My oldest, dearest friend was admitted to the ICU on April 1st suffering from bilateral pneumonia. The suspected cause was COVID-19. He was put into a medically induced coma and placed on a ventilator (aka life support) where he spent the next 14 days. I had a mental picture of him serenely lying in a hospital bed like a patient on Grey’s Anatomy. Nothing could have been further from the truth. He was completely alone, face-down and unconscious. They turned him over a couple of times a day to see which position achieved the highest blood oxygenation levels.
He was extubated on April 15th and placed on a BiPAP machine. Days later, he became semi-aware of his situation. He was restrained (to prevent him from pulling out the tubes) and unable to speak above a whisper, the nurse held his phone for him. We facetimed. We cried. He was alive.
Hours later he developed a pneumothorax, with both lungs partially collapsed, and he needed a chest tube inserted. He has been in the ICU for 46 days, and at this point (chest tube still in place), he is coughing up necrotic lung tissue. If he survives, he will never be the person he was. I’m getting daily reports from the hospital, but he has not been able to communicate with me.
If this were everyone’s experience with COVID-19, we would be approaching this differently. But this disease is very personal.
My friend’s office manager became infected with the virus at the same time. She did not know. As far as she can tell, she was completely asymptomatic. No cough, no fever, no symptoms of any kind. But she tested positive for the virus.
This would be good news, except that at the same time that my friend and his office manager became infected, so too did his office manager’s mother. She was placed on a ventilator in early April as well. Sadly, she passed away April 25th. May she Rest in Peace.
Three people. Three cases. Three completely different outcomes. For me this has been a very up-close and personal view of the wide range of possible outcomes.
How Safe Is Safe Enough?
America is getting ready to reopen for business. Everyone has their own ideas about how this will work. On paper, or from a dispassionate conference room, it is easy to speak of “an acceptable level of risk.” Or to ask, “How safe is safe enough?” But at present, it is impossible to know where you will fall on the spectrum of outcomes if you become infected, and that makes decisions about reopening very personal.
In practice, we cannot stay sequestered forever. Aside from going stir-crazy, we’ll all go broke. So, what is likely to happen next?
Over the next few weeks people are going to start getting back to the doing of life. Some will remain sequestered to very high levels. Others will reengage more quickly; it will be a heterogeneous mix of behaviors driven by personal needs and an incalculably large number of experiential variables.
If we have learned anything from history, it is that nothing plays out according to predictions. But we have also learned that outcomes in the real world are far more subtle and far more diverse than suggested by soundbite quotes and clickbait headlines.
A Personal Strategy
Is there a right way to reopen America? No. There’s just the way it is going to reopen on its own. Each person doing what they think is right for themselves and their families. Trying to predict what that will ultimately look like is a fool’s errand. The best you can do is to attempt to strategically forecast a range of probable scenarios and place some bets on the ones you believe in the most.
I am interested to understand how you are thinking about the reopening of America. I am specifically interested to understand what you consider an “acceptable level of risk.” So, please take the survey below, or just reach out and let me know.
Please note: 100 percent of your information will be anonymized. It will not be shared with anyone other than being aggregated into a graphical illustration of the survey results which we will share publicly. I am asking for your email and other personal information to verify that individual humans, not bots, are answering the questions. Your personally identifiable information (PII) will not be attached to your answers in our system.
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Author’s note: This is not a sponsored post. I am the author of this article and it expresses my own opinions. I am not, nor is my company, receiving compensation for it.