The virus is the enemy
I was called at 3 a.m. to respond to an 11-year-old oncology patient with spiking high fevers. I was the second-year resident physician on hospital night call for the pediatric team at the world-famous Mayo Clinic in Rochester, Minnesota. I hurried into the patient's room to find his mom, his grandmother and his older brother all awake by the sick boy's bedside. His dad was sitting on the bed soothing his son's forehead.
I explained that the boy's white blood cell count was too low and several important tests needed to done immediately. Understandably, the thin, pale boy wondered aloud why this all had to be done right now, he just wanted to go home. The snow fell quietly outside the large double-paned windows near the boy's bed while I explained that he was still very sick and we wanted to safely treat his cancer before we could send him home.
His father's face turned red with rage. He instructed me to walk with him outside the room. With utmost self-control, the broken-hearted father who served as the church pastor in a farm town several hundred miles away told me that I was an idiot for telling his son that he had cancer. The family had decided that they wanted to keep that bad news from the patient. I felt miserable for unveiling the terrible secret, but it was the truth.
Lambasted, reviled and condemned, healthcare professionals and government leaders are subject to psychological, emotional and too often physical violence when dealing with intimate, life-or-death truths like the Covid-19 pandemic.
Last week, Gov. Lou Leon Guerrero, a former intensive care unit nurse, ordered Guam back into Pandemic Condition of Readiness 1 due to the re-emerging threat of critically ill patients overwhelming the island's poorly maintained government hospital.
Infuriated small business owners berated the governor's duplicitous treatment of unemployed private taxpayers who have gone months without meaningful local assistance. Incensed, desperate citizens vilified the governor for perpetrating the idiocy of simultaneously coddling 5,000 non-essential government workers who have been continuously paid to stay home for the past six months.
The Guam Chamber of Commerce called for a more balanced approach to the new pandemic surge. Local business experts argued passionately for the avoidance a devastating massive island shutdown because they believed that Guam had done a good job of controlling the virus. They noted that Guam's rate of infection had been among the best in the nation as recently as last month. They praised the majority of citizens and businesses who had done a good job of protecting each other. Despite the evidence of new Covid-19 clusters, the Chamber of Commerce argued that a targeted approach with precise societal restrictions would be the better path already demonstrated by successful economies like Singapore, Taiwan and Germany.
The Guam Chamber impressively cited data released by Guam's Joint Information Center that suggested that we had robust contact tracing and minimal hospital ICU utilization. Despite warnings from the national Centers of Disease Control that Guam's hospital resources were not safe for travelers, the Guam Chamber praised Public Health and the Guam Memorial Hospital for being more than up to the task of keeping the economy open. They were wrong.
The governor's press secretary and the Joint Information Center had decided that they wanted to keep that bad news from the patient. The miserable secret was that the cancer of payroll politics had made GMH unsafe for travelers and for the people of Guam. The terrible truth was that Public Health had too few real contact tracers and most of these so-called medical detectives were lazy political appointees who just wanted the lucrative $20/hour paycheck. Like in the movie "Poltergeist," GovGuam had just removed the tombstones in the cemetery but they didn't remove the dead bodies.
Across the nation, bad politics is feeding the virus. Elected officials at the highest levels including President Donald Trump have lied about the pandemic; used misinformation as a weapon; and hostilely attacked Public Health experts who tell the truth as painful as it might be. All across America, at least 49 state and local public health leaders have resigned, retired, or been fired since April and the list continues to grow.
The past few months have been “frustrating and tiring and disheartening” for public health officials, said former West Virginia public health commissioner Dr. Cathy Slemp, who was forced to resign by Republican Gov. Jim Justice in June.
“You care about community, and you’re committed to the work you do and societal role that you’re given. You feel a duty to serve, and yet it’s really hard in the current environment,” Slemp said in an interview before she was invited to leave.
Hopefully, we on Guam are better than that. Hopefully, we can find a way through this pandemic by all being humble and kind. We have to be good to each other; make GMH stronger and free from political patronage; and develop truly robust contact tracing at Public Health. We have little choice but to do better, because this virus is a bitch.
Dr. Vincent Akimoto practices Family Medicine at the American Medical Clinic. Send feedback to firstname.lastname@example.org