March 26, 2020

Addendum

Today was a tough day. New York City has shown the reality of exponential growth. Italy, a country I love dearly, will never be the same. So many Nonnas gone? Who will teach us to make pasta, how to make balsamic vinegar, make limoncello? Heartbreaking. I heard stories that wring your heart and set fire to your fierceness.

But my day was actually focused, with little drama. For the first time, I worked the whole day 8-530 and never saw or talked to a patient. I actually can’t remember a time in the past 30 years when that happened. I worked on a plan for managing our patients after they get SARS-COV-2. I have recruited a team to help call patients with positive results and check on them. This virus is different than many, and I will say, again, that most people have milder cases, but some crash through a cytokine cascade that can cause respiratory failure within hours. Higher risk if you are older, but still happens in younger folk. We want to check on our patients and be vigilant for signs. It takes educating the doctors doing the calls so they know what to look for. This will take planning on our part and dedicated staff, especially with a surge.

I confess, I am still having trouble imagining the surge they say is coming. Where is ours? It is hitting NYC with horrifying speed. Have we actually been able to flatten the curve here? I hope, but next week will tell. The numbers are increasing and will spike soon.

Today also made clear to me about the disparities in health care. I am saddened about this. Some places, like ours have time and equipment to prepare, more resources, deeper pockets. Others are overwhelmed and may not survive. And some areas are still in denial. What will their patients do? The virus is coming.

I am making an addendum to my essay yesterday. I actually still believe that “Ring Around the Rosie” is about the Plague. Remember that. Singing about the signs and symptoms of the plague, with the acknowledgement of death. Ashes to Ashes. I wonder what myths and nursery rhymes will arise after this new plague sweeping the world?

Will it be about ignoring the signs until it is too late? Or will it be about people wishing and hoping for certain groups to die, their greed getting in the way of their humanity? Will it be about the ways people pulled together to protect each other by flattening the curve, creating and inventing solutions? Or could they be about how many people stepped up to help and risk their own lives? And will it be about learning to slow down again and appreciate time and beauty? We can write these stories and make them our own, so let’s make the stories be of love and care, not hate and greed.

Be sensible (Thanks Dixie, Thanks Debbie)

Wash your hands.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.cnn.com/2020/03/26/tech/dyson-ventilators-coronavirus/index.html

https://talkingpointsmemo.com/news/primary-care-doctors-coronavirus-financial-challenges