Number of cases / Positive tests
As of 3/20/20…
- In Florida - ~563 positives, ~5700 negatives, ~1100 pending; ~7200 total tests done
- In the U.S., approaching 20,000 cases, ~120,000 negative tests, ~256 deaths
As many of you are aware, we have the capability of doing virtual visits for appropriate conditions, and we are planning and prepared to significantly increase the utilization of these visits in the coming weeks. Most commercial insurance plans in Florida have historically not paid for these visits (though we hope the Florida legislature will change this soon). However, due to the current outbreak, many more of the payers are agreeing to pay for telemedicine visits and there have been some Federal legislative directives towards making sure these visits are covered during the current outbreak.
"Is all this an over-reaction?"
I had mentioned in the previous update that I wanted to address some of the comments I have heard questioning or not understanding why such extreme measures were being taken for a disease whose absolute numbers are much less than a typical flu season and whose symptoms can be quite mild in a large percentage of the patients. Many of these sentiments have been expressed by comparing COVID-19 to influenza, and this is understandable and potentially helpful as influenza is something we are much more familiar with. However, often when this comparison is being made, it is being done in a spirit of “why are we so worried about COVID-19? The numbers are so small compared to what we see with flu!” (As an aside, we think the American public should be more concerned about influenza than is typically the case, and so if these statements were being made in the spirit of a healthy respect for influenza and the regular impact it has, that would be welcomed). These "downplaying comparisons" to flu are in many ways not helpful and not accurate. It must be stated that this is definitely not the same as the flu and definitely appears to have the potential to be much worse than the flu. The extreme measures currently being enacted are not being done so because of the current number of COVID-19 cases and deaths. In fact, none of the recommendations are even because of fear that the disease will continue at the current incidence for the coming weeks and months. The concern, based on data learned from other countries, is based on what might be, not what currently is. Comparing it to influenza (in terms of absolute numbers of cases and fatalities) is sort of like looking at influenza numbers in October of a season and concluding that it has been a mild flu season because we have so fewer cases than last year. In this way, the comparisons are not helpful and not accurate.
There are ways that comparing it to flu actually are helpful and instructive. COVID-19 does seem to be transmitted in a very similar method to influenza. Though there are some symptoms that are similar, the illnesses seem to present somewhat differently in that influenza typically has an abrupt onset (i.e. you tend to feel sick and miserable from the very beginning), whereas COVID-19 seems to begin mildly and then in some cases progress to more serious cough and difficulty breathing.
It certainly could end up being not nearly as bad as many factors would suggest (and we all hope that is true), but the decisions being made are based on what is currently known about the virus, not what we are hoping is true. And what is currently known is definitely concerning for all of us as a community (even if as an individual, there is a high likelihood it would be fairly mild).
An article with some practical advice
See the following article from the Washington Post about grocery shopping in a time of COVID-19
And, finally, some relevant wisdom from 500 years ago
Many of us are wrestling with how one's faith should guide our actions and emotions in a time like this, and there have been many encouraging words written offering perspective and even personal encouragements shared with our team from families of the practice. We are so grateful for those. In that spirit, I find the words of church leader Martin Luther from 500 years ago when asked how the church should respond in such a time inspiring and instructive and wanted to pass them along.
“I shall ask God mercifully to protect us. Then I shall fumigate, help purify the air, administer medicine and take it. I shall avoid places and persons where my presence is not needed in order not to become contaminated and thus perchance inflict and pollute others and so cause their death as a result of my negligence. If God should wish to take me, he will surely find me and I have done what he has expected of me and so I am not responsible for either my own death or the death of others. If my neighbor needs me however I shall not avoid place or person but will go freely as stated above. See this is such a God-fearing faith because it is neither brash nor foolhardy and does not tempt God.”
So... unless your presence is essential and needed, please stay home and follow the recommendations of our leaders.
Here for you and your family.