Opinion: Act now to prevent overwhelming hospitals

Pulmonologist Dr. Laren Tan, center, with his medical team of nurses and respiratory therapists intubate a COVID-19 patient who's oxygen levels were dropping in the ICU at Loma Linda University Medical Center on December 15, 2020 in Loma Linda, California. The hospital is experiencing a huge surge in COVID-19 patients. (Gina Ferazzi/Los Angeles Times/TNS)
Pulmonologist Dr. Laren Tan, center, with his medical team of nurses and respiratory therapists intubate a COVID-19 patient who's oxygen levels were dropping in the ICU at Loma Linda University Medical Center on December 15, 2020 in Loma Linda, California. The hospital is experiencing a huge surge in COVID-19 patients. (Gina Ferazzi/Los Angeles Times/TNS)

Credit: TNS

Credit: TNS

All Georgians can play role in curbing COVID-19′s spread

Georgia and the rest of the country are facing a grim reality -- the nation’s hospitals are on the verge of being overwhelmed because the COVID-19 pandemic continues to erupt.

In the United States, the current 7-day moving average of daily new cases is 171,556, the highest in the world; and in Georgia, it is 5,366, an increase of 352% since Oct. 1, 2020. The nightmare scenario we were worried about in March and April is here, and too few Georgians are paying attention. We must take action now.

The two of us have been working on the COVID-19 pandemic from the beginning. One of us is an ER doctor who works on the front lines, receiving patients and providing emergency care. The other is a university professor, infectious disease modeler, and Director of the Center for the Ecology of Infectious Diseases at the University of Georgia. We both agree that Georgia has not been in such a precarious position at any point since the very early days of the epidemic.

John Drakephoto by Peter Frey
John Drakephoto by Peter Frey

Credit: contributed

Credit: contributed

In the early days we knew far less than we do now, but Gov. Brian Kemp took decisive, precautionary action -- and it saved lives.

Now we know much more about how SARS-CoV-2, the virus that causes COVID-19, is spread. For instance, we’ve all heard about how large social gatherings like the Sturgis motorcycle rally were identified as probable “superspreader events” early in the pandemic, but most Georgians seem unaware that 70% of new COVID-19 cases originate from households and small gatherings, familiar kitchen table environments in which we let our guard down because we are with family and friends. We must use face coverings and other simple interventions, even in these settings, to slow the spread of the coronavirus. Tragically, many Georgians are not doing this.

Jonathan M. Davis
Jonathan M. Davis

Credit: contributed

Credit: contributed

As a result, our hospitals are close to full capacity. In Georgia, 89.7% of ICU beds are in use. There are too many critical patients and not enough beds. Patients are waiting days for access to critical care that should be provided within hours. As hospitals have filled in Georgia and the rest of the country, we now hear stories about sick patients waiting for 10 hours to receive treatment, ambulance crews instructed to not transport patients who may not survive, and hospitals having to ration care because they are full. This situation isn’t only affecting those with COVID-19. Patients with other medical conditions are facing dangerous delays in care, if care is available at all. COVID is crippling the medical system and making Georgia a dangerous place to have an injury or a heart attack.

On December 28, three important medical organizations -- the Society for Healthcare Epidemiology of America, the Society of Infectious Disease Pharmacists, and the Association for Professionals in Infection Control and Epidemiology -- wrote to HHS Deputy Secretary Eric Hargan to request that Medicare suspend its practice of penalizing hospitals for healthcare-associated infections and other preventable conditions. This is a direct and honest recognition that medical facilities across the country are now no longer able to provide the expected standard of care. People are dying in hospitals we could have saved last year.

Now, just as vaccines are being rolled out to the population, a newly documented variant of the virus has begun spreading, including here in Georgia The new virus, dubbed “B.1.1.7” has been estimated to be as much as 56% more contagious than the original virus.

What should be done?

To lessen the demand on the health care system, Georgia must reduce transmission in the community. We urge Gov. Kemp to issue a statewide mask mandate, close restaurants and bars except for takeout and outdoor dining, and encourage all Georgians to refrain from attending social gatherings of any size.

Closing schools (including universities) is a possibility if we come to the conclusion that children are a driving force maintaining transmission. Fortunately, emerging data suggests that spread in schools may not be as large a factor as we had first feared.

Our local and state leaders must continue to encourage the public to abide by well-defined safety protocols. In early December, Savannah Mayor Van Johnson ordered his police department to start issuing citations to individuals who are not abiding by city social distancing and face covering requirements; on December 30, Gov. Kemp asked Georgians to “wear your mask, wash your hands, practice social distancing, and follow the public health guidance in our executive order;” and on January 2, Atlanta Mayor Keisha Lance Bottoms tweeted “PLEASE wear a mask.”

An 11Alive/Survey USA poll conducted in December concluded that 66% of surveyed Georgians believe that wearing a face covering in public places should be mandatory (50% of respondents who self-identified as a Republican agreed with this provision). But, enter any public place in Georgia and you will see many people without masks. This is deeply discouraging to us as we both work to the point of exhaustion only to see deaths rising and our fellow Georgians still dangerously unaware of their role in spreading a deadly virus that can be transmitted by people who are not showing any symptoms.

As the state continues to increase COVID-19 vaccine distribution, everyone who has the opportunity to receive a vaccine should take it. However, it will take time for the vaccine to be distributed. Georgians need to understand that more decisive action now -- and all of us protecting each other through mask use -- could prevent the need for the general business closures and shelter-in-place orders of last spring and bring us back to a healthy and prosperous Georgia where we can sit around a table at a favorite restaurant with friends and family once again.

John M. Drake is director of the Center for the Ecology of Infectious Diseases at the University of Georgia and the director of the Global Infectious Disease Intelligence Consortium. Jonathan M. Davis, M.D., has spent the majority of his career working in emergency rooms of critical access hospitals in rural Georgia.

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