The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
We are entering the fourth month of our war with Covid-19. The virus was first officially detected on our shores on January 19th but had probably established a beachhead weeks earlier. Its Blitzkrieg-spread caught us unprepared, fearful and playing defense. We have been limited by confusing and imprecise information and lack of data as the virus silently spread among thousands of asymptomatic hosts across our continent. Our understanding of this invisible scourge has begun to crystalize, thanks to an unprecedented mobilization of scientists, medical professionals and our remarkable healthcare system. Today, we are better armed, focused and ready to fight back.
Our initial, appropriate response was to slow the spread of the virus by sheltering in place, social distancing and improving hygiene. Wisconsin began its “Safer at Home” policy (emergency order #12) on March 25th. The intent was to allow the healthcare system time to expand its capacity of staff, ICU beds, ventilators, personal protective equipment and testing. The rationale was to cover two 14-day incubation periods and to “flatten the curve” of infection; it was never to eradicate the virus.
The virus cannot be stopped. The scientific evidence is clear that Covid-19 will continue to spread through the population until enough people are exposed that we develop “herd immunity.” Studies from Stanford and New York estimate that as many as 15-25% of their populations have already been exposed, most with no symptoms. In the United States, we have made strides in treatment and, after Germany, have the lowest mortality rate (per million of population) in the Western world. The mortality for those under 60 is less than 1% and for those 60 to 70 years old, approximately 3%. We are fighting this monster with improving results. Nevertheless, Governor Evers’ order, which states, “without effective treatment or a vaccine, the only way to slow the spread of Covid-19 is through non-pharmaceutical measures,” has been extended for another month, or perhaps even longer.
The collateral damage caused by the economic shutdown is staggering. There is rampant unemployment, bankruptcies, destitution and hopelessness. In my home town of Wausau, over half of the 220 businesses in the River District are at risk of closing. These are mom and pop shops; the dreams of people who have risked their life savings to start a small business. It’s the tax base of our small town and its very life blood. In the Northwoods, there are businesses that will never open again. The human cost is frightening and the repercussions difficult to imagine.
Ironically, our healthcare systems – the front lines in our battle – are collapsing in the midst of the pandemic. In central Wisconsin, Aspirus, Marshfield and Ascension have closed many of their primary care clinics, stopped “non-essential” procedures and visits, and furloughed thousands of staff and nurses. As a result, there has been a huge spike in non-Covid related deaths. This is a national tragedy. People are terrified to go to the hospital, and our healthcare infrastructure is being dismantled.
In Wisconsin, our policy makers have devised a response that treats nearly 6 million people as a homogenous population. It treats the Northwoods, where social distancing is a way of life, the same as Milwaukee. In reality, 80% of the Covid-19 cases are in 6 counties with the predominance in Milwaukee. There are 32 counties with no deaths, 21 with less than 5. Marathon county has one reported death. Science would suggest that, as we are not a homogenous population, our response should be strategic, tailored to population density and the availability and preparedness of healthcare.
In Marathon county, we have surged the capacity of beds, staff and ventilators. We have increased testing and have reported a greater than 30-day supply of personal protective equipment (PPE’s). Meanwhile, there has been a total of 17 confirmed Covid-19 positive cases and only one death, an 85 year old nursing home patient. There are currently no Covid-19 positive patients hospitalized in the Aspirus system. Although we have met the challenge to prepare, our hospitals are ghost towns.
The intent has always been to reopen our society and economy safely and judiciously. This should be done by county or region, rather than with a one-size-fits-all approach. Most effective would be a strategic plan taking into account the density and mean age of a population, medical system preparedness and access to care. The Wisconsin Chamber (WMC) has proposed such a regionalized plan: “Back to Business: A plan to protect lives, livelihoods and Wisconsin’s future.” Likewise, The Center for Research on the Wisconsin Economy (CROWE) has proposed a detailed plan called “Reopening Wisconsin: Regional health and economic factors.” These non-political, data-driven proposals analyze the demographic factors that make a population more or less vulnerable in order to give a detailed plan to reopen the economy in a stepwise way. They are currently on Governor Evers’ desk, waiting for him to take action. The clock is ticking.
The pandemic is costing Wisconsin roughly 1.7 billion dollars per week in lost economic activity. The downstream repercussions to our people will be immeasurable, and the most vulnerable of us will suffer most. Our soldiers on the front lines in Wausau and central Wisconsin are ready. We gave them time to gird for battle. Let’s follow the direction of scientists and experts and put politics aside, for we are divided at our own peril. Let’s put in place metrics for safety and care, protect our most vulnerable, and release our least vulnerable, the youth, to work and live their lives. Let’s open up and fight.
– Riveron is an independent cardiothoracic surgeon who has practiced in Wausau, Wisconsin for the last 24 years. He has been a physician for 37 years and is currently practicing surgery in four other states as well as internationally in Kenya and the Dominican Republic.
