The following is a guest editorial by Dr. Duane Rommel, M.D. Duane graduated Alpha Omega Alpha, with highest medical honors, from Stritch School of Medicine in Chicago; trained in Pediatrics at the Mayo Clinic in Rochester, Minnesota, and now practices Pediatrics with Children’s Medical Center in Palm Harbor, Florida.
Fantastic News! The coronavirus pandemic is not as scary as we thought.
In the last 2 weeks, surveillance data has shown that the Covid 19 virus is much more widespread than testing had been able to show, because of the limited testing previously available. As a medical doctor, I’ve been anxiously waiting for these results of antibody testing. The surveillance statistics from this shows the real numbers of people who have been infected with Covid 19. Two of the most recent surveys were reported in the Wall Street Journal’s interview (April 25, 2020) with Dr. John Ioannidis, professor at Stanford’s school of Medicine. He’s a well regarded expert in statistics, biomedical data, prevention research and health research and policy. The surveillance testing showed that in a random population in the Stanford area, the infection rate was between 50 to 85 times the number of previously confirmed cases. This data has been confirmed by surveillance studies in high incidence areas in New York recently.
This is great because it demonstrates that the Covid 19 fatality rate is between .12 to .2%. This is far less than the initial reports of a fatality rate of 2 to 4 %. Also, of the fatalities, only 1% of the deaths involve people under the age of 65. Therefore the fatality rate for Covid 19 is .0012 to .002% for people under the age of 65. This rate is the same of most seasonal flu illnesses every year. This is the key statistic that all public health decisions are being based on.
I’m excited about this new data because I’m a primary care physician. My son and daughter-in-law are also primary care physicians. We are uniquely qualified to analyze this data, as practitioners in the medical community. We routinely digest research and statistics from the the ‘experts’ in university and government programs, such as the CDC and FDA. We continually have to make judgments for our patients based on real life applications of medical .research and statistics. We practice evidenced-based medicine, which means we make decisions based on scientific data. However, statistics can be interpreted in different ways, depending on the biases of the physician looking at the numbers. Medicine is not an exact science.
The first rule of medicine is “Do no harm.” The next rule is that when a patient comes to us, we weigh the risks versus the benefits of the treatment which we are prescribing. As this applies to our current situation, the nation’s physicians, Dr. Anthony Fauci and Dr. Deborah Birx have prescribed a “stay at home” treatment program for our country. Based on their knowledge at the time when they made this prescription, this was the best treatment course of action. Now, with the new information about the surveillance data, we need to adjust our treatment program.
In light of the latest scientific data, we are doing more harm than good with our treatment program. . First, in the field of medicine, I am referring to the delaying of medical treatments and prevention. The statistics are clearly showing that childhood, life-saving immunizations are being delayed. Screening tests for breast cancer and colon cancer are not being done. Patients are afraid to go to the doctor to get their diabetes or chest pain evaluated. Medical problems are being caused by our current treatment program which are leading to an increase in mortality greater than the pandemic.
Other ancillary problems of our national shut downs are more difficult to quantitate. Job loss leads to lack of meaning in life which leads to depression. How will we tabulate the suicides related to our isolating treatment program? Fear and anxiety contribute to physical illness. This is where primary care physicians are in a unique position. We see the whole patient, not just the Covid related concerns. We see the stress to our patients which is being caused by our treatment. I have not even touched on the economic pain and disruption since I am not an economist, but that is interwoven with our current treatment.
The major objection to changing our current treatment plan is that people will die. As physicians, we know that people die every day. We also know that there are many illnesses for which we have no good treatments. When a child comes to see me with a stomach virus, I routinely tell parents that the infection has to run its course. I have no treatment for the infection. I can make sure the child does not get dehydrated but I cannot cure the virus.
This is the case with most viruses today. We have no treatment for Covid 19. We cannot stop this infection from infecting 60 – 70% of people eventually, despite the public’s most vigorous practices. When the virus entered our country, medical advice pushed for us to ‘flatten the curve.’ This means that we were trying to spread out the infection over a longer period of time. There was never a cure. The same number of people are going to get the virus: either now or later. Covid 19 is a highly contagious virus. This is the truth that I am not hearing from the leaders of our government, being advised by our medical community. ‘Mitigation’ does not mean ‘cure.’ Your infection with Covid 19 may not happen in the next month but it will certainly happen in the next 12 – 18 months. A vaccine is too far off for any help. No responsible medical expert has promised any cure with our current stay at home guidelines. Unfortunately, most people think they’re not going to get the virus if they work hard enough. That is not truth.
We cannot make present medical decisions on “what if” possible treatments. With the new statistics showing a far lower mortality rate, we must reevaluate our strategy. We’re creating problems now and for the future with our treatment plan. As a doctor, I make decisions based in the scientific facts of the here and now. Consider the fatality rate. That is the good news. It is not Ebola virus. It is proving to be similar to a flu virus, despite what the news has trumpeted with its 24/7 hospital videos and incoherent number counts.
In light of this latest scientific information, government and medicine must lead our country with a new treatment plan. We need to let the public know that we do not have a cure for coronavirus and it will have to run its course. We will monitor the course, to make sure it does not overwhelm society, but there are not any cures for viruses. In mercy, we need to remove the gigantic layers of guilt we’ve laid on the general population; that by our own unhygienic practices, we are causing our loved one’s deaths.
We need to reeducate a panicked populace. First, we need to remove excessive “stay at home” directives. Encourage all people to resume all doctor visits. Start meeting with family and friends. Open up all retail and restaurants with reasonable social distancing. Allow all outdoor activities: playgrounds, beaches, kids sports and fitness centers. Reassess in 2-3 weeks the Covid 19 surveillance data. If the infection rate is reasonable, make more changes such as opening churches and other larger gatherings. Allow all domestic travel. As much as possible get everyone back to work. Responsible medical scientists will continue to monitor the numbers and statistics as we go forward to adjust for what we need to do.
The bad news, the hard truth that I am not hearing from our government and medical leaders, is that we have no cure for Covid 19 and you likely will get infected with it. The good news is that Covid 19 is nowhere near as fatal as the original estimates. The really good news is that when you get your infection you probably will not know you had it. Let us start behaving with that reality. We need to change our treatment plan and not harm the patient (our society) any further. As more scientific knowledge becomes available, we will continue to adjust our treatment program based on that science and the wisdom which God provides to us.
Disclaimer: My views may not reflect the views of Children’s Medical Center. Please consult your own doctor for specific advice in your situation.