Relaxing Restrictions

I can feel it in myself and hear it in the voices and social media commentary of others: this shut down is wearing.  Not all of us are taxed the same; we chafe at different pain points.  Anti-restriction protesters speaking up.  While not all of us agree with their methods or their proposed solutions, many of us share in the frustration. 

During my decades of practice, when I imagined the need to respond to a global pandemic, I presumed I would be led by folks who had thought it through, who had a plan, who had prepared equipment and technology.  I never imagined even in December and January when this virus began to spread that we would be so limited in testing, in PPE, in medicines, in plans. 

In various places, restrictions are being officially loosened.  And I can feel myself thinking that it's time to lighten up.  I can see even some of my cautious friends making some tiny steps towards more exposure to more people.  In Boone County, MO, we have very few active cases (that we know of, yet) and so it seems like it's time.  We have so far been spared the real tragedies, hardships, and staggering deaths that has been seen in Italy and New York City.  Does that mean we can safely expand our activities and contacts?  Or does it just mean that we have a lot of hardship ahead of us? We have flattened the curve.  We took action that was painful.   And we got really lucky. New York City with really stressed hospitals and hospital workers, refrigerated tractor trailers serving as morgues and increases in temporary mass burials has only about 13% prevalence of antibodies. How much more will they have to endure before the 60-90% prevalence we think might create herd immunity is attained? Will we follow them eventually? It seems clear that there is no easy way through this.  There may be, however, some saner ways to try. 

Many people will feel the need and the pressure to return to work next week in Missouri.  Without the protection of the government, there will be less unemployment benefits and no longer the cover of clear guidelines for those who wish to remain at home. Hair and nail salons, massage therapists, yoga studios, gyms, theaters, restaurants, retail outlets will certainly reopen for business. I wish that we were putting a higher priority on: 
1. resuming all non-emergency medical care.  Some folks got their surgeries and treatments postponed.  Some of these procedures can be safely put off for a bit, but not without a price
2. Educating our children.  I don't think it's time to resume regular indoor classrooms, but maybe some smaller groups outdoors? 
3. Allowing a bit larger gatherings for marking important life milestones such as funerals, weddings, and graduations.  
I think we might could have started to do those things carefully IF we had had more testing available, so we could have a better idea of what was really going on. 

Despite my preferences, Missouri is about to open back up its businesses.  I will be watching the apparent hotspots of nursing homes, jails and prisons, and meat processing facilities and hoping this will go better than I fear.

For me:  I am not going to change anything I am doing right now.  I will continue to see patients virtually, reserving in person visits for the infrequent circumstance where an in-person visit really just can't be wisely avoided.  I will dream of the day when I can once again welcome patients into the office  and when I can once again offer acupuncture, hyperbaric oxygen therapy and infrared sauna to my patients.  I will keep advocating for more testing of all kinds. My household will still obtain our necessaries through curbside and delivery.  I will continue to stay in touch with friends and relatives by phone or video. I will continue to wish I could get some really good body work.  For each of you:  I hope that you have all you need so you can make your own best and wisest decisions.