A group of more than 75 emergency room doctors, nurses and physician assistants issued an open letter Monday to the people of Miami-Dade County, pleading with them to help stop what they described as a developing crisis like none they have seen before.
The letter was signed by doctors at nearly every major hospital in Miami, including Baptist Health South Florida, Jackson Memorial Hospital and Mount Sinai Medical Center, among others. The physicians stressed that the relatively low number of confirmed cases of COVID-19, the disease caused by the novel coronavirus, doesn’t reflect what they have been seeing at their own hospitals, and that it only reflects a delay in testing. Once testing ramps up, they expect many more cases to be revealed.
They offered some blunt advice to those who still won’t take the public health crisis seriously, urging people to avoid all unnecessary contact with anyone they are not currently living with.
“One of the most insidious aspects of this epidemic is that it draws strength from people’s skepticism and feeling of invulnerability,” the letter said. “If people need to personally experience COVID-19 by having a loved one or close friend infected in order to take this crisis seriously, then it will be too late and we will suffer the full brunt of this epidemic.”
Dr. Antony Friedman, an emergency department physician with Baptist Health South Florida who led the effort to persuade the public of the virus’ real threat by issuing the warning letter, told the Miami Herald that he organized the effort because he was seeing too many comments from people on social media who weren’t taking the novel coronavirus seriously enough.
“What we’re trying to tell people is not coming from what we’ve been seeing on social media. We are talking to people based on personal experience, what we are seeing with our own eyes,” Friedman said. “If they don’t believe the media, or think what they’re hearing is rumors or hype, we have something to tell them, and it’s based on reality.”
The letter comes after a weekend that saw boaters packing Haulover Beach and tying their boats together to hang out in large groups. The day after, Miami-Dade County Mayor Carlos Gimenez ordered the closure of all marinas and boat ramps countywide.
Friedman said that the pandemic has created an entirely “separate line of work” for those in his department. He said there has already been a wave of patients “seriously ill” with fever, cough and respiratory symptoms, and they skew much younger than doctors are used to seeing.
“Any time of year there are going to be older people and people from nursing homes coming in with pneumonia, and we’re used to that,” Friedman said. “Now we’re seeing this dramatic increase in younger, healthier people, from 20-50 age groups, and it’s definitely abnormal.”
Friedman said he is often working without knowing for sure the patients he has seen have COVID-19 so he has to rely on past experience as well as X-rays and CAT scans. That’s because testing is still not widely available, he said.
“We can look back 10 days later and say, ‘Oh yeah, that person had it,’ but we are too busy to do that,” he said. “We don’t have that case-by-case information, but we are getting positives.”
The open letter stresses that “every close interaction between people” creates the risk of transmission through respiratory droplets that can travel up to six feet from a carrier’s nose and mouth, and that it is virtually impossible to avoid being exposed to the virus if you come into contact with a carrier.
“Since many carriers have no symptoms at all, we must avoid all unnecessary contact with EVERYONE that we are not currently living with,” the letter said. “We are going to have to sacrifice a great deal temporarily for a better future for ourselves and the most vulnerable among us.”
Friedman said he doesn’t think the problem is unique to Miami, and reflects human nature that relies on personal experience to gauge threats. That is a dangerous element when dealing with a novel pandemic.
“By the time that [personal experience] happens, there have been so many additional infections that it becomes a disaster scenario,” Friedman said. “Anything anybody can do to help people understand that this is not Ebola 2, this is not swine flu 2, this is an entirely new thing. ... This is real.”