Pandemic Perspective #34 November 14, 2020
Covidiocy by the numbers
San Diego crossed an important threshold this week; we have passed the magic number of 7 – the number of new cases of COVID-19 per 100,000 residents per day, placing the region in the tier that requires resumption of restrictions that are health-damaging and economically devastating. We are at 8.9 and various public venues will be on lockdown again beginning today. It is certain that some businesses will not survive this new clampdown, and some San Diegans will not, either.
It’s not my intention to dismiss the seriousness of the situation that we are in, a rise in cases that will strain healthcare facilities and personnel in several parts of the country, including ours. Influenza is joining the attack and that will certainly make things worse. My concern is that decisions are not being made thoughtfully, fairly or evenly and that such responses are inviting not only resentment but anger and refusal to adhere to the guidelines.
The media report that hospitals are reaching capacity in some parts of the country but that is certainly not true in San Diego. According to the tracking information provided by the San Diego Union-Tribune (www.sandiegouniontribune.com/tracking-coronavirus-cases-san-diego-county) the county’s available bed capacity is approximately 2,000 while those currently occupied by COVID-19 patients is about 400.
San Diego County is the second largest in the state both in area and in population. Public health authorities shouldn’t consider it as a single entity when assessing risk of coronavirus infection. For instance, most cases by far have occurred in the South County, where restrictions might have a greater effect than in North County, which has experienced many fewer cases and fewer deaths
The strictures applied to different businesses and organizations are frankly bizarre. Consider that fitness centers are closed or restricted but casinos are open. My local fitness center clientele is predominantly young, healthy and not obese. The risk of death or serious illness among those who work out there is almost zero. There have been only four COVID-19 deaths in the entire county among those aged 20-29 since the onset of the pandemic.
How about those casinos? Many if not most of their customers fit the all-American profile: older, overweight or obese, diabetic, smokers, with at least one marker of coronary artery disease. Does the term comorbidity ring a bell?
Of course, if you are stressed out by fear of the virus or of losing your job you are welcome to stop by your local pot shop. It’s still open.
Stone Age Doc 
Deae Phil, while I appreciate your knowledge as a physician, this particular commentary feels more tinged by frustration/anger and perhaps less informational at the end. Your last 2 emails have felt that way. We are all tired of the virus and likely to become much more so. But many people are ignoring public health mandates already, not wearing masks or honoring keeping out of household gatherings low. Yes, the county is large, and dividing lines are often arbitrary. But we are truly all in this together. And higher socioeconomic groups in north county are not isolated from those lower socioeconomic residents in south bay. Younger people may be less at risk themselves but can also be unknowing agents of spreading the disease to those at higher risk. I truly believe our elected officials are doing the best they can, whether I agree or not. You are certainly entitled to your opinions, as am I, but undermining public health officials right now can also be harmful to us acting together to protect each other. I apologize for my ramblings. I miss your past more informational writings on your influential platform Thank you for reading, Tina
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Hi, Tina,
Thank you for your message. I realize that some of my blogs will stir controversy but in more than 60 years in medicine I have never witnessed such differences of opinion regarding a single topic, so no surprise there. Right off the top of my head I can think of three large groups of physicians whose views are quite different from those of the medical rulemakers (that last term is not a pejorative) on three different topics — Hydroxychloroquine, lockdowns and schools. You are correct: I am angry and frustrated. But most of my pediatric colleagues agree that all schools should be open. Protecting the students’ older and more susceptible contacts is not an impossible task; several studies now show that children are less likely to spread the virus than adults.
I expected that my comments regarding North County/South County would draw some fire. That issue has many aspects, some of which are themselves flashpoints and not amenable to being addressed in a short blog — maybe not even a long one. If you look at the demographics on the U-T website that I mentioned in the blog the numbers are overwhelming. The South Bay area deserves more medical services than it is getting.
Neither is it my intention to undermine public health officials. They are doing that to themselves, as witnessed by their failure to adhere to their own rules. I cannot fault their flip-flops on policy; they are justified in doing that as more information about this peculiar virus becomes available.
I do appreciate your feedback. Feel free to let me know if there are some issues that you would like me to address, including viewpoints that are different from my own.
Best regards,
Phil
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Love your messages and comments, Phil!!
Many thanks for all you do yo keep us informed (and sometimes amused).
Sandra M
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