My husband and I have always relished being in the thick of it, “in the trenches,” we would say, at our hospital. He is a head and neck cancer surgeon, and I am a pediatric otolaryngologist (ear, nose, and throat specialist for children). Working at an academic tertiary/quaternary care center in a major city, with over five decades of experience combined under our belts, we feel as though we’ve nearly seen it all. We have always cared for the sickest of the sick, the most complex problems, as patients have often come to us when there was nowhere left to go. We were, for all intents and purposes, the last resort, the end of the line.

Now we are seeing our colleagues — anesthesiologists, intensive care specialists, emergency room physicians, nurses, medical assistants, and respiratory therapists — as our front line heroes. They are the first responders as well as the last resort, the end of the line. We have supported the hospital by canceling our elective visits and surgeries in order to minimize the use of supplies and personnel, as well as to minimize added person-to-person exposure by bringing people into the buildings. For now, that is our job: to keep our patients at home. While much of what we have to offer our patients in need is sub-optimal care, we are indeed living in sub-optimal times. Some cancer and airway surgeries absolutely cannot wait, but most of them will. This painstaking, carefully thought-out rationing of care will soon be moot. We will soon be called to help in another way, to step out of our comfort zones both from a medical standpoint as well as a safety standpoint. As patients flood our hospitals, supplies are running low, and health care workers are falling ill. It will likely be “all hands on deck” in the not too distant future. We will no longer be sub-specialty surgeons caring for complex surgical patients. We will be part of the care force caring for COVID-19 patients: the first responders and the last resort. Until that day, we need to stay healthy.

For me, that means I need to keep running.

As I took my solitary morning run through the streets of a tony Los Angeles neighborhood this morning, a quote by former dictator Joseph Stalin came to mind: “A single death is a tragedy; a million deaths is a statistic.” In pre-COVID-19 times, my morning runs have been sources of peace for me. A time to myself to exercise, breathe some fresh air, to think, to meditate, to take in the sights. As a surgeon who operates on airways of tiny humans, these times of tranquility are as important to me as breathing. Many friends and acquaintances who I haven’t seen in ages, have said to me, “I often see you running.” Yes, you do. Probably less so during winter months when I run before sunrise, but nonetheless, I am out there.

Today’s run was anything but peaceful. Yes, it was a beautiful morning. The sun was shining, and the low-grade heaviness of smog-filled Los Angeles air has lifted a bit. The friendliness of passersby is now measured by one of us stepping into the street or crossing to the other side, in order to maintain the now ingrained six feet of physical distance. We strangers smile and wave, as one of us yields to the other. It’s a bizarre connection, giving each other safe physical distance. But as I turned on to a busier thoroughfare, I noticed large groups of cyclists, walkers going to pick up coffee, and runners in packs. None with masks. These were not families, but friends congregating. My peace was pierced by anger and frustration. Here are “health-conscious” folks, getting fresh air and exercising, but all I saw were killers. Yes, killers. Last evening, three families congregated as their children rode bikes. I didn’t see a happy, healthy group enjoying a beautiful Friday evening in early Spring. I saw murderers.

You see, while many are finding creative ways to engage children, bake the best banana bread (“Oh no! I’m out of walnuts!”), or settle for a less bougie brand of olives, those of us in health care are worried about catching the virus at work, spreading it to co-workers or to sick patients, or bringing it into our homes. Those of us with two-physician families have reviewed our wills, and drafted contingency plans for our children if one or both of us gets sick, hospitalized, debilitated, or worse.

I’ve racked my brains on how to channel the anger when I see that health-minded people just don’t fathom the harm they are causing. It reminded me of some of the rationale I’ve heard from anti-vaxxers: “My children are healthy.” “Measles really isn’t a big deal if you have a good immune system.” “I’m taking immune boosters, so I won’t get sick.” When it comes to vaccine-preventable diseases, or any infectious disease, there is no personal connection while reading graphs and medical data. Personal experience makes diseases real. When it comes to COVID-19, many people are starting to feel removed and are getting data-fatigue from reading what seems to be the same charts day in and day out, while they are feeling just fine, but are frustrated being stuck inside. These charts are not personal, so the math makes no sense.

Here is some math, albeit crude, that may help make this more real and more personal: Every time you congregate with someone from outside of your home, you add one day to this quarantine. On second thought, that may not be effective. How’s this: Every time you congregate with someone from outside of your home, you are potentially responsible for one death. Every time.

Friends, family, and neighbors have asked us in health care how they can help. We have had such generous donations of masks, offers to spread the word, and offers to help if we get sick. These are acts of love that we will never forget. But it’s not enough. And maybe it’s not enough to ask; maybe we need to beg: Please stay at home. Stay at home like your life depends on it, stay at home because our lives depend on it.

Nina Shapiro is a pediatric otolaryngologist and a professor, department of head and neck surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.  She is the author of Hype: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice – How to Tell What’s Real and What’s Not and can be reached on her self-titled site, Dr. Nina Shapiro, and can be reached on Twitter @drninashapiro. 

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