While waiting for the Super Tuesday Primary Election results to become evident, it became clear to me that some thoughts about the COVID-19 pandemic may be more appropriate at this time. Indeed, I have been personally touched by the threats and fears posed by this situation. My church buddies and I have already postponed a cruise around Hawaii, and I just turned 72 years old, which puts my case fatality ratio at 8%.

The wise tact is for all of us to take this novel coronavirus seriously. The pandemic of 1918 killed 50 million people and changed human life on this planet as we know it. Hopefully we have the scientific knowledge, technology and collective resources to prevent similar worldwide carnage. Unfortunately, there are a set of obstacles presenting challenges to successfully and expediently taking control of this epidemic.

First of all, we need to keep our signals straight. It is incumbent upon all of us to listen to the scientific and medical experts in the fields of virology, epidemiology and public health, and take their lead in heeding warnings and recommendations. Political leaders across the world are exhibiting different degrees of cooperation with scientific leaders. China’s leadership in first acknowledging that it was the epicenter of the coronavirus outbreak and then putting up face-saving and authoritarian propaganda to minimize the problem was very suspect. They then repudiated and nearly imprisoned a brave Chinese primary care physician who tried to alert his fellow medical school classmates about the new epidemic. He went from goat to hero after he lost his life due to infection from the virus while working tirelessly to save his patients from infection in Wuhan, China. The Chinese finally came around to isolation and containment procedures which, at first, seemed rather Draconian, but have now proved somewhat effective in mitigating the disease in their country.

Meanwhile, in this country, we have experienced mixed messages from our political leaders who have frequently contradicted the advice of medical experts. At the time of writing, President Trump wisely appointed Vice President Pence to take over the reins of the political leadership during this health crisis, and he appears to be coordinating more effectively with the medical experts.

We are also suffering from a lack of sufficient number of test kits due, in part, to a misfire by the CDC in mass producing kits which were initially faulty due to too many false positive results. With few exceptions, notably Iran and maybe North Korea, most countries are coordinating their identification, isolation and treatment protocols with medical experts.

This lack of testing brings us to the “tip-off the spear” for fighting this epidemic in the U.S., namely within the Emergency Department. At the beginning of this pandemic, many medical offices were screening newly sick patients by telephone and referring them directly to the ED if COVID-19 was suspected. Besides creating a viral incubation environment for the coronavirus in the ED, threatening the health and safety of personnel and patients, a lack of test kits will confound diagnoses, which may lead to excessive crowding in ED’s and hospital in-patient services.

We already know we don’t have enough ICU beds or functional ventilators in this country. Hospitals and emergency departments are developing contingency plans to deal with the crush of potential coronavirus patients screening protocols, etc. Patients who feel that they may have been exposed to COVID-19 need to quarantine safely and seek medical attention if they become sick, especially if they fall into particular vulnerable categories of patients of older age and/or with serious underlying chronic medical conditions which include hypertension, cardiovascular disease, chronic lung disease, cancer, and other ailments. Personal interaction hygiene measures such as frequent hand washing, keeping hands away from your face and other people, avoiding people who seem sick, and avoiding large crowds which may contain sick people (social isolation techniques), are being promulgated throughout the country.

To my former mates in the ER, good luck and Godspeed. ■