Coronavirus (COVID-19) has changed all of our lives. As I write this, it has been two weeks since schools were dismissed, two weeks into a new and restricted living. It was two weeks that seemed like two months. The only normalcy is the bickering of our two political parties, approaching an agreement on relief efforts.
As a Decatur native and primary care physician, I am invested in our city, county, region, and country. I have enjoyed many successes in life through hard work, education, and preparation. But the coronavirus challenge is much different. I share many of your concerns. There are many more unknowns than knowns. But again, with hard work, education and preparation, an acceptable public heath outcome can be achieved. But only if we all choose. Positive results are still possible.
First, let me make it very clear, COVID-19 is a real and significant public health risk. It is not political. It poses the biggest threat to our community, country and world in decades. Its wrath favors some, but spares none. But for some reason, there still seems to be confusion. I can only imagine this was born from conflicting reports and a lack of understandable terms.
Simply, there are three main risks.
First, the most significant personal risk, is a mortality rate of approximately 1%. In comparison, seasonal flu mortality rate is 0.1%. So the risk of dying should you contract coronavirus is 10 times the risk of dying should you contract seasonal influenza. While 10 times is significant, many view 1 in 100 as low risk. This, by itself, has not convinced many of the severity of this virus.
Second, the most significant public health/epidemiology risk, is the concerning rate of spread.
Simplifying, the transmission rate for influenza is approximately 1 to 1 (actually closer to 1 to 1.3, but that’s more complicated to explain). So when one person contracts the flu, he or she will generally spread it to 1 additional person.
1 + 1 + 1 + 1 + 1 + 1 + 1 + 1 …
The transmission rate for coronavirus is approximately 1 to 3 (estimates change daily). So, again, when one person contracts coronavirus, he or she will generally spread it to 3 people.
1 + 3 + 9 + 27 +81 + 243 + 729 + 2,187 …
So if left unattended, it is easy to see how quickly an outbreak becomes uncontrollable. The news has flashed the “curve” on screen and talked about “flattening” the curve. Basically, this means we need to decrease transmission to the rate of influenza. This is why Gov. Kay Ivey and, my friend, Dr. Scott Harris, closed schools, discontinued hospital visitations, closed beaches, etc. I am so thankful for this leadership as I am convinced had this spread into the schools we would not have had a chance to fight.
Third, the most significant public health/medical community health risk, is the morbidity associated with coronavirus. Estimates suggest between 10% and 20% of all infected with coronavirus will require hospital care with 5% requiring intensive care (ICU). This is what keeps me up at night. If we do not act now, we will quickly overwhelm our medical system. If my calculations are correct using a population of 50,000, a 3% to 5% rate of infection (3 to 5 infected people out of 100 citizens) could easily overwhelm our hospital’s ability to properly care for patients.
The only way we slow this down is by strict social distancing, avoiding any compromising situations, washing hands, and good decisions.
I have one more request as a result from an interesting observation in clinic this week. In general, my patients 65 and older are taking this seriously. Many are retired and able to stay home. Many are hibernating in their homes. This appears to be working. Possible cases last week (test results are pending) are younger, 25- to 55-year-olds. If my observations hold true, the biggest risk of the older generation is younger family members and friends passing the virus.
So, despite older generations often describing Generation X as lost and millennials as selfish and self-entitled, I would like to directly challenge my generation (Generation X) and younger to join me in strictly following the guidelines set forth by the CDC (CDC.gov) and the Alabama Department of Public Health (alabamapublichealth.gov). Our leadership, teamwork, and discipline can and will save lives. I can’t imagine living with the fact I passed a virus to a family member or friend causing a critical illness or death.
So, everyone, please consider living under the strict rules and guidelines of social distancing and hand washing. Get in the habit of avoiding touching your face. It ultimately is an act of love and respect for yourself, your family, and your neighbors.
— Dr. Scott Matthews is a Decatur internist.