CHARLOTTE, N.C. — This was written by two physician leaders at Atrium Health and shared with Channel 9.
Most of us are not infectious disease experts, but all of us know how to keep score. Whether managing our household budgets or tracking our fitness, we use numbers in our daily lives to direct us in how to best move forward. So while there’s so much we don’t know about COVID-19, let’s look at what we do know from the numbers.
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First: Public health experts aren’t seeing any evidence that COVID is receding from our region. In fact, we see the opposite. They know this by calculating Rt, the average number of people that a single COVID carrier will go on to infect. When Rt is less than 1.0, pandemics die out over time; when over 1.0, they spread. Currently, Rt is less than 1.0 in half the US, but it is over 1.0 in South Carolina, Georgia, North Carolina, and the Charlotte area.
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Second: Extreme though necessary actions taken during the height of the pandemic back in March 2020 were very effective in containing COVID (the Rt value here fell from over 3.0 to less than 1.0 in just over a month), but this came at considerable cost. Aside from dismantling the national economy, those actions also led to unanticipated health consequences. The number of patients seeking heart attack care was 30 percent less than in a typical month, with similar values for stroke care. (While COVID has many health effects, curing heart attacks and strokes are not amongst them.) Meanwhile, during this time behavioral health visits spiked.
Third: The United States has less than 5 percent of the world’s population, yet roughly 25 percent of the world’s COVID deaths. Allowing that COVID statistics are underreported in many parts of the world, consider this: Germany—with an older and presumably higher risk population—has a COVID mortality rate 75 percent less than the US. If the US had performed similarly, we’d have 30,000 COVID deaths instead of the 120,000 we’ve recorded. Hong Kong, Japan, and South Korea — all regions with dense populations —have all had COVID outcomes much more similar to Germany than to us.
So what exactly do all these numbers tell us?
COVID is real, it is impactful, and it doesn’t appear to be going anywhere soon. Dealing with COVID will be part of our “new normal” for the foreseeable future.
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Short of a vaccine, the most effective way to control it—quarantine with shuttering all but the most essential activities—also produces devastating side effects. Not only in the economic sense, but also directly to our well-being.
But there is a path forward. Other nations have shown us that there are things we can do and should do to mitigate COVID’s impact. At a public health level, COVID testing and contact tracing are vital. At an individual level, our choosing to consistently follow a few simple rules can make a very meaningful difference: Wash our hands. Stay at home when we feel sick. Maintain social distancing – in particular, avoid large indoor crowds. Always wear a mask when out in public.
We are all still learning how to cope with COVID, a pandemic the likes of which very few of us have ever experienced and one that none of us fully understands. How successful our community will be in managing the pandemic going forward hinges on the sum of the individual actions each of us chooses to take. And in the end, the numbers will one day mark how committed all of us were in doing the right things.
(Written by: Geoffrey Rose, MD, President, Atrium Health Sanger Heart & Vascular Institute and Anthony Asher, MD, President, Atrium Health’s Neurosciences Institute and Neurosurgeon with Carolina Neurosurgery & Spine Associates)
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