Wednesday, March 18, 2020

An ER physician's advice to the general public: How to flatten the curve


Mercy Hylton, MD
Indiana Pediatric Emergency Medicine Physician


Editor's note: This article originally appeared on KevinMD.com.

Some advice as an emergency physician, daughter, mother, and concerned citizen.

Help keep older relatives and neighbors self-quarantined at home. Same goes for those of any age who are immune-compromised (cancer-patients, on immune-suppressant meds for autoimmune diseases, etc.) Pick up and deliver their groceries and prescriptions to their front-door for them.

Health care workers (physicians, nurses, respiratory therapists, social workers, pharmacists, environmental services, EMS, etc.), law enforcement, and other public agency workers are essential personnel and need to go to work. College students home from school and older high school students can help by stepping up to provide childcare for these families. It is not a good idea to ask grandparents to provide childcare if at all possible. The young and healthy can do their part.

Postpone all non-essential doctor’s appointments (check-ups and annual physicals, routine follow-ups, elective procedures, etc.) This is to prevent you from being exposed to sick people as well as to free-up physicians’ time to care for the acutely ill.

Save the emergency room for true emergencies only. Call your primary care doctor’s office before you head to the ER (i.e., not just if you have a flu-like illness). Many things like rashes, constipation, and muscle sprains can wait to be seen in a few days in the office, or recommendations can be given over the phone. Do not “play up” symptoms in order to be given the authorization to go to the ER.

At this time, tests for COVID-19 are not readily available for people with mild illness. If you are not sick enough to be admitted to a hospital for respiratory distress and low oxygenation, you are unlikely to be tested. Do not go to the ER, urgent care or your doctor’s office for a test just so you can definitively know if you can go back to work. It’s not going to happen at this time. This may change in upcoming days as tests and the regulations on their use change.

Many children from low-income homes receive two free meals a day at school, and school cancellation for weeks may be a heavy burden to these families. Donate or volunteer at community food banks.

Your kids are going to go stir-crazy in the next weeks since many schools have been closed, and spring vacation plans have been canceled. However, this is not a good time to go to the Children’s Museum, movie theater, arcade, or other indoor group activities. Playing outside is a good idea, with the exception of people who have a history of asthma or environmental allergies (which may get worse outside). Put them to work with projects around the house: spring cleaning, cleaning out your closets, cleaning out the garage, etc.

Social distancing does not mean we should not continue to patronize businesses, but we should do it in responsible ways. Order take out instead of eating out. Order groceries online and pickup. Go to the grocery store at low-volume times (early morning).

Business owners, please send home employees with any sign of illness, and please be understanding of your employees’ struggles with lost income and finding alternative childcare. Please do not require a doctor’s note from your employees.

Get your information from responsible sources. Do not stir panic. Do not hoard supplies or food. Do not take advantage of others’ misfortune or ill-planning. Be extra patient and kind with everyone and in all venues.

This is a great time to teach our children the value of community-mindedness, not wasting food or other goods, prudent use of resources, healthy habits like hand-washing and avoiding public outings if you are ill, planning not panicking, etc. Our children are watching and learning from us.

#FlattenTheCurve #SocialDistancing #StayHome #DoYourPart

Mercy Hylton is a pediatric emergency physician.

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