Alaska’s emergency departments and hospitals are an inflection point. Now is the time we must take steps to slow the spread of COVID-19. If the health care system is overwhelmed, it would result in activation of “Crisis Standards of Care.” These predetermined standards provide hospitals a framework for deciding who to treat and who not to treat if they are not able to care for every patient. This would apply not only to patients with COVID-19, but all patients who are experiencing a critical illness, whether due to car accident, stroke, heart attack or sepsis from a serious bacterial infection.
Be wary of political leadership that points to previously low hospitalizations as a reason to delay or avoid measures to stop community spread. By the time hospitalizations reach critical levels, it will be too late, because the tide of infection will continue to rise for weeks after any public health measures are implemented. Alternative care sites outside hospitals have been touted as a stopgap measure, yet there are few trained people to staff these facilities. Hospitals are having trouble keeping their own beds staffed fully. National Guard members with health care positions often have a primary job in the civilian sector that needs them right now. When hospitals run out of space and staff, they have run out. There will be no rescue.
We can all agree that we want children in schools and businesses open; taking steps to limit the spread of COVID-19 is the surest, most sustainable way to achieve both of these goals.
Fortunately, we have a very good way to get there: avoiding large gatherings, maintaining physical distancing as much as possible, and wearing masks when unable. The science is not ambiguous or political — masks work. Masks prevent you from spreading COVID-19 to others, and protect you from getting it or will make your illness milder by lowering your exposure to the virus. We need everyone to exercise their personal choice to wear a mask when in public places. We need everyone to exercise their personal choice to avoid close contact with others unless absolutely necessary. Now is the time to cancel or postpone large gatherings. Now is the time to support local businesses via takeout or contactless pickup options. We Alaskans value our personal freedoms; we should honor our personal responsibilities.
The benign nature of COVID-19 for some has led to a complacency which has caused people to not take it seriously. But no one is completely safe from COVID-19. Someone with no symptoms can give it to someone who will get critically ill or die. Nor does beating COVID-19 mean you are out of the woods. We see “long-haulers” who remain sick for extended time, and many will be left with permanent damage to their hearts, lungs and nervous systems. Alaska thus far has an enviably low mortality from COVID-19 specifically because of its success early on “flattening the curve.” Let’s continue to be an example of how to control this disease.
Just as we came together after the November 2018 earthquake and at other times in our history, we can come together now. If it is truly the Alaskan way to look out for one another and act selflessly, then show that Alaska spirit by wearing a mask. Let’s not reveal Alaskans actually to be selfish or disinterested in protecting their neighbors. Don’t mistake the inconvenience of wearing a mask for oppression.
This pandemic ultimately will come to a close, and each of us will have to reckon whether we did everything possible to limit suffering. We hope we all will be able to look back and say, “I did all I could.”
Dr. Nate Peimann, Dr. Nick Papacostas, Dr. Dave Scordino, Dr. Russ Johanson, Dr. Stan Robinson, Dr. Leigh Wright, Dr. Chris Mickelson and Dr. Ben Shelton are emergency physicians from across Alaska. They are members of the board of the Alaska Chapter of the American College of Emergency Physicians.
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