COVID19 - A Story Worth Reading
This is a story about a father of 3 in the prime of his life. An avid athlete with no preexisting conditions, he was hit with COVID19 and has spent about 30 days in the hospital under harrowing conditions.
It’s a factual story. It doesn’t need a peer review. It’s life.
As a father of three who loves to ski, hike, and run, I found it easy to connect to the father in this story. He’s not just a statistic. He could be anyone of us.
https://apple.news/AzavLhfEaQTW8oBThEINTjQ
The economy is no longer driven by politicians, fiscal policy, or monetary policy. It is driven by emotion. Confidence will lead a turn around. But right now fear will justifiably keep companies from opening and people from shopping, eating out, and attending sports events. Without a national plan to put in place large scale testing and tracing, without bringing case loads back down to a small traceable number, without a plan to protect our heath care workers on the front lines, and without other fact based measures in place to instill confidence, the economy cannot recover. But much worse, hubris and a second wave will send the economy into a deeper recession.
Be safe, be cautious, be healthy.
If you’ve gotten this far and you avoided the story so far, don’t worry, it’s a good story. A story worth reading.
This story is beautiful and powerful - brought tears to my eyes. Thank you for sharing it! This guy Jim Bello could be any one of us. The personal devotion of the medical workers is incredible. And I believe, like the doctor alluded to, that the wife's visit may have played a pivotal role.
I don't care if we're all jobless, broke, eating weeds and potatoes from gardens planted on overgrown basketball courts. Life is sacred -- let's do everything we can to save as many lives as we can. It could very well be our own.
I mean no offense at all by this, but I’m not willing for everyone to be jobless and broke, eating weeds etc. if that is the cost of taking an age group with a mortality rate of <1% to 0.
I guess that's the difference between you and me. I have personally lost 3 friends under age 50 to coronavirus, 2 of whom had no risk factors, and the 3rd was obese but otherwise healthy. One was a single mom, 33, with 4 kids. I am now trying to help her kids find a safe place to live. I would eat weeds and potatoes for a year if I could bring these people back. It's heartbreaking. These are not crazy outliers; these stories are plentiful. Just because it hasn't happened to someone you personally know doesn't mean it's not happening on a wide scale. 50,000 dead Americans so far, in less than 8 weeks. More than 20 years of fighting in Vietnam.
This is a war and a war means sacrifice. If you're not willing to make sacrifices to save lives, I can't convince you. One day we'll look back on this time and reflect on our contributions. The heroes will be the doctors, nurses, grocery store workers, garbagemen, and bus drivers who put their lives on the line to keep the country going — AND everyone who stayed home to help keep their community safe. Maybe those who didn't want to stay home (or felt that they couldn't) and cost lives will find a way to spin it to themselves so they're not haunted by shame. Good luck.
April 27th, 2020 at 10:42 PM ^
My condolences. Seems to me we’re having two different conversations here and I’m not interested in trying to convince you of anything.
I’m not going to speak to the other stuff you implied out of respect for your loss.
April 27th, 2020 at 11:46 PM ^
Thank you for being so respectful. We're all in this together and I truly am wishing the best for you and your loved ones. Same with everyone on MGoBlog. I love this community.
April 26th, 2020 at 10:42 PM ^
There, but for the grace of God, go I
April 27th, 2020 at 10:31 AM ^
I'm new to posting, and I fear I am inviting immeasurable hate with this reply, but I will do it anyway.
Bottom line up front: terrible and dramatic stories like the one linked above are terrible and dramatic for a reason - they are rare - and should not be used as the basis for sound public policy or public health measures. If the news media's job is to keep its readership informed and educated, stories like this do more harm than good, on balance.
Before you hate me, please hear me out. I am a pediatrician. In medical training, I had lots of exposure to adult inpatient and critical care medicine. In my pediatrics training and career, I've had even more exposure to pediatric inpatient and critical care medicine. Walking through an ICU, I would pass bed after bed occupied by elderly, frail, and chronically ill patients. Then I would see the healthy 40-year-old mother of three who was clinging to life after a cut she sustained while gardening became infected and led to septic shock. I would pass another ten elderly patients at the end of their lives before stopping at the 21-year-old hiker, on ECMO after developing an overwhelming histoplasmosis infection (an airborne fungus abundant in the Ohio River valley which almost never causes disease until, for some reason, it does). The pattern repeats: most people in the ICU are elderly and frail, but there will always be young and healthy people there felled by things you've never even heard of, and some things you certainly have (flu, pneumonia, trauma).
The Pediatric ICU (PICU) is even more dramatic, because by definition there are no elderly people there. There are lots of kids in the world with chronic or congenital conditions that make them frail and vulnerable, and just like in the adult ICU, they are very well represented in the PICU. So I walk around there and see many of those kids. But there is also the 3-year-old who developed autoimmune hepatitis, progressing to liver failure, who is awaiting a liver transplant as the only thing that will save his life. There is the previously healthy kindergartener, who went to the ER 5 months ago because she fainted, was found to have aplastic anemia (complete failure of the bone marrow), and hasn't been home since. She got a bone marrow transplant, developed a complication known as bronchiolitis obliterans (her lungs are failing), and she will die in this PICU. Another patient is already deceased, a 4-month-old with a common viral respiratory infection (RSV), found unresponsive at home, on a ventilator but already brain dead, awaiting the family's approval to turn off the vent (it took them another week). His neighbor in the next bed is another young RSV patient, on the ventilator for the past week, who will turn around and go home in a week or two.
All of those patients are real. None of them had their stories in the New York Times, because none of them was part of a larger story currently gripping the nation. Are their cases any less dramatic or less terrible? If "there but for the grace of God" applies to the story in the original post, does it not also apply to these?
I'm not saying the original post isn't dramatic, but to tell a dramatic story of a young person severely ill or dead from Covid19, and then to make the "if-then" claim that because this happened, we must do X, Y, or Z, because it could be any one of us, is not sound public policy. I have hope that our elected and public health authorities are being sane and sober, and not making appeals to emotion and drama, but I am losing more of that hope every day. "If it saves one life" is not a serious approach to public health policy. Focusing on outliers and dramatic stories is not a serious approach to public health policy. A news stories that compiles unrepresentative cases of young and healthy people felled by Covid19, so that we can say, "oh God, that could be ME", is no different than a news story compiling cases of people who have died in plane crashes, with the implication "YOU could be next!". If they did that we would rightly call it out as sensationalistic, unhelpful, and irresponsible. The media has clicks to sell, but we don't have to buy it.
I agree with the OP - we should be using fact-based measures to tackle this crisis and reopen responsibly. Part of that approach means, as difficult as it is, not letting dramatic and unrepresentative stories affect our decision-making. So my advice is the opposite from his - don't read that story.
I am sure that I will get replies with a list of other young and healthy people who have been severely ill (or worse) with Covid19. Don't bother. I know they are out there. I also know the data and that they are outliers, which is precisely my point in making this post.
Stay well, stay sane.
April 27th, 2020 at 12:31 PM ^
MHYDE,
Before the deluge of anti comments comes in, I have to applaud your presentation of rationality. Too much of what is going on now is knee jerk emotional WEHAVE TO DO SOMETHING!!!. As more information comes in we are finding out all kinds of relevant points. For instance, the NY Times reported a over 80% co-morbidity rate in the deaths in the state. Anti-body test results are biting the shut down fans in the ass, as we find out that it is incredibly likely that the disease was prevalent in the US months before advertised, and that some degree of herd immunity was already in play, meaning the actions to crater the economy were based on mis-information. We need voices like yours who are in the medical community to be heard and push us toward more sensible actions. Protect those with pre-existing conditions, and get everyone else back to work.
This story and others like it are good reminders about the value of a human life. For those here calling for rational, unemotional decision making, know that these decisions involve weighing economic hardship for many against death for fewer. We are for from economic hardship leading to death comparable to that from covid, so we are comparing different things. Any decision made will ultimately draw upon subjective values.
To those arguing to tuck away the at risk folk, it is worth noting that we cant keep people in plastic bubbles while everyone goes about their business. High infection rates put everyone at more risk.
I have to say, I don't find posts like this helpful. Nobody is a "fan" of the shutdown. Everybody agrees that being shut down sucks. Nobody is getting "bitten in the ass" by test results, because, so far, there aren't enough test results to be meaningful.
What we have going on is a debate with insufficient information on all sides. There is a significant amount of evidence that more people have been infected than we have been counting officially. There's also, if you look at the unexpected death statistics, a fair amount of evidence that more people have died from Covid-19 than we have been counting officially. What's the real fatality rate? We don't know yet. What's the real level of exposure? We don't know yet. What's the real level of immunity provided by recovering from the disease? We don't know yet. How long does immunity last? We don't know yet. What's the long term damage to the economy? How long will it take to recover? We don't know that either.
At this point, we're all picking sides based on our priors. "WE HAVE TO GET BACK TO WORK!!!" is just as knee-jerk as "WE HAVE TO STOP THE VIRUS!!!". Hopefully we can try to stay rational, and learn from the information as it comes in, and not just select from it to confirm our positions.
Where did the article conflate the patient's experience with "serious approach to public health policy?"
It's a newspaper article telling the story of one person, well-written and thankfully with a happy ending.
Your attempt to find fault with the OP or any positive commentary in support of the OP is childish and condescending.
I agree the article itself did not attempt to provide commentary on anything, just related the story of one family's issues, that's fine as far as it goes. The original post however provided exactly that, with reference to lack of preparedness etc. What both MHYDE and I are concerned about is the conflating of emotion driven articles with the determination of path forward. I find that neither childish nor condescending. I think that is prudent and more likely to provide a more positive eoutcome
The OP, and the article it links to, are of a piece with many others all over social media and news media, typically with a tag line something like, "so stay home". The unwritten (and frequently written) subtext: "or you'll be next". Maybe I was too harsh on the OP here, but I am trying to counter that narrative. Is the man in the article famous? Why is his struggle newsworthy? Because it's dramatic? It certainly is. And his story is certainly extremely important to him, his friends, and his family, but how does it help to meaningfully inform the public at large? My point is that it doesn't. The question remains - where are the articles written about the patients I mentioned? All real, all dramatic, yet no interest from the public. The most charitable answer is that nobody would care enough to click, so why bother; the less charitable answer is that the media is trying to drive a narrative. Neither answer is very satisfying if you care about real and useful information.
I'll leave the ad hominem alone. Stay well.
I apologize. I overreacted. I get what you're saying.
I saw the article and the OP's comments as two separate things. Certainly there are media narratives that are driven by themes most likely to resonate, but I also feel as though serious treatment of this current situation requires more comprehensive testing and more clarity from all levels of government about what they expect to happen based on one course of action, and then a willingness to adapt based upon certain contingencies.
But your overall point is absolutely correct. Reason should be our guide, and I suspect the President and others are not acting from a reason-based foundation.
I appreciate your perspective, but in my opinion (and apparently the OP) this is not a matter of a anyone choosing one crazy outlier and planning a public health approach based on that. Look at the raw numbers. A huge percentage of coronavirus cases are in the 20 - 64 age group (probably the age range of most MGoBlog readers), with roughly 20% hospitalized, 5% in ICU, and .1% - 3% death rate, depending on age and other factors. While some had other risk factors, many did not.
I have personally had 3 friends under the age of 50 die from coronavirus, 2 of whom had no risk factors (the 3rd was obese but otherwise healthy). One was a single mom, 33, with 4 kids. This is unbelievably tragic. And even those who are infected but survive may have long-term health complications. I know these are small sample sizes, but look at the numbers nationwide. Yes, it's unlikely someone will suffer like the man in this article... but I don't think you can call these cases crazy outliers when they are happening in significant numbers.
Also, my parents are extremely high risk, and I resent the idea of people spreading disease willy-nilly and increasing their risk. An Oxford vaccine, if successful, could be ready as soon as September. Despite the real and challenging economic hardships, given the risks to healthy people and especially to our most vulnerable citizens, why would we NOT try to diminish the spread of the virus the best we can?
I personally think that most anti-Stay Home people's tune will change once they lose people they know and love, as I have.
thank you for posting a very valid perspective on what the world and our country are dealing with. i think one giant issue that would help is trying to find the 'true' numbers about those impacted by the virus. what source(s) do you utilize?
and to davy, above, i have lost an admittedly not-close family member and came within a day of losing a long-time, close friend who was saved by U of M using chloroquine. and i understand your concern about your parents, but what is the problem with them staying home? their bodies, their choices. if someone else chooses to run the risk, as long as they don't go to your parents' house, why is that something you condemn?
April 28th, 2020 at 12:27 AM ^
Hi XM! Thanks for this post -- I have profound respect for you and the way you live your life; in particular, your posts about parenthood have energized and inspired me. After 10 years reading the blog, but just getting active actually commenting on the boards, means a lot to have a chance to respond to your thoughtful question here. And let me say first, my condolences for the loss of your family member. Even if you weren't close, I'm sure the loss has weighed heavily on the people closest to them. Life is sacred and every death is a tragedy.
I only wish coronavirus safety was as simple as each person making their own personal choice, and their choices only impacting their own personal safety. Unfortunately that's not how this disease works. People who are choosing not to stay at home are putting themselves at risk of infection. Even if they're "careful," they can catch it from someone who is asymptomatic or has not yet shown symptoms. Likewise, if infected, they can spread it without realizing it. (As many as half of infections are estimated to be asymptomatic.) It's been widely estimated that without physical distancing measures, each new infection can lead to 40 new infections within 3 weeks. In other words, someone who takes it upon themselves to disregard expert guidance and circulate freely can, without even realizing it, further the spread of the virus -- sometimes widely and catastrophically. To me, the closest analogy is texting while driving. There's a reason it's illegal -- because it's so dangerous. I only would ask to limit other people's freedoms when they could be damaging -- even fatal, in this instance -- to others in their community.
Now, as far as my parents, my dad is in a nursing home because of round-the-clock care needs that we can't provide at home; however, he leads an active life (before Covid) with several day-trips a week, loves spending time with his grandchildren, and is still 100% mentally present, even if he has physical limitations. He has many quality years left to live. The nursing home employs 100 staff members -- nurses, aides, cleaners, more. Each of these people, while trying to minimize their contact with coronavirus-positive people, may not be able to 100% self-isolate while not at work. Or even if they can, they may live with kids or other family members who are not self-isolating. The more community spread of the virus, bolstered by people who are circulating for non-essential reasons -- "choosing to run the risk," as you said -- the greater chance that someone who is infected will spread it to someone who works at the nursing home (or their family) and it will eventually spread to my dad.
Meanwhile, as mentioned above, I know people who are low-risk, even as close to no-risk as you can imagine, who have gotten sick or died. The more community spread of the virus, the more total infections -- in the short term, at least -- and the more unusual cases of perfectly healthy "younger" folks like you and I facing severe outcomes. Unfortunately not everyone has the luxury of staying at home, even if they're in a high-risk group. For example, I have friends who work at grocery stores, as police officers, or in hospitals; some are above 50, have high blood pressure, etc. Is it fair for them to face higher risks and greater community spread because other people chose to circulate when they didn't truly need to?
I'm not saying no one should leave their house for 2 years. There are "smart" ways to open things up, little by little. And I truly empathize with those who are losing jobs and facing other devastating economic effects of this. My main source of income was suspended and I'm freaked out about money, same as everyone else. But with promising treatments and vaccines on the horizon, maybe within weeks or months, I believe we should all make an extreme effort to Stay Home to the very farthest limits of our ability. In doing so, we can truly save lives. It upsets me that people don't want to explore the limits of sacrifice to help their neighbors, community, and country. My take is not that they're bad people, it's that they have not personally suffered loss or don't quite understand the science about how the virus is transmitted and the effects of increased community spread.
Sorry for my manifesto! I just respect you and your thinking so much, I wanted to give you a fully engaged answer to your earnest question. All the best to you and your family!
thank you for your gracious comments, and will do my best to reply in kind. if i fail, its not because of a lack of good faith, its because it went to the school 'for kids who don't write good'.
like probably everybody on this list i have family that would be considered high-risk, my in laws come to mind in particular. wonderful people who we have tried to talk into coming to live with us for years. the rational and avowed reason for the stay at home order was to 'flatten the curve' and i think most folks, myself included, agreed with that wholeheartedly. well, we did that successfully even in the 3 worst hot spots, Det, NYC, and N.O.L.A. once accomplished, then its time to roll out of this wisely. i think most states are heading in that direction and that's good.
the second part of this addresses your concerns and sounds harsh though i don't mean it to be: there is no way for me, my family, you, your dear parents, or my dear in-laws to avoid the virus. it will come to them (and all of us) eventually. we might buy some time with the continued extreme measures, but we are already at the point where we are wacking millions of lives, and impacting hundreds of millions for very little benefit. we have never had a vaccine for SARS and EBOBLA is just getting there after over a decade. i do think we might get some very effective methods to deal with the virus, some of the anti-virals, some unorthodox treatments, things like that. that is for your parents and my in-laws. meanwhile the rest of us need to get on with life, raise the kids, farm, go to sporting events, let the kids go to social activities, go to religious services, etc. for their development and their lives.
and while we're at it, its time to pay back china for their deceit and misinformation, not to mention this is the 5th deadly virus to come from that communist hell-hole: bird flu, swine flu, SARS, MERS, and now this. china is the enemy in so many ways and its time we started conducting our affairs accordingly.
EDIT: oops, i wrote quite a manifesto myself. sorry.
"terrible and dramatic stories like the one linked above are terrible and dramatic for a reason - they are rare"
What was "rare" was the recovery after being affected so severely. What's not "rare" is the damage inflicted by the virus--more than 63,000 U.S. Covid-19 deaths so far, which is already more than the U.S. death toll inflicted by the entirety of the Vietnam War.
The Vietnam casualty rate seems to be the latest comparator as I have heard it on several news outlets. So as long as we are comparing, how about the ~65K dead americans from the flu this season (5 months) or how about the 50K who died from heart disease this past month (based on 600K a year from the CDC), and I would be willing to bet that a whole bunch of them are being counted as COVID deaths. This virus, while terrible, is not justifying the destruction we are wreaking on ourselves. And contrary to what another poster said, this shutdown is now and will be for months causing deaths. There are places where the medical facilities for elective procedures such as cancer screening are shut down. When those cases start rearing their heads in a few months, then we will begin to see the costs of the immediate safety mindset.
When SARS-Cov-2 is a contributing factor to a death, then it's right to count it as a Covid-19 death. Until very recently, the Covid-19 deaths were undercounted because only confirmed cases were counted, and testing for the virus was almost never done on corpses. As for heart disease deaths--what? Are you seriously implying they're communicable in the same way and growing at the same rate as SARS-Cov-2 infections and deaths? They're not.
Everyone, rightly, has their own opinion about the Coronavirus issue. At this point in time, here is mine. On April 20, I decided that this is the course of action that we should be taking. My simple 3 point plan is as follows: (1) Everyone over 65 or with a high risk health condition should be STRONGLY encouraged to stay at home. I am in this group. (2) Drastic measures should be taken to safeguard those in nursing homes, assisted living facilities and other senior communities. (3) Everyone else, on a voluntary basis, should get back to work.
As more data becomes available, it appears that most people can beat this virus. Getting people back to work will restart the economy before it is too late, lessen the money flowing out of government and increase the flow of tax dollars back in and get us closer to achieving herd immunity. It will restore individual pride, provide purpose and allow for a return to a more normal lifestyle. It will also allow non-covid patients to get the medical attention that they need.
This does not mean an opening of the flood gates or a discarding of common sense. We can still choose (or require) social distancing, hand washing, cleaning surfaces and the wearing of masks. The plan can be implemented by county or state as appropriate, but it needs to get going now. We should stop thinking in terms of what is essential and think instead think what is safe.
People are going to continue to get sick and die from this virus if we open up or continue to be locked down. We need and end game strategy. Hoping for a cure or vaccine is not realistic.
Editorial:
First, I want to comment on how civil the discussion became in this thread. Thank you. Perhaps I will have to make the mistake of posting in Diaries rather than the main board more often.
Yes, second, when I wrote this post and posted it I couldn’t figure out where it went. I just happened to rediscover it today. Funny!
I want to address a couple questions that came up in the thread.
The reason I picked the story: It’s easy for everyone to discard the value of a life when it’s represented by small fractions like 1% or .5%. Those small percentages are intended to undervalue and misrepresent. The real numbers are the 70,000 deaths and growing. Or the real numbers are, if nothing was done at all, millions of deaths. But even then it’s still just a number.
It’s important to share the personal stories because that’s what these numbers represent. I can’t post 70,000 stories though. So I picked one that accurately describes what can happen, and had a rare happy ending unlike the other 70,000 deaths. I believe that any effort to avoid the reality at a personal level is an attempt to avoid facing the truth.
Some of you won’t accept that. But that’s what people do when they don’t want to face the reality of what their convictions or decisions actually mean. When CEOs of large corporations have a layoff for example it’s just numbers and it’s not each individual person. It’s well-known that owners and CEOs of small companies have a much tougher time laying people off because they feel it’s like family and they know everybody’s story.
I added the plan for what we need to do for exactly the reason that people in this post have complained. I am not just going to post a gloomy story. There is a plan that can work and that has worked in other countries.
Further, I believe it’s important to dispel the myth that the government saying you can go back to work will fix the economy. That is absolutely not true. Sweden is an example. The economy is not driven by politicians right now. It’s driven by fear. And as long as people are going to fear going back to work or going shopping the economy can’t rebound. The government ”can” do things monetarily and fiscally to keep money in people’s hands and flowing through the economy as much as possible. But the other thing they need to focus on are policies that reduce the risk for people getting COVID-19 and thereby reduce their fear
So the only way to fix the economy is to take the steps necessary for people to feel safe when shopping, working or using public transit. And, large scale testing, smaller new caseloads, and contact tracing is enough to get us back to work. That won’t take 12 months and that shouldn’t take two months as long as everyone does everything they can to social distance, stay at home, and even wear a mask. In the meantime, medical remedies are being tested and won’t be far behind.
If we don’t do the above one of two things will happen. First politicians will get nervous and try to restart economies too fast and as a result caseloads will go up, the crisis will come back, and people will be less trusting and more fearful than the first time, all of which will cause a much longer recession. Or alternatively, caseloads won’t go down fast enough because people are still breaking the rules. And in that case we won’t be able to go back to work and shop.
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