As a cardiologist, I answer requests for help on an airplane whenever a passenger is in trouble. Most of the time, it is fainting. But 15 years ago, I had the opportunity to save the life of an elderly man who was returning from a tour of Charleston via Atlanta.
Automatic defibrillators arrived on the planes, which allowed me to shock her back to normal pace. I later learned that a small heart attack had caused its near-fatal rhythm. She was discharged from Atlanta after a few days, and her son came to take her to her home in San Francisco, where she was fine and without problems a few months later.
Despite being elderly and clearly having heart disease – both important risk factors for COVID-19’s death – she and her family were happy to have her alive and reasonably healthy for perhaps many more years. Therefore, the risk factors did not affect its outcome.
I think about that saved life and realize that on Saturday, 3,409 South Carolinians were captured by COVID-19 in the past seven months, almost the same as all accidental deaths in South Carolina in a year, and the equivalent of 34 regional jets from Charleston to Atlanta.
About 450 of those victims were 60 or younger. Some died in well-equipped hospitals, and there was nothing that doctors could do. And we, in South Carolina, somehow got used to almost a plane full of people dying every week.
Why is this 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 around 20 a day; most days there were no deaths. Vinalhaven Island, where we were, had no cases from June to September. Maine’s population is about a third that of South Carolina, which means that SC rates are about 20 times that of Maine, the state with the largest number of people over 65, putting the state in a very high risk category. When we left Maine, the restaurants were full and the summer had proved to be a decent one for tourism, an important economic driver.
How can all this be true?
It’s very simple. In contrast to Governor Henry McMaster, who continues to take the “quarterly earnings” approach to controlling the virus, Governor Janet Mills of Maine took a long-term view. It required masks from the start, required quarantine or negative testing for visitors, and had clear rules for restaurants and bars.
Many people and companies did not like it, but everyone watched and became very calm when hospitals in the South were filled to capacity in July and death rates skyrocketed while Maine remained safe.
In another contrast, McMaster is opening restaurants at full capacity, while infection rates remain moderately high and are not decreasing.
Returning to Mount Pleasant, we are satisfied and concerned: more people are wearing masks, but many are not yet. I have heard several people say, “It shouldn’t be too bad, because I still don’t understand it.”
Our opinions are restricted by what we see personally and we want to believe. Even 3,409 South Carolinians are only 1 in 1,500, so you may not know anyone who died, but with an estimated 15% of infected SC residents, you certainly know someone who has.
Perhaps now that we have seen President Donald Trump being infected for breaking the rules for so long, the message that we are all at risk can get.
Certainly, we are all happy that the president, with his multiple risk factors, is fine, but not everyone will be diagnosed within a day after being infected and will receive experimental therapies.
J. Philip Saul, MD, is a professor of pediatrics and a pediatric cardiologist.