The only certainty about the future is that it will be uncertain. It has always been that way. The people who crossed the ocean from Europe to start a new life in America faced uncertainty. So did Americans who settled the West. And uncertainty is present today in this pandemic as COVID-19 cases increase in many cities and states.
Uncertainty and fear of the unknown can be paralyzing. As we continue to learn and apply learning during this pandemic – as we develop new and more targeted treatments– as we begin to roll out safe and effective vaccines – as we apply prevention strategies – we gain confidence and reduce fear. What we are learning every day helps us engage the virus more on our terms. What we learn reduces uncertainty.
Over the last few months, the treatment of COVID-19 has evolved. The result of the evolution of treatment has been significant reductions in length of hospital stay, severity of illness, and mortality rates for COVID-19. This may be best exemplified this week when, despite a record number of COVID-19 cases nationwide, the capacity of community health systems has not been overwhelmed like in March and April.
The rollout of safe and effective vaccines against COVID-19 is imminent – much earlier than anyone expected only six months ago. These vaccines are expected to be made available to those with the greatest need (first responders, healthcare workers, elderly and high-risk patients and their caretakers) this winter and to be made available to everyone by the summer. Safe and effective vaccines and widespread immunity will mean the end of pandemic levels of cases and hospitalizations.
As we now get closer to the rollout of vaccines, it makes even more sense to follow recommendations by the President’s Task Force concerning physical distancing and use of masks in indoor settings where social distancing is difficult. The same is true in avoiding large indoor gatherings of people in crowded places. Reasonable precautions can tide us over until vaccines are widely available. These measures reduce transmission of the virus and facilitate the reopening of businesses and the creation of jobs.
Our country and especially our state cannot afford another round of lockdowns. The unintended consequences of lockdowns are both health related and economic. Preventable deaths of Americans with heart disease and cancer are the result of people not seeking medical care during the pandemic. Other consequences also include increased domestic abuse, suicides, and drug, alcohol and opiate abuse.
Business lockdowns and stay-at-home policies have resulted in significant economic consequences requiring government help for businesses and workers. An estimated 20% of small businesses are likely to permanently close. Nearly half of the millions of people in the restaurant and bar sector have watched their jobs disappear. Similar losses have struck the hotel, entertainment, conference, rental, and airline industries. The ripple effects have been enormous and recovery will not be immediate.
Our political and health policy leaders should expand the definition of vulnerable in the COVID-19 crisis to include not only the elderly and high-risk patients that we care for in the hospital but also working people and small business owners. They have suffered and will continue to suffer until the dual health and economic crises are solved.
With the lockdowns, we learned the hard way about the enormous harm associated with closing down schools. Education is the fundamental accelerator to opportunity and COVID-19 will have a significant negative impact for a generation of students. Marked drops in reading and math skills have been noted with the substitution of distance learning for in-school learning.
The negative mental health and social development of children and the impact on the employment of the parents has been substantial. Thankfully, the complications of COVID-19 are much less in children and young and middle-age adults. Because of this, the opening of schools in our country and across the globe have gone well.
What do we do now? First, we accept the inevitable tension of different perspectives and of different degrees of risk acceptance in different people. We continue to work together to physical distance and wear a mask at least through the time needed to complete vaccination protocols. We concentrate resources on prevention efforts for the vulnerable population in our nursing homes and “hot spots” within our community. Upward of 50% of COVID-19 deaths have been in nursing home patients; 30% in people over 65 living at home; and only 20% are from the whole rest of the population.
We stay at home when ill and continue reasonable limitations on crowded large indoor gatherings. We concentrate on monitoring the most important metrics of hospitalizations and hospital capacity and mortality rates and be less fearful of case rates. We get as many children as possible into in-school learning. We avoid the institution of lockdowns or rigid stay at home policies. We all get vaccinated and we do what needs to be done to prevent overwhelming our health systems.
New vaccines and new treatments will significantly reduce the rate of COVID-19 but won’t rid us completely of the virus. We can expect continued but a much smaller number of cases, hospitalizations, and even deaths attributed to COVID-19 for years to come. The rhythmic ups and downs of COVID-19 cases will continue to be a reality for the next few months and none of this will be impacted by elections. The timing of these vacillations will vary among states and communities. However, new treatments and vaccines will put us in a place where we have more control over this virus than the virus has over us.
We are all in this together is not a trite statement when connected with the COVID-19 pandemic. Hope and faith trumps fear and anxiety. Isaiah 41:10 says “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you. I will uphold you with my righteous hand.” We have to remember these truths along with those of scientific discovery as our community, state, nation, and world come through this pandemic.
There is a song that we sang in church when I was a child with the refrain “This little light of mine, I’m going to let it shine.” Lots of people for lots of reasons are hurting now. In a world filled with anxiety and fear, expressing love, practicing grace, and serving others may be the most important antidote to COVID-19. Letting our light shine gives us all a role in helping others overcome the pandemic. It is how America has weathered all its crises in the past.
Dr. Phillip Rozeman is a practicing cardiologist and past chairman of the Greater Shreveport Chamber of Commerce and Shreveport Medical Society.