If You’re Sick, Stay Home, If Not, Let’s Get to Work!

Governor Henry McMaster has been put in a difficult position. He has a very healthy population of South Carolinians with a few who are sick or immuno compromised, with a potentially fatal disease lurking in some shadows. It is the duty of the governor to protect the citizens of this state, but sometimes that may not be as clear as one would desire when dealing with the unknown. The duty of the governor is also to assure that citizen property is secure and they are able to conduct their business affairs without interference.

Just like the annual flu, the coronavirus or CoVid-19 has come to our state and is causing harm to our citizens. But, our state and nation is handling this disease differently than we’ve ever handled disease or sickness in recent memory by calling for a statewide quarantine. Quarantines have happened before, but not one for the entire state.

Now, Governor McMaster is calling for reopening select businesses over the next week as we ease back in to the “new normal”. What the “new normal” is remains to be seen as nobody knows exactly what that definition will be. If it is anything different from the ‘old normal’ many citizens believe it should be in favor of less governmental interference and control over their lives and businesses.

It is a fact that different parts of the country experience different levels of severity with CoVid-19. In the Southern states we have not suffered to the extent that many states in the New England area have, especially New York City. Population density probably plays a large factor in that, as well as hygienic and sanitary conditions. Some of these factors must be taken into consideration when calling for quarantine, stay home and close business orders.

Another common sense idea is that for all those who are currently sick, have compromised immune systems, physically weakened, or who are just afraid to venture out for fear of contracting CoVid-19, or any flu or sickness, the simple answer is just stay inside or at home. We don’t desire anyone to compromise their health or life by venturing out, but that is a risk that people have taken for thousands of years with everything from the influenza to the plague.

Many healthy people are willing to take a calculated risk to go outside and go to work. Why? Simply because they have people who rely on their ability to provide income to sustain life.  Those who are forced to stay in when they are healthy and want to work may even put themselves at risk of suicide and depression. Forcing healthy people to go contrary to the human spirit can be quite hazardous.

A recent letter from a medical doctor in North Carolina sent to her state representatives and Senators outlines her personal experience and understanding of the CoVid-19 situation. The Standard includes her letter in its entirety.

 

Rosemary Stein, MD
April 16 at 4:10 PM

Hello, Friends. I have received several requests for the letter that Dave and I wrote about our experiences at our Clinic dealing with COVID-19 management. It was sent to NC House and Senate yesterday. I received an email from DHHS yesterday in response to my letter.

Here it is:

Greetings, Representative Pittman and Legislators of North Carolina.

I have been very concerned about how COVID 19 has been handled in my community and our State. Therefore we wanted to share with you and the NC Legislature what my experiences have been that have alarmed me.

First of all, I would like to introduce my credentials to you. I am a pediatrician of 27 years experience. My husband is a Family doctor that has been practicing medicine for 28. He was trained in the military and I in a civilian setting. We both have owned our Clinic which is in Burlington, NC for the past 20 years. We were trained at a time when data and medical knowledge were of utmost importance. Some of the physicians that instructed us and molded us are now legends in medicine. We both take our vocations very seriously. In fact, our profession is a lifelong ministry. Our Clinic has about 5,000 patients that we care for. We have a staff of 15 full time employees plus 4 doctors. We consider ourselves more than just our young patients’ doctors. We are physicians and friends of the families as well. I have served on many educational and medical societies, Boards and committees. My husband has as well. We are balanced and try to do our best to have an evenhanded, thoughtful approach to medicine and decision making.

I began to be concerned about how the Novel Coronavirus was being dealt with when our Alamance Health department offered no updates. We have often experienced epidemics and public health concerns over communicable diseases. We received communications informing us of new cases, the trends and how the disease was being handled from a public health setting. With that information Dave and I could make decisions on how to approach the possibility of the disease affecting our patients. We have only received one fax from our health department four weeks ago regarding the impending COVID -19 pandemic. We have not received any updates on cases, locations, contacts, nor treatment plan. This information would be paramount to slowing the spread of the disease. NC DHHS had a teleconference several weeks ago. Little time nor information was shared about identifying, diagnosing and treating CoronaVirus. Instead most of the time was spent on the importance of telemedicine as a modality to see patients and keep our practices functioning.

We have had 3 patients that we considered suspicious for Corona virus infection. When we requested testing on them, we were unable to do so. On two of them the lab or the institution threw the specimen away as invalid but did not inform us until well after the patient was well. Both families remained under quarantine for 2 weeks but were not informed that their specimens had been discarded. The third patient with chest pain, fever, shortness of breath and a severe cough was sent to the ER. No tests were performed on him and he was sent home.

We received a total of three Coronavirus tests from LabCorp four weeks ago. We asked for more but were refused. We therefore considered that only if our patients did not improve when we treated for other conditions that we would consider a patient suspicious for COVID-19 infection. Since all our patients did well 2-3 days out, we had no need to test, thankfully. We, of course, quarantined. This quarantine was without a real endpoint since we did not have testing to confirm our presumption. This is a great burden to the family since they cannot work nor gather food and supplies during that time.

“This is clearly not a pandemic nor an epidemic infectious disease by any definition.”

 

We have never, in nearly 25 years each of practicing medicine, dealt with communicable disease in this way. We have always been presented data, cases, possible contacts, treatment modalities and a plan of action. Furthermore, we can access the number of cases in a community based on the disease incidence

among our patients. We have no cases to report thus far. Our Clinic of 5000 patients and the county population of 169,000 denotes the County incidence to be approximately less than 3% of the population. In fact, today’s count of 44 positive cases yields an incidence of 0.026% in Alamance County of detected cases. This is clearly not a pandemic nor an epidemic infectious disease by any definition. Even if we were to use the more severely COVID stricken County which is Mecklenburg that has 993 identified cases, this yields only 0.09% of the population.

In the past weeks I have seen the incidence of mental health issues, anxiety, poor health, and poor nutrition affect my patients far beyond what the novel Corona Virus has done. The outcome of our management of the disease has and will continue to cause more health issues than the illness itself. Who will be responsible for the ill effects that our patients and community suffers because of this management? What will it cost us in dollars and in lives? I do not have the answer for such a question but present the responsibility and solution to North Carolina legislators and Governor Cooper.

My husband and I ask that we cease to manage the novel Corona Virus in this unscientific and harmful approach as soon as possible. Many of us in the medical community in North Carolina can assist the State Legislators and Governor Cooper to solve the question of containing the spread of COVID while allowing the community to recommence their normal lives once again. We are in contact with several physicians that can offer an evenhanded, knowledgeable, and unemotional approach to this most important task.

We hope that we have appealed to you as leaders, professionals and fellow citizens of the great State of North Carolina and our beautiful United States. Our State motto is Esse Quam Videri. May we live up to this phrase indeed . To BE rather than to SEEM in our freedoms and rights.

Most sincerely,
Rosemary Stein MD
David Stein MD
International Family Clinic
Burlington, NC

Some in the medical community are starting to speak up about the draconian measures used to halt life for everyone when only a small number seem to be infected. Based on what factual information that has come forward a more common sense approach to managing the spread of disease would benefit the entire community better instead of punishing those who are healthy. The number affected by the coronavirus versus those who die is approximately .5 – 1%, and the normal death rate in America is 0.8638% or 863.8 per 100,000.

And yes, I understand that some are more susceptible to sickness and disease than others. The answer I think is to use common sense. That is simply to stay home and away from the danger if you choose, while others get out and about their business.

Other news and opinion will follow this to get a full view of what is happening with CoVid-19. Comments are welcome. Please use good Southern manners and courtesy whether you agree with the opinions of others or not.

 

Michael Reed is Editor of The Standard.

 

 

 

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