KAUFMAN, Texas — Kaufman County Health Office Dr. Benjamin Brashear says Kaufman County has avoided many of the worst case scenarios first predicted at the onset of the COVID-19 pandemic, in an update posted on Tuesday.
KAUFMAN, Texas — Kaufman County Health Office Dr. Benjamin Brashear says Kaufman County has avoided many of the worst case scenarios first predicted at the onset of the COVID-19 pandemic, in an update posted on Tuesday.
With business set to open under Phase 1 of Governor Greg Abbott's plan to reopen the Texas economy, Brashear is asking area residents to continue practicing safe social-distancing guidelines, proper hygiene, and common sense aimed at protecting those more vulnerable to the complications of COVID-19.
"Generally, I think Governor Abbott’s plan could be wise and appropriate, if implemented with caution and care and according to each of the guidelines as directed," he stated. "I think his timing is at least reasonably cautious -- and I appreciate that his plan is incremental."
"That being said, my biggest concern is that we are so anxious to get back to “normal life” that any step allowed in that direction will be seen as a confirmation that some of our safeguards are not needed," he continued. "The governor’s plan (if done correctly) is based on considering others who are more vulnerable, continuing to do the things we’ve been doing that have been very effective, and practicing common sense. Please join me in continuing those efforts."
Read below for Dr. Benjamin Brashear's complete update:
"I hope this message finds you and your family healthy!
The last time I posted was over a month ago. It feels like longer than that. Since then, much has changed in the way of guidelines and basic knowledge about COVID-19, the disease caused by the SARS-CoV-2 version of Coronavirus. We have seen hundreds of patients at the clinic, hundreds more over Telemedicine, and we will continue to do so, as long as at least a few of us in the office remain healthy!
The good news is that the medical fallout has been better thus far than we hoped and certainly better than many predicted nationally. It’s definitely had an impact locally, but for most of us, the worst case scenarios have certainly missed us in the Kaufman area. As we all know, the long term effects and collateral damage of shutting down society remain to be seen. Thankfully at least, it looks like the beginning of the end of the shutdown is upon us, which is why I’m posting today.
In the last week, many patients, officials, family and friends have asked me about Governor Abbot’s plan to reopen Texas economically. The answer for me is not simple, and I’d like to take a minute to explain what factors come to mind when I am approached with that question:
1. There have been many epidemiological models, and there is a tendency to look at only the worst case scenario in those graphics. If we do that, then almost none of them have been correct. However, a quick review of the most well-thought-out models shows that we actually are in the “shaded area” of those predicted outcomes. In other words, as counter-culture as it may sound, those models have been reasonably accurate. Because of this, we can more confidently predict the shape of the curve as we move forward.
2. So, yes, for the US as a whole, it appears we are flattening that curve. The trouble is, we are not exactly sure of all of the reasons why -- at least not 100%. Hindsight will eventually give us better answers to this, but my suspicion is that it is a combination of two separate forces: The first is likely through your efforts (social distancing/ hand washing/general awareness). The second factor is that hopefully, the virus’s characteristics may not be as dangerous as we feared. Regardless which of those was more accurate or more influential, we here in Texas haven’t seen hospitals overwhelmed like they have in Italy or NYC. Thankfully, as of this writing, Texas has shown a decline in number of deaths per day for the last 4-5 days, so that is favorable. Not enough to declare it permanent, but still a good sign.
3. I believe that we do have enough data to know that this virus hits humans harder than the seasonal flu. How much worse remains to be seen, and cannot be reliably known until we have a year (or more) of data. I base this on several factors, most worrisome being the current number of deaths. Even with significant social distancing, the number of deaths in approximately 7 weeks is already over 57,000. In most years, influenza is a factor in generally 35-40,000 deaths – so it’s already worse than an average flu year, and keep in mind that it takes well over 6 months to reach that number for flu (October through April, generally). **Side note: for those who think the numbers are “inflated:” please keep in mind that flu deaths each year are often lab-confirmed, but some percentage of those counted each year are “presumed” based on the season and symptoms. So annually they are measured in the same way as some of the COVID deaths are currently estimated – we lab test as many as we can, but we cannot possibly or reliably test every death for all factors prior to filling out a death certificate. Especially the large percentage of deaths that occur outside the hospital. Practically speaking, since we are concerned about how this compares to flu seasons of the past, it makes sense to count the deaths in the same way as we always have. Also, I hate that this needs to be said, but doctors fill out the vast majority of Death Certs, and despite popular opinion, we don’t make more money or gain anything of value if we inflate the numbers -- but we can lose our licenses and our reputation if we tried it. The risk/reward ratio is kinda awful to consider falsifying that particular document. After you consider this, and you tack on the higher rates of infection and longer asymptomatic incubation period where the carrier can easily infect others, and hopefully you can understand my position.
So how do we proceed from here?
For those at high risk (over 65, heart problems, immunocompromised), the risk is still very real and very serious. Just because you are able to go out to restaurants or churches does not mean you should at this point. Each of you will have to make your own choice, but I would generally recommend you stay home as much as possible. If you are not sure where you fall in the risk category, please speak to your doctor or NP/PA. And when you do have to go out, continue to do all of the things you have been doing - hand washing, keeping your distance from others. The virus is not LESS dangerous to you than it was two months ago, and one thing that is sure: more of the people you encounter will have the virus, whether they know it or not.
For the public as a whole, I am hearing more often than not that each of you wants to make up his own mind. That you want to live and die based on the ability of your own immune system, your own choices, and your own determination of what is risky vs what is needed. I understand this desire. I’m a Texan, after all. But I have spent some time in school and in my 16 years of office practice learning in way too much detail about some of the consequences of those desires. I only ask that you look hard at what those choices really entail. Understand that by making *some* choices, you *can* endanger others. As you get out of your home and live your life and exercise your freedoms, try to consider that you may inadvertently and unknowingly harbor the virus. When you do, you are much more likely to endanger others. As you go out to get those essential items, you might accidentally contact a nursing home worker, a first responder, or a hospital tech. Maybe after you use that shopping cart, the next person in line is the sole caregiver of a cancer survivor. Most of those who are actually vulnerable remain at home, but try to remember that they need healthy people to care for them. And those healthy people need essentials too. So you WILL encounter them, and you WILL affect those who are less fortunate, even if it’s indirectly.
I’ve also heard the reasoning that others who are worried can be careful – after all, they are the paranoid ones so it should be “their responsibility” to keep themselves clean, right? Unfortunately, there are inevitable weaknesses in our attempts to disinfect ourselves and our environments. Even with a hazmat suit and a bucket of Lysol, and even despite our best efforts to maintain that 6 foot radius, it’s not perfect. The bottom line is that no amount of mask wearing or hand washing or clothes changing can defeat a virus AFTER it enters a human body. Each person you physically encounter has the chance to assimilate all of your germs and all of your choices. We know we have to encounter each other to some degree as we get essentials, so we are asking everyone to consider limiting the things that would create the chance of a voluntary or unnecessary encounter. We are not asking for sterile perfection – we are just trying to reduce the load, to try to limit the number of viral particles that are out there.
Generally, I think Governor Abbott’s plan could be wise and appropriate, if implemented with caution and care and according to each of the guidelines as directed. I think his timing is at least reasonably cautious -- and I appreciate that his plan is incremental. That being said, my biggest concern is that we are so anxious to get back to “normal life” that any step allowed in that direction will be seen as a confirmation that some of our safeguards are not needed. The governor’s plan (if done correctly) is based on considering others who are more vulnerable, continuing to do the things we’ve been doing that have been very effective, and practicing common sense. Please join me in continuing those efforts.
We have seen tremendous response from our citizens and leaders in this community over the last 6-7 weeks. We’ve seen local businesses make difficult changes to ensure worker and customer safety. We’ve seen parents become teachers, teachers learn to Zoom and virtually hug their students, and factories remodel themselves to provide needed PPE and medical equipment. I’ve seen generosity and good will towards the hungry and homeless, and lots of appreciation towards our healthcare workers and first responders. So all that to say, “Thanks.” You have done well. I feel I can speak on behalf of the other physicians in our community in saying this: You’ve prevented illness and saved lives and you have made our jobs easier. Keep up the good work!"
