I’m a nurse, public health professional, soon-to-be nurse practitioner, wife of a pilot, caregiver to an elderly grandmother, pregnant mom of three, soon to be four, and best friend to a woman set to deliver her second baby any day. COVID-19 is all-consuming for me and I know I am not alone.
On March 18, I displayed some of the symptoms: fever, dry cough, sore throat, aches. I was one of the lucky ones who met criteria to get tested. As of March 29, I remain housebound, still awaiting results. Soon after, every member in my house became ill with similar symptoms and we all went through it at our own pace.
This is not a failure of our health care team; they continue to work diligently for the sake of their patients, often lacking essential supplies, rest, and staff. I was incredibly humbled when talking with a colleague while being tested. He said he and the nurse who was assisting were going to be the only providers conducting testing because “when (they) fall ill, we’ll need healthy providers to step in. We cannot all be sick at one time.”
The immense sense of camaraderie and dedication of so many health-care professionals is palpable and humbling. It is our job to protect them. I know several who have been waiting six or more days for results.
For me, personally, that is affecting nearly every area of my life; personal, professional, and financial. My husband, a pilot, is unable to return to work until we receive results in case he was exposed and it would help us determine if that was his illness as well. The airline industry is already quite uncertain, financially we need him to return to work while we are still certain he has a job.
It has eliminated my ability to get essentials for my grandmother or even simply wave to her from her window as she is isolated in her room alone. I am unable to return to clinicals to finish up my degree without results or even jump into the front lines to lend a nursing hand. Nor can we have our sitter over here until we know if we were ill with COVID-19. We continue to avoid our OB appointments until we know for certain what I had, leaving us wondering how our baby girl is doing in all of this as well. All of this leaves my family feeling anxious and helpless and I know we are not alone in those feelings.
Delayed test results convey false security
While personally this is frustrating, it is miniscule to the public health concern it raises. The numbers we continue to discuss in Iowa are not real-time, they cannot be when results are so delayed. This is portraying a false sense of security that the number of Iowans with COVID-19 is a tiny percentage of the total population of the state and that we are addressing the curve with all the right precautions in place.
Emergency response plans are based on the assumption that public health surveillance is available and accurate. Crucial decisions are then based on this surveillance. With lack of testing supplies, and therefore public health data, we cannot know the true community spread of this disease and only know that it will increase over the coming days and weeks. Without the rich data that public health usually relies upon, we must implement population-based measures to prevent disease spread in all communities across the state, and we must act now.
A shelter-in-place order is not a sole solution. However, it sends the message that this is not just the flu. It will give us means to enforce social-distancing recommendations, and it aids our health care community in preparing and not becoming overwhelmed. We must illustrate to Iowans the severity of the situation. Dancing around semantics for political gain does not help protect us.
Increased testing allows health-care systems to prepare
There are two prongs to an appropriate public health response: increased testing, and strong physical distancing measures such as shelter in place. Increasing testing does not necessarily change medical management of patients, but it does arm us with more information. It helps us be more prudent with already dwindling numbers of personal protective equipment such as face masks. It helps project future needs in health care essentials and staff, and prepare for the worst-case scenario. By allowing our system more time to prepare, access to accurate data, and enforcement of all measures to minimize spread, our incredibly competent health care teams will have the ability to arm themselves and decrease both morbidity and mortality.
Dramatic measures now will allow our communities to recover more quickly than continuing to address the situation in a small, stepwise approach. These measures must be clearly communicated to the most vulnerable among us, beyond the legalese and political press conferences that are currently the main strategy for sharing information.
Iowa’s health care system is incredibly integrated, with many critical access hospitals that play a crucial role in access to care. These hospitals already struggle for adequate supply and personnel and count on our urban hospitals to assume their critical patients. We must prepare our hospital systems to provide statewide care for critical COVID-19 patients.
Panic is not the answer, it only fuels dangerous missteps and oversights. Common sense, timely and clear communication, realism, and access to data are the weapons of success. We need more aggressive measures and we need them now. We need to learn from the states and countries that have already seen drastic COVID-19 impact.
If, at the end, the response seems like an overreaction, we will have been successful. It means we saved lives both in quality and quantity, we spared our health care system from becoming overwhelmed, and our community banded together for the greater good.
If nothing else, please listen to Dr. Emily Landon, chief of infectious disease at University of Chicago Medicine. Her seven-minute speech is worth every second. Dr. Landon warns, “the healthy and optimistic among us will doom the vulnerable.”
We live in an amazing state armed with incredible health care teams. Let us do our part in protecting it all and let us do it NOW!