Covid-19 Update and Test Then We Will Reopen Ohio Responsibly

The devastating effect of COVID-19 is continuing to slowly abate.  Yet, more than 63,000 Americans have lost their lives to this disease that has been diagnosed in over 1.1 million US citizens. Fortunately, over 100,000 have been hospitalized and discharged. This human toll has been great and unfortunately deaths and hospitalizations will continue, hopefully at a slower pace, until we get a vaccine in 12-18 months or so.  

The economic impact can be summarized by the loss of 30 million jobs, 10+ TRILLION dollars borrowed and spent by Congress, and hundreds of businesses which may never come back. The Coronavirus Taskforce put forth minimal guidelines for states and regions to reopen their economies. The very next day the President implied that several states disregard those guidelines.  Multiple states have decided that reopening of their economies takes precedence over the likely increase in loss of life and are therefore violating even these minimal guidelines.  This week the future projected death toll from COVID-19 has already been increased from 68,000 up to 74,000, even before these states announced plans for reopening. 

No one is advocating keeping the US economy shutdown any longer than necessary. Unfortunately, the mainstay of defense against this scourge is “social distancing” meaning staying at home.  This needs to be part of the defense until we get a large portion of the population vaccinated, at the earliest 12-18 months from now; or a medication cure is discovered. It should be noted that one antiviral, remdesivir, looks like it will be effective for severe form of COVID-19. While we wait for further research, we are best served by going on offense consisting of supplementing the social distancing with TESTING (accurate and rapid results), contact tracing (and testing), isolation of the known and suspected positives (and testing), and treatment of the infected. The mainstay of this life and economy saving strategy is obviously testing.  Despite what you may hear from the White House podium, testing in the USA remains woefully inadequate.  Everybody that needs a test, cannot get a test and certainly “everybody that wants a test” still cannot get a test. Currently approximately 200,000 tests per day are being performed and a robust testing strategy requires anywhere from 500,000 to 5 million tests per day.  To this date we have only tested just over 5 million Americans (just short of 2%). Dr. Anthony Fauci, one of the lead Taskforce medical consultants, states they he will be overly concerned if we do not have the 500,000 daily tests that we have again been promised by early June.  We, as a medical organization, again call for a federally coordinated approach and for the President to fully implement the Defense Production Act (DPA). American manufacturing, mandated by the DPA, can produce all the supplies necessary to get universal USA testing done!

As African Americans, we too have a huge stake in the responsible reopening of our economy both from a healthcare (life and death) standpoint as well as an economy standpoint.  The two are not mutually exclusive. We account for 34% of the US deaths from COVID-19, although we represent only 13% of the population.  African Americans bear a disparate burden of preexisting conditions of hypertension, diabetes, asthma, obesity and chronic medical problems. These preexisting conditions cause us to be in the “vulnerable population” which the Taskforce’s reopening guidelines recommends stay home until the later stages of economic reopening.  Yet so many of us are either essential workers, who have already been out there risking our personal wellbeing, or work in jobs which will be the first called back. Because our nation’s health insurance system is so intimately attached to employment, the loss of jobs means a loss of health insurance coverage. This is another concern of the “essential workers” along with getting to work on public transportation. There are physical and mental health, as well as economic issues, to be considered in the decision to return to work. The testing that would help to reassure people must be made available. Our federal government is best equipped to make the necessary testing available. We are screaming for the Defense Production Act to be used to produce enough gloves, masks, hand sanitizer, face shields and appropriate Personal Protective Equipment for the general public to be better protected. 

Although, there is enormous pressure and possibly less control over the decision to return to work, Americans are clearly not willing to return to optional, albeit typical, tenets of American life.  Again, this ties into the necessity of rapid result and accurate TESTING for COVID-19! Americans are smart enough to know that COVID-19 is a highly contagious disease, which does not have a cure nor vaccine currently. We are not even able to adequately test for the presence of the disease.  A new NPR/Marist poll finds that, by large percentages, Americans believe that it is a bad idea to resume specific activities without further testing: 1) 91%- large sporting events 2) 80%- sit down meal in a restaurant 3) 85%- children return to school 4) 65%- return to work. Americans know that adequate testing is necessary before we return to even a new normal. 

Government, at all levels, can help more, but as we wait, we must protect ourselves at the current time. Take your medications and do what is necessary to control any health problems.  “Stay home” if you can. When you must go out, wear a mask or nose/mouth covering at any time where you are not able to stay six (6) feet from any other person who does not live with you. As physicians, we hope that Governor DeWine’s recent decision to make the wearing of a mask voluntary for Ohio citizens visiting retail stores be changed back to requiring mandatory usage. The science is clear that the wearing of a mask protects others from the wearer of the mask, who may be among the 20% of people who might be asymptomatic.  Additionally, wear gloves if you need to touch anything and wash your hands (20 seconds) or use hand sanitizer. Avoid touching your face. If you sneeze or cough, do so into the bend of your elbow. Change your mask, as necessary. 

The individual decision to join the reopen is a difficult one. It has life and death ramifications. Protect yourself as you continue to protect others. We need rapid result, accurate, and widespread testing to protect our health and boost our economy. There are levers in the federal governmental arsenal which, if used, might lessen the anxiety about getting back to our “normal” activities.