Steve Long: We are in this for the long haul

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Steve Long

On March 16th, I wrote an “open letter to the community” outlining the potential impact of COVID-19 on the residents of our county. On that date, there were 170,000 reported cases worldwide with 6,500 deaths. There were 3,600 cases, including 68 deaths, in the United States. At the time, Indiana had reported just 30 cases and two deaths, and none were reported in Hancock County.

Fast forward just 10 days, and the numbers skyrocketed. In Hancock County, through Friday, March 27, we have experienced nine confirmed cases and one death from the disease, with 40 test results not yet reported. In Indiana, 477 cases and 17 deaths have been reported. In America, there have been more than 54,000 cases and nearly 700 deaths. Globally, there have been 500,000 cases and nearly 21,000 deaths. In one day last week alone, more than 43,000 new cases were reported, and 2,100 people died, none of them in China.

In response to this alarming trend, the CDC has issued nearly daily advisories recommending events with attendance of more than 500 be canceled, then lowering this mark to 50. Many sports leagues began cancelling events, then entire seasons, and were soon joined by large entertainment venues as well. As some states began seeing exponential growth patterns, they responded by limiting crowds to fewer than 10 people, then issued orders to close gathering places such as restaurants and bars altogether. New York, California and Illinois were the first to declare states of emergency and then “shelter-in-place” orders effectively limiting travel outside the home only to “essential” activities. They have since been joined by 18 more states, including Indiana. Gov. Eric Holcomb but the order in place here on March 23.

Many businesses have closed for the time being, their employees laid off. Store shelves have been emptied of commodities within hours of restocking. Churches are not meeting, schools are closed, perhaps for the year, and the streets are eerily empty. A week ago, people were curious about the disease, and many were concerned. Today, people are alarmed, irritated and impatient. Some are beginning to ask if the unintended consequences of our actions are worse than the impact of the disease itself. Sure, 1% of people who contract the disease may die, but isn’t it likely that the economic suffering we are beginning to endure will lead to even worse outcomes in the long run? Deaths from suicide, lack of financial resources needed for health care, and the inability to take care of the necessities of life may dramatically increase. Is it worth all this pain for the more than 99% of us who will survive this disease?

The point is well made. All these statements are true. They will become an even greater issue the longer we remain in “lockdown.” So why don’t we just stop, or at the very least keep it going for the least amount of time possible. Let’s just pick a date when we can be done. Last week, the CDC said we have “15 days to make a difference”. That period ends today (March 31), which is perfect because it gives us 10 days to get things back to normal before Easter.

I’m with you. I want this to be over too. We had big plans in place at Hancock Health this year. Plans to provide access to more and better outpatient health care services. Plans to do things to improve the quality of life in our county. We saved our money for years to do this, and now we are redirecting that money to retrofitting inpatient units to care for COVID patients; eliminating most of our outpatient work to create capacity for inpatient care; closing our wellness centers; and holding off on construction projects that we are not already committed to finishing. We are also assisting our employees to ensure they don’t crash emotionally, physically and financially. We all want this to be over…

The problem is in the math. Exponential growth means that the number of infected people is doubling nearly every day. Central Indiana experienced its first case on March 6th. In the 19 days after that, we added 310 cases. More than 100 of those were in the last 24 hours of that period. The disease is here. It is growing. It will not stop in the next week, or the week after, or even by Easter. In fact, many estimates point to the peak not arriving until mid-April at the earliest. If we stay our present course and endure to the end, we have a chance, just a chance, to make it through in one piece.

Because this is a new disease, we have no vaccine to prevent it, and no medications to treat it. The progression of the disease in each person is determined by the ability of their immune system to ward it off. We know 20% of the people who contract the disease will need to be hospitalized and one fourth of those will need to be on a ventilator. If just 10% of the people in Hancock County contracted the disease in the next four weeks, we would need 1,600 hospital beds and 400 ventilators to care for them. As I write this, there are not enough empty beds and ventilators in the entire Indy metro area to care for them. And this is just 10% of Hancock County alone.

Like it or not, we are in this for the duration. This is a war, and Hancock County is one front in the battle. The only weapons we have are the choices made by each of us, every day. We must stay at home if we can. Work at home if we can. If we must go out, let’s do it when the crowds are sparse and keep our distance from each other. Let’s cover our coughs (or even better, wear a mask); don’t shake hands; and wash our hands, often. And most important of all, let’s not end the work too soon. If we don’t see this through to the end, everything we are doing now is for nothing, and we will be right back in the same position at Christmas.

Steve Long is president and CEO of Hancock Health and Hancock Regional Hospital