The COVID-19 pandemic is a danger on par with airline disasters and terrorist attacks.

I have avoided this topic because there is so much out there already.  However, as a knowledgeable physician who has cared for these patients, I feel I have a responsibility to say something.

Total infected

I won’t bore you with more numbers.  Whatever numbers I give will be out of date as soon as I type them.  Plus, our brains have a hard time contemplating the scale of numbers like fourteen-million anyway.  Let me put it this way; the US currently has a number of confirmed infections equal to the population of its two largest cities (NY and LA) combined.   That is now more than the population of the states of Illinois and Pennsylvania.  Only four US states have populations larger than the number of people infected with the virus.

Total deaths

The number of deaths so far this year is greater than the population of more than half of the State Capitals (37 of 50).  Imagine people filling a football stadium to cheer on their favorite time.  Think of the massive numbers of fans that would be.  Now imagine how many people it would take to fill that stadium for a month of Sundays.  That is the number of Americans COVID-19 has killed so far, and the stadium is continuing to fill. 

Daily deaths

Daily, the number of deaths is roughly equal to a dozen 737 Max 8 airliners crashing with all souls’ lost.  In terms of 9/11, it is equivalent to the loss of life experienced in the World Trade Center attack every day.  If that many planes were crashing or terrorists were murdering that number of Americans daily, my guess is people would think no actions taken by the government would be too severe.

Yet, the United States government is taking surprising little action given the magnitude of the tragedy.  Instead, the federal government is abdicating its responsibility to local governments and community hospitals to handle.  And those hospitals are becoming overwhelmed.  At least six states have more than two out of three ICU beds occupied by COVID-19 patients.  Those beds were not occupied a year ago by patients with that diagnosis.  That means that there are not enough ICU beds available for heart attacks, pneumonias, congestive heart failures, strokes, traumas, cancers, and post-surgical patients.  My hospital administration asked me to decide which of my patients need surgery and which can wait.  A rationing of care I never experience in two and a half decades of practicing medicine.

We the people

If the US government doesn’t take action, then we, the citizens, must step up.  That is democracy in action.  Yet, many Americans feel this situation does not apply to them.  They pass it off as overblown by comparing it to influenza, which in its worst year resulted in only a fourth as many deaths as Coronavirus produced in eight months.

We the people, can help prevent a collapse of the American healthcare system by changing our behavior.  If nine airliners a day crashed, my guess is people would stop flying on them until the problem was corrected.  This may be a loss of some personal liberty in not being able to jet off to any destination, but the majority of people would choose that limitation over the risk of fiery death.  Not getting on the planes would be the most effective strategy citizens could employ to avoid dying.  I assume that most Americans would avoid air travel willingly even if the government insisted unsafe planes needed to fly.

What individuals can do

In the case of Coronavirus, we do have choices we can make to limit the danger to ourselves and our loved ones.  We can wear a mask in public, wash hands frequently, avoid groups, restrict travel, and practice social distancing.  It sounds strange to say, but one of the most loving things we can do for those we care about is avoiding contact with them for the time being.  Like avoiding air travel, these restrictions are inconvenient, but they are a livable level of temporary inconvenience.

Stop the deaths

If terrorists were running through American city streets, murdering more than two thousand citizens per day, people would demand the government get involved.  The terrorist would look for targets with many people to achieve the most damage — which is also what the virus does.  In the face of that threat, businesses would close, and large gatherings would be canceled to limit the targets available to the terrorist.  Curfews would be instituted in American cities, and laws would empower police to enforce those rules.  To protect themselves and their nation, people would request these restrictions to limit murders in the streets.  These same restrictions can also prevent the unnecessary loss of life caused by the virus.

If terrorists did succeed in pulling off a major attack in your city, the loss of life could be more than just those injured in the attack.  As the wounded flowed into local hospitals, those hospitals would be overwhelmed.  With other hospitals in the area also at or above capacity, there would be no way to share the burden as happens in most disasters.  Instead, each hospital is on its own, using its limited supply of medical personal and supplies.  If those resources are not enough, doctors must decide who lives and who dies.  

Rationing of medical care is a danger to all

Hospitals face making decisions about how to treat other patients with limited resources and beds available.  Amid hospital shortages, people are at risk of becoming sicker and even dying from common illnesses like pneumonia, heart attack, cancer, stroke, and even appendicitis.  The lack of timely healthcare availability for common ailments increases the risk of poor outcomes and even deaths for those not infected with the virus.

The worst disaster we have faced.

The COVID-19 pandemic is not a danger on a par with airline disasters and terrorist attacks.  It is worse.  All the airline crashes and terrorist attacks this county has faced have not produced the loss of life this virus has, and the problem is only getting worse.  Americans need to see the nation as under attack from an outside agent and respond in the same way we would to a more visible threat.  The problem is that while terrorist attacks and airline crashes make great visuals for the nightly news, Coronavirus death occurs out of sight in hospitals.  Just because we don’t see the death and destruction caused by this virus on our TV’s does not mean it is not happening.

We are a nation at war.

It’s time to start acting like it.

Recognize the magnitude of the problem we are facing.  Not only are people dying from the virus on a scale unparalleled by previous disasters, but the strain that puts on healthcare resources is putting the uninfected at risk as well.  We can each do our part to protect ourselves and the ones we love by avoiding group events, wearing a mask, washing hands, practicing social distancing, and thinking about how our actions may affect others.  We are a nation at war with an invisible but very real enemy.  We need an attitude like that of the generations before us who faced down more tangible armies.  We need to accept that if we all make small sacrifices for the common good, hopefully, fewer of us will need to make the ultimate sacrifice.