Island doctor: Risk mitigation versus elimination
According to Dr. Daniel Hanley, when it comes to the coronavirus, Pine Island is doing very well overall. Much of this well being, he says, can be attributed to the geographic bubble which comes with being isolated on an island. However, he draws an important distinction between realistic and unrealistic goals.
“There’s really no risk elimination going on,” said Hanley, “it’s really more about risk mitigation. All we can really do is try to control spreading the virus.”
Although Hanley, of Ancuram Family Medicine on Pine Island, feels the onslaught of the virus is inevitable, saying the vast majority will become exposed in a matter of time, he also says most will be fine, even if they become infected. Some, he said, will surely have prolonged issues, as he pointed out the virus seems to be affecting the blood vessels, adding that no one knows at this point for sure if that’s truly the case, or why.
“It seems to be worse in people with blood vessel problems,” said Hanley. “Even if the problems weren’t existent beforehand, now it’s being brought to light. We want to be sure that we manage the complications. That’s what we’re worried about — that’s why we have lockdowns, to give hospitals a chance to manage this so people aren’t dying unnecessarily of COVID-19 simply from a lack of resources.”
The island, he said, is well suited for this type of manageability, because it’s basically a small community, so if anything happens, most islanders will know about it fairly quickly. He explained that if you are simply planning to see your core group of family and close friends, you can likely do so safely without wearing mask, with the appropriate social distancing and hand washing as well as the avoidance of anyone known to be ill. Other than taking necessary precautions, he said, people can live their lives relatively normally.
“When we travel outside of that bubble,” said Hanley, “by going to the grocery store, or going to the hairdresser, we definitely want to be much more careful. We should at least have a mask on hand. When you’re around a group of people, the chances of contracting the virus become much higher so you at least want to give yourself a chance to be protected as much as you can. Remember, this is about risk mitigation, not risk elimination.”
What it comes down to, Hanley explained, is that personal space matters, hand washing matters and when people are thoughtful and careful, it can go a long way toward maintaining health. Since the outbreak of COVID-19, Hanley said there haven’t been nearly the cases of other illnesses usually seen, in large part, due to the extra care the population has been taking not to contract this particular virus.
“In this space, on this island,” said Hanley, “we are doing pretty well. There haven’t been many cases and I don’t anticipate a huge spread because it seems like most people are being careful. People are going to be at a higher risk than usual, simply because of age. Age alone affects blood vessels.”
Hanley said it has been his observation that islanders overall seem to be active and motivated to stay healthy by making suggested changes that are already recommended in general. It is his opinion that the island is well situated to overcome this kind of pandemic. Although this is his basic contention, he said just as all of Lee County is being affected by the virus, people can expect the same on Pine Island.
“We have to make sure that if we encounter complications, we are aggressive,” said Hanley. “If we can handle hot spots here and there and keep it contained, over the next year or two, it shouldn’t be too bad.”
He said even though COVID-19 is simply a virus, people are not used to this particular strain, but that over time we will be better able to handle and combat it. He foresees the future of the virus looking more like a bad cold. Herd immunity, he said, could potentially take a long time for the population to achieve.
“There are two sides to that,” said Hanley. “One side says we should promote herd immunity as quickly as possible, since everyone is going to get sick anyway, we might as well get it over with. The problem I have with that is that there is such a high rate of complications, not just deaths, but complications, that we have to monitor, that if we have too many people sick at the same time, the rate of complications will go up as well, and you only have so many hands and so many beds.”
Although he said the idea of herd immunity is a sound concept and he does believe in it, Hanley maintains that if we were to let everyone get sick in order to achieve it, it would be pretty risky and that too much could go wrong, too fast, likening it to a game of Russian roulette. He believes letting the virus progress naturally is the best idea, since it’s going to anyway. Everyone’s best bet, he said, is to exercise basic, common sense precautions and try not to get sick too frequently. Eventually, he said the herd immunity will win out, but that it isn’t likely to happen for another year or two.
Although Hanley admits he would love to see a vaccine come to fruition, he points out that we still haven’t been able to wipe out a common cold and flu virus, which continually adapt, change and mutate. For now, he said he isn’t hanging his hopes on the virus going away any time soon and feels it’s a critical time to focus on complications. As far as the future, Hanley explained that people have an adaptive immune system, meaning once our bodies are introduced to something, such as a virus, people know how to deal with it much better the next time around.
“There’s no minimizing this,” said Hanley, “but I will say this, what happened in March and April seems to be a little bit different than what’s happening now. The behavior of the virus seems to be changing. Just because there’s an increase in cases, there’s always a delay in terms of the increase in deaths .. .but so far we’re not seeing that yet … but it doesn’t mean it won’t happen. That being said, I don’t really feel that this virus will get more and more virulent, I feel like if that was going to happen, that kind of adaptation that the virus would have to make, probably happened already. It seems to be a relatively stable virus and not genetically changing itself like it does with the flu.
“While I wouldn’t go so far as to say we are lucky this flu isn’t like the others, what we are doing goes a long way,” he continued. “The basic precautions we take to protect ourselves and the people in our bubble really helps, not only from becoming infected, but from transmission, and therefore the rate of increase.”
Hanley said in a time such as this it is wise to remember the three W’s: Wash your hands, Wear a mask and Watch your space.
Ancuram Family Medicine is at 10700 Stringfellow Road, #50, Bokeelia. For additional information, call 833-742-6276 or visit Ancuram.com.