PCMS President Dr. Robert Segal Addresses COVID-19 Pandemic

From the President of Pima County Medical Society

To Members of the Society:

We are all dealing with a memorable event, which will define our generation. This novel virus is not even living, but acts like a malevolent nemesis, striking hardest at the elderly. I am writing to you personally, not as a formal statement from the Society, as we have not had time to discuss the COVID-19 pandemic. By now, you have probably stopped seeing patients in your busy outpatient clinic, and if you are over 60 or have underlying health issues, you have probably stopped seeing anyone, unless they live with you. Based on the reports from Italy, we cannot underestimate the violence of this scourge, and how quickly healthy patients can decompensate.

The obvious problems are these:

• The virus is exceedingly contagious.
• The infection has an incubation period of over a week.
• Infection can occur from an asymptomatic individual.
• The death rate is about 2%, but of those who die, almost all are over 60.
• There is no effective antiviral drug for this infection, nor a vaccine.
• Our health care system has little reserve, is unaffordable for many, and let’s not even discuss the maddening insurance company mandates.

Add these facts to the recognition that our physician workforce is ageing, and the concept that the American health care system is imperfect, to say the least, and you have a private and public disaster. The private disaster comes as our older physicians should stay home, but that leaves them with office overhead, staff out of work and their patients with unmet needs. Should these doctors go to work, they create a petri dish from their offices, which could infect many. Should they stay home, they risk their financial and emotional health.  The public disaster is already occurring with all sorts of businesses and gatherings shuttered. Going out to dinner and a movie is just a fond memory.

Governments are trying to flatten the curve (of hospital utilizations) with isolation measures. This will prevent widespread overloads, but it does not change the volume under the curves; the same number of patients will need care, over a longer period. That is the basic problem we face, which is that this epidemic is not going to be over in two months, unless a miracle happens. I urge all older and at-risk clinicians to try their hands at telemedicine, working from home. There are CPT codes to bill patients/insurance for this service, or do it for free. HIIPA regulations have been relaxed, and such activities will keep you from going stir crazy during this period of quarantine, which may be very long.

The Executive Committee and Board of Pima County Medical Society will be meeting soon, remotely, of course, and we will soon have a formal statement.

Robert Segal, MD
President
Pima County Medical Society