COVID-19: Our Proposals

Editorial

COVID-19 and Community

Some Modest Proposals

Our most informative view of COVID-19 will, of course, come in retrospect. Just as has been the case in humanity’s past brushes with pandemics, we will as is usually the case, respond better than the last time, and not as well as in the future.

In the instance of COVID-19, here is what we know so far. Most experts believe that 50 to 60 percent of the U.S. population may become infected over the next two years. Current World Health Organization figures show COVID-19 patients average a fatality rate of 1.4 percent if there is no underlying chronic health condition. Patients with cardiovascular disease show a mortality rate of 13.2 percent; with diabetes, 9.2 percent; hypertension, 8.4 percent; chronic respiratory disease, 8 percent; and with cancer, 7.6 percent. These figures have been in flux, but you get the idea.

Depending on which figures you look at, between 40 and 60 percent of Americans have at least one of these underlying conditions. Notably, chronic health conditions are on the rise across all age groups in both this country and in emerging market countries.

With each decade of life, mortality rates increase for COVID-19 patients. This is especially the case for patients age 60 and over – given their higher prevalence of underlying health conditions, and an immune system that weakens for even the most active elder adults. The spike in mortality for patients over age 80 is remarkably pronounced at between 18 and 21 percent, depending on which figures you rely on.

The onset of COVID-19 symptoms can feel reassuringly like a cold or flu. However, this isn’t a cold or flu – it lays you down longer and harder, it’s deadlier, and there is no vaccine. Physicians in Hong Kong have reported that about a quarter of their recovered patients have what appears to be permanent organ damage, losing between 20 to 30 percent of their lung capacity.

This is not like SARS, which had more severe symptoms and morbidity, making it both easier to isolate and less able to spread. In short, COVID-19 is more fit to persist in human populations. It makes sense to take steps that slow the spread of this infection, and to take some precautions.

But balance and mindfulness are also called for, and on this count, we are becoming concerned about our shared community.

HERE IN CORVALLIS
The hoarding of goods can seem novel and funny until you think about it. Higher risk groups are being advised to avoid supermarkets with the exception of the least crowded times – although pretty much everything one may need is now out of stock by later in the evening. For others, an early morning foray isn’t even possible if they have to work or take care of kids.

Additionally, there are people in our community with no independent means of transportation, and those that can only afford to buy what they need as they need it.

We’d like to see cooler heads prevail.

Maybe people could consider donating their overbought goods for distribution to people in need. Possibly, the city or a non-profit could stand up to help with that effort. Also, and this is no small aside, if the hoarding continues another week, we’d like to see either the government or supermarkets themselves implement some sort of rationing, stricter than what is currently happening at some stores. If we do need to move to rationing, it would be best to do it earlier than later – earlier meaning fewer repairs and less intervention. We suspect the coming disruptions to supply chains wouldn’t require rationing on their own, but that people’s responses may.

We also suspect the advice that everyone stock up on 14 days of goods, all at one time, will be looked at as an error at some point. It may have been more helpful to implement a support system for people voluntarily self quarantining or otherwise in need.

Local doctor’s offices need to make immediate shifts. Patients concerned they’ve become infected should be able set a brief, same day phone appointment with a healthcare provider. Our community’s providers have been woefully behind as goes telephonic medicine. Waiting for a call back at an unspecified time is ridiculous for anyone that works or has kids. An even further miracle would be a temporary hotline connecting appropriate medical staff with callers, quickly.

Obviously, there are solid reasons to see patients in person, but in the instance of COVID-19, many experts believe a phone call is the best initial triage. Corvallis could relieve pressure on its emergency room if local physician practices made themselves more readily available by phone. Last week, we learned that some patients had become quite badly behaved toward emergency staff, and we know that doesn’t help anyone.

Emergency room staffers know you’re scared, and they want to help, but there is nothing they can do about how understaffed they are or the wait times patients experience. Also, there’s no reason to call the CDC – you’ll wait for hours, and they’ll just tell you to call your doctor.

Local social media has been a mixed bag. It’s been as low as posts celebrating the idea that COVID-19 is especially dangerous to older people, and there’s been the usual conspiracy theories and political finger wagging.

Encouragingly, however, there have been multiple offers of help – everything from childcare to trips to the store. We’d be remiss in not stating that would-be recipients should accept help with a certain amount of caution, but we also noted that some of these offers came from people that we’d trust in a heartbeat.

There have been numerous calls to help locally owned small businesses and non-profits. We can report that their pain is real. One local restaurant we work with has seen their business decline by 40 percent – the owner tells us he will be taking a loan out in an effort to avoid laying anyone off, however that’s not a long-term solution, and the business decline could go on for months.

Likewise, you will note our own paper’s predicament outlined on page 4.

WHAT’S NEXT 
Most experts are optimistic about a vaccine becoming available, but agree it will be at least a year or two away. Currently, there is some indication that many of the patients who died in Wuhan were victims of their immune system’s overkill – a so called cytokine storm – rather than the virus itself, and there are some known treatments for this phenomena.

There is also some indication that medications used to fight AIDS may be effective in treating COVID-19. A clinical trial is underway in China, and manufacturers of these medications are also conducting research.

Of course, all of this is out of our hands.

What we can put our well-washed hands on is the care we offer others, and our kindness – in short, our generosity and our grace under pressure. Even as we no longer physically gather so much, we are in spirit still a community, and there can be tremendous power to overcome in that realization.

One prediction we feel confident about is that our community will reunite in physical space again – and we believe that our current actions toward one another will most certainly impact how that feels.