The medical community continues to learn new features about COVID-19. We are constantly reminded that people over the age of 65 and those with pre-existing conditions such as hypertension, diabetes, obesity, asthma, and chronic conditions involving the heart, lungs, kidney, and brain (dementia) are at greatest risk of hospitalization and death from COVID-19. It is becoming clear that younger people, without pre-existing conditions, are not immune. A seven-fold increase in stroke occurring in COVID-19 infected people, under the age of 50, is being reported in New York. Other complications related to abnormal blood clotting, associated this disease, is being studied at multiple medical centers. A Broadway actor, Nick Cordero, lost a leg due to a blocked blood vessel related to this coronavirus. Further verification of COVID-19 affecting the young is the death of a five-year-old African American girl in Michigan this past week. It is therefore essential that people of all ages “stay home” unless you have an essential reason to be out. When you must go out wear a mask or a nose/mouth covering, maintain proper “social distancing” of six feet. If you cough or sneeze, do so into the bend of your elbow or your mask (change mask when necessary). Remember, wash your hands (20 seconds) or use hand sanitizer, often!
The federal government coronavirus task force has issued guidelines that were designed to allow for “Opening Up America Again”, https://www.whitehouse.gov/openingamerica/ . These state and regional guidelines called for three phases of relaxing of the constraints which were necessary for “flattening the curve”. These constraints have been effective at decreasing COVID-19 deaths. Each stage represents less restrictions on the citizens of a state or region. Progressing from one stage to the next is based on a deceasing number of that state’s new cases over a 14-day period, appropriate testing, contact tracing, and having a healthcare system that will not be overwhelmed by the likely increase in cases. Despite the guidelines being minimal recommendations, a vocal minority of people have been protesting for full relaxation of all restrictions. Several governors have declared that reopening their state’s economy takes precedence over public safety.
As the providers of care for many in the “vulnerable population”, we do not believe that economic concerns should be the driver of healthcare policy. We recognize that there are health ramifications to job, school, and activity shutdowns but this risk does not supersede the benefits that have derived from the ‘Stay at Home” policy. A coordinated robust testing policy is still not in place and the Personal Protective Equipment (PPE) necessary for healthcare providers, first responders, essential workers, and ordinary citizens is still not available. African Americans represent 13% of the US population and 34% of the unfortunate people who have died from COVID-19. Proceeding with plans to open the economy without clear acknowledgement of the facts on the ground demonstrates a willingness to sacrifice the vulnerable population since it is likely that the spread of the virus will increase. We note that 30% of “essential workers” are African American and people of color. There will be a disproportionate number of vulnerable who will be more frequently exposed to infected and asymptomatic individuals as the economy reopens. We continue to call for the full implementation of the Defense Production Act to solve the supply chain and production problems preventing appropriate testing and PPE production. There must be adequate protection and accessible healthcare for the entire population, especially the most vulnerable.