Wednesday, 28 Oct 2020

Opinion | My Patients Can’t Take Trump’s Advice

Imagine wanting, needing, to take a gulp of air and finding that you can’t. On Monday, a patient walked into the emergency room where I work. He struggled to breathe as he explained his symptoms to me. When the test result came back positive for the coronavirus, his eyes brimmed, and he spoke quietly: “Will I be OK?”

I see some version of this story every day at my hospital in rural west Michigan. It’s some 700 miles away from the White House, and feels even farther as I watch President Trump whisked to the hospital and back in helicopters, and flanked by men in white lab coats, ready to serve him.

And yet he tweets, “Don’t be afraid of Covid.”

My patients are genuinely afraid. That fear didn’t come from CNN or “fake news.” Nor did it come from Dr. Anthony Fauci. My patients’ fears come from the fact that they can’t breathe.

The people who come to my hospital seeking care are largely underserved with underlying conditions. As they struggled and wheezed, they may have thought of their own mortality in the context of the more than 211,000 lives cut short — too many in their prime, healthy one day, dead a week or two later.

For nearly 20 years, I’ve had the privilege of serving the same small community and getting to know many of the people who now come to my emergency room. Two-thirds of the voters in our county voted for this president. In my area, many fly his flag and hang on every word he says. Compliance with safety guidelines is thin; most people in our community refuse to wear masks or stay six feet apart.

Because social distancing naturally occurs in sparsely populated rural areas, we didn’t see the summertime surge of positive cases like Arizona, Texas and Florida did. But two weeks after our schools resumed in early September, we began to see a spike in Covid-19 cases among children and teenagers. As President Trump urged Americans not to let a highly contagious and lethal disease “dominate” our lives, their parents began showing up in my emergency room, gasping for air.

This is the terrible but predictable outcome after the most powerful man in the world told people to “LIBERATE MICHIGAN!” and “SCHOOLS MUST OPEN IN THE FALL!!!” even when we didn’t have enough masks, tests and contact tracers.

We still don’t. Eight months after the first Covid-19 case was reported in the United States, my hospital still has only a limited supply of N-95 masks and tests. And Michigan, like many states, is still fighting over mask requirements and crowd limits.

Now the patients I have come to know and love over the years are starting to feel the full impact of following a science-denier down the primrose path. As the president mocked masks and flouted social distancing by holding packed campaign rallies, the virus took hold of my corner of America, accessible only by winding roads through small farms and single-street hamlets.

The coronavirus is indiscriminate. If you’re young, healthy and lucky, you may be fine in the near term, but there’s a lot we still don’t know. We don’t know what kind of carnage the virus could wreak on your lungs, brain and kidney long after you test negative after having been infected, or if an infected patient is immune after recovery. Science takes time.

What is virtually certain is that you will get the coronavirus if you don’t wear a mask and are exposed to it in an enclosed space. And we know that people older than 55 with high blood pressure, obesity and diabetes are more likely to get severely ill, even die, from the virus.

My patients may not know that of the more than 211,000 that have died of Covid-19 in the United States, roughly 40,000 have been between the ages of 65 and 74, a rate much higher than deaths from the flu. They may not have seen Mr. Trump struggling to breathe after he bailed out of the hospital. They may or may not understand the Hail Mary cocktail of antivirals, plasma, antibodies and dexamethasone (the only drug so far shown to help with Covid-19, which we may have to use if their vitals go south).

They may not care that their governor, Gretchen Whitmer, is using every science-based intervention she has to protect people — a stay-at-home order, masking requirements, limits to gatherings — while the Republican Legislature, like Mr. Trump, has given up even trying to slow the spread.

What they do know is they can’t breathe. They’re afraid. And until the president takes the coronavirus seriously, and models how to combat this virus for the rest of the nation, the rest of us should be too.

Dr. Rob Davidson (@DrRobDavidson) is an emergency room physician in West Michigan and executive director of the Committee to Protect Medicare.

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