When hurricanes spin up off the coast of Africa, most Floridians know what to do. We pull out our National Hurricane Center app and start to watch. The tracks are familiar lines in the middle of a widening cone, indicating that the storm is coming, we know where it is today, but we’re not sure exactly where it’s going. We don’t worry too much about the track until the tip of the line hits close to home. At that point, our ears perk up, eyes open, and experienced emergency response teams mobilize. This is because we’re ready for hurricanes.
But a pandemic is different. We aren’t ready for a pandemic. American business, including healthcare, is efficient, but not robust. Just-in-time supply chains fill shelves as products are needed. Warehouses full of extra supplies and equipment are frowned upon. This fact combines with government policy shying away from and widely defunding public health. Pandemic response and Epidemiology have largely been on the shelf.
Ready or not, the experience in China gets our attention, but there’s a lot that happens in other parts of the world that never comes to our shores. In some ways I think we have developed a collective mystical belief in the safety of distance and our continental isolation. In this small-world era of global travel, that belief needs reassessment.
Italy wakes us all the way up. It’s closer to home both geographically and culturally, many of us have traveled there, and they have a free press so news flows out more smoothly. Stories of overwhelmed hospitals and exhausted teams running out of ventilators filled the airwaves. So did stories of Italians dying in hospitals and at home in the thousands. For some reason I remember the day the 13th doctor died in Lombardy. Florida doesn’t lose 13 doctors during flu season.
We begin planning hard, knowing now the pandemic has its eye on America. As we plan, we notice something interesting that’s different from a hurricane. There is power carried by the virus that has nothing to do with the disease itself, an ability to expose the true character of the places it attacks.
When character is exposed, it is rarely uniformly good or heroic. In the case of America, Coronavirus exposes certain pre-existing conditions.
• A dysfunctional political environment in which a virus has to carry a label. We react to the virus differently based on our political lens.
• A dysfunctional religious environment that tolerates church leaders who boast about Spiritual immunity. Even Jesus didn’t test His Father.
• A dysfunctional social environment in which conspiracy theorists, stories, and untrained pseudo-experts come out of the woodwork.
• A dysfunctional socioeconomic environment where health disparities give the pandemic a disproportionate impact on low-income communities.
Each dysfunction combines with the lack of robust preparation and adds to the degree of difficulty of our response. The global supply chain collapses at the peak point of global demand, impacting availability of personal protective equipment, ventilators, and testing supplies.
Fortunately, when character is exposed, it is rarely uniformly bad or villainous either. There are so many functions, so many meaningful moments and heroic acts as well.
• A functional community support environment in which signs, car parades, and countless acts of love bolster our courage.
• A functional leadership environment in which badges and hierarchy are left at the door and entire teams lean in to solve problems together.
• A functional healthcare environment in which it is clear clinical teams got into this work for the right reasons and run without hesitation toward the challenge.
Our healthcare team has worked to minimize the dysfunction and embrace the function. It’s important that we do, as the Coronavirus is a life and death challenge and being distracted is dangerous. We know it’s our job to focus.
And so, we do.
Floridians know what a sandspur is. The nastiest form of burr. If you walk into a field full of sandspurs, you walk out of the field with sandspurs hooked to your pants and shoes. If you don’t, you won’t. Healthcare teams know this virus is the same way. Even if we don’t understand everything about it, it works just like a sandspur. If you don’t want a sandspur, stay out of the field (shelter in place). If you do walk in the field, you’d better check your pants and shoes (testing).
It’s important to understand this because as I write, the total number of American known dead from the virus — the real number is higher — is poised to exceed the total American deaths in the Vietnam war.
This isn’t the flu. We all know the flu well. It hits us every year from October to April and kills an average of 161 Americans a day during flu season. This mortality, sadly, is built into the “normal” death rate in America. That normal daily mortality in America is just over 7,000 deaths per day of all causes. COVID-19 arrived on our shores and quickly grew to a daily death rate in the hundreds and then in the thousands. At its peak, it passed Cancer and Heart Disease and became the number one daily killer of Americans. It is still competing for that position. The flu hasn’t done so in generations.
These deaths, to put it far too impersonally, are incremental. They are not just another way we reach the normal 7,000 daily deaths in America. They are turning the 7,000 into 10,000 or 11,000. Imagine a 9/11 happening every day for some sustained period. Imagine that happening and too many people forgetting to mourn.
We learn new things about COVID-19 every day. There is much still to learn. But the daily death rate is an intensely reliable and undercounted fact. It is driven by one of two possibilities: 1) COVID-19 is far more deadly than the flu, killing a higher percentage of people who are exposed to the virus, or 2) COVID-19 is no more deadly than the flu, but it knows how to spread so fast that it can infect and kill many more Americans per day if left to rage.
There is little value in debating with friends and neighbors between these two possibilities. The outcome is the same. Until there is a vaccine or “cure,” society will be disrupted. It is never prudent to move back into a burning house while it is still on fire. Instead it is our responsibility to build a new house, a new normal. A normal in which wearing masks and being tested and being isolated when sick and other critical steps are an ongoing reality.
My twin girls are high school seniors. They are spending their last weeks of high school at home. Their graduation won’t happen when it was supposed to happen, and neither will their senior trip. They’re mature about it, but it is a source of stress and sadness. You’re probably experiencing similar things in your own family. Contemplation, study, and wise processing are necessary. Loud arguments, confrontations and protests won’t eliminate this virus. They will create stress, destroy relationships, and put lives at risk. But they won’t cure the underlying condition.
In the end, the cure for the underlying condition will be the dispassionate experts on the front lines of the fight. People who don’t have time for the sport the rest of us sometimes make of it: the scientists, public health workers, doctors, nurses, laboratory professionals and environment services workers who toil every day to solve the real issue at hand.
This is why I think communities trust healthcare. More than politicians. More than media. More than their crazy uncle on social media. Politicians and media and crazy uncles everywhere hate this fact, but the trust has been earned. And it continues to be earned. Every day through fearless, fact-based, and compassionate acts. This is the one part of the national pandemic response that has never faltered. It gives me good chills, just thinking about it.
I see our small piece of this story most clearly. The hundreds of COVID-19 patients we have treated in our hospitals. The several dozen people who have passed away in one of our beds from the virus. The nearly 100 team members who have contracted the disease caring courageously without hesitation.
We will soon be making the attempt to edge slowly back toward normal. But we will do it thoughtfully and carefully. Measuring our steps and choosing the right path for this marathon that won’t turn into a sprint.
As we do, I would ask you to take on the role of an advocate and to take pride in the role. America needs adults in the room who are ready to take things seriously, to study carefully, and to accept some of the bruises that will come from being a voice of reason in a time of irrationality.
God’s work has always happened in the face of difficulty. I think this is one of the reasons the healthcare ministry is core to the work of the church. It has always been a platform to join God’s work within transformational and sometimes excruciating moments. Lives change in those moments and we get to be there, close, and on the front line. Just as we are today.
For such a time as this…
Daryl Tol is President/CEO of AdventHealth’s Central Florida Division.
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This is a companion discussion topic for the original entry at http://spectrummagazine.org/node/10417