A Common-Sense Local Perspective on Coronavirus

Photo by Svetlaya

Frank James MD, San Juan Coun­ty Health Offi­cer Mark Tomp­kins, Direc­tor, San Juan Coun­ty Health & Com­mu­ni­ty Ser­vices Bren­dan Cow­an, Direc­tor, San Juan Coun­ty Depart­ment of Emer­gency Management

Coro­n­avirus is on all of our minds, and for good rea­son. We are liv­ing through a glob­al pub­lic health cri­sis that has the poten­tial to become a pan­dem­ic in the weeks or months to come. There’s much we still don’t know, and with that uncer­tain­ty comes fear. Despite the fact that the cur­rent risk of coro­n­avirus in San Juan Coun­ty is low, it makes per­fect sense to be on edge.

In this arti­cle we will take a very com­plex and fast mov­ing sit­u­a­tion and share some key under­stand­ings that we hope will be use­ful to our island com­mu­ni­ty. We don’t know how this event will play out, but there are some facts to know and some basic steps we can all take, regard­less of the exact spread of the disease.

At this point, we may risk being accused of sow­ing even more fear. But there’s also a risk of being too late and miss­ing a crit­i­cal oppor­tu­ni­ty to pre­pare. We’d rather be guilty of over­play­ing some­thing that turns out less seri­ous than the oth­er way around. We’re con­fi­dent that this sit­u­a­tion won’t be as bad as our dark­est fears are telling us, it rarely is. We also don’t want to put our heads in the sand.

First off, and this is real­ly impor­tant: social dis­tanc­ing and quar­an­tine efforts are as much (or more) about slow­ing the spread of the dis­ease as stop­ping it. Sure, stop­ping it is ide­al, but if the coro­n­avirus becomes wide­spread (as it like­ly will be), we want to do all we can to slow trans­mis­sion. Why? Because slow­ing the pace of the dis­ease buys time for our per­son­al and civic response sys­tems to pre­pare, it lets us work on devel­op­ing med­i­cine and vac­cines, and most impor­tant­ly, it spreads out the num­ber of patients over a longer time, less­en­ing the strain on our health­care sys­tem. Under­stand­ing the crit­i­cal impor­tance of slow­ing the spread is essen­tial to com­pre­hend­ing and hope­ful­ly sup­port­ing the cur­rent and future pub­lic health response.

If at some point down the road there is a need to close schools, lim­it pub­lic gath­er­ings, or restrict trav­el- it will be done with the ulti­mate goal of sav­ing lives. And not just a few lives, but a large num­ber of people’s lives may depend on our abil­i­ty to suc­cess­ful­ly imple­ment these dif­fi­cult decisions.

That said, these moves to lim­it social con­tact are incred­i­bly chal­leng­ing for a com­mu­ni­ty- espe­cial­ly the deci­sion to close schools. Start­ing to pre­pare now for pos­si­ble (but not cer­tain) impacts is key. We’re in a win­dow of oppor­tu­ni­ty of uncer­tain dura­tion to make some prac­ti­cal prepa­ra­tions. We must make the most of it, and also remem­ber that if a severe pan­dem­ic does not hap­pen, the efforts you’re mak­ing will also help ensure you’re ready for a major earth­quake (as all islanders should be!).

We think being thought­ful, con­sid­ered, ratio­nal, and engaged is the right approach. Things are like­ly less ter­ri­ble than they seem on the front page, but at the same time there is cer­tain­ly rea­son for con­cern. Find­ing that com­mon-sense mid­dle ground between anx­i­ety and denial is the goal that enables us all to act with use­ful purpose.

Indi­vid­ual and com­mu­ni­ty prepa­ra­tions will focus on three tasks:

1. Reduc­ing each person’s chance of get­ting sick
2. Help­ing house­holds with basic sur­vival needs dur­ing a pandemic
3. Min­i­miz­ing and cop­ing with larg­er soci­etal disruption

With that in mind, we want to share some spe­cif­ic best prac­tices and places to focus your attention:

• Have sup­plies on hand to last a few weeks with­out need­ing to leave your house. There’s no need for pan­ic buy­ing or doing it all at once. Just start to build up your sup­plies. The Coun­ty DEM has a nice cal­en­dar that high­lights what is need­ed for two weeks of pre­pared­ness. Start with two weeks, but aim for a month. If you can build up your sup­ply of essen­tial med­ica­tions, do so.
• If you haven’t got­ten your sea­son­al flu shot, now is the time to do so. Symp­toms of the flu are very sim­i­lar to the symp­toms of nov­el coro­n­avirus. Also, flu has killed far more peo­ple glob­al­ly and with­in the US than nov­el coro­n­avirus. Get­ting a flu shot pro­tects you, those around us who are most vul­ner­a­ble, and reduces the bur­den to our health care sys­tem at a time when we are gear­ing up to pre­pare for major demands on an already stretched network.
• Hand-wash­ing doesn’t guar­an­tee immu­ni­ty. But it’s easy, it’s under your con­trol, and it has no sig­nif­i­cant down­side. Also focus on not touch­ing your face. Seri­ous­ly. Do. Not. Touch. Your. Face. We know it is hard. But prac­tice. Make it a game. Give your kids a quar­ter every time they catch you doing it. What­ev­er it takes.
• Now is the time to think a bit about how you will care for chil­dren who have to stay home due to pos­si­ble school clo­sures. Do you have fam­i­ly, neigh­bors, or oth­er options for child­care? Resist the temp­ta­tion to infor­mal­ly assem­ble kids togeth­er in larg­er groups. That’s an under­stand­able solu­tion, but in the end defeats the pur­pose of the closure.
• If you man­age a busi­ness or orga­ni­za­tion, think through how you can sup­port your staff work­ing remote­ly. Con­sid­er what steps you should take to pre­pare for employ­ee absences or loss of cus­tomers. Start to think about how you can con­tin­ue to oper­ate your busi­ness while min­i­miz­ing social con­tact. There aren’t always answers for every busi­ness, but some­times there are- and those are crit­i­cal to iden­ti­fy ahead of time.
• If you are sick, stay home. This one is impor­tant. We should do it all the time, regard­less of coro­n­avirus, but we don’t. Com­ing to work or school sick is self­ish, don’t do it.
• If you are expe­ri­enc­ing fever and a cough, AND you have returned from anoth­er coun­try with­in the last two weeks call your health­care provider and alert them of your symp­toms and trav­el his­to­ry before seek­ing med­ical atten­tion. They will take appro­pri­ate pre­cau­tions to pre­vent fur­ther spread of the ill­ness. You prob­a­bly won’t have coro­n­avirus, but it is good to give your provider some advance warn­ing regardless.

We know there are no mag­i­cal solu­tions to any of this, and there are lots of incred­i­ble chal­lenges involved in much of what we’re talk­ing about. Few of us will ever get to 100% pre­pared, and that’s OK. The main thing is to do what you can, start doing it method­i­cal­ly now, and work to build a thought­ful rea­son­able cul­ture of pre­pared­ness and com­mon sense in the islands that will out­last this crisis.

We’d like to direct islanders to the Health and Com­mu­ni­ty Ser­vices Coro­n­avirus Page for links to up to date infor­ma­tion. And please feel free to con­tact the Health and Com­mu­ni­ty Ser­vices Coro­n­avirus Hot­line at 360–370-7500 should you have spe­cif­ic con­cerns or ques­tions that we might be able to help you with.

We will con­tin­ue to share reg­u­lar arti­cles to share our sense of the sit­u­a­tion, detail actions being tak­en by your local gov­ern­ment, and answer ques­tions we’re hear­ing from our island com­mu­ni­ty. Work­ing togeth­er dur­ing uncer­tain­ty as this glob­al out­break unfolds, there is much we can do local­ly to keep our com­mu­ni­ty healthy.

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