Phillip Rozeman: Looking ahead – realistic expectations

1975

Over the last few weeks, we have watched the global pandemic and economic recession unfold on our television and computer screens. The phrase “flattening the curve” has become a part of most people’s vocabulary and tragic videos from hospitals and emergency rooms in New York City and Northern Italy are on all channels.

Prentiss Smith wrote in the Times, “People are afraid. People are anxious.” Those emotions are amplified by uncertainty about expectations. So what can we realistically expect over the next couple of months?

First, we can expect health systems will continue to provide relief to patients suffering from the complications of the COVID-19 virus. Leaders from Governor Edwards down to health system leaders will continue to spend their time thinking ahead – anticipating problems and developing solutions. Local physicians will continue to modify treatment protocols based on the best thinking of experienced people across the globe. Pharmaceuticals and clinical research will continue to develop new treatments, testing, and vaccines for COVID-19.

We can expect to continue to put into practice some form of social distancing until an effective vaccine has been developed and people inoculated. These efforts are relatively easy and have been effective in reducing transmission of this and many other viruses. Social distancing has been effective in flattening the curve of the virus in our community.

We can expect different prevalences of COVID-19 in different regions of the country and significant differences in the number of cases in different neighborhoods within the same community. As a result, restart efforts will be done at different rates in different communities. The COVID-19 virus will not magically disappear and be replaced by a roaring economy by the end of May. Victory over COVID-19 will come with a curative treatment, vaccine, or widespread immunity in the community.

We can expect a substantial reduction of complications of the virus if we concentrate significant efforts on reducing the spread of the virus in elderly people with chronic disease and people in high risk areas of our community. Aggressively managing high risk subsets (like done in nursing homes and the Caddo Parish Commission testing van to high risk neighborhoods) not only reduces risk in that subset but speeds the safe reopening of the economy and lowers the incidence of a second wave of COVID-19.

We can expect schools will open this fall. Children have a very very low risk of complications of the virus. We need to be ready with whatever resources to mitigate the transmission of the virus between children and elderly relatives and friends.

We can expect the development of benchmark health criteria to guide local decision-making in dealing with the health and economic crisis. These benchmark guidelines (new cases, hospitalizations, ventilators) are vital to judge the speed of modifying stay at home, business opening, and social distancing policies.

We can expect loosening social distancing strategies might result in some rebound of the virus. Flattening the curve does not mean the curve goes away. The key in each community is maintaining these rebounds as small blips and not a significant wave that swamps the health systems. It is the reason for continued monitoring, continued social distancing efforts, and continued willingness to be flexible and modify course as the future unfolds.

We can expect tension between efforts to control the illness and restart our economy. This tension between two very important issues is predictable and handling that tension will require leaders to acknowledge that personal perspectives are different. This difference in perspective may be based on everything from individual tolerance of risk to individual personal experience with the pandemic, health risk, and economic situation. As noted by Louisiana Senator John Kennedy, we “need to save both lives and livelihoods”. We must do both.

We can expect widespread testing to be a focus in reopening the economy. Health officials and the U.S. Chamber of Commerce are calling for expanding testing. However, there is significant doubt this robust and widespread testing strategy can be delivered as envisioned. At this time, there are just not near enough tests for everyone to have ongoing testing.

In addition, there are warnings from scientists over what tests are accurate as well as questions about the degree of immunity conveyed by antibodies. For now, we need to develop a plan that does not depend too heavily on testing everyone. We will implement the plan and monitor progress and add new testing provisions as they are developed.

We can expect there will be no silver bullet solutions for reopening the economy. Ripping off the band-aid is not the best approach. A graduated approach better serves our community. We can expect businesses, Chambers of Commerce, local government, faith-based and nonprofit leaders to have a big hand in implementing restart efforts. Along the way, consideration will be given to long-term reimagining efforts in our state and community. Could Shreveport-Bossier benefit from moving pharmaceutical and critical supply chain manufacturing back to the United States?

We can expect that the reinstitution of long-term strict stay at home and temporary business closure strategies will result in the same outcomes for the economy as noted in the initial use of this strategy. We simply cannot afford another round of massive unemployment. This means we have to work together to prevent a second wave of the pandemic.

And most important, we can expect doctors, nurses, and respiratory therapists to continue to care for those with COVID-19 without expressing fear. We can expect small business owners to give to their employees more than they can really afford. We can expect volunteers to work 18 hours a day at food banks. We can expect Americans to innovate to help others.

We can continue to expect random acts of kindness to be numerous. People overcoming fear and anxiety. People expressing love for each other. People caring for each other. People working together. People building a greater future for our community and nation.

Dr. Phillip Rozeman is a practicing cardiologist. He is past board char of the Greater Shreveport Chamber, Blueprint Louisiana, and Northwest Louisiana Medical Society.