OP-ED: Listen to the experts, not Dr. Pandelidis
Reading Dr. Steven Pandelidis’ opinion piece on the pandemic makes me feel obliged to respond and show there are other physicians in York who do not agree with him. I am one.
Where to start? First, before I retired from family practice, Steve and I were colleagues in the York medical community. He cared skillfully and compassionately for a number of my patients. Much appreciated.
However, neither of us was trained in the specialties of virology, epidemiology or infectious diseases. In this brave new COVID world, it is unwise and even dangerous for us riverboat pilots to pretend to be substitutes for those specialty pilots who are the only experts trained to deal with pandemics and carry us through. Full stop.
And, while understanding we are all awash in angst about COVID, it is heartbreaking to see things made worse by attempts to shoot the messengers (sometimes literally) like Dr. Anthony Fauci. They were speaking up about the dangers of COVID-19 in January and early February. Countries like Germany, New Zealand and South Korea, and Washington State, as well, chose to listen and respond rapidly. Their amazingly low death rates show what happens when you listen to experts and promptly respond.
This is what outcomes look like when there is effective, trust-worthy leadership — leadership that relies on experts and communicates through fast-moving crises with clarity and consistency. With effective leadership it would have been less likely that the national media that Dr. Pandelidis refers to would “fail to keep us informed as it mostly delivered the worst news.”
Columbia University just released a study showing that if broad social distancing measures had been put in place nationally one week earlier, on March 8 instead of March 15, there would have been 36,000 fewer deaths and if, two weeks earlier, 55,000. That’s between a third and a half of all actual deaths up to the study’s end on May 3.The point is those deaths didn’t have to happen if we had had strong leadership from the top. What we’ve had is the opposite. To quote Dr. Pandelidis, “ At times, with the best of intentions, our government can steer us in the wrong direction.”
Dr. Pandelidis notes York ended up not having the New York City horror show. Sheltering in place, the horizontal distancing he names, is a main reason and it’s to be congratulated. When he speaks of now going with vertical distancing, the approach he seems to advocate is to open up everybody except the elderly and those with co-morbidities.
How does that account for caring for people in nursing homes or prisons? Those living in poverty and or multigenerational households? What should the immunosuppressed father of several school aged children do? The solution he is proposing is a searching, hopeful one, but one that is resigned to substantial ongoing death and hospitalization.
An alternative approach, a massive large scale investment in overwhelming testing/tracing/isolating would allow things to be opened up efficiently and safely and not require the sacrifice of “heroes” or whatever the nearly 100,000 who have died already, including health care workers, have been labeled (and then seemingly dismissed). Dr. Fauci has warned over and over that we can’t leap-frog over this essential step in overcoming COVID or we will pay dearly later, including with our economy.
As a result of failure of leadership at the national level, we missed the boat on ramping up the test/contact-trace/isolate project in March, April and May. For all those of libertarian bent, for those who have spent the last 40 years demonizing “government,” it’s unfortunately true that it’s only our national government that has the ability to meet these needs on a national scale because projects of this scope can’t occur except under federal guidance at the highest level.
Dr. Pandelidis holds up the food pyramid changes over time to implore the reader the ignore scientific experts. It is in my opinion disingenuous to invoke the food pyramid as a contextual basis for our scientific response to COVID-19. The food pyramid evolved, albeit likely with industry lobbying involvement, over the course of decades. By contrast the speed of scientific progress regarding our understanding of SARS-CoV-2 has been breathtaking. Of course it looks different than it did in January, and will look different in August. That is no reason to throw out the scientific method in favor of our “gut.” There is a reason the first name of this virus is “novel.”
And while Dr. Pandelidis wants us to dismiss certain experts, he then holds up Sweden as an example of an appropriate approach to COVID. Sweden actually now has the highest deaths per capita in Europe, and a recent Stockholm sero-survey shows just 7% of those in the densest, most hard-hit city in the country have protective antibodies. Also, the rural/urban issue has at least some basis in fact but deceivingly leads one to believe that rural and suburban communities are fairly immune to COVID. This virus, when given the chance, can devastate any community. The U.S. county with the highest deaths per capita is Randolph County, Georgia, in a rural part of the state.
Basing any arguments on the infection fatality rate number (which is at least 10 times higher than flu) ignores the not-insignificant proportion of patients with COVID who end up hospitalized, many of whom are left with prolonged recovery and possible long term disability.
Accepting that we are going to have to live with tens or hundreds of thousands more deaths while waiting for a vaccine in order to allow the economy to open is setting up a false choice. If that degree of death and morbidity continues then we can't just wish the economy back with slogans (people won't show up). It actually requires the hard work and investment mentioned above as well as at least a healthy majority of all of us Americans faithfully abiding by mask-wearing, social distancing and getting tested when there are any symptoms or if we have been exposed to someone who has been diagnosed with the virus. Then the tracers need to jump in.
When the facts on the ground evolve as rapidly as they have with this pandemic, we have a choice. We can look to the scientific experts in the field, those who have spent their whole lives studying infectious pandemics, or we can look to sources elsewhere — for example, to the two now-famous urgent care physicians in California who have become a viral hit, or the disgraced scientist who penned the "plandemic" video. We can turn to a president who recommends injectable Lysol, who doesn’t wear masks but does pop a potentially harmful Hydrozychloroquine because “someone” thought it was a good idea.
Don’t listen to him. Don’t listen to me or to Dr. Pandelidis, either. Do, please, listen to the virology, epidemiology and infectious disease experts, of which the vast majority are in total agreement and who are invoking a playbook which is 100 years old.
Every community will be in a different place at different times during this pandemic, but safely re-opening any community requires a) protective mitigation strategies and b) the ability to robustly test, trace and isolate.
To me, the greatest tragedy here is the politicizing of the pandemic from day one. It’s tragic that it had to occur in a presidential election year and that its optics appear to bother Mr. Trump more than our collective lives. Tragic that the nationwide identity belief systems, and polarization, as well as the rupturing of trust, the common good, the Constitution, have all laid the groundwork for the pitiful mess we find ourselves in.
One more time: We just need to make sure we are pointing our ships at the North Star and listening to the scientific experts. They're out there and talking to us. Somehow, I don’t know how, we need to figure a way to cut through the noise.