Toll Plied

(Author’s note:  while I am a rabid college football fan, I’m not a Bama fan.  I am Florida Gator, and we haven’t beaten Alabama since 2008, so I have my agenda.)

“The University of Alabama on Monday reported more than 500 cases of COVID-19 since classes resumed last week.”  Earlier in the summer the university had announced plans to test the entire student body starting in August, and proceed until all were tested.  That in itself was a pointless, arguably stupid plan which would yield flimsy results upon which no effective plan could possibly be based. In short, like the rest of society, Alabama is playing CYA.  The state’s pearl-clutching governor followed the velvet authoritarian model of mandating masks throughout the state, and threatening any non-compliant businesses.  Drive through the southern part of the state (I do frequently) and the number of closed retail businesses is a testament to state compassion.  In fairness, our regional ICU’s have stayed pretty full – as they have during successive flu seasons over the past several years, when I have had to keep patients in the ER for over 6 hours before being able to transfer to an available bed. 

So spare me the “saving lives, we have to sacrifice” reflex bleating.  I never said this was a hoax, it has been deadly serious, and our panicky lockdown & mask response has only done the virus’ work for it, and made things worse. 

I keep trying to get away from these beyond-tiresome COVID stories, so why repeat my ire?  Because word from the University of Alabama is that their president is already making noises about suspending the fall semester if the infection rate continues to arrive.  Last week was “bid” week, when the newly arrived students packed the bars, and spread the virus around in doubtless hilarious and recreational ways.  Now the cowardly mayor of Tuscaloosa, Walt Maddox, “said bars will be closed for two weeks and bar service at restaurants would be suspended.”  Following the lead of the governor, this petty tyrant will take the CYA line to punish the innocent. 

What hasn’t been publicized, is the number of students who even needed treatment for this apparently near-fatal diagnosis.  How many were hospitalized, or even had to go to the ER?  Obviously, some students with Type 1 diabetes or other immunosuppressive diagnoses SHOULD take precautions; but why are they even on campus?  Why should the vast majority of a college town be punished to protect a few, either on-campus, or theoretically in the home towns of the infected students when they return over the weekend or on holidays?

If this squirmy university president shuts down the fall semester, it is a fait accompli that the school will not play football.  If the Crimson Tide does not take the field, then the Southeastern Conference will fold and that will kill college football for the year, which would be another needless, terrible tragedy.  And if you think I’m trivializing this issue, you obviously aren’t from the South. 

This is a microcosm of the current foolishness-without-end that is causing damage that will reverberate for years, if not decades.  Mass testing proves very little, and at this point isn’t protecting anyone.  We don’t have a plan for handling low(no)-acuity “positives” other than self-quarantining and flailing around to harm others, to show that we are doing …something.  I respect that physicians are on all sides of this issue, and so here is my side:  We should encourage quality of life as indispensable to life itself.  I’m sorry for those living in the cowed footprints of the Big-10 and PAC-12, but society worth saving will find a way to save the college football season.  It’s 31 days till toe-meets leather…hopefully.

Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  8 comments for “Toll Plied

  1. Tom Fariss
    September 7, 2020 at 6:29 pm

    “At present, there is no direct evidence (from studies on COVID-19 and in healthy people in the community) on the effectiveness of universal masking…to prevent infection with respiratory viruses, including COVID-19.” This is a quote from the WHO website, not your average anti-mask group. They go on to list multiple adverse effects from wearing masks, in contrast to the “just wear your mask” campaign.

    Those of us trained in infection control, industrial hygiene, hierarchy of controls, respiratory protection, fit testing, etc. will know the difficulty in ensuring compliance with effective PPE under appropriate circumstances. Atul Gawande wrote a book about the difficulty of getting health care professionals to simply wash their hands. We should also recognize how utterly ridiculous it is to require the general public to wear random strips of cloth of whatever material on their faces. The governors and mayors are foolish and out of control (mask mandates on the beach, etc.) and the general public is understandably confused. But please tell me the medical profession has the critical thinking skills to see through the mask charade. We lose about 1.5 million people a year from TB (over 200k children), a disease transmitted in a similar fashion and with known effective treatment for decades. No it’s not a perfect analogy but some perspective is needed before we completely succumb to this “new normal.” COVID-19 is less serious than TB and actually less serious than the flu for the vast majority of people, especially under 65. Lastly, if you actually believe that the only reasonable end game with COVID is a vaccine, then you have a hyper inflated sense of confidence in medical technology and an underdeveloped knowledge of immunity and biology.

  2. Phil Lavine
    September 2, 2020 at 5:33 pm

    Can’t understand your position. So far masks and social distancing are pretty much the only way to minimize covid transmission. Its too bad that the places where these can’t happen (bars and restaurants mostly but i wonder about football games+practice+locker rooms) have to be shut down. Wanna die with your rights “on” but not a mask? Think about peeps you will take with you… ERs are essential, football games anf frat parties, not so much.

    • Pat
      September 3, 2020 at 2:17 pm

      1. Masks and ridiculous closure aren’t preventing anything at this point. (And no, when not at work, I never wear the damn things unless forced to by a store owner. My mask is black with white lettering that proclaims, “THIS IS BULLSHIT”). And yes I’ve been around a ton of Covid for months, and have seen nothing to change my mind.
      2. Apart from immunosuppressed individuals -as mentioned – college-age students are at extremely minimal risk. Why hasn’t even one Bama student had to be admitted to the hospital.
      3. How nice for you that you are willing to sacrifice people’s livelihoods and time-investment in order to “save lives”, when the evidence is overwhelming that the lockdowns and mask mandates have only made things worse.
      4. This is not a widely fatal virus, so your hysterical assertion of dying with “my rights” only exemplifies what a cowardly societal element my sorry-ass profession has enabled.
      5. Quality of life is essential, which includes whatever the Individual determines it to be. Physicians used to know that.
      6. We should want MORE otherwise healthy to have gotten it in the hot months, to develop some herd immunity before we are all immunosuppressed by flu season.

      • Phil Lavine
        September 5, 2020 at 5:11 pm

        What’s the overwhelming evidence that masks and lockdowns don’t work? I find your anecdotal observations far from scientific. And isn’t saving lives why we went into medicine in the first place?

        • Pat
          September 7, 2020 at 2:04 am

          There are innumerable studies on the efficacy of masks, many conflicting, and so it is simply unsettled.

          What should be obvious is the enormous psychological/emotional damage, and drastically frayed public discourse and increased authoritarianism for which the masks have become the primary symbol. Walk into any Wal-Mart, and the exhalations from the top, sides, and even bottoms of these silly paper masks are visibly evident. Do you really believe lingering virus-laden droplets are less potent because they have been swirled to the side before being trapped against your face by your mask?

          As for the shopworn “saving lives”…no, I did not go into medicine to save lives if it meant depriving those lives of happiness or good quality, or using my training as some do-gooder’s license to start bossing strangers around. That is why I write for AM, to be a lone voice pleading for doctors to respect the individual above the collective. Doing otherwise is what has so devastated this profession.

      • Frank Rubino
        September 6, 2020 at 5:44 pm

        It made a difference in 1918 when Philadelphia decided to sell war bonds and have a political rally. 200,000 people descended on Philly the week of Sept 28 th, and 7,000 died in the next 6 weeks after the event. Baltimore Md decided in not having the parade and rally and only 200 people died in the same 6 weeks. The health dept insisted on Masks and social distancing and hand washing. It reminds me the Charles Dickens line of Ebeneezer Scrooge when asked to give donation to the poor he refused because “It will help to reduce the surplus population”

        • Pat
          September 7, 2020 at 8:32 am

          So I guess we still need to flatten…something?

  3. Harrietta Christodoulos
    August 29, 2020 at 3:05 pm

    We are facing a similar fate here in Michigan, so much so that there is an order for people to wear masks outdoors and anywhere on campus including walking between buildings and the downtown area. I am just not clear on the point of that. It sends a conflicting message as to how the virus is spread.

    Are we as physcians going to just say, “don’t be afraid to come in to the office its safe in our clinics/ ED… ” but walking out in the open air is dangerous…even if you are 20-100 feet away from another person. Am I missing something..? How does that improve the public opinion and trust of doctors…?

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