By Dr. Anthony Policastro

As a Commanding Officer in the Air Force, I had disaster plans in place. We followed the wartime disaster plan to the letter when I sent 147 of my personnel to Desert Shield.

We knew in advance that there would be an increase in COVID-19 cases when the lockdowns ended. However, the goal was never to make the virus go away.

The actual goal was to allow us to have enough medical resources to handle the expected future increase.

The manufacturing industry made more needed Personal Protective Equipment. They made other needed medical resources. They did their share.

The medical industry put additional resources in place. They also learned about better ways of treating COVID patients to help lower mortality. They did their share.

 During the recent lockdowns we had rather steady levels of infection for the months of April, May and June. So that would leave us with 90 days to build a plan.

If I was the one building such a disaster plan, it would include the following aspects at a minimum:

• A nationwide computerized reporting system so that every hospital with ICU beds could give a real time update on conditions to a central monitoring location.

• A medical evacuation plan for heavily populated regions like the northeast. That would allow us to use the computerized system to move sick patients to hospitals in the area that were not as busy when one hospital was overwhelmed.

• For more sparsely populated regions like the heart of the country, medical resources (both personnel and equipment) could be sent to them. The computerized system would allow us to know where the needs were. 

• There would be a second computerized system that would tell us where the medical resources were that could be moved to the less populated regions. Large states like New York could move resources from upstate to New York City when the city was overwhelmed. Small states like Delaware do not have that capability. So some states would need outside help.

• There would also need to be a plan in place to create additional ICU beds in hard hit areas. This would require identifying locations in advance to put those beds. It would require identifying resources to put there.  It would require knowing what would be done to open it up. That resource identification would also use the  computerized system in Item 4 above.

 A lot of this may already be in the works. However, with the national media focused solely on the number of cases, we don’t necessarily know if that is the case.

Just like when I was on active duty in the United States Air Force, I still believe that planning for disasters is one of the best ways of handling them when they come.

COVID-19 UPDATE

Despite what the national news media would have you believe, new cases of COVID have only increased modestly within the last week. They were running 33,000 to 49,000 daily the previous week.

This week the numbers were between 38,000 and 56,000. For three days the numbers were above 50,000.

However, those extra few thousand cases do not overly strain medical resources. There was nothing magical about breaking the 50,000 mark the way they would have you believe. Therefore, we are still at a level consistent with the number of patients who can be cared for from a medical standpoint.

For anyone wondering why I became a pediatrician, they need only look at the behavior of adults during the current pandemic. They do as they darn well please regardless of the advice they get from physicians. I would not be able to stand the frustration of non-complaint adults on a daily basis.

The studies involving hydroxychloroquine were discontinued because of patients dying from the cardiac complications of the drug. In a new study, only patients with no cardiac risk factors were given the medication. It appeared to cut down on mortality in this particular group of patients.

Thus, there seems to be some benefit but it can only be used in certain patients. Of course patients with cardiac issues are already high risk for mortality from COVID but they cannot take the drug.