Sex, Drugs, and Public Health

It’s been a month since I wrote the last article of Public Health Notes, but it feels like years have passed. I’m guessing a lot of you can relate to that. During that time, I find there are parts of my brain I can’t shut off. So I’ve been comparing Epidemic curves of various countries, calculating Prevalence rates and studying Coronavirus genetic mutation. Then I analyze what measures other countries took in an effort to control the virus, and the results they had. Figuring we should be able to learn from that and apply the measures that appear to work.
When I take a break here in Home Isolation, a different part of my brain elaborates, whether I like it or not, the eleven Phases of Coronavirus.

1. The PHASE OF FASCINATION : A new disease in a far away place. Yet again, a pathogen has jumped from a different species to us following in the footsteps (metaphorical; few disease have feet) of many other human infections. And such a pretty virus with its crown and all.

2. PHASE OF HOARDING: clearly a symptom of anxiety, causing abnormal behavior. Ironically, this behavior empties shelves which only increases anxiety among friends and neighbors. Therefore, hoarding is a communicable disease.

3. PHASE OF WEIRD FOOD: hoarding means getting food that won’t spoil over two to four weeks. Which means a change in what you eat. Like lentils. Those colorful little round things that have been on your shelf, untouched, for ten years. Hint form Dr. Mosher’s kitchen: they’re much less chewy when cooked. Also, you can never have too many tortillas.

4. PHASE OF BAD JOKES: see Facebook. Lots of toilet paper – themed comic relief. Parenthetically, my four year old granddaughter continues to insert the word “poop” into almost any sentence, followed by joyous laughter. Perhaps we never outgrow that. What do millennials from San Francisco call Covid-19 disease? “The Boomer Remover,” which I find personally insulting and, if it weren’t for the fact that I can’t leave the house, I would go to S F and straighten out.

5. PHASE OF DENIAL: wherein self-centered college kids congregate by the hundreds on Florida beaches and subversive elements hold “Coronavirus parties” and packed religious services, imperiling everyone.

6. PHASE OF SUPERSTITION: a hundred and fifty years ago, bearded men driving covered wagons roamed the west (anything beyond Pennsylvania), hawking magical cures and preventatives in brown bottles. The delivery system has changed, but human gullibility in the face of fear has not. Examples all over the Internet.

7. PHASE OF ALCOHOL: No. Not hand sanitizer. The same chemical but in different form. Beware this infamous Retirement Trap. Set a limit that you consider reasonable (I used to recommend no more than three drinks a week to patients on drugs that could effect the liver). On Home Isolation, alcohol is not the magical cure for boredom.

8. PHASE OF DUELING INFORMATION: anyone can come up with a theory. And anecdotal reports can be misleading, which is why we conduct clinical trials. Proving that a given therapy is safe is a major component of such trials, as is proving effectiveness. Depend on the advice of responsible physicians and your own good judgement. If you’re going to extract information from the Internet, be a good researcher and check several sources. Then you can put all that information together and, again, use your good judgement.

During this pandemic, against a virus for which we have no vaccine and no proven “magic bullet” treatment, our best chance is to slow the virus’ invasion into our community so that Health Care Workers can keep up. Follow the advice of the Public Health professionals, not politicians.

This is not “the economy” versus Public Health. Medical and Public Health professionals care about the economy like everyone else. It will come back. Always has. But people who die from the virus will not. Several economists have understood that our current economic slowdown is NOT AN ECONOMIC PROBLEM. It’s a Public Health problem. Control the pandemic and the economy will recover. First things first.

9. PHASE OF REJECTING THE JOHN WAYNE SYNDROME: hey, I loved cowboy movies when I was little. The Cisco Kid, Roy Rogers, Zorro. Maybe I was seduced by their clean clothes and perfectly shaven faces. Maybe the desire to be rescued is inherently human.

But I’ve learned in my travels, that our culture is unique in its worship of the lone hero: cowboy riding into the sunset; rebel cop single-handedly saving a city; fourteen year old with superpowers saving the planet.

But this is different. No hero will ride in on a white helicopter and save us. WE will save us. Working together as a community. Anyone of us messing around and ignoring the concept of Physical Distancing could sicken and kill many. But, together, we can all become Health Care Workers (see # 11).

10. PHASE OF “NOT OUR FIRST RODEO”: Public Health and medical people in most Counties have been through this before. We trained and drilled for pandemic responses to Influenza, Swine Flu (2009), West Nile Virus and Ebola (2012-14). Many of the folks who planned and drilled for these potential pandemics are still around. Moreover, Health Departments, hospitals, Ambulance services and first responders are getting ready again. But they need your help.

11. PHASE OF BECOMING A HEALTH CARE WORKER: if each of us follows the Public Health directions of Physical Distancing, home isolation, covering your cough, and calling your doctor if you get symptoms, that will transform our community into an army. It’s our best defense against the virus. It seems to be the action that worked in countries where the epidemic curve is low, giving hospitals, doctors, nurses, and other Health Care Workers time to fight.

The second action you can take in becoming a member of this army – becoming a H C W – is to send any N-95 masks you have to hospitals for use by the medical folks on the front lines. And if you have any surgical masks, send them also. The medical folks need the masks. Now.

If you have the skills, time, and motivation, you can also sew masks for the medical professionals.

Protect yourself and everyone else by behaving as if everyone you meet is infected. And meet as few as possible. It’s the safest way to win this war.