city, killing many, stranding others and wreaking unimaginable havoc.  1,200 people died and $125 billion was spent repairing the damage.

This pandemic is not unlike that situation.  The vulnerable in our population are like the city of New Orleans, nervously hoping and praying that the levee restraining the churning waves of the pandemic will hold.  But this is no earthen levee engineered and built through physics and heavy machinery.  It is one engineered by epidemiologists and built through social initiatives and behavioral modification.  Essentially, it is our only current weapon against the deadly pandemic.  

The difference is that floods are predictable.  We have centuries of experience engineering and building levees to hold back the waters and still, an extraordinary natural phenomenon overcame our experience.  In this case we were introduced to this virus half a year ago.  The entirety of what we know has been learned in days, months – not even years, much less centuries.  Do masks work? Probably.  Do they work as well as we first thought? Maybe not.  But they definitely help a little and so I’m wearing one anyway, not for my protection but because I care about you and anything I can do to protect you, Erath, I will do.  

This is one of my favorite sites.  It’s full of helpful, true information but scroll down for data on how well masks of various materials work.  https://informationisbeautiful.net/visualizations/covid-19-coronavirus-infographic-datapack/

The backbone of Western Medicine is evidence.  Theories must be developed and studied.  And the studies are underway but not all studies are created equal.  I recently saw a headline mentioning that the asymptomatic carrier state may not be as strong a theory as was once thought.  When I went to the source article to view the structure of the study, I learned that the study evaluated a single Chinese woman that came into contact with hundreds of others with only a few of those contacts contracting the disease.  This study has what we refer to as very low power. The evidence from a study is more powerful if it studies many subjects (preferably thousands) from many walks of life with many different health conditions. This one studied one person.  It is a tiny study – only a starting point.  Extrapolating from a single case in a general way in easy to forward “sound bite” headlines is irresponsible and dangerous.

The CDC has done its best to distill the whole of the current body of knowledge into actionable data that we can use to protect the most vulnerable in our population.   To expect a flawless performance in the setting of nascent science about this most recent extraordinary natural phenomenon is unrealistic.  The CDC is, after all, comprised of people – people who are doing their best to provide unbiased truthful guidance in a time when truth is in short supply.  

To the list of responsibilities we all have in the face of this pandemic, I humbly request we add another.  Test the veracity of information before you share it.  Forwarding untested and unproven soundbites via social media that simply align with your political views is irresponsible, selfish and unacceptable.  You are part of the levee of social responsibility.   When you spread misinformation you are weakening the only protection we have for our vulnerable loved ones.  

When the pandemic became apparent in March I was awed by the sense of togetherness and responsibility we all exhibited during that time.  This verse from the Bible rings true.

“Though one may be overpowered, two can defend themselves. A cord of three strands is not quickly broken.” Ecclesiastes 4:12.  

I fear the collective strain of the last few months has started to peel the strands away from our fortified cord.  Division over perceptions of the severity of the pandemic, over the level of economic strain we are willing to accept, over the fear of government intrusion into our personal lives have started to leave us more vulnerable than we were even a few weeks ago. Fear mongers abound on both sides of every argument.  As seems to happen on every major issue that impacts our country, the polarizers have started to erode the clarity of focus we initially directed at this pestilence.  

To be clear, civil discord is the fertile ground from which springs the path our country follows, and that has served us well for the whole of our existence – as long as we don’t seem to lean too far one way or another.  But if we aren’t careful we can allow polarity to take root, engendering enmity against our neighbors, those strands with whom we must intertwine (from an acceptable social distance of course) in order to form that unbreakable cord that sustains us through crisis.

The horrific damage unrestrained polarity can do is no more apparent than in the recent murder perpetrated by one who swore to protect and the resultant destruction and violence perpetrated by people so blinded by their polarity that they refuse to acknowledge the role they are playing in widening the gap.  

Civil, respectful, humble discourse solves problems – binds the cord more tightly.  Unabashed, unbudging, unthinking polarity unravels the cord.  It erodes the levee – begs for destruction.  As a people we are frenetically trying to cope with increasing threats to our personal health, our economy, and now the fabric of our social contract.  

You have responsibility in all of these crises.  You must be kind.  You must be patient.  You must be respectful.  You must care about people you don’t know.  You must care about people you don’t like.  You may disagree.  You are expected to.  Thoughtful disagreement and rational discussion is absolutely necessary to propel us forward.  

Today I had to tell several employees they must quarantine for two weeks.  Many were tearful because they will chose not to be around their loved ones because they dont wan’t to be responsible for spreading the disease.  The social restrictions that have been REQUESTED and not MANDATED by your government leaders protect many people you don’t know.  It protects their livelihoods, their physical health, their mental health.  If you are sick, quarantine.  Period.  Do not visit others.  Do not go to public places.  If you are out, you know how to prevent the spread.  I and others have repeated the requests ad nauseum.  If you forgot how to prevent the spread I still endorse th CDC’s recommendations and you can see them at CDC.gov.  We who are caring for you need you to help protect us so we can stay at work and bind the levee together.

Erath County, I’m pleading with you to look outside yourselves.  Be the levee.  Strengthen the cord.  Reject pettiness.  Reject your natural bent toward self aggrandizement and self preservation.  Disagree and discuss but do so with the goal of concord and not discord. 

Think.  Strive.  Persevere.
BAM

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