As a cardiologist, I respond to calls for help on a plane whenever a passenger is having trouble. Most of the time it’s a fainting spell. But 15 years ago, I had the opportunity to save the life of a senior returning from a tour of Charleston via Atlanta.
Automatic defibrillators had come to planes, which allowed me to shock her back to normal rhythm. Later, I learned that a minor heart attack had caused her nearly fatal rhythm. She was discharged in Atlanta after a few days, and her son came to take her home to San Francisco, where she was well with no problems a few months later.
Despite being elderly and clearly having heart disease — both also important risk factors for COVID-19 death — she and her family were happy to have her alive and reasonably healthy for perhaps many more years. So the risk factors didn’t affect her outcome.
I think about that one life saved and realize that as of Saturday, 3,409 South Carolinians have been taken by COVID-19 in the past seven months, about the same as all the accidental deaths in South Carolina in a year, and the equivalent of 34 regional jetloads from Charleston to Atlanta.
About 450 of those victims were 60 or younger. Some died in well-equipped hospitals, and there wasn’t a thing the doctors could do. And we in South Carolina have somehow gotten used to almost a planeload of people dying every week.
Why is it happening, and why do people not seem to care anymore?
My wife and I returned home recently after three months in Maine, where the number of new COVID-19 cases for the state averaged about 20 per day; most days there were no deaths. Vinalhaven Island, where we were, had no cases from June through September. Maine’s population is about a third of South Carolina’s, which means S.C. rates are about 20 times those in Maine, the state with the highest number of people over 65, placing the state in a very high risk category. When we left Maine, the restaurants were pretty full, and the summer had turned out to be decent for tourism, an important economic driver.
How can all this be true?
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It’s pretty simple. In contrast to Gov. Henry McMaster, who continues to take the “quarterly profit” approach to controlling the virus, Gov. Janet Mills of Maine took the long-term view. She mandated masks early on, required quarantine or negative testing for visitors, and had clear rules for restaurants and bars.
Many people and businesses didn’t like it, but everyone observed it, and they were quite calmed when the hospitals across the South all filled up in July and death rates soared while Maine stayed safe.
In further contrast, McMaster is opening restaurants to full capacity while infection rates remain moderately high and aren’t going down.
Coming back to Mount Pleasant, we have been both pleased and concerned: More people are wearing masks, but many still aren’t. I have heard a number of people say, “It must not be too bad because I haven’t gotten it yet.”
Our views are restricted by what we see personally and want to believe. Even 3,409 South Carolinians is just 1 in 1,500, so you might not know anyone who died, but with an estimated 15% of S.C. residents infected, you certainly know someone who has had it.
Perhaps now that we have seen President Donald Trump get infected after flouting the rules for so long, the message that we are all at risk might stick.
Certainly, we are all glad the president with his multiple risk factors is doing OK, but not everyone will get diagnosed within a day of being infected and will receive investigational therapies.
J. Philip Saul, M.D., is a professor of pediatrics and a pediatric cardiologist.