Keep it Real
MEDICAL AND MENTAL HEALTH UPDATE
What a week, and it’s only Monday!
I’ll provide a COVID update below, but first let’s face it: with so much bad news, it’s easy to feel helpless and scared. We are anxious, sad, and angry. We want to scream, cry, and escape this unpleasant—and seemingly unending—reality. And we do. Some of us stare at the ceiling at 4 am, while others of us numb uncomfortable feelings with ice cream, booze, drugs, and good old fashioned denial.
Still other people are wonderfully learning the guitar, getting in great physical shape, and stenciling their own bathroom wallpaper. Yet another patient of mine last week described the unpleasant emotional consequences (“killing me softly”) of ingesting social media images of toned bodies, picture-perfect meals, and families on vacation when they themselves feel vulnerable, afraid, and lonely.
I get it. When we are happy and thriving, we want to share it! We want to tell the world about our homemade granola! After all, social media is a HUB for the human interaction that we crave so badly. Let’s be happy for those who are thriving. Indeed, it’s great for those fortunate enough to use this time for self-improvement and healthy living.
But let’s also be real: this is taking a toll on all of us. Most people are suffering quite a lot—and often behind the scenes. (Hats off to anyone posting photos of their acne, cellulite, or burnt toast. I love you already.)
Then think about how WE could author our own stories right now, get back in the driver’s seat of life, and take control over the parts of our lives that we can control. It’s possible. We are wired for survival, people! And when we lean into our discomfort and dare to face unpleasant feelings—and then make necessary behavioral changes—miracles can happen. Why do you think I go to work every day?! Regular people are infinitely brave and resilient. That includes you and me!
OK, so now for the POST-PEP-TALK REALITY CHECK—and answers to some COVID FAQs from you:
COVID-19 cases have climbed to approximately 60K per day.
Some people are saying that the case rates are climbing simply because we are testing more people. WRONG. If you look at the “percent positives” of tests (i.e. the number of positive tests relative to the number of total tests administered), THAT also is increasing, as is the number of hospitalizations. Long story short: cases are definitely increasing. Why?
Because of reopening, remingling, and reconvening. Recall that our only defense against the virus is our own behavior. And it WORKS! We were doing pretty well for a while, and some states continue to beat back the beast of COVID-19. But when states reopen too soon or without adequate safeguards, the virus surges. The virus’ behavior hasn’t changed; human behavior has.
So why are the case numbers rising but the death rates are not?
Younger people are getting infected more frequently than older people. Why? Again, because of behavior. Older and more vulnerable people seem to be generally taking precautions, whereas younger people are often liberalizing their behaviors (many times without a choice—e.g. going to work without adequate precautions) and getting sick as a result. And when younger people get infected, the death rate tends to be lower because younger people die a lot less frequently from COVID than older people do.
We are getting a lot better at treating our sickest patients. People of all ages are dying less. The evidence is rolling in—specifically the gold standard randomized controlled trials—on therapies like Remdesivir (antiviral), dexamethasone (steroid), and anticoagulation (blood thinners) to keep our sickest patients from dying. That’s GOOD NEWS!
It takes time to die. In other words, as cases surge, we will probably see an uptick in deaths in a week or so. And in some places where ICU beds, protective equipment for healthcare workers, and testing supplies are short, more unnecessary deaths are likely to occur. It’s difficult to process this distressing information when we know it didn’t have to be this way.
We are completely capable of shutting this virus down as many other countries have. We need the political will and personal commitment from each and every one of us. I am ever optimistic and hopeful that we will get through this, but unfortunately it appears it’s gonna be a while. Maybe it’s time to learn the guitar after all.
In the meantime, try to sweat every day (with exercise), prune your media inputs, and don’t SWEAT IT if you don’t make your own prunes.
I will check in later this week to discuss antibodies, testing, herd immunity, and the possibility of a vaccine.
But first: Join me and Dr. Clay Ackerly for a Facebook LIVE Q & A TONIGHT at 8 pm, with a special focus on school reopening! See you there.