My mom just got out of the hospital after two weeks. She almost died from COVID. At 82 she had been completely independent, an avid quilter and reader, tech savvy, still driving, balancing her checkbook, with one eye always on the news.
The first signs of her illness were mental confusion. My sister and I thought she had a stroke and took her to the ER. Only there did she spike a temperature. She tested positive for COVID, and a CAT scan showed lung involvement. We almost lost her several times during the admission.
Fortunately, although she needed oxygen, she never required a ventilator. IV steroids, plus a plasma transfusion donated from a COVID survivor, loaded with antibodies to fight the virus seemed to help. Although she survived, she is now extremely weak and confused and cannot be left alone. She can’t even remember how to use her smartphone. It’s too early to tell, but she may not be able to return to the life she loved.
The graphs illustrating a surge in COVID cases and impending deaths are obviously alarming, yet too little consideration is being given to the long-term damage to health for COVID survivors. People who live through the disease might need renal dialysis for kidney failure for the rest of their lives, regardless of age. Others might have permanent scarring of the lungs requiring oxygen or perhaps can manage on ambient air but will never be able to exert themselves again. Some will sustain long-term damage to the nervous system with physical weakness or mental confusion.
How does a society come to grips with an illness in which almost a third of the cases are asymptomatic while the vast majority have a flu-like illness that requires no treatment, yet 15% of cases require hospitalization where half end up on a ventilator with only a 50% survival rate?
Let’s look at how Hawaii has managed so far. It could be argued that our state has actually suffered from its early success in flattening the curve. Why? With so few cases and a downward spiraling economy in the absence of tourism, there’s been a misguided sentiment that we’ve overreacted at the expense of jobs. Consequently, we’ve let our guard down, and we are now paying the price.
Our political leadership has made some gutsy decisions in the face of this pandemic in an effort to save lives while preserving jobs. The original plan to open Hawaii to visitors starting today with pre-travel testing would have helped the economy while reducing, though not eliminating, COVID-infected travelers from entering the islands.
Upon further consideration, however, that plan proved to be too risky. With COVID surging on the mainland and now in Hawaii, the pre-travel testing program was wisely deferred. The situation is dire, but it is also fluid. Our leaders must continue to develop strategy according to evolving conditions, and they are doing just that.
Now is not the time to bring back visitors without a 14-day quarantine. This is the time for a total commitment to testing for prompt identification of active cases. Contact tracing is also crucial so long as the case rate remains manageable. At such time that pre-travel testing does come online to replace the mandatory 14-day quarantine, given the circumstances, it will probably need to be made more robust. It might need to include follow-up testing for visitors once they arrive in Hawaii, pending adequate testing capacity.
Now is the time for the people of Hawaii to redouble efforts to contain the pandemic locally. Each and every one of us must do our part. It is vital that we keep our gatherings to 10 people or fewer, continue to wear masks, wash our hands frequently and maintain appropriate social distancing. To the extent that it’s possible, we must remain in our own work-home bubble.
We can’t let down our guard, but we did. When Hurricane Douglas was approaching, the impending risk of high winds, torrential rain and storm surge distracted some from COVID prevention. It comes as no surprise that a few days later the rate of infection is breaking records.
We must all pull together to make a rigorous, sustained effort to prevent the spread of COVID for the people we love and the community we care about. Keep mom safe.
Ira Zunin is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. His column appears the first Saturday of every month. Please submit your questions to firstname.lastname@example.org.