My colleagues are working flat out these days. After seeing our list of patients, we are on the phone and email advising people to quarantine, to get tested, or take measures such as social distancing.
What we are trying to do is help ‘flatten the curve’ of the outbreak: to avoid a peak of infections; to slow down the rate of transmission; and have it play out over as long a period as possible.
The frightening reports from doctors in Italy describing an overwhelmed hospital service, dealing with a peak in admissions of potentially fatal bilateral interstitial pneumonia caused by the virus, makes the work ever more urgent.
Many of our patients are elderly, multi-morbid, and therefore vulnerable to the worst effects of the virus.
When I advise our healthy patients about measures they can take, many are blasé, given the symptoms they get will probably be mild. When I explain that these measures are not for their own sake, but rather for the most vulnerable among them – their relatives, friends or neighbours – I can see it sinking in, and a new seriousness emerging.
If there is a silver lining to this crisis it is the revelation of how connected we are to each other, in ways we have almost forgotten. We are a species with special concerns. We cannot afford to operate alone as individuals; to do so is to threaten us all. This realisation is putting into stark relief the way we have organised our societies over the past few decades.
Some private health care clinics in Dublin are now putting up signs saying they will not accept patients with respiratory symptoms, directing them towards their G.P’s. This is in one way understandable as a means of limiting transmission, but while the public service is taking extra measures to distribute information and organise the response, these private clinics are under no compulsion to do so.
Successive Irish governments have developed a dual private\public system, where the state health service lacks resources and, not least, organisational capacity, meaning that this crisis could be a painful exposure of its limits.
In the U.S, Trump’s apparatchiks like Mike Pompeo have sprinkled their public statements with references to the ‘Wuhan corona virus’, pointing the finger abroad to evade criticism of their response to the crisis.
As of Sunday, a mere 1,707 Americans had been tested due to a lack of test kits. South Korea, by contrast, has tested more than 189,000 people. The U.S is hampered by a hollowing out of the U.S civil service and the privatization of health care.
Turns out big government, when the shit hits the fan, is a very good idea.
This crisis will abate. It is hard to gauge how many people we will lose to the infection, but when the wave has broken and dissipated, hopefully the realisation will have dawned that the defences we build are only strong enough if we build them together.
Dr Samuel McManus is an Irish G.P. currently working in Norway.
1/ I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen "here". The media in Europe are reassuring, politicians are reassuring, while there's little to be reassured of. #COVID19 #coronavirus
— Silvia Stringhini (@silviast9) March 9, 2020