Remember the scorn and derision heaped on anyone who said that the deaths caused by the shutdown might be just as problematic as the deaths caused by COVID-19?
We’re not laughing anymore — not with real unemployment likely at roughly 20 percent and estimates of deaths of despair creeping higher with each number we see.
And, if you’re one of those people who wants to listen to the experts, listen to these 500-plus doctors who signed a letter to President Donald Trump calling the shutdown what it is: “a mass casualty incident.”
The letter was written by Dr. Simone Gold, an emergency medicine specialist in Los Angeles.
“We are frustrated,” Gold said in an interview with Fox News Thursday, telling “America’s Newsroom” that “there are thousands and thousands of stories of patient harm” from the lockdown.
In the letter, Gold compared the situation to triage.
“During a mass casualty incident, victims are immediately triaged to black, red, yellow, or green. The first group, triage level black, includes those who require too many resources to save during a mass crisis,” she wrote in the Tuesday letter.
“The red group has severe injuries that are survivable with treatment, the yellow group has serious injuries that are not immediately life threatening, and the green group has minor injuries.”
The red group, she wrote, is the one that gets the most attention.
“Millions of Americans are already at triage level red. These include 150,000 Americans per month who would have had a new cancer detected through routine
screening that hasn’t happened, millions who have missed routine dental care to fix problems strongly linked to heart disease/death, and preventable cases of stroke, heart attack, and child abuse. Suicide hotline phone calls have increased 600%,” she wrote.
“Tens of millions are at triage level yellow. Liquor sales have increased 300-600%, cigarette sales have increased, rent has gone unpaid, family relationships have become frayed, and millions of well-child check-ups have been missed.
“Hundreds of millions are at triage level green. These are people who currently are solvent, but at risk should economic conditions worsen. Poverty and financial uncertainty is closely linked to poor health.”
This isn’t just abstract theorizing, Gold wrote. Instead, she provided examples that she or her colleagues have seen.
“Patient E.S. is a mother with two children whose office job was reduced to part-time and whose husband was furloughed. The father is drinking more, the mother is depressed and not managing her diabetes well, and the children are barely doing any schoolwork,” she wrote.
“Patient A.F. has chronic but previously stable health conditions. Her elective hip replacement was delayed, which caused her to become nearly sedentary, resulting in a pulmonary embolism in April.”
Another nursing home patient had a stroke and has been receiving no rehabilitative care, causing him to lose weight and deteriorate instead of improving. Another college freshman is unable to return to normal life, which puts him at risk of alcohol and drug abuse, depression and “future financial uncertainty.”
“We are alarmed at what appears to be the lack of consideration for the future health of our patients. The downstream health effects of deteriorating a level are being massively under-estimated and under-reported. This is an order of magnitude error. It is impossible to overstate the short, medium, and long-term harm to people’s health with a continued shutdown.”
“Losing a job is one of life’s most stressful events, and the effect on a person’s health is not lessened because it also has happened to 30 million other people. Keeping schools and universities closed is incalculably detrimental for children, teenagers, and young adults for decades to come. The millions of casualties of a continued shutdown will be hiding in plain sight, but they will be called alcoholism, homelessness, suicide, heart attack, stroke, or kidney failure. In youths it will be called financial instability, unemployment, despair, drug addiction, unplanned pregnancies, poverty, and abuse,” Gold wrote.
In her interview with Fox News, Gold said the evidence of the crisis is undeniable.
“I could read you heartbreaking story after heartbreaking story sent to me by physicians of patients that have died or suffered severe harm because they were afraid to go to the hospital and their own doctor’s offices were shut,” she said
Social media users have made the same point. One used a picture of Los Angeles County beaches, which were closed by the pandemic but reopened for the Memorial Day weekend, to illustrate the problem.
originally, this (the shelter-in-place order) was put in place to flatten the curve and to make sure hospitals have the resources to take care of COVID patients.We have the current resources to do that, and our other community health is suffering.” https://t.co/7LePYrSpJx
— VindiciaeContraTyrannos (@raphaellaN) May 25, 2020
“The last couple months have been historically low as far as volume, as far as screening, as far as cancer surgeries, basically because patients are concerned and very anxious to be going to a clinic environment, a hospital environment, because of their concerns regarding COVID-19 … Many patients are concerned about coming to visit us, to be screened for cancer, to be surveilled for their previous cancers we’ve taken out,” said Dr. Costanzo DiPerna, a thoracic surgeon in Carmichael, California, just outside Sacramento.
“What I’m concerned about right now, not just for lung cancer but for all cancers, is are there patients out there that don’t want to come in because they’re afraid of getting COVID-19? And, so, they avoid mammograms, they avoid cat scans, they avoid colonoscopies … Then in two years we’re hit with this massive wave of patients that are all at a later stage of essentially incurable cancers.”
DiPerna wasn’t a signatory of Gold’s letter.
Yes, the number of people who have died of the coronavirus is massive. However, the number of those who will end up dying from a complete shutdown is, as of yet, unknown — and it could end up being just as problematic.
When stroke evaluations drop 40 percent during the COVID-19 epidemic, there’s a real problem. It’s not that we were suffering from too many stroke evaluations before the virus struck. Instead, it’s caused people to put off necessary medical care, either because of fears of the disease or because that care simply isn’t available.
Make no mistake: This is a crisis. It’s already too late to stop the deaths of despair and neglect of health that this will cause. The question now is how deep it goes.
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