COVID-19, My Thoughts on the Road Ahead
The situation surrounding the COVID-19 novel coronavirus has rapidly evolved since my blog post last week. We are seeing a once in a generation public health and financial crisis. I know that many people are anxious, scared, and uncertain about what the future will bring.
I debated about what I should write about this week. On the one hand, If you’re like me, you’re probably sick of hearing more news about the coronavirus. I don’t necessarily want to add to all of that noise. However, with that being said, I feel like it’s hard to focus on anything else other than how this illness is affecting each and every one of us.
As a medical doctor, local church leader, and personal finance blogger, I feel like I have a unique perspective on this constantly evolving global pandemic and it’s far-reaching effects. Many people have asked me for my opinion and advice. So today, that is what I’d like to write about. My hope is to offer some insights from my perspective that might help answer some questions you might have about what is going on in the world. This will be less focused on financial topics and more about the overall situation and how we can get through this together.
What’s Happening Where I Live
First, I’d like to start by sharing with you some of the impacts this has had on our family and what is going on where we live. Most of you will undoubtedly find similarities with what you are experiencing in other areas of the United States and throughout the world. Sharing our experiences during these tough times, especially with the restrictions of social isolation, can help us understand that others are going through similar situations, helping us to not feel so alone.
At the time of this writing there are more than 300,000 reported cases of COVID-19 worldwide, with nearly 13,000 deaths. In the United States there are more than 21,000 cases and nearly 300 deaths. In my home state of Wisconsin, there are 157 cases and 2 deaths. While the spread has certainly been less here than in states like California and New York, we all know its just a matter of days before the numbers go up dramatically.
Beginning with our family, as I had written last week, we had to cancel our family trip to Japan for spring break that we had been planning for months. We had made other last minute vacation plans, but we ultimately canceled those as well. With the ever increasing travel restrictions and spread of the disease, combined with the need I felt to be available at the hospital and for our local church members, my wife and I agreed it was the right thing to do to stay at home.
Like nearly all hospitals in the United States, we are preparing for a surge of patients with COVID-19. We have canceled all upcoming elective surgeries to preserve medical supplies and ventilators. I have also had to go through my entire clinic schedule through May and postpone all non-urgent elective appointments.
As a neurosurgeon, I will likely not be treating COVID-19 patients directly. However, people will of course continue to have other medical problems, including life-threatening neurosurgical emergencies. We have 4 neurosurgeons in our practice and we are the only major trauma center in northwest Wisconsin. In this time of crisis we have changed our call schedule such that we are in now in two teams of two neurosurgeons each. The first team will be on call for a week, with one surgeon covering the ER and taking patients to surgery, and the other covering urgent/emergent clinic appointments. The other two surgeons will be on standby in case one of the other surgeons becomes sick, working from home to minimize exposure to anyone with COVID-19. During the week on standby we will be doing as much as we can to connect with patients via phone calls and telemedicine. The next week the two teams will switch, and this will continue through at least May.
While the hope is that our hospital systems will not become overwhelmed, we are hoping for the best, but planning for the worst. We have also been asked to be backup for other hospital roles such as working in the ER, on the hospital floor, or in the ICU. All healthcare workers are banding together to try and do what we can for our patients during this global pandemic and healthcare crisis.
Things have also changed significantly at church. As with most other faiths, all in person church meetings have been canceled for The Church of Jesus Christ of Latter-Day Saints for the foreseeable future. As the bishop of our local congregation, I have been very concerned about the health and financial well-being of our members. It constantly weighs on my mind and my heart. For the last few days, after I have finished my work responsibilities, I have been reaching out to dozens of church members to ask about their health, what is going on with their job, how they are doing financially during these difficult times, and offering assistance where it is needed. Analogous to our preparations at the hospital, I have also been working with our other local church leaders to create a response system to care for people in need when and if things significantly worsen.
The schools here have closed for the rest of the school year, as they have in most other states at this point. That means our four kids, now ages 17, 15, 13, and 11 are all home. We’ve tried to create a schedule for the kids to maintain some consistency. Some days we’ve been more successful with this than others. We’ve had some great family moments where it has been so nice to have everyone home and do fun things together. But I’m not going to lie, there have also been moments, usually sparked by the kids fighting or complaining about something, where things spiral out of control and it feels like we’re not going to make it trapped under the same roof for an extended period of time.
Many local stores and businesses are shutting down. Restaurants are closing with only takeout food available. Many grocery store shelves are empty as people try to stock up on food and supplies for the uncertain times ahead. There are limits on how much you can buy of certain items. It seems like there is a palpable, somber feeling in the community.
I’ve felt like it is important to stay informed and up to date on the constantly changing situation in our country, state, and local community. As a result, I constantly find myself watching the news or reading articles online. I’m sure it isn’t healthy, but it is difficult to stop and its hard to focus on anything else.
It also seems like I’m getting a COVID-19 email from every company and organization that has ever had my email address. It’s honestly getting a little ridiculous. Just yesterday I got an email from both my car dealer and where I get my hair cut about COVID-19, among many others. Seriously? While I’m now deleting most of them right away, it reinforces the fact that this pandemic has permeated every aspect of our lives.
Now that you better understand what my experiences have been, here are some questions that you might be asking yourself and my thoughts on each.
Should I Be Taking This Serious?
If you remember one thing from this post, remember this. Yes, you need to take this disease seriously. Not only for its public health implications, but also for how it is affecting our economy and our very way of life for an unknown amount of time. Those that are not taking this serious are either uninformed, naive, or in denial. Do we need to panic? No, but we should all be concerned and anxiously engaged. Does the media sensationalize some of the information we are getting? Absolutely. That is how they get us to come back and watch more.
But putting any media bias aside, the facts are the facts. Hundreds of thousands of people have been infected. Nearly 13,000 people have died. There has been a 30% decline in the stock market in about a week’s time, drops not seen since the Great Recession in 2008 and the Great Depression in 1929. Millions of people have lost their jobs. And nearly 1 in 5 Americans are currently under a shelter in place order, with more likely to come, further stagnating the economy. Yes, we need to take this seriously.
So, what does that mean? Well, in simple terms, each of us has a social responsibility to do all that we can to prevent the spread of the disease. As you have likely seen or heard many times by now, we are trying to flatten the curve. This means we are trying as a country to try and slow the spread of COVID-19 so we do not overwhelm our healthcare resources. This means doing the simple things the federal and state governments, as well as epidemiological experts, are asking us to do. This includes regularly washing our hands, social distancing, and eliminating all discretionary travel.
Let me try to dispel two misconceptions here. First, that this is just a disease of the elderly. Many younger adults believe that if they are infected, it is just like a cold or mild flu and they aren’t at risk of dying; they will recover quickly, and life goes on. While it is true that those that die from COVID-19 are mostly the elderly, that does not mean you can’t become critically ill.
The most recent CDC data in the United States shows that nearly 40% of those sick enough to be hospitalized with COVID-19 are between the ages of 20 and 54. Furthermore, half of all ICU admissions for COVID-19 in the US (which pretty much means you are on a ventilator) are age 65 and younger. And we can’t confidently predict at this point who will have a milder form of the disease and who will be critically ill. From my perspective as a doctor, this is mildly terrifying.
Even in the face of this data, I’m sure many younger adults will still say, even if I get seriously sick, I’m not going to die. True, you are less likely to die. But let me tell you with confidence, from someone that is in an ICU almost every day, that you DO NOT want to be in an ICU on a ventilator. It is miserable and you should do all you can to avoid it.
Also remember that even if you don’t become seriously ill after becoming infected, there is still a good chance you can transmit the virus to someone else, including the period when you might be asymptomatic. This could be someone that is elderly or that has an underlying medical conditions and is in fact at higher risk of dying of the disease. And these aren’t just statistics or numbers, these are real people. We all have parents, grandparents, neighbors, and friends that fall into this category. Imagine if a significant percentage of them were to die after this is all said and done.
Second, some people look at statistics and footage from countries like Italy, that are absolutely drowning right now, and say that could never happen here in the United States. Again, as someone that works in a hospital every day, let me tell you that is absolutely NOT the case. Hospitals throughout the United States were already operating at near capacity before the outbreak of this global pandemic. If COVID-19 cases surge out of control, we could just as easily be overwhelmed.
How could this be? Why weren’t we more prepared? You have to understand that hospitals are businesses. They don’t have a surplus of beds “just in case” something bad happens, like an epidemic. Empty hospital beds lose money. Thus, hospitals try to function at or just below their maximum capacities to maximize their revenue streams. Even then their margins of profit are usually very thin. This is why we are canceling all elective surgeries and procedures, to make room in already full hospitals for the anticipated waves of COVID-19 patients. And this is why it is so imperative that we try to flatten the curve and avoid overwhelming our healthcare system. Because if we don’t, in 3 weeks we will look just like Italy does now.
So please take this seriously. Stay home and stay healthy so you don’t become seriously ill with COVID-19 or spread it to others.
What Should I Be Doing in This New Normal?
I won’t pretend to have all the answers to this question. But I think we need to make sure the things that are the highest priority in our lives are attended to. With that in mind, here are some of my suggestions:
Take Care of Yourself
If you aren’t taking care of yourself, you can’t function at your fullest capacity. And you certainly can’t take care of others.
In this new normal, where many if not most of us are restricted to our homes, our regular daily routines have been completely disrupted. There may be the temptation to “let yourself go.” Don’t let that happen. I guarantee it won’t make you feel better in the long run. Create a schedule for yourself to be productive. Make goals that you can work towards and track your progress.
Take care of yourself physically. Make sure you exercise regularly or have some form of physical activity. Going from the couch to the refrigerator doesn’t count. There are plenty of things you can do to exercise at home, even without any exercise equipment. If you can, spend some time outside going for a walk or a run. I went for a walk today and it was amazing to feel the sun on my face (even if its only 30 degrees out) after having been mostly indoors for the last 3 days.
Although it may be hard, try to eat a healthy diet. There will be a tendency to want to eat bad foods and/or more food as we try to deal with the stress and anxiety of everything happening in the world, especially since food will be easily accessible if you are home all day. I promise that you will feel worse about the turmoil in the world if you are 5 or 10 pounds heavier. (This is probably more of a warning for myself)
Take care of your mental health. Don’t spend all of your days watching the news or scrolling through online updates on the pandemic. You’ll end up going crazy and be more stressed than you need to. This is what I need to work on. Make time in your day for spiritual things and/or meditation. Rather than always focusing on the negative and uncertain (which is so easy these days), try to spend some time counting your blessings and the positive things around you.
Take time to learn and grow. This may be more difficult if you have children that are home all day. But try to find some time to continue to develop yourself intellectually, maybe early in the morning before the kids wake up, or at night after the kids have gone to bed. Read a book. Listen to audiobooks or podcasts. Take an online course. Read my blog. Heck, start your own blog. Do whatever makes you feel like you are still growing as a person.
Take Care of Your Family
Nothing is more important than your family. During this time of uncertainty, do everything you need to do to make sure they are cared for and safe.
If you have a job, be grateful that you do, and do it well. If you are one of the millions of Americans that have lost their job or source of income during this crisis, I am so sorry this has happened to you. But even though you’ve taken a significant blow, you must quickly get up, dust yourself off, and do all that you can to provide for those that depend on you.
I would recommend filing for unemployment right away. I would also try looking for opportunities to work for those businesses that have had a huge increase in demand, like grocery stores and hospitals. Some large companies have announced that they are looking for thousands of new employees to meet these demands, like Walmart and Amazon. It may not be your ideal job, but in the short term while the economy is reeling, anything to pay the bills and care for your family would help. I would also reach out to family members that might be able to help during these difficult times. If these options aren’t enough, you could also look to your church or charity organizations for assistance. The government has promised that financial aid is coming, but the best estimates suggest that it could still be a month away, so I wouldn’t wait for that to come, act now.
Financially, I would recommend that every family does what they can to reduce expenses and save money. This extra time at home would be well spent going through your expenses over the last few months and seeing what can be cut. I would recommend that other financial goals, like paying down debt or investing, be temporarily put on hold unless you already have a very large liquid emergency fund at your disposal and your job/income is very secure. While paying down debt is certainly a worthy financial goal, a paid off auto loan is not going to buy you groceries or pay your rent like liquid cash in your savings account can. Likewise, investments are so volatile right now that I would not recommend you invest any money you might need for ANY purpose in the near future. Only invest if you have a robust emergency fund and very secure income.
In addition to caring for your family’s temporal needs, make sure that you focus on strengthening relationships as well. This will likely take a conscious effort. The allure of technology is so strong that most families will probably default to a state of everyone being consumed by video games, movies, and social media on their individual devices. Even though they are together under the same roof, they are separated by the walls of technology.
Set time for family meals and eat together. Make everyone put their devices away and talk to each other. Talk about how each person is doing. As parents, reassure your children that things will be okay during this time of uncertainty. Play games together. Have talent shows. Pray together. There are so many things we can do with our families together to make the best of these difficult times.
Take Care of Others
Throughout my life I’ve been blessed with many opportunities to serve others. I was able to spend two years in Japan as a missionary serving the wonderful people there. I have had the opportunity to serve as a scoutmaster in the Boy Scouts of America for many years. My job as a neurosurgeon allows me to use my education and training to serve others in their hour of need. And my current church responsibilities give me the privilege of helping the members of our congregation through some of the struggles of life.
During these years of service I have discovered an amazing truth. When we lose ourselves in the service of others, the troubles in our own lives don’t feel so overwhelming, or simply seem to vanish. For some reason, when we put other’s needs above our own, our burdens seem lighter.
As this global pandemic spreads and worsens, many people are feeling very lonely, isolated, and scared. This may include ourselves. Despite the restrictions of social distancing, we can still find opportunities to serve and help others. We can use technology to overcome this barrier. Phone calls, text messages, emails, FaceTime, and Zoom allow us to connect with one another, even in the face of a global pandemic.
Who in your life is lonely and isolated right now? Perhaps a grandparent or neighbor. Who could you reach out to? Is there someone you know that has lost their job? Are you in a position to help with some groceries? Maybe give an anonymous cash donation. Could you involve your family in acts of service for others? A lesson to your children about helping someone in need could be more valuable than anything they could learn from a book or in the walls of a school.
As you seek out ways to take care of those around you, I promise that there will be an added measure of light in your life. Your own feelings of stress and anxiety will become less oppressive, and you will see the world from a more positive perspective.
When Will This End?
Of course, no one has the answer to this question. But it’s probably the number one thing on everyone’s mind. While I obviously don’t have a crystal ball, let me share some of my thoughts on this burning question.
I’m not going to sugar coat this. From both a medical and financial perspective, I honestly cannot realistically see things going back to the way they were any time soon. Let’s look through each of these two lenses.
First, from a medical standpoint. Let’s start by looking at what we know from the Chinese experience. Over the course of about 2 months, the Chinese government was able to lockdown the city of Wuhan and the Hubei province, thereby isolating it from the rest of the country. While there were more than 80,000 cases and 3,000 deaths in China, these draconian measures were able to stop the virus from spreading to the rest of the country and its vast population.
Is this possible in the United States and other western countries? The simple answer is no. China has a communist authoritarian government. The drastic measures taken there are beyond what would be tolerated and possible in western society. But if it were possible, we would rationally expect to see society shut down for at least 2 months (like in China) to achieve the same result before returning to some form of normal. But since it is not possible, things will likely last much longer in the west.
Furthermore, it‘s really too late for this type of containment. The disease is not isolated in one city or state. There is evidence of community spread of the disease throughout all 50 states, and as of today 148 other countries in the world.
Let’s examine the strategy that the United States, and most of the world, is now left with to try and control the spread of the disease: flattening the curve.
Nearly everyone has seen a graph like this one over the last week or two. Countries like Italy are unfortunately in the red. They cannot adequately care for all those that are getting sick at the same time, and as a result people are dying at a rapid rate. In the United States we are trying to drastically slow the spread of disease through social distancing and isolation so as not to overwhelm our available healthcare resources, moving from the red trajectory to the blue trajectory. There are two important things to note with this shift.
The first is that the number of people infected (as represented by the area under the curve) is not drastically different than the red curve. It just doesn’t peak as fast, which would hopefully prevent our healthcare system from being over saturated. This would allow all who need medical care to get it, and would hopefully save lives.
The second is that one result of flattening the curve is that you stretch it out over a significantly longer period of time. So back to the original question, when is this going to end? If our current strategy is successful, it could be many more months. This doesn’t necessarily mean that we will all be under strict quarantine for many more months. I don’t think that is possible from a societal perspective. But to avoid a second wave in the “red zone” on the graph we will have to slowly ease back into societal norms controlling the infection rate as we go. A vaccine could speed up the process, but even the most optimistic estimates state we are at least a year from that point.
Second, from a financial standpoint. As I reviewed above, the damage this virus has done to our economy has been severe and widespread. Entire industries, like travel, tourism, and service industries have been completely decimated. Millions of Americans have lost their jobs and unemployment rates may rise to levels not seen since the Great Depression. And the market is on a free fall reminiscent of the Great Recession and the Great Depression.
The difference between those economic fallouts of the past and the current financial crisis is that the underlying problems in our history were financial in nature, whereas the current crisis is a pandemic. In the past, financial interventions from the federal government, such as drastic cuts to interest rates and government bailouts of big business, were able to help speed economic recovery because the root problems were of a financial nature. While the federal government is desperately trying similar remedies today, including a trillion dollar economic stimulus package, they will likely only be of limited benefit because they do not address the root cause: a disease.
I believe this means that we cannot truly start to heal economically until the cause of this crisis (the pandemic) has peaked and is significantly improving. The economy cannot recover until businesses are able to operate as normal and people are allowed to return to work and consume. As discussed above, it will likely be months before this is even possible from a medical perspective.
But even though it will likely take months before things start to significantly improve, I do strongly believe that our country and our economy will recover from this. I implore everyone to not lose hope. Remember that this too shall pass. I have faith in our country and faith in each other. I believe in my heart that when this is over, we will all be stronger and more united than ever before.
Conclusion
While these are difficult and uncertain times, hopefully my post today has helped answer some questions you might have and give some perspective. Here are some take home points to consider:
- Please take this disease seriously. Each of us has a role to play to try and slow the spread of disease. If we are socially responsible and all play our part, it will help save lives.
- In this new normal, make sure you take care of yourself, your family, and those around you. Focus on the most important things and what you can control.
- While it may be a number of months before things start to slowly return to normal, don’t lose hope. We will all get through this together.
Thanks for reading. Please stay healthy and safe. If you have any experiences that might help or inspire others, please leave them in the comments below.
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