COVID-19- When will Fargo look like New York?

Hopefully we never suffer the same level of tragedy that the city of New York is currently facing. We may have some advantages. Maybe living a more distant and rural life helps or the benefit of the cold keeping us indoors, or maybe because our public spaces are not as densely populated we naturally slow the spread. I fear however that some of those advantages are countered not by being isolated but instead by believing we are insulated. This would be a catastrophic assumption, and I think some of us, including our leaders, may be making it.

I am getting closer to believing I no longer need to try and scare my patients or the public. But I’m not there yet. My own internal Hippocratic oath (do no harm) won’t let me stop trying to educate people. Not speaking about this feels potentially harmful to my patients. Although I want to write to you about how to stay calm and manage your anxiety, I am remaining concerned that the general population is not grasping the situation and every day matters. While I am trying to keep my practice alive in this crisis and educate my patients about how essential staying at home is, the state is seeking my signature for construction on Main Avenue which they hope to begin in a couple weeks. I see no way for construction crews to successfully carry out their work 6 ft from each other. Who is making these decisions?

“If you look at what’s going on in this country, I just don’t understand why we’re not” mandating nationwide stay-at-home orders, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN on Thursday. “We really should be.”

There is a stream if misinformation or diluted information that must be countered for the sake of public health. There is also a dangerous level of loyalty to sources of information that are inhibiting the necessary sense of urgency. Assuming that we’re insulated from this pandemic has been one reaction in a series of reactions that have lead to the United States being the global epicenter of this pandemic. I could go on describing this in detail, but what matters more is not the decisions we made beforehand but the decisions we make now. 

Let’s look at the numbers. As of a refresh a moment ago on the ND.gov website, we have conducted 6787 test on a state population of 762,062. Of the 6787 tested there are 207 positives or 3%. I would suspect this is not a random sample. I would suspect that those being tested are those that are either symptomatic or connected somehow to others who are infected. Nevertheless 3% of the entire population means up to 22,862 potential carriers. Even if we cut that number by half we end up with over 10,000 active carriers. Why do we not have a stay at home order?

The man quoted above, Mr. Anthony Fauci is the man often at the podium with president Trump. He is one of the key advisors leading the response to the pandemic. Isn’t that who we should be listening to about appropriate state responses?

We may benefit from living rural lives in a city with a low population density but we are not insulated. This virus is moving around as people move around. We have limited testing, no vaccine, limited medical resources, and we may be the location handling a large number of critical patients well after the rest of the nation is exhausted from that effort. There is no evidence we will avoid the same fate of New York. I say we plan for the worst, wish for the best and stay home!