To Monroe County Residents

The following comes from a Monroe County resident who happens to also be a physician. I pass this along because it is well written with facts. I encourage you to read and share. I most certainly thank the author to step forward and speak up.

I will also add that people in the emergency departments including ALL staff, plus firefighters, police officers and EMT’s/paramedics will be sitting in the front of this.

Dear people, Below is a letter I drafted to our local government officials in regards to their insufficiently robust response to the Covid-19 crisis. If you agree and would like to add your name please sign below, I will send it later today. Dear Dr. Mendoza, Mr. Bello, and other respected members of the Monroe County Health System, I am an Emergency Physician, a mother, a daughter, and along with my husband a life-long citizen of Monroe County. We chose to raise our children here because we love the community and have always considered Rochester a wonderful place to live. I am writing today to express my concern over the insufficient response this leadership has taken over the new Covid-19 pandemic, which is surely headed our way in a matter of weeks. Dr. Mendoza, you stated in your press conference that the best way to fight fear was with facts. I think you misunderstand why the people are scared – it is not the virus itself that we fear, but the lack of appropriate response to and preparedness for it. News of this virus first appeared on the horizon in late December/early January. While China’s neighboring countries immediately put stringent precautions in place, limiting movement, monitoring infected individuals, and aggressively testing – we sat and waited, hoping it won’t show up at our doorstep. We watched, still in disbelief, as Italy struggled to contain the virus, finally shutting down its Lombardy region as a last-ditch effort to contain the madness, sadly much too late. Now, Rome is facing what Milan did just weeks ago, and is doomed to the same fate. People are scared that while all of these events were unfolding before our eyes, and even as we knew that the virus must already be here, our government repeatedly told us it was “just the flu” and failed to provide adequate testing. While South Korea has tested over 250,000 people, we have tested a meager 4,000+. We don’t fully understand the scope of this illness in the US, and certainly not in Monroe County as we’ve tested only a handful of individuals due to our overly strict testing criteria. We’re scared because even our local government officials don’t seem to be telling us the whole truth, out of denial, or fear, or perhaps unknown to us vested financial interests. And the truth is simple – WE are now the new epicenter, not just China or Italy. Other countries are closing their borders to us, and rightfully so. Our own physicians traveled to an Emergency Conference held in New York City just last week, and are now working in the community, untested, unquarantined. The virus is here, and as multiple scientists, epidemiologists, and physicians have repeatedly stated – there is now world-wide community spread. To tell this community that our risk was low is a simple lie. The truth is that eating out at a restaurant, going to the movies, traveling, or drinking at a bar is dangerous and irresponsible, and the public needs to hear this. You stated that you wanted facts – here they are: As of today, there are 2,189 confirmed cases in the US – but this number is likely much higher. Based on the exponential growth curve model we have seen with other countries, this number is expected to double every 5-7 days until it reaches its peak, which some experts believe may not occur for months. A team of epidemiologists at Northeastern University predicts that if our degree of surveillance and intervention remains low, the number of affected individuals in the US will be 1,382,926 by April 30th. About 0.5-6% of them will die, depending on our response. In contrast, if we implement even modest intervention measures, we could drastically reduce that number of affected patients to 355,873, saving potentially tens of thousands of lives. According to a recent report published by the Center for Health Security at John’s Hopkins University we currently have about 160,000 ventilators nationwide available for use at a single time. If this pandemic follows the curve of the 1918 Spanish Flu (worst case scenario) we would need roughly 760,000 ventilators. What this means, is that we will need to ration care as they are currently doing in Italy. In Lombardy, people over 60 years of age are no longer being intubated, which means all of our baby boomers will essentially be left to die if they fall severely ill. This sounds alarmist, but these are just facts. Meanwhile, our movie theaters are open, restaurants are full, our children go to school, and our public market is proceeding as if nothing is happening. Approximately 40,000 people visit the market on a given Saturday. With 2 confirmed cases now in Rochester I can only imagine what the numbers may be by Monday. This is in part because your reassurances and lack of decisive language and action (such as not recommending that public venues and schools shut down) has misled the public as to the risk of these activities. Make no mistake – transmission of Covid-19 is happening in all these contexts and will continue to occur. Recognizing this fact, most universities and colleges nationwide have closed their doors already, but this is not nearly sufficient. Science tells us that when we can prevent children from being a high transmitter group, we can significantly reduce the number of older people who die. This is the whole basis for childhood vaccinations. But until we close our schools, private businesses will continue to stay open and people will continue to go to work, infecting each other and raising our infection rates to a number our health system simply cannot support. As Public Health Commissioner it is your duty to advocate for the safety and well-being of your constituents. This must go beyond simply telling people to wash their hands and avoid large crowds. This is what you can and should do: 1. Tell the schools and all nonessential businesses to close. In the meantime, work with the federal government to provide assistance for those individuals and small businesses that will be financially affected by this change. Do not wait another day to do this. 2. Demand the cessation of all non-essential activities and gatherings. 3. Demand more testing be done. Loosen the testing criteria – we know by now that early symptoms are often mild. We need to catch these cases early on and isolate them. 4. Set up drive-by testing stations NOW. This will reduce exposure of people in Emergency Departments and doctor’s offices. 5. Test hospital or nursing home staff that feel they may have been exposed or have even mild symptoms. 6. Ensure adequate PPE for all healthcare personnel. If they fall ill there will be no one left to care for the sick. 7. Consider setting up a mobile alert system or app that tracks all new cases in the area as well as that individual’s place of employment and recent whereabouts (stores, places of worship, etc.). This will allow other individuals who may have come in contact with the infected person to isolate themselves and watch for symptoms. This is what South Korea has done and it has worked beautifully. Most importantly, communicate clearly the vital necessity of changing our habits now, rather than later, and be transparent about the challenges to come. This will be a public health emergency the likes of which we have not seen here in our lifetime. To tell people otherwise is a misrepresentation of the facts and wishful thinking. Your words and actions may change the course of thousands upon thousands of lives, and you need to act now. Sincerely, Elena Kapilevich, M.D. Emergency Physician