The following blog post is my personal predictions and an action plan about COVID-19. I don’t represent any group, employer or any other healthcare professional and the following is not medical advice.

It has been three weeks since the first case of SARS-CoV-2 ((Novel Coronavirus) presented in my hospital in South Jersey (March 6th 2020). Since that time I have become increasingly alarmed by the spread of the virus and the potential for devastation. My fear has always been that many patients and frontline healthcare workers will die during this pandemic. Some colleagues have agreed with me, others have labeled me alarmist. My only motivation has to speak the truth and make sure that we are well-prepared as a society to face this war against an invisible enemy.

In order to move away from ranting on Facebook I decided to publish an op-ed in The Philadelphia Inquirer. I urged politicians to make bold and unpopular decisions to ensure social distancing was followed: “We haven’t paid attention to the lessons from the catastrophe unfolding in other countries. We need politicians with the guts to close all schools, mandate that sporting and entertainment events are canceled, and coordinate a response with neighboring areas.” I don’t know if it made any difference, but it seems that many others are calling for the same restrictions, and in some parts of the country – they are being implemented.

On March 9th 2020 there were only 16 deaths in the United States from COVID-19 and now fast forward nearly three weeks and we are beyond 1000. The U.S. has more confirmed cases of the coronavirus than any other country with 85,000 cases and nearly 1,300 deaths. The sad truth is that we are likely no where near the apex of this tragedy and life seems forever altered. People are dying, we cannot socialize, children have been pulled from school, our work and financial lives have been disrupted, our economy is tanking, and healthcare professionals are overwhelmed. To add insult to injury, many of us in healthcare are facing the harsh reality that we don’t have enough personal protective equipment (PPE) or vital tools like ventilators, and the flood of patients is only expected to increase.

I’ve been constantly anxious about getting infected myself, but more-so about potentially infecting my family and making them sick. Coworkers have confided in my that they’re scared of leaving their children as orphans, others have threatened to walk off the job if we aren’t supported with adequate gear, and there is a sense of doom palpable around those who work in the hospital setting. Despite this – we all show up to work each shift because we took an oath to take care of patients. I’m not talking about some spoken aloud oath at a white coat ceremony or graduation – but that personal oath we take everyday to stay working in clinical care and on the front lines.

My Predictions about COVID-19:

Unfortunately I don’t think places of public gathering (or schools) can open until the end of summer. Even then, in reality we may be fighting a long drawn our 12-18 month battle and through winter at the end of this year we may even face a second wave of infections. Along with strict social distancing, a vaccine seems to be our best hope to contain this infection.

Many more people will get sick, and an unfathomable number will die. Pragmatic folks love to make comments like “influenza kills 30 000 people” or “car accidents kill many more.” However, even putting aside worse case scenario modeling that shows “1.7 million people could die” in the United States – some quick math reveals an alarming figure.
325 million population x 30% of the population infected x 0.5% mortality = 487 500 deaths.
I chose 0.5% mortality because Germany’s rate has been the lowest (vs Italy’s of 10% mortality!) and I hope with the tremendous resources of our country we can make dramatic interventions. Even if the spread ends up being half as bad, the projected deaths are still in the order of 200 000 – which would make it the third leading killer of Americans in a 12 month period (after cancer).

From the CDC – the causes of death and numbers per year in the US are as follows-

• Heart disease: 647,457
• Cancer: 599,108
• Accidents (unintentional injuries): 169,936
• Chronic lower respiratory diseases: 160,201

So What Should We Do:

1/ Figure out how to get healthcare professionals appropriate protective gear and hospitals the right equipment.
If society can’t protect those who care for patients, this battle is lost. There are reports of nurses, doctors and healthcare workers dying and this travesty cannot go unchecked. We are human and of-course susceptible to all diseases, however we should have the appropriate gear to do our jobs. Also, it seems obvious – but the world’s richest country should be able to ensure patients don’t die because of lack of ventilators. I keep hearing about the “Defense Production Act” – so why aren’t existing companies using their factories to make ventilators?

2/ Enforce even stricter social distancing.
As painful as the current restrictions have been – we are likely going to have to make more sacrifices if we want our citizens to survive. It makes little sense to have hundreds of businesses open and thus exposing shoppers and workers to coronavirus. Some townships have a dedicated hour early in the day for senior citizens. However, all businesses should likely have restricted hours for each age-group throughout the day, so that we minimize the number of shoppers at one time. There is no way that community spread isn’t worsening because citizens are forced to shop with hundreds of others to ensure they have adequate supplies to survive.

3/ Protect the elderly and immunocompromised.
Do whatever it takes to keep those dear to you inside their houses. Go shop for them etc. It is life-threatening for vulnerable populations to venture out into stores at the present time. We are all at risk of succumbing to this illness, however the data clearly shows fatality worsens with increasing age.

4/ Mentally prepare for life to not return to ‘normal’ for 3-4 more months.
Schools being closed and people not working has put unprecedented financial and mental stress on millions of households. However, it is completely unrealistic to expect that while numbers continue to go up worldwide and in our own country – we can magically reopen for business as usual.

5/ Support science over politics.
We are all going to inevitably pay a price for this historic pandemic (health or financial). It is in our best interest as a species to listen to scientists rather than get caught up in rhetoric and risking even more horrific outcomes.

Just a regular old surgical mask per new CDC guidelines

My daughters and I after I’ve stripped in my garage, decontaminated all of my stuff, showered – I can finally see them after a shift

Weekly allotment of N95 mask – with a daily surgical mask.