I am reading articles and watching “news” broadcasts and social media statements that make me wonder if the current crisis has taken away our common sense. People are citing impossibilities as if anyone could do them. They often look back with 20/20 hindsight thinking people should have known things that there was no way to know at the time.
It has become hard to turn on a “news” channel without hearing questions that are inflammatory and irresponsible.
Following are three examples of the ridiculous loss of common sense I’ve seen recently and what we should learn from them.
“Why can’t the most prosperous nation in history provide doctors with face masks?”
This statement, like many others, sounds like it makes sense on the surface since our nation can afford and has the ability to product face masks. But it presupposes a ridiculous assumption: That when one has a lot of money, like the US government, their resources are unlimited.
Can you imagine asking for an unlimited supply of anything? We all know that supplies are limited no matter what we want.
The truth is, when this pandemic started, we did have a lot of supplies on hand for the typical problems and demands we have faced in the past. We have never faced a problem this extreme that required so much personal protective gear. Every health care worker and first responder in the country suddenly wants to wear their PPE on every encounter so as not to risk their lives. That usage pattern is so much higher than anything we have ever encountered that supplies were quickly depleted.
Manufacturing cannot just turn on production and make 100 times more product than they used to make and get it delivered tomorrow. I used to be one of the owners of a factory. We had a maximum amount of production the machines could deliver. At Christmas time the demands dramatically increased every year creating the need to get a jump on the supply for the season, while there was excess capacity the rest of the year. We had to find a balance. But that balance was based on what we had seen in the past.
This is an unprecedented time requiring an unprecedented amount of medical supplies. I suspect we are getting the PPE’s made as fast as they can be made and faster than anyone ever anticipated we would need. Companies that produce other things are being repurposed to make PPE’s and other needed healthcare equipment. The companies that normally make PPEs have an incentive to crank out their product as fast as possible, because not only is it needed, but that is how they make their profit. So don’t you think they are already ramped up to full production capacity right now?
Imagine your boss coming in and telling you to increase your production by 100 times by Friday or you are fired. Or you need to see 10 times more patients than you normally see in clinic each day.
It is nobody’s fault that we don’t have enough material to fight a problem no one has ever seen before. So stop blaming others and pointing fingers.
We have ridiculous petitions circulating being signed by physicians demanding their hospitals provide enough PPE, as if the hospital isn’t already working hard to do just that. They can’t buy what the country has run out of. And signing a petition is not helping get more, it only serves to vent your anger and create fodder for “news” channels.
In 1973 Johnny Carson told several jokes in his monologue about how a coming toilet paper shortage would affect us all. His comments caused a run on toilet paper. Stores were cleaned out and it took weeks to recover their supplies. No one could have or should have prepared for that random onslaught.
This current crisis has also caused a ridiculous run on toilet paper, causing the stores to run out and shoppers are finding empty shelves. Everyone knows why they were empty, because a sudden demand skyrocketed way above supply. The stores have worked quickly to restock their shelves. They will be able to catch up because actual toilet paper usage has not changes. That is not true for PPE.
Where were the petitions demanding the stores provide more toilet paper? Where were the reporters telling us how incompetent the store owners were for not seeing this coming? We all know what happened, and everyone knows the stores could not have prevented it or predicted it. Let’s give the PPE story the same consideration. We have never had such a high demand, and no one could have, or should have, stockpiled enough PPE supplies to meet this incredible demand. I know the PPE is very important to have and a great disaster with lives on the line when it runs out. But we need to let the suppliers do their best to ramp up production. Complaints do not speed them up.
Moral: Nobody has an unlimited supply of anything no matter how much you want it to be true.
“Why aren’t we doing more testing? We should test everyone right now, so we know who to isolate.”
Another statement that sounds good on the surface. Four months ago, no one knew of this disease. It wasn’t until the end of December 2019 that it was discovered in China. Four months ago, there was no such thing as a test for the virus that causes the Covid-19 disease. Now a test has been developed and millions of people have taken the test all around the world. That was an amazing feat.
The PCR test that was first developed takes about 6 hours to run. In order to run that test it requires a person to take the sample, the protective gear for them to wear, the test kit itself, a lab to run the test, and someone to contact you with the results.
A typical hospital lab can process 200 of these tests a day. (They do not have unlimited resources.) If all of the 6,000+ hospitals could do 200 tests a day, that would be 1,200,000 tests a day. (That would be a phenomenal feat I believe no country has reached.) The population of the U.S. is 331 Million. To test everyone would take 275 days! More than nine months!
Testing everyone so you knew who to isolate would require all the tests to be done at about the same time so you could segregate those who are contagious right now. There is no way to test everyone who wants a test. We do not currently have the resources to achieve global testing. It is amazing that millions of tests have been produced and made available to test the sick for something we had never heard of four months ago.
The labs providing these tests are overwhelmed and doing what they can, so give them a hand instead of gripping that it is not enough.
Moral: We have a country with an amazing ability to respond to a crisis, but everything can’t happen instantly.
“Why didn’t you do something sooner?”
Let’s look back to the beginning of this crisis. In late January, while everything in the U.S. seemed normal to the average American, the first case of Corona virus was discovered in Washington State from someone who just returned from Wuhan, China.
The biggest story on every news channel at the time was the impeachment trials, which didn’t come to an end until February 5th.
What if on January 30th, the president locked down the country, instead of just stopping travel from China? There would have been mass protests. Americans would not have adhered to the rule. At that time there were only six cases in the United States all in the Seattle area. Italy at that time had only two cases.
Imagine the government telling us to stay home, close non-essential businesses, shut down schools, cancel Marti Gras in New Orleans, stop all NBA games and all other professional and college sports, don’t go to church, cancel all conventions, send everyone home from college, shut down the cruise lines………
In the middle of the impeachment, the “news” pundits would have been saying Trump was just trying to distract us from the “real” issue, the impeachment trial. The Governor of New York would not have agreed to shut down his largest city because six people were sick on the other side of the country. It would still be another month before New York would get its first confirmed case.
As it was, when the national emergency was declared on March 13th, the US had just topped 2,000 cases, and many citizens did not heed the order. Spring breakers were not about to let their vacation of heavy drinking and partying be ruined by a national emergency. They had been looking forward to their break for months and already had reservations. If it was hard to convince people to stay home and practice social distancing when the government requested it in March, how much harder would it have been to enforce if this regulation was proclaimed in January?
I was one of those in January who was disappointed that my upcoming trip to China had been canceled. I would have been appalled at the time if they shut down the state. In retrospect it might have been a good thing, but at the time, it seemed like overkill.
Just look at the response, a week and a half ago, when the president merely suggested that the government was looking into the possibility of a quarantine for the New York area. New Yorkers were outraged that he was even thinking about it. A month from now, we may be sorry that quarantine wasn’t ordered. Then the headlines will say the president made a mistake by not issuing a quarantine for New York in March.
Too often we use the retrospect-a-scope to decide if we did the right thing, instead of asking that question in light of what was known at the time.
Other times, when we see the government change courses, many are outraged, saying “Why didn’t you do this sooner?” “Why are you flip flopping on your decision?” “Were you wrong last week?” At the same time the “news” media wants them to work from evidence. So, when new evidence comes and the government switches gears to what the new study shows, where is the praise from the “news” outlets that real evidence is being followed? They should be super happy. But instead they go on the attack for not acting sooner, before the evidence arrived.
I remember when we were deciding on a treatment for my wife’s breast cancer. We could do a lumpectomy or a Mastectomy. The evidence supported those two choices. A few months after surgery, reports started coming out about nipple spearing mastectomies. Would it have been appropriate for me to complain about not being offered this treatment option when my wife had surgery? NO. The studies had not been completed. Should we be offended that the surgeons are now “changing their minds” and offering this new procedure? NO. Progress is a good thing, I’m thankful that breast patients now have another option.
Why isn’t our government treated the same way we treat the surgeons? When new data becomes available that suggests a better course, they should be praised for taking the new course, not blasted for not doing it sooner, or being “wrong” earlier.
Moral: We can only do our best with the information we have at hand at the time of our decision.
I could go on and on about the silly things I am hearing in the “news” media and on social media. I will stop with those three examples.
Please support those who are on the front lines in this crisis, they are doing the best they can, with what they have. That includes government officials, physicians, healthcare workers, hospitals, supply lines, first responders, truckers, grocery stores, mail carriers, and everyone who is staying home and following their state and federal orders. Many are currently overwhelmed and at the breaking point. I’ve been there before and know what that is like.
It is time for every American to step up and do all they can to stop the spread of this pandemic. Stop tearing down those who are making the difficult decisions and start following their leadership. We have a fight on our hands that we must win, and we can only do it if we unify in the fight.
This is so well written and articulated. Thank you.
Could not have said it better myself. People love controversy. But this is not what we need here. We need unity and support, We need appreciation for those who are on the front lines. We need positivity, not negativity. And this article is right on point.
Absolutely right on the spot:I don’t want to add anything else. When I was in residence, back in the country I came from, we used to called this: “,… is very easy to diagnose with the retroscopio”, an imaginary instrument that allow you to see in the future. One thing is clear: the media’s purpose of rejoice with the hopeless and frightful of the situation overcome any supposedly public service. For the common human being the only sensible thing to do is turn off any instruments that convey such pile of rubbish.
“It is time for every American to step up and do all they can to stop the spread of this pandemic. Stop tearing down those who are making the difficult decisions and start following their leadership. We have a fight on our hands that we must win, and we can only do it if we unify in the fight.”
I’m curious if with that philosophy you’ve rejoined our ranks of active practice, to do your part?
ScopeMonkey I looked into the question of should I go back into practice and help. I wondered if an extra general surgeon would be needed. I wondered if my town needed help, but we only have a couple dozen cases in town, and only a few in the hospital. Then I checked with my license and found I have been out of practice too long and the state would not reactivate my license. So I have not gone back into practice. So my part cannot be as a practicing physician.
Very well articulated