UPMC Chief Medical and Science Officer: “What We Cannot Do is Extend Social Isolation”
The following is testimony before the Pennsylvania Senate Aging & Youth and Local Government Committees by Dr. Steven Shapiro, chief medical and science officer at the University of Pittsburgh Medical Center.
His conclusion: While an urban area with high population density and diversity may need more COVID-19 protocols, Gov. Tom Wolf and Secretary of Health Rachel Levine’s draconian lockdown measures for the rest of the state are far more harmful than the corona virus.
Dr. Shapiro’s testimony follows:
Madame Chairs, Chairman and Senators, I am also pleased to appear before your committees to discuss what we at UPMC know about the coronavirus based upon our clinical experience and research, which will help inform how to safely reopen the economy and society.
I am UPMC’s chief medical and scientific officer and president of UPMC’s Health Services Division, which consists of our 40 hospitals in Pennsylvania, Maryland and New York, comprises over 5,500 licensed beds, 700 doctors’ offices and outpatient sites and more than 6,300 employed and affiliated physicians.
In addition to what Dr. Yealy said in terms of our experience, around mid-April we peaked, and at that time we utilized about 2% of 5,500 beds and 48 of 750 ventilators, and since then, admissions have been decreasing with a majority them now coming from nursing homes. As we’ve started to reopen and get back some of our essential care, we have been testing on all preoperative patients, even those who are asymptomatic. Having done over 2,000 viral antigen tests on asymptomatic patients to date, we have four positives: three in central Pennsylvania and one in western Pennsylvania. Right now in our areas, the rate of community infection is extremely low.
This will help inform how we grapple with opening society. Philadelphia, not too dissimilar to New York, with high case rates as a result of density, travel and socioeconomic diversity, must open up in a measured, stepwise manner with extensive testing, contact tracing and treatment. But, for the rest of the state, as people come out of their homes cautiously and safely, if we protect our vulnerable seniors, particularly those in nursing homes, we should be able to keep case rates manageable, buying time to prepare for a potential resurgence as we bolster our supply chain and discover effective interventions.
COVID-19 is a disease that ravages those with preexisting conditions – whether it be immunosenescence of aging or the social determinants of health. We can manage society in the presence of this pathogen if we focus on these preexisting conditions.
What we cannot do is extend social isolation. Humans are social beings, and we are already seeing the adverse mental health consequences of loneliness, and that is before the much greater effects of economic devastation take hold on the human condition. The Academy of Family Medicine estimates up to an additional 154,037 deaths of despair from drugs, alcohol or suicide over the next decade attributable to the rise in unemployment, isolation and uncertainty.
This has been a wake-up call for our health care system and our nation in general. Health care workers have stepped up to the challenge, and we will be here to safely and scientifically help our society reemerge.
One thing is certain: Pandemics will be part of our future, and we must be better prepared. We can’t be put in a position to have to choose between death by pathogen or death by economic shutdown.
In this particular case, the problem we’re not going to be able to fix in the short term is the complete eradication of the virus. The problem we can fix is to serve and protect our seniors, especially those in nursing homes.
If we do that, we can reopen society, and though infectious cases may rise, as in the Theodore Roosevelt, the death rate will diminish, providing time for the development of treatments and vaccines.