It is all but impossible to truly know where we stand in the fight against the coronavirus.
Restrictive social distancing policies that have come at great economic cost clearly have helped lower infection rates across the country. In Dallas, we have not seen the surge in cases that officials rightly prepared for.
But the growing sense that we are out of the woods as a community could be misleading, and one important data point shows us why.
On Monday morning, top medical officers from Parkland Memorial Hospital, including its CEO, Dr. Fred Cerise, shared some troubling facts with us.
As cases appear to have stabilized across the nation and region, Parkland is experiencing a rapid increase that is worrisome on a number of levels.
Dr. Matthew Leveno, director of the Intensive Care and Tactical Care units at Parkland, said that a sense of calm had set in a couple of weeks ago after a quiet period in the area.
That sense didn’t last at Parkland.
“Other places have remained relatively stable. But over the last 10 to 14 days, our numbers have continued to climb. We have more intubated patients now than we have at any point in time, and many have been in the last few days,” he said.
As of this writing, 21 COVID-19 patients at Parkland are in critical condition requiring assisted breathing. The hospital has a total of 67 infected patients, up from 38 about two weeks ago. The hospital has a current capacity for 99 COVID-19 patients.
Parkland has the ability to rapidly and substantially increase bed capacity beyond that number and has wisely avoided reopening for elective procedures — meaning more staff and beds are able to be allocated to the virus.
But the fact that hospitalized cases at Parkland have increased rapidly both in total number and in severity suggests that we need to check the all-clear sense that is taking root around us.
Instead, it’s critical that state and local leaders take this information from Parkland into consideration as they move forward with plans to reopen segments of the economy.
We have urged leaders to do so slowly, cautiously and responsibly, understanding that we must balance public health and economic concerns in ways that recognize we are a long way from returning to normal, but that people must also have a path to return to work.
This is another reason why the state must continue to work to create the broadest possible testing regimen.
And it also provides us information on how to target testing as it becomes available.
Parkland has always treated an economically vulnerable population. It is easy to understand why that population would be more susceptible to COVID-19. Many rely on public transportation. Many live in multifamily homes, often with multiple members of the same family under one roof. Many lack the ability to work from home and must choose between going out to earn money or seeing their family needs go unmet.
The current COVID-19 cases at Parkland mirror the hospital’s larger population in terms of demographics, Cerise said. That means many are from poor, minority communities.
What’s more, many members of the same families are now at the hospital with COVID-19, said Samantha Rowley, Parkland’s vice president of Nursing and Surgical Services.
In any number of ways, the people Parkland normally serves are more likely to be exposed to the virus. As testing capacity is increased, it should focus on areas where the virus is most likely to spread — for example, in areas with multifamily housing.
We can also see that this information tells us something important about how we should all go about living in coming months. As Dr. Deborah Birx said over the weekend, social distancing will remain a way of life for some time to come. We need to wear masks as we go out. We need to practice the best possible hygiene when it comes to hand-washing and avoiding physical contact like shaking hands.
Parkland is a window into the lives of people who often don’t have the same voice to announce what is happening in their communities. So even as we see people rallying to reopen without restrictions, we need to pay attention to the COVID-19 ward filling in our public hospital.
That is a signal for what this disease is doing, how it is still at its deadly work, and how we must not now wholly abandon our efforts to stem its spread but must adapt to best practices for living and working with it around us.
It’s persistently tempting to compare this disease to the flu, especially as we learn that infection and recovery rates are likely higher than we initially understood.
But it’s also important to recognize that what we are seeing came in the context of strict social distancing.
Leveno’s experience inside the COVID-19 ward at Parkland is sobering. As a doctor with a great deal of experience treating infectious diseases, he sees this virus as something far worse than what we typically face.
“This looks different. The severity is different. The length of time recovering after critical illness is different,” he said.
Patients on his ward are in their 30s, 40s, 50s. They are active. They are working people. It isn’t just the old and sick, he warned.
We have heard these warnings before. We listened and distanced. Just because we stop listening doesn’t mean the virus will stop working.