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  • Dr. Kemia

Tough Love

Updated: Apr 3


Dear Everyone:


This is a tough-love post.


I'm writing this one specifically for those of you who need to share it with people in your circles -- to those who may need a small, *loving* reminder that if they aren't aggressively social-distancing, aka #StayingTheHellHome, to help #FlattenTheCurve, they are putting every single American citizen, and the American economy, directly in harm's way.


If you and everyone you know and love is already doing their part, feel free to skip to the bottom. If you have already done your part by warning everyone and you really don't feel like reading scary stuff today, also skip to the bottom.


If, however, you or someone you know and love is wondering what the actual hell we're accomplishing with all of this other than driving the economy into the ground, OR if you or someone you love is physically indestructible and therefore unafraid of the big bad #Coronavirus, please read on.


NOW is the time to hunker down. Today. (Well, really, yesterday or even the day before). But seriously: Right NOW.


This post is long, but I want everyone to really understand the modeling and what is going to happen. Ready? Here we go...

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The U.S. is approaching a peak acceleration point in #COVID-19 infections. Over the next two weeks in many states, we will begin seeing a rapid acceleration in the number of cases (particularly in those states that are geared up to do more aggressive testing). We are going to see increasing reports of hospitals that are overwhelmed. We are going to see dramatic increases in the death toll, both nationally and in every state.


I do not use hyperbole when discussing matters of science, public health or medicine: IT IS CRITICAL that we stay home and completely minimize all interactions in the next few weeks. It is LITERALLY a matter of life and death. Each one of us have daily decisions in the weeks to come that WILL either save lives, or will cause the death of those who would otherwise have survived.


The Institute for Health Metrics and Evaluation (IHME) has some of the best and most understandable modeling about where we are headed in the U.S. regarding the Coronavirus pandemic. As of today, and based on forecasting that assume whatever protective measures your state is taking right now remains unchanged, the U.S. as a whole will hit peak hospital overload on April 16th.


The peak in infection, hospital capacity/overload and death will vary by state due to differences in how they timed and how aggressively they deployed at least 3:4 of the necessary strategies for #Suppression: School closure, closure of nonessential services, stay-at-home orders, travel restriction.


The peaks will come slightly earlier in the states (NY, NJ, LA, MI) we've talked about here previously. They were hit harder, earlier, and suppression strategies weren't deployed or adhered to fast enough in those populations.


Nationally we are anticipating that on April 16th we will have more than a quarter of a million Americans hospitalized. The overall anticipated hospital bed shortage is 85,000 with a deficit of 19,000 ICU beds. Because of this shortage and because of how widespread the virus will be, that peak will be accompanied by high, daily death tolls.


What can we do as individuals to improve this prediction?


Stay. The Hell. Home.


Seriously folks: no trips to the grocery store to pick up "a couple" things. No trips to a second store to find something the first store didn't have. No taking your kids on an outing to the store because y'all just "got to get out of the house." No playdates of any kind. No visits with family who don't already co-habit with you.


Can we please, PLEASE just agree that this *&#! virus is bigger than us as individuals. Can we please, PLEASE all understand that the smartest minds in the country - in the WORLD - are working on this and that with one voice they are begging us to stay home.


Doctors are infected, on ventilators and dying. Nurses are infected, on ventilators and dying. There isn't enough PPE, there aren't enough beds, and most importantly, there aren't enough doctors and nurses. Police and EMS are endangered with even the most routine of calls. Working in a grocery store is now a high-risk profession. Everyone in these jobs is putting themselves at risk to ensure that your life is safe. We honor them by taking shelter-in-place orders seriously.

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I know this isn't the first time I beat on this drum, and some of you may wonder why I've chosen today to jump on the table with an extra big megaphone. There's a good reason why *today*


If you look at the IHME modeling link you'll be able to determine when the peak is predicted to hit your state. If you live in an area that is peaking in the next 2-3 weeks, or if you have friends or family who do, it is VITALLY important that you and they minimize any possible exposure for the next 3 weeks beginning NOW.


On average, patients infected with COVID-19 who get worse and need hospitalization present between days 8-11 of their infection. This means that if you get sick NOW, and your state is predicted to hit maximal overload in two weeks, you will potentially need hospitalization precisely when resources are the most stretched.


This is the point in the conversation where I'd tell my kids, "Look. At. My. Face. I'm not screwing around."


Stay home. Batch your grocery shopping and send only one person. Wash your hands obsessively and correctly and break any nail-biting, nose-picking habits once and for all. If you are the designated someone who leaves the house because you are essential services or you are the shopper, leave shoes outside and strip out of and wash your clothes and yourself when you get home.


We've been talking about Suppression and flattening the curve as our duty to one another as Americans: it's how we buy time for our hospitals to gear up. It slows the spread and allows for better data to inform our decision making. Right now, I'm talking TO YOU about protecting YOU. For at least 2 full weeks before your specific state hits its peak, take every extra precaution you can so that you don't become one of those who need care when it is scarcest.


And NO, insert-name-here, this doesn't mean that if your state isn't going to peak for another 3-4 weeks you have a free pass to make things worse by living your #bestlife as if nothing is happening. Our duty to one another as #Americans is to do every last thing we can to flatten the curve, and that means being as aggressive as possible every single day in minimizing our contact with others.


Still need the selfish reason? Look at the graph. In many places, even though the peak infection is delayed they STILL hit an ICU bed deficit in the next couple weeks. Now is not the time to get sick. Now is not the time to need hospitalization. Take care of yourself, please.

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It feels really important to remind everyone that this modeling is based on current, state-by-state mandates and tracking. It is also predicated on our compliance with those mandates. If we make decisions to do what is right, we can push those peaks farther out, flatten peak demand, and avoid overwhelming our ability to deliver healthcare to everyone who needs it.


WE are the solution. We can fix anything but dead, friends.

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I don't want to end without saying the following, too:

EVERYONE'S emotions are running high. EVERYONE'S coping strategies are running thin. Compassion fatigue is already ramping up, economic fear and realities are driving decisions, and none of us are getting a damn thing accomplished at home as we try to work, teach, parent, cook, clean, exercise, manage emotions (ours and other's) and simultaneously socially-distance while staying connected.


Right NOW is the time to reach out to the coaches, mentors or mental health providers you may need. There are lots and lots of virtual resources available, including phone and video support. Depression lies. Anxiety lies. It tells us that how we feel right now will be how we feel, always. That the way things are right now are the way they will be, always.

These. Are. Lies.


We are on the upswing of the curve, but I PROMISE it is a curve and the down-slope will come. Knowledge of this allows us to plan and prepare accordingly, and part of that preparation should be focused on tending to our personal resiliency strategies every single day.


If I'm truthful, that statement makes even me roll my eyes a bit, because who has time for resiliency building in the middle of a crisis?!


We do. We have to. This is a marathon, and if we don't keep breathing, stay hydrated, stay nourished, stay rested, stay grounded, keep laughing, keep connecting, keep talking, keep naming and taming our fears and failures, keep doing all the things that help us self-regulate, we are going to burn out on mile 4.


I'll admit to never having run a marathon (I don't run unless chased) but mile 4 seems a pretty early place to flop over.


If you don't know where to begin in building your personal resilience, may I suggest picking one small, attainable goal. Read through my recent posts, find something that resonates and put it into practice. If you need something more immediate than even that, here is a link to my friend Becky's recent podcast with a fantastic grounding exercise that will help you restore autonomic balance.


We can do this, #SeparatelyTogether.


Keep asking questions. Keep connecting with the people who love you. Keep being brave, generous and kind, always.


More soon,

K


#FlattenTheCurve #Suppression #CareinthetimeofCovid #PatrioticIntroversion #America #WeCanFixAnythingButDead #ResiliencyCapacitance

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