LETTER TO THE EDITOR — As physicians who live and practice in Southwest Utah, we are concerned about the rapid spread of COVID-19 in our community. During the month of May, and especially over the last week, we have seen a steady rise in the number of people testing positive in our community.

This is not because we are doing more tests, nor is it because visitors are testing positive while here. Our numbers are now rising precipitously because we are spreading it amongst ourselves.

If we continue to see case numbers increase in this way, we are concerned that Utah will be forced to again close our doors and isolate. This will not only cause loss of life but will further damage our economy. None of us want that.

In fact, we are certain that everyone wants COVID-19 to just go away, but the hard truth is that COVID-19 is a contagious disease easily spread by respiratory droplets that pass from person to person when we cough, sneeze, talk, laugh, breath hard or sing.

COVID-19 is not just another cold virus. It is much deadlier than the flu, a virus that also takes a high toll on human life every year. In just over three months, despite strict physical distancing in most places, we have had three times as many deaths from COVID-19 in the United States as the entire 2018-2019 flu season.

Here in Washington County, it appears that we effectively socially distanced early in the pandemic before we had very many cases. We were able to keep our case counts very low for quite a while. Then, as we learned more about the nature of the virus as well as the positive and negative effects of strict physical distancing, we moved through the color-coded phases of the state response.

As much as we may want life to return to “normal,” this is not what the yellow or even the green phases call for. Wearing masks in public places and social distancing when possible are essential parts of the guidelines for the yellow phase and the safe green phase. Coronavirus is here to stay and should affect our behavior for the foreseeable future until a safe vaccine is developed or effective treatments are identified.

Adherence to these guidelines is more important now than ever

We recognize that this has also turned into an economic challenge of epic proportions which threatens to worsen many other public health problems – alcoholism, opioid addiction, major depression, anxiety, suicide, domestic violence and undiagnosed cancers. We care about all of these problems. Any strategy to effectively fight coronavirus must take these into account. An either this or that approach is not going to work, nor is denial.

We’ve all heard that COVID-19 affects older people to a far greater extent than younger adults and children. People with certain underlying conditions of any age are also at greater risk of doing poorly if they get COVID-19. These underlying health conditions are very common and include, but are not limited to, diabetes, obesity, heart disease, high blood pressure, moderate to severe asthma, liver disease, cancer, and other diseases that cause weakened immune systems.

We are grateful that COVID-19 has a less devastating impact on kids and younger adults without certain health conditions, but it is important to realize that kids and younger adults are not unaffected. In fact, we are currently seeing most of our positive tests in people aged 30 to 49. People in this age category, some of whom may not have symptoms, are unknowingly spreading the virus to others at higher risk.

You may not know who in your circle is at risk of dying from this disease or who has loved ones at risk.

What we are dealing with now is a numbers game. We cannot reduce the number of cases or deaths to zero, but we do have it within our collective power to decrease both the negative economic and health impacts of this unfortunate situation. Every single one of us has an important role to play.

Here’s what we can all do:

• Acknowledge that this is a long-term game – a marathon not a sprint.
• Realize that public health is a team sport and only works if we support each other.
• Maintain a 6-foot distance from others whenever possible, especially when in public places. Putting this space between us allows most droplets to disperse before they reach someone else.
• Wear a mask when in public:
  • You wear a mask to protect yourself, but also to protect others from you (if you are infected but have no symptoms). There is good evidence that, if we all wear masks, transmission of the virus drops significantly. Masks are not perfect, and some are better than others, but even cloth masks are beneficial. Don’t let perfect be the enemy of good.
  • You wear a mask to help protect the store clerk who may be over the age of 60 or have an underlying health condition, or your mechanic who has diabetes and needs to work to support his family. You may only be within six feet of one person while in a store or office, but these people may encounter greater than 100 people in close range on any given day.
  • Not everyone can or should wear a mask. Facial coverings are not recommended for children less than age 2 or people with health conditions such as asthma, COPD or a tendency to hyperventilate. It is not your job or our job to be the mask police in public. Let’s give others the benefit of the doubt and do our best to wear masks when within 6 feet of others.
  • Remember, wearing a mask is not a sign of weakness, fear or ignorance. It is a sign that you care and is one way that each of us can contribute to controlling the spread of COVID-19.
• Limit the size of social gatherings. The current Utah guideline in the yellow phase is 50 people or less. Of course, the virus can still spread within groups of this size, so we encourage you to exercise personal responsibility and take precautions regarding hand hygiene, mask wearing and keeping a safe distance from others.

This is a complex problem that requires a consistent and persistent approach. We all want to slow down and control the spread of the disease, keep our economy thriving, open up our schools and ensure individuals remain healthy and families strong.

As healthcare providers, we are committed to being there for you when you need us. We hope that you, in turn, will help us in our effort to provide the medical care that our community needs by doing your part to keep the numbers as low as reasonably possible. Doing so will not only save lives but will also allow our economy and preferred way of life to return to normal sooner rather than later.

We will get through this, but we must pull together as a community, trust in good science (acknowledging that this is a process and we are learning new things daily), use common sense and share a belief in our collective humanity.

Submitted by ELLEN ARCH, MD, and CATHLEEN O’BRAY, MD, with the following signatories from the Southern Utah area:

• David Blodgett, MD, Director of the Southwest Utah Public Health Dept
• Patrick Carroll, Medical Director for Dixie Regional Medical Center
• Jon Pike – St. George Mayor
• Steven Temple, MD – Internist
• Randy Clark, MD – Orthopedist
• Derrick Haslem, MD – Oncologist
• Michael Marsden, DO – Pediatrician
• Brad Myers, MD – General Surgeon
• Sharon Richens, MD – Ophthalmologist
• Larry Cain, MD – Family Practice
• David Grygla, DO – Hospitalist
• Stephen Clark, DO – Family Practice
• Warren Butterfield, MD – Orthopedist
• Rajiv Kaddu, MD – Pediatrician
• Timothy Larsen, MD – Pediatrician
• Adrianne Walker-Jenkins, MD – Pediatrician
• Carlos Leon, MD – Nephrologist
• Monica Moreno, MD – Endocrinologist
• Carlos Mercado, MD – Nephrologist
• Paul Whitecar, MD – Maternal Fetal Medicine Specialist
• Kurt Hales, MD – Maternal Fetal Medicine Specialist
• Joseph Te, MD – Oncologist
• Andrew Vaughan, MD – Otolaryngologist
• Ryan Williams, MD – Psychiatrist
• Greg Larsen, NP – Oncology
• Tyler Haberle, MD – Internist
• Kent Gardner, MD – Otolaryngologist
• Scott Parkinson, DO – Internist
• Gordon Smith, MD – Internist
• Larry Eggert, MDN – Neonatologist
• Joan Eggert, Andy – Obstetrics/Gynecology and Hyperbaric Medicine Specialist
• Bryce Ferguson, MD – Dixie Regional Medical Center ICU Medical Director
• Zahabia Gandhi, MD – Internist
• Mustafa Saifee, MD – Pulmonologist, Critical Care and Sleep Medicine Specialist
• Mitchell Cloward, Dixie Regional Medical Center Administrator
• Chris Hart – Ivins Mayor
• Thomas Bigham, DO – Family Practice
• David Boorman, MD – Cardiologist
• Steven Chase, MD – Otolaryngologist
• David Magnesen, DPM – Podiatrist
• Matthew Fabiszak, DO – Internist
• David Crimin, DO – Medical Director Southern Utah Veterans Home
• Coleen Andruss, MD – Internist, Obesity Specialist
• Kathryn Walker, MD – Obstetrician/Gynecologist
• Carl VanGils, DPM- Wound Clinic Medical Director, Dixie Regional Medical Center
• Swati Laroia Coon, DO – Neurohospitalist/Stroke Medical Director, Dixie Regional Medical Center
• Melissa Hinton, DPN – Doctorate Nurse Practitioner, High Desert Counseling
• Joy Welsh, MD – Gynecologist

Update June 27. Additional signatories added.

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