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‘We know it didn’t have to be this way’ @brownemergencymedine faculty @MeganRanney


https://www.boston.com/news/coronavirus/2020/09/22/megan-ranney-whats-next-coronavirus


‘We know it didn’t have to be this way’: Rhode Island doctor says 5 actions are needed to prevent future COVID-19 tragedy

“There are more deaths coming. And how many more, depends on us.”




Dialynn Dwyer, Boston.com Staff September 22, 2020

A Rhode Island doctor is sounding the alarm about the COVID-19 death toll continuing to rise unless action is taken immediately.

On Tuesday, the United States topped 200,000 COVID-19 deaths — the highest confirmed death toll in the world — with experts predicting that number will double by the end of the year.

Ahead of the devastating milestone, Megan Ranney, an emergency room physician at Brown University and director of the Brown Center for Digital Health, broke down the five steps that need to be taken “today” to prevent further “tragedy.”

“We know it didn’t have to be this way,” she wrote of the loss of life Monday on Twitter, noting that despite representing only about 4 percent of the world’s population, the United States comprises about 23 percent of the global COVID-19 deaths. According to Ranney, the absence of a national strategy early on in the pandemic for detecting the virus, continued underfunding for public health, the lack of “smart utilization of strategic stockpiles” of personal protective equipment or PPE, as well as the shortage of public trust in the government, are just a few of the “innumerable” failures so far in the pandemic response.

“Structural failures like racism, lack of access to healthcare, and lack of protection for essential workers are key drivers of this uniquely American death rate, as well,” she wrote. But the emergency room physician wrote it is time to look forward toward prevention of more deaths.

“We need to act,” she wrote. “Because there are more deaths coming. And how many more, depends on us.”

The first strategy needed is testing, she wrote, citing an ongoing lack of rapid testing at emergency rooms, hospitals, and clinics. Waiting one to five days for the results of a COVID-19 test leads to increased transmission, decreased contact tracing, and fewer quarantining, according to Ranney.

“We still can’t monitor for hotspots or new outbreaks,” she wrote. “We are being so stingy with the tests we do have, that we can’t ‘spare’ for screening/surveillance/testing of asymptomatic people. This means we’re constantly behind the 8-ball in fighting the Guidelines, too, are driven by scarcity, she argued.

“I’m also counting on local government, to set clear guidelines & support for asymptomatic testing, symptomatic testing, and hospital testing,” she wrote. “WITHOUT THIS THERE IS NO HOPE.”

An increased focus on PPE is the second strategy that needs attention, Ranney wrote, stressing that if every person wore a mask — even a cloth one — about 60 to 90 percent of infections could be prevented.

“We *can* make adequate PPE for the country,” she wrote. “Manufacturers are standing by – they just need a little reassurance. It could be done on a state-by-state basis… but national level production would allow distribution to where it’s needed most.” The third strategy for preventing further tragedy, according to Ranney, is clear and consistent public health messaging, while the fourth strategy is a focus on data. The fifth strategy is a focus on equity.

“I can’t say it enough,” Ranney said. “Until we make sure that EVERYONE – regardless of education, income, or job description – has PPE & access to testing & the ability to safely quarantine/isolate, we will not beat this virus.”

The emergency room doctor argued the implementation of the five strategies are the steps needed to prevent super-spreader events, both symptomatic and asymptomatic, from occurring.

Ranney conceded that she isn’t sure the steps will be implemented on the national level, but stressed that individual communities can do their part, citing Rhode Island’s response to the pandemic.

“The trouble is, the virus doesn’t stay within community boundaries,” she wrote. “So…. stay alert. Keep pressure on your elected officials. Do YOUR part. And support those who are on the frontlines.”

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