It is hard to look forward when looking down the barrel of the dual crisis of a deadly pandemic and a historic economic recession. It is hard to believe we have gone in a matter of weeks from the realization of a pandemic to comprehensive social distancing, stay at home orders, quarantines, and curfews to unprecedented unemployment and business closure numbers. What started as a potential temporary health concern has expanded to a combination of significant health fears and unemployment concerns impacting all families.
At the beginning of the millennium, the fashionable thing to do in communities across the nation was to develop 2020 strategic plans. None of these plans had overcoming a global pandemic and severe recession in them. The reality of the year 2020 is communities like ours working to develop processes and plans in response to this dual health and economic crisis.
In a matter of days, the president is expected to share details about the gradual reopening of the economy. Governors will have their own take and proposals. But at the end of the day, local civic, government, business, health system, faith, and nonprofit communities will be left with the job of picking up the pieces and putting the puzzle back together. It will be difficult work balancing priorities and envisioning solutions but it is work that must be done if we want to rapidly come out on the other side of these troubling times.
Thus far, national prediction models have greatly overestimated the mortality rate of the COVID-19 virus and greatly underestimated the negative economic impact of stay at home and business closure strategies. These national prediction models are even more difficult to interpret and assess at the local level because of variability in demographics, density, distance, and disease in different communities.
Populations with demographics of significant poverty have greater mortality rates from the COVID-19 pandemic. New York City is more impacted than Los Angeles because of its density. Communities that practice social distancing with fidelity are less impacted. Cities with high levels of obesity and diabetes like ours will see greater ventilator needs than most moderate sized cities.
On the positive side, we can be thankful social distancing has resulted in flattening the curve and slowing transmission of the COVID-19 virus. The lessons learned will be used in some form in our communities for years to come.
The restructuring of industry to produce more needed medical supplies is well on its way. Testing will continue to accelerate and there will be benefit to communities that are early adapters and investors in rapid COVID-19 diagnostic and antibody testing when questions of accuracy and significance of results are answered. Identifying people with immunity will make people more comfortable working with COVID-19 patients as well as providing for people who could be potential plasma donors to help treat others.
The good news is a vast majority of health systems are holding up well in the pandemic. Most emergency rooms do not resemble the videos of New York City and Northern Italy. These hot spots are tragic and are examples of overwhelmed healthcare systems. But the truth is most health systems (including those in our community) have not yet experienced severe surges that overwhelm the system. Because of the community’s dedication to social distancing, the curve is flatter than expected in Northwest Louisiana.
Health systems restructured overnight to meet emergent conditions. By and large, these systems are crisis-oriented and adaptive organizations that face triage and flexible workforce conditions all the time. Cyclical demands are expected in our work.
With that said, our government leaders must make honest communication and realistic expectations a priority. The COVID-19 pandemic is not going to magically disappear and the relaxation of social distancing will likely result in some rebound in COVID-19 cases. Major reductions in the threat of COVID-19 will require effective therapy, effective vaccine, or herd immunity in the community.
There will be no perfect outcomes when balancing two crises at one time. Tension will exist between efforts to treat and curtail the transmission of the COVID-19 virus and restart the local and national economy. Our initial community goal should be the prevention of a second wave with continued diminution of new cases over the next few months – accepting minor rebounds as a function of the degree and speed of relaxation of business closure and stay at home strategies.
The federal and state government can chart us a destination and help choose a course but it is going to remain for the people of our community to make the journey. “We are in this together” will need to be more than a mantra.
Charting the course, making the journey, and getting to the right destination is going to take different people with different expertise and different passions each creating solutions. It will take the same or even greater attention to detail as that experienced at the start of the pandemic crisis.
Our community’s economy reopening strategies have to start with major input of public health and health system leaders. This is their expertise and their strong input will be required to gain the confidence of the community. Continued rules on social distancing and personal protection equipment; consistent testing protocol; adequate hospital capacity; and health protocols to manage employee and customer safety created by them will be a must.
The best results and most rapid change will happen if we can trust each other – not blind trust but trust with accountability. Success will require using objective health and economic criteria to guide decision-making. This will be vital to judge the speed of modifying social distance policies and the rate of opening of various economic sectors.
As an added bonus of working together, communities thinking ahead will likely benefit from the re-imagining of America’s economy. Who will benefit from moving pharmaceutical and critical supply chain manufacturing back from a global to a national business? It is certainly something this community has done before and could do again.
Spending hours finding blame in others and parsing through what went wrong in the middle of this crisis is not only wasting time, it is diverting attention from real needs of real people in two real crises.
And while this is certainly a time of trial and tribulation, this crisis can be a reminder of things that really matter – expressing our love to those close to us; helping people less fortunate; and finding solace in the hope of our faith. We are better together.
Dr. Phillip Rozeman is a practicing physician. He is past board chair of the Greater Shreveport Chamber, Blueprint Louisiana, and the Northwest Louisiana Medical Society.