By Chip Ross
April 30, 2020
As a Board-Certified physician in Internal Medicine, I have spent 40+ years diagnosing and treating infectious diseases in Emergency Departments and private practice. I have been potentially exposed to AIDS, hepatitis, influenza, whooping cough, diarrhea, and many other infectious diseases hundreds of times, if not thousands of times. Healthcare workers have a healthy respect for life and infectious diseases. Over the years I have carefully tried to practice protective measures and have been fortunate enough to have never become ill with any of the above diseases with preventative measures. Health care workers manage the risk of potential infection.
COVID – 19 is a highly infectious virus that can cause severe illness, permanent damage and death in any age group. Simply check the figures at any state’s Health Department website. But older adults and younger people of any age with underlying health issues such as diabetes and high blood pressure are at higher risk for severe illness. There is no doubt that the debate will rage for years as to whether disruptive interventions taken primarily by the Federal and State government, and augmented by the County and City government averted the projections of various disease models or were superfluous.
However, there are some facts that can be counted upon to be fairly certain with COVID-19. A person can be asymptomatic and still be infected and transmit the disease. The most effective way to prevent getting the disease or managing risk, is to stay at least 6 feet from other people and not touch anything an infected person has touched or breathed on.
For at least the next 4-6 weeks my wife and I will continue to do what we have done for weeks; respect life and the virus. We will only go out for essential reasons such as going to work, getting groceries or restaurant takeout, and other items we cannot order and have delivered. We will not be going over to friends’ houses, eating out, walking the beach or Greenway or otherwise closely interacting with other people – all activities we enjoy doing. We will continue to ride our bicycles staying at least 10 feet from anyone else. I will continue to participate in City meetings with appropriate social distancing. We will continue to manage our risk of getting infected and potentially infecting others.
Once you get ill it is too late to wish you had respected the virus earlier.
Stay well.
Mr Ross, While I respect your opinion and your career experience, I have read with interest the views of other practicing Dr.’s dealing with infectious diseases and actively dealing with Covid-19 patients. One of these doctors has stated that locking down the country away from not only covid10 but all other germs and viruses that we are interacting with every day of our lives actually reduces our natural immune system and ability to cope with them. If we completely sterilize our homes to the point of no infectious viruses or germs being present…and hunker down until the experts think it is safe to come out…what do you think will happen? Once we do come out and come back in contact with ALL problem viruses you will have mass new infections of not just covid but everything else we have not been around while in lockdown. Now you will really have a pandemic on your hand that will over run the health care system. Just a thouhgt here.
Why would I share this story, as you command? I don’t know why others would be interested in your particular professional experiences, even the successful protective measures, or the reiteration of information about COVID-19 that they likely have already know, nor how you plan to behave. They might take it as a lecture or maybe even an attempt to control them. Though the part about participating in City meetings would probably be a give away.
Dr. Ross, How ironic that an opinion titled “Respect not Fear” is based in large on fear mongering. Your arguments are specious at best.
Your statement that, “COVID – 19 is a highly infectious virus that can cause severe illness, permanent damage and death in any age group.” is as undeniably true as it is misleading. In your commentary, you treat everybody the same, as if an 80 year old and a 40 year old share the same risk of being harmed by Covid-19. If you are unaware of the dramatically different risk profiles by age group, I suggest that you take five minutes to do an online search where this information is well documented. It’s been known almost from the the outset of public awareness of the Covid-19 virus and has become increasingly substantiated over time.
In your role as a physician, I’m confident that you would counsel someone with a peanut allergy to not eat peanut butter, but certainly you would not provide the same recommendation to a patient who does not suffer from a peanut allergy. Treating every patient the same regardless of their specific risk factors would be malpractice. Your article is malpractice!
You commingle the concept of risk management and disease prevention, which indicates that you are unable to differentiate between “best practices” and actual risk management. There are ideals and there is common sense. I have no doubt that your intentions are to help as many as possible. However, your policies do not take risk into consideration and are, thus, a fundamentally flawed as public policy.
You are deceiving yourself and others that riding your bike ride is safer than going to the beach or walking on the greenway. Perhaps you have your own Olympic peloton track, but you are definitely not going to have 10 feet of buffer if you are riding on the bike trails or streets of Amelia Island.
You end by saying, “Once you get ill it is too late to wish you had respected the virus earlier.” Pure fear mongering! Nobody is immune and no one wants to get the virus, but the vast majority of people who get the virus across all age groups do not die. Many, perhaps even the majority, have zero symptoms. Respect takes into account actual risk and the omissions and illusions in your commentary ignore the most critical information necessary to keep people safe.
It’s fascinating how highly intelligent people can draw such different conclusions and interpretations from the same set of facts or statement.
Dr. Ross presents – at least through my eyes and the filters of my circumstances and experiences – the forthright opinion of a highly experienced professional.
Yes. He calls the virus deadly – and it is. That’s not an overstatement by any stretch. Just read the obituaries and the latest death count here in the U.S. is over 60,000! Those include young and old – and the odds and the breakdowns don’t matter much – when it’s your father, mother, or relative or friend who has died.
Dr. Ross makes it clear that the odds of contracting and dying from the virus increase significantly – regardless of age – if the immune system in the body in question is compromised. That’s easily verifiable.
He states that people who look and even feel normal can carry and unknowingly spread this deadly virus. And that keeping a safe (at least and preferably more than 6 feet) distance can help prevent passing or catching this deadly bug.
He then tells the reader that he will do what he thinks is “right” (perhaps efficacious is a better term) to both protect himself and his family as well as others – including practicing what he – as a doctor – tells others to do – i.e. “manage – rather than fear – risk”.
This is not fear mongering. Nor are his arguments by any stretch “specious.” Certainly, he is not exaggerating the risk nor – if he is being overcautious – doing harm to anyone with his suggestions.
Dr. Ross is not “ordering” or “commanding” anyone to do anything or attempting to control anyone by the statements above. But he is telling us what he personally is doing – and hoping to influence behavior that in his judgment will enhance safely for everyone.
Dr. Ross should be applauded for his service to the community both at our local hospital on the front lines and for years at our city council, for his courage in letting people know what course of conduct will spread the virus the least – even if that conduct calls for self-discipline and sacrifice.
There has been much talk of “We Have Our RIGHTS” but little mention by the same people of responsibility. As a member of a community that we expect to protect us and provide us with things and services we want, we in turn have an obligation to respect that others have rights too. The (fortunately relatively few) church leaders who insisted they had the “right” to bring hundreds or even thousands to worship in their churches in spite of state bans on such gatherings to prevent the spread of the virus gave no thoughts to those whose “right to life” (familiar phrase?) they could be violating by creating such a risk when most clergy knew better. (Wiser more caring clergy used telecommunication to hold their services and one wonderfully clever leader encouraged all to come to the church – in their rolled up windowed cars – where he held a radio broadcast and congregants beeped their horns to say “Amen”. He proved that rights and responsibilities are not mutually exclusive)
Caring for others and living our lives fully is not a mutually exclusive thing. We will open up to business (we really never totally closed thanks to hundreds of wonderful people in our Publix and Harris Teeter supermarkets and others providing medical, police, fire, and other vital needs regardless of personal risk) at the time and to the degree wise officials think it is safe. But this pandemic will not quickly or quietly go away! Even when it first appears to be gone, it – or its mutated self – will be (like the Terminator) back!
So it’s not too much to ask that, before you jump to criticize a man who could have turned his back and said, “That’s not my job!” “I don’t need this aggravation.”, you step into the shoes of one who has accepted responsibility. Dr. Ross’s words above are measured, well intended, and sound.
Dr. Ross was clearly commenting on my earlier editorial, “Are You Afraid of the Dark”. I felt the need to defend it. I had submitted another evidenced based editorial and later decided to, instead, comment directly to this editorial. I certainly am not diminishing the number of deaths from the virus, but creating policy from a total deaths number ignores the actual functionality of the virus.
Below is a table based on actual data about Covid-19 morbidity.
AGE DEATH RATE (all known cases)
80+ 14.80%
70-79 8.00%
60-69 3.60%
50-59 1.30%
40-49 0.40%
30-39 0.20%
20-29 0.20%
10-19 0.20%
0-9 no fatalities
For a detailed explanation see: https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
How many were aware of the extremely low risk to anyone under 40? Do you feel manipulated by the media and policy makers not communicating on these important statistics?
I am speaking to public policy and not personal decisions. Clearly facts matter in public policy. The risk could not be more dramatically different between age groups. This has not been included in the public policy from our local authorities, Commissioner Ross, to President Trump. It is critically important that these factual numbers are made a part of public policy decisions.
It clearly makes no sense based on the covid-19 data to keep younger people from working and keeping the economy moving. There are just too many people hurt more by their lack of employment than the virus. These same, low risk, individuals should be able to choose to continue in other life activities, such as going to the beach, etc. Their doing so does not put anyone choosing to shelter in place at significantly greater risk.
In my own life, I have avoided visiting my father and mother-in-law because they are both older and compromised by various health conditions. It’s unlikely that I have Covid-19, but I have made a personal decision to limit contact due to their risk stratification. I have limited my contact with other family members out of respect for their fears rather than their actual risk.
I am not suggesting individual recklessness, but am calling for public policy that does not restrain individuals from very low risk actions. There will always be individuals who act recklessly given their freedom, but they will also deal with the consequence of their choices.
Steve, your remark,
“Wiser more caring clergy used telecommunication to hold their services and one wonderfully clever leader encouraged all to come to the church – in their rolled up windowed cars – where he held a radio broadcast and congregants beeped their horns to say “Amen”. He proved that rights and responsibilities are not mutually exclusive”
This demonstrates my point. Those same individuals, safely distanced in their cars were threatened with arrest! Is that not wrong by your own standard? Public policy has been based on fear and not respect!
Steve commented, “Dr. Ross is not “ordering” or “commanding” anyone to do anything or attempting to control anyone by the statements above.” In the context of this single editorial that is true, but Chip is a city commissioner and has been instrumental in the policies that have legislatively controlled people living in his district. I don’t see how to disconnect this article from his policy making role. As I previously indicated, I believe that Dr. Ross has good intent. I disagree with his ultra conservative approach which I believe does more harm than good, despite such good intentions.
I feel the same about Dr. Fauchi. Fauchi is best known for his research in AIDS prevention. In this role Dr. Fuachi did not dilute his efforts by focusing on the entire population, he focused on the homosexual community. Clearly AIDS is a virus that attacks regardless of sexual preference, but Fauci wisely focused on the most prevalent methods of virus transmission to achieve the best results with the available resources. I just want the same level headed approach to Covid-19 or any other virus.
“Even when it first appears to be gone, it – or its mutated self – will be (like the Terminator) back!”
And how will react then? Will we close society again? Our current response is not sustainable. What happens when Covid-20, 30, etc comes? Our response has created issues that will be destabilizing for years to come.
One of my greatest fears about our response is that we may have just kicked the can down the road to the upcoming fall and winter when corona viruses generally thrive. If that turns out to be the case, will we be able to look back at our current response and feel good about it? Will our response eventually result in a greater number of deaths?