Dr Joshua White: A new normal

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Dr Joshua White: A new normal

Tue, 05/05/2020 - 7:24am -- tim

by Joshua T White, MD, Gifford At 3 pm Wednesday, April 29, the Vermont Department of Health was reporting no new COVID cases in Vermont for a 24-hour period. This is a stunning accomplishment, and one that I would not have imagined possible. On the same day, New York reported more than 4,500 new cases and Massachusetts just under 2,000 new cases. And here we were at zero. This is particularly incredible given that a number of Midwestern states are now in the unfortunate position of realizing that a rural environment is not a guaranteed defense against widespread disease. Vermonters should be proud. 

Lest we celebrate early, it’s worth considering that we’ve painted ourselves into a bit of a corner. We did it, but we’re not done. Suppressing COVID to this degree means that almost none of us has immunity, and so the risk of a surge hasn’t really changed. It won’t change until there is a significant alteration of the environment. The best-case scenario would be a vaccine, but that’s not likely for a year or more. Alternatively, if social distancing stops, the surge would occur and soon enough we would be done. Although rapid, that route would be a horror show. 

Soldiers’ Home, a nursing home in Holyoke, Mass., has reported 83 COVID dead – one nursing home with nearly as many dead as all of Vermont for the entire pandemic. It’s obvious that we must stop that from occurring here. That one nursing home should highlight that this is not the flu. The United States has not seen an infectious disease outbreak like this for 100 years. 

Yet, living in a bunker is also not an option. 

Those clamoring about the economy are right to do so. There are families in Vermont struggling to put food on the table, and this is intolerable. There are families in Vermont that have lost health insurance due to businesses closing. Someone who arrives in the ER – sick because they cannot afford their meds – is not a victory over COVID. At a minimum, the value of our lives is diminished if we forgo the activities that bring us joy, and none of us wants to live this way. Finding answers will require us to look past our longing for yesterday. Yesterday is gone and we are not going back. We cannot hide or bury our heads in the sand. We must think our way out of this and find our new normal.

Community leaders and business owners, now is the time to rewrite your strategy. How will you serve your customer base and still align with public health goals? This is not a binary choice, and there is a middle ground. Our towns can be open and functioning, and we can be safe. 

Patients, return to your clinics. Our healthcare system in Vermont has demonstrated its ability to safely provide patient care during the age of COVID. You can come in and you can be safe. Public health is something we do well. If you hide at home for fear of coronavirus and your emphysema decompensates, we have not beaten COVID. If you push off a mammogram or a colonoscopy for too long and suffer from a preventable disease, we have not beaten COVID. If you turn to substance abuse due to the stress of this new world, we have not beaten COVID. If lockdown creates more opportunities for perpetrators of domestic violence to abuse family members, we have not beaten COVID.

Talk to your doctors, your nurse practitioners (NPs), your physician assistants (PAs). Find out when and how you can get what you need to stay healthy.

Vermonters, go outside and care for yourselves and your neighbors. Be generous. Be considerate. Be respectful and wear your masks. Remember community members that are vulnerable and find ways to let them know that they are not forgotten, that they are cared for. Allow for the space of social distancing, but return to your local shops as they open. Participating in the economy now is crucial to financial viability tomorrow. If you would like your favorite restaurant to be here tomorrow, then order takeout today. Buy a punch card at a coffee shop. Purchase future classes at a dance studio. Arrange curbside pick-up at a garden center. Our state government has demonstrated wisdom and is mindfully and carefully reopening Vermont. Participate. 

We have done amazingly well thus far. We can see this through.

Joshua T. White, MD, MBA, Chief Medical Officer. For more information about coronavirus, visit giffordhealthcare.org/coronavirus-covid-19cdc.gov or healthvermont.gov. Additionally, you may call 2-1-1 with questions.

Gifford is a community hospital in Randolph, Vt, with family health centers in Berlin, Bethel, Chelsea, Randolph, Rochester, and White River Junction; and specialty services throughout central Vermont. A Federally Qualified Health Center and a Top 100 Critical Access Hospital in the country, Gifford is a full-service hospital with a 24-hour emergency department and inpatient unit; many surgical services; a day care; two adult day programs; and the 30-bed Menig Nursing Home, which was named by U.S. News & World Report as one of the best 39 nursing homes in the country in 2012. The Birthing Center, established in 1977, was the first in Vermont to offer an alternative to traditional hospital-based deliveries, and continues to be a leader in midwifery and family-centered care. The hospital’s mission is to improve individuals’ and community health by providing and assuring access to affordable, high-quality health care in Gifford’s service area.