I Am Begging You

As a plastic surgeon, it’s hard for me to stand on this soapbox and preach like I’m some world expert on infectious diseases because I am not. But there are certain things I know well, and one of them is statistics. The other is impulsive human behavior. I am also a physician which makes me a relative authority on the subject of COVID-19, so it is my duty to reach out to you, my small but faithful audience and tell you what I know. Maybe you can share this and get the message out to more people. I want to make three aspects of our fight against the coronavirus very unambiguous.

#1. There ain’t nothing instantly gratifying about fighting a pandemic. If you follow my alma mater, Johns Hopkins’ website, you will be discouraged. WTF. Not only are we #1 in the world for cases (USA! USA!), but there seems to be no inflection point or flattening of the curve. Not even after 1-2 weeks of what we call “quarantine”. It looks like all our efforts of social distancing and staying at home have been aimless, right? Wrong. They aren’t. Do not be discouraged. Do not stand down. Our efforts are working. We just can’t see it, not yet. All we see are headlines and death tolls and the sort. That’s because the data is not in real time. The numbers we see today reflect uninformed decisions we made 2 weeks ago.

#2. You will get restless. You will fight the urge to give in. After a week of what we seem to call “quarantine”, those I follow on social media are beginning to show signs of restlessness. People are getting creative, and according to the NextDoor app there is even a “quarantine pop-up Macarena” event in Costa Mesa tonight. Coffee shop patios are packed. People are hosting parties where they “swear” they keep 6 feet apart. The streets are filled with runners, cyclists, and basketball games. This is how we fail. Our attempts at “adapting” to carefully designed rules and regulations will invariably undermine global efforts and galactic economic sacrifices to curb the spread of disease.

#3. Cheaters are delaying the cure and ruining it for the rest of us. Do not cheat. Social distancing decreases the odds of two random individuals coming into contact, but it increases transmission risk among more intimate contacts and groups. So if there are isolated groups (be they families, businesses, or the sort), all it takes is one “bad egg” to go out, get a haircut, be exposed, and bring the disease back to the entire group that worked so hard and sacrificed so much to “stay healthy, stay safe”. So if your son or daughter gets a haircut, or IV hydration, or a manicure, you’re all in trouble now. Slumber parties? Same. As though you never socially isolated in the first place. I feel the same way about Costco, Ralphs and the sort. If you must go out, please do so infrequently and get the essentials as these centers will likely become nodal epicenters for community spread.

Draconian as they sometimes seem, CDC and WHO recommended measures are not about individuals, they are about societies working together as one. It will take a long time to see results. Do not be discouraged. Avoid temptations to bend the rules when your restlessness hits. Do not cheat, not even a little. I am begging you all to hear me loud and clear: we will be fine, but we have to make sacrifices to beat this disease. It’s no small feat. Thanks for taking the time to read this. My next task: study critical care for the non-ICU physician. Because in the next few weeks, I may be called into action. This is not joke. So kids, millennials, Americans, whoever needs to hear this: we are NOT invincible. Stay at home.

In this together,

Dr. Zelken