An open letter from Dr. Michael McLoughlin regarding COVID-19

The number of cases of COVID-19 reported daily across the country continues to increase. On Friday, July 17^th a new single-day record was set with just shy of 75,000 new cases reported in the country and the overall trend remains upward. The number of new cases and hospitalizations in Iowa also continue to rise. Our current number of cases is similar to the prior peak in early May.

I’d like to explain a few aspects of the current situation, but primarily I have a plea. The plea is this: please wear a face covering and be very thoughtful about the close contacts you have with others. I don’t like it any more than anyone else, but it works and is the only real chance we have of preventing further spread that is going to disrupt our economy, our schools, and many people’s lives without a vaccine (or the unnecessary suffering that it takes to reach herd immunity the natural way).

To the explanation of why I think this is so important:

Even though most people will recover, this virus is dangerous. In Wright County we have had 418 known positive cases. Of these patients, 19 have been hospitalized and 6 have had to be transferred to intensive care units. Fortunately, only one has died. These numbers mean that over 1 out of every 25 people in the county that we know has gotten the virus has been hospitalized. Approximately 1 out of 70 has been admitted to an intensive care unit. That is even with the fact that only 6% of the cases in the county have occurred in people over the age of 61, who are the highest risk group for severe illness. Of the 6 individuals who have been admitted to the intensive care unit, 3 have been under the age of 40. I am certain that there have been more people infected than we know about in the county, but there is simply no other common infection that is anywhere near this severe. If we start seeing more of our older adults getting infected, this is going to look a lot worse. Please don’t be fooled by seeing the number of infections rising but not the same large increase in hospitalizations and deaths. Many people who are going to need hospitalized don’t require this until they are in the second week of illness. The deaths tend to increase several weeks after the infections rise. Our treatment has improved some, but I take care of COVID-19 patients in the hospital and can tell you it hasn’t improved enough yet that we should lower our concern substantially.

We also have to keep in mind that the infections that are being reported today are infections that actually occurred at least a week ago in most cases. It takes 5 days on average for a person to develop symptoms and then typically two days for test results to come back. So there’s always a delay. A virus spreads exponentially; every person that gets infected today has the potential to unknowingly infect several more down the road. Our actions today when the risk seems low are what can keep it low in the future. When we see it get out of hand it’s already too late.

But what can we do, you might ask? Remember – this virus doesn’t randomly appear in the air. It’s carried by humans to infect other humans. The vast majority of this spread is from respiratory droplets that exit the mouth and nose and get to the face of another person who is within 6 feet. That’s why avoiding unnecessary close contact and using face coverings is so important. If you don’t get close to someone, it’s very unlikely they could infect you. Face coverings decrease the distance that virus particles travel from several feet down to just a couple inches. Most of us don’t get within a few inches of many people on a regular basis. These measures are incredibly important when dealing with a virus that can spread even from someone who doesn’t have symptoms, as COVID-19 can.

As an example of how we know asymptomatic spread happens with this virus, one of the local nursing homes had a patient develop symptoms. None of the patients in the facility had left the building and no visitors were being allowed. Every single patient and employee who had been in the facility was tested, and the only employees who were positive had no symptoms. There is no other explanation for how the virus could have gotten to this facility besides asymptomatic spread.

If you don’t think the virus is dangerous enough to you or you are offended about your personal liberty being restricted in being asked to wear a mask, please just think about others. Again, everyone who doesn’t get infected can’t spread it to the next person. So when we take precautions, we may be protecting someone else’s grandparent down the road. Or we may be helping make it possible for someone’s business to stay open when their employees stay well. Or we might be helping to keep it safe for our teachers to be in school this fall. Or we may be helping there be a chance to have a football season. This isn’t about any one of us. It’s not a political issue or a control issue; it’s a love-your-neighbor issue. And hopefully we can all agree on that and know that a little inconvenience now is worth it even when the risk seems far off.

Most people who will read this know that I’ve advocated for getting kids back in our local schools this fall. This is necessarily dependent on how widespread the virus is in the community at the time. I’m very worried that if we don’t make changes now that the risk of putting students and teachers back in the classroom will be high enough that it won’t be safe to do so even with precautions. Let’s act now and keep the number of cases in our communities low so it is an easy decision.

Dr. Michael McLoughlin
On behalf of Iowa Specialty Hospitals & Clinics and the Wright County Board of Health