Hey everyone Dr. Z, if you're watching the news these days
you're in a bunker right now
panicked, hoarding PPE, and toilet paper,
and feeling like the world is ending
'cause cases are skyrocketing.
You see it all over the news.
We're breaking records every single day
for number of coronavirus cases.
Certain states like Utah, El Paso, Texas,
the hospitals are reaching capacity,
and that can feel terrifying.
None of this was actually particularly surprising
because we know the dynamics of this virus much better now
it spreads more rapidly in cold scenarios
because people come indoors,
and they're sharing poorly ventilated space,
and the virus is more stable at cold temperatures,
so it can live on surfaces longer,
it can live on the air longer.
And so for all those reasons,
we're seeing a much predicted surge in the winter.
Now, why did we have cases in the summer,
particularly in the Sunbelt?
I think it still goes with this cold theory,
in warm areas like the South West, the West
people go indoors when it's hot
and there's air conditioning,
low humidity, crowded circumstances,
big boom in cases.
But what we're seeing now is
hospitalizations are rising to levels
that are starting to exceed what we saw
in the very early part of this,
where the Northeast was most affected,
in that cold time
in like January, February, March April,
again fits this theory of how the virus spreads.
But what we're seeing now is a little different.
If you get hospitalized coronavirus now
your chances of dying are so vastly less
than they were in the beginning,
and that's why our death rate is still rather subdued,
it's going to rise,
but I'm hoping, looking at the data
that it's not going to rise
to the levels we saw in the beginning
if one thing holds true,
we don't overwhelm our hospitals.
So what happened in New York,
where the hospitals were absolutely overwhelmed
is people were probably losing their lives,
not so much because we didn't know what we were doing
although there was a component of that,
we were intubating too many people
we didn't understand about dexamethasone
we didn't understand as much about anticoagulation,
blood thinners.
We know that now, but what was that happening is
the staff were overwhelmed,
they were getting sick, they didn't have enough PPE.
And so patients were dying,
because they weren't getting the attention.
Now that could happen again if we overwhelm our hospitals,
but the thing is, then you have Michael Osterholm
going on TV and going, well,
we should have a national lockdown,
four to six weeks where we pay everyone to stay home.
That's the dumbest idea I've ever heard in my life.
And this is why.
You want to target protection where you need it.
You want to not overwhelm the hospitals.
That's really it.
So how do you do that?
We know that our early lockdowns were done
because we didn't know what we were doing.
We used a blunt instrument to shut everything down,
and then we found out, oh, we broke the economy,
we caused mental health, substance abuse, alcohol abuse
domestic abuse, our children weren't getting educated,
because we didn't know what we were doing.
Now we know.
Where is this thing spread?
In super spreader events,
in things like restaurants, gyms,
big crowds with poor ventilations in indoors.
Where is it not super spread?
Probably schools with young kids right?
And so we can target,
okay, pay restaurants to be takeout only right?
Pay gyms to close.
Target your efforts
and then let the rest of us get to work,
doing another thing which we've learned,
which I've learned, which is masking.
Look, I get it,
Americans hate masks.
I hate them too.
From the very beginning I'm like cloth masks are dumb,
this is the stupidest thing I've ever heard.
Look, I'm a doctor,
I wear a mask in the hospital,
I know it works there,
why would it work in public
when you're putting a diaper on your face?
Well, it turns out
there's more and more and more data
that says, okay, masks,
not only protect others from your droplets,
they protect you by lowering the amount of virus you inhale
at any given time.
It's not zero, but it's less,
which means you can mount an effective immune response,
develop maybe even immunity
without getting so sick that you're hospitalized or dying.
That's huge.
And it's a tiny price to pay
for getting to the finish line without economic devastation.
The finish line is another thing that's starting to emerge,
which is the vaccine.
Early on I said, you know,
I'm very skeptical that we're going to get
to a vaccine very fast because it's a new technology,
messenger RNA,
we don't have data on it,
we don't know what's going on.
Well, now we have more data
With Pfizer's emerging data of 90% efficacy in early data.
Oh my gosh.
Even if we get, you know, 60% efficacy,
if we can get that vaccines in people's hands
early next year,
that's going to be a game changer
which means there's a finish line.
So what do we need to do?
A, stop panicking,
B, probably stop watching the news.
C, don't go to big crowded events.
Don't have a ton of people over to your house.
Wear a mask when you can't socially distance,
wash your hands,
get on with your life,
get your kids in school
as safe as they can be with structures in place.
And we'll get to that finish line.
Is it going to get ugly this winter?
Well, it's going to get uglier than it is now.
That's for sure.
Can we prevent our hospitals from being overwhelmed?
A thousand percent yes.
And I'm going to do a separate video on what we can do
on the front lines as healthcare workers,
that can make it easier for caring for our patients,
for doing the right thing for our patients.
And if we get through this together,
then we're done with this nightmare of 2020.
All right?
So that's what I wanted to say.
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All right, guys,
I love you.
And we are out.
Peace.
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