• Dr. Kemia

Resiliency in the time of COVID-19

Dear Everyone:

First – Breathe. And I promise as reductive and condescending as that sounds, I say that for me every bit as much as I say it to and for everyone else. Breathe in evenly over a count of 5-7 to the very, very bottom of your lungs, and out again slowly for the same count. Keep it as even and mindful and lung expansive as you can: in and out.

Most of us are in some form of autonomic overdrive right now, and that is not good for the psyche nor the immune system and I’ll tell you the absolute truth: I fielded a lot of phone calls yesterday from folks who were clearly holding their breath. I caught myself many, many times yesterday breathing so shallowly that my little red cells had to be screaming. I've listened a great podcast from my friend Becky – she gives a wonderful synopsis on the importance of autonomic balance and does an excellent breath-balancing exercise for the last 10 minutes that I find myself returning to, frequently.

Second – Hydrate. You know you’re not. I know you’re not. I cannot state in strong enough terms the importance of being extremely well-hydrated right now. You should be drinking enough water (DeathWish coffee does not count and you know who you are! (Me! It’s me!)) that you need to pee every 90 minutes or so. THAT is hydrated. Do it. Put a tall glass of water next to your bed at night and drink the whole thing before you are allowed to check your phone in the morning. Curse me for delaying your a.m. phone fix – I can take it.

Third – For those of you who are really scared for your personal health, please don’t forget the following:

It is still cold season

It is the beginning of allergy season

It is still flu season

AKA “Not Every Symptom Is COVID.” Also, my gentle reminder that most people who do contract the coronavirus (and that will, eventually, be most of us) will recover without any problems whatsoever.

Which brings me to the big topic of conversation in Illinois this morning: Shelter In Place.

Let me open with this for anyone out there who is calling this order “draconian”: This was absolutely the right call. We must, as Americans, institute a national policy of #Suppression.

The COVID-19 response team at Imperial College in London obtained the first accurate dataset of infection and death rates from China, Korea, and Italy. They plugged those numbers into widely available epidemic modeling software and ran a simulation: what would happen if the United States did absolutely nothing (i.e. if we treated COVID-19 like the flu, went about business as usual, and let the virus take its course) vs. what happens if we run a Mitigation strategy (i.e. pretty much what common sense would tell us to do: America places all symptomatic cases of the disease in isolation, quarantines their families for 14 days, and orders all Americans over 70 to practice social distancing) vs. what happens if we run a #Suppression strategy.

A Suppression strategy means that, in addition to isolating symptomatic cases and quarantining their family members, we implement aggressive #SocialDistancing for the entire population. This is what the Illinois Governor has ordered starting today at 5:00 p.m.: All public gatherings and workplaces that do not provide essential services will be closed. Our schools and universities were closed a week ago, and our restaurants and bars have been closed since mid-week.

Of these three strategies, SUPPRESSION provides us with the lowest death rate by at least an order of magnitude. It gives physicians, nurses and hospitals a fighting chance to get COVID care operationalized and diminishes the overwhelm of our ERs, ICU beds and ventilators. Radically flattening the curve saves lives.

*Please note that these simulations assumed a realistic rate (about 70-75%) adherence to these requirements. There was recognition that in an open country such as the U.S., we have to rely on folks to act in the best interest of each other, not self. The modelling takes into account that not everyone will behave in the best interest of America and Americans by adhering to #PatrioticIntroversion

What does radical social distancing, AKA #PatrioticIntroversion, look like? Well folks, I hate to tell you but it ain’t fun and games:

1) No playdates. Please stop it. No adult playdates, either

2) 6 feet of distance between you and others. Yes, please do go out for a walk. Yes, please do go to the store for yourself (if you’re healthy) or for someone who is elderly or medically fragile if necessary. Just keep a large physical distance between you and others.

3) Stay home. Mostly, that’s it.

I get this isn’t a terribly sexy war.

But we desperately need to Buy Us Time. American Individualism has always been a cornerstone of our national identity, but at this moment in history, we are called to something bigger than self. #Staythehellhome isn’t a typical call to action, and it isn’t a terribly satisfying one, either – we Americans like a good brawl. We like to face the enemy, kick its ass and know the faces of the lives we’ve saved. But we can’t pick a street fight with this virus: it requires that we heed the science and work together (separately!) if we are going to win.

Everywhere you turn right now you’re likely hearing from or about physicians, nurses and hospitals who are asking the public for help. Think for a minute: have you ever seen anything like it before? The people who have dedicated their lives to taking care of and saving others are saying, “please, stay home.” They’re telling you that they do not have the tools or personal protective equipment they need to stay safe, themselves, and yet they’re going to work, anyway.

Honor them by doing your part, please.

Meanwhile, there are some absolutely wonderful and many hilariously funny memes and gifs floating around out there, so my closing #Resiliency strategy for everyone today is to remember to laugh. Irreverent humor is totally fine (and when coupled with lots of swearing, it's my favorite). Dark and twisty humor is favored by health professionals. It's ok to be funny.

Be courageous, be generous, be gracious and be kind, always.

More soon,


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