The Doctor’s Order

March 20, 2020
Doctor Maria Torreolla Carney, professor, medical director and former Commissioner of Nassau County Department of Health, explains how and why we must “flatten the curve” and provides helpful reminders on how to best navigate the COVID-19 pandemic.

Maria Torroella Carney, MD, FACP is the medical director of Post-Acute Services at Northwell Health and serves as Northwell's Chief of Geriatric and Palliative Medicine. Dr. Carney is also a professor at the Zucker School of Medicine at Hofstra/Northwell. She is the former Commissioner of the Nassau County Department of Health.

Flatten the curve

“Flatten the curve.” News, websites and social media have been repeating this phrase. But, what does it mean? The curve refers to the exponential increase in infections that occur during a pandemic. An important public health goal is to “flatten the curve,” or reduce the number of daily new cases, in order to lessen the strain on our healthcare system. Social distancing and other efforts are meant to lower the rate of infection during a pandemic to “flatten the curve.”

The COVID-19 pandemic has the potential to incapacitate the U.S. healthcare system. Exponential increases in infections lead to hospital and healthcare supply over-utilization, with the possibility of contributing to the inability to respond to other medical needs. This is what is happening in China and Italy, and it could happen here too. For that reason, we must make efforts to “flatten the curve.”

This graph shows how the curve of infectious disease cases can be flattened with protective measures so as not to overwhelm the Healthcare System Capacity. Without protective measures the curve is too steep and will go over the system capacity


Managing fear

COVID-19, like most crises, causes not only infection, but also the ripple effects of panic and fear that impact us all. That fear factor is, in part, fueled by an insatiable 24-hour news cycle that can unsettle even the calmest among us. Furthermore, the recommendations to prevent illness can have the unintended consequence of also contributing to social isolation, exacerbating the fear and anxiety. Like the virus itself, that resulting fear needs to be managed.

Tips for navigating the crisis

Here are some things to keep in mind as we navigate the current COVID-19 crisis:

1. Take precaution

People with underlining illnesses or who have serious chronic medical conditions like heart disease, diabetes and lung disease are at the greatest risk, but no one is free from contracting COVID-19. Be smart and listen to the advice of public health officials. Currently, they are advising to: avoid large crowds, stock up on essential supplies, wash hands often (for a minimum of 20 seconds), stay home as much as possible and practice social distancing (six feet is recommended) when outside the home.

2. Connect with those who may be isolated; use technology

Applications like Skype, FaceTime, texting and even phone calls can keep those at-risk connected to family and friends and can replace in-person participation with real-time interaction at family gatherings or social functions until it is safe to resume in-person activity. Connecting with those who are more isolated can keep those at-risk connected to care providers as well. Amazon and other delivery providers can ensure replenishment of needed supplies, and even food and medication. It’s important to remember that social distancing may be recommended but social isolation is not. Use technology to stay connected.

3. Be knowledgeable

Obtain your information from credible sources such as Centers for Disease Control and Prevention (CDC), New York State Department of Health (NYSDOH) or Northwell Health. See the resource list provided. Know the emergency warning signs for COVID-19. If you notice any of the following symptoms – difficulty breathing or shortness of breath, persistent chest pain or pressure or new confusion – make sure you seek immediate medical attention.

4. Communicate and advocate

Encourage those who are fearful or concerned about the situation and their own health to share their concerns with you and/or their healthcare professionals. Listening, understanding and reassurance go a long way to allay fears and worry. Encourage people to avoid spreading illness by staying home when they are sick and avoiding close contact with people who are sick. Make smart efforts to “flatten the curve.”

5. Stay up-to-date

Pay attention to the latest up-to-date news regarding the situation and what is happening in the community so you can respond accordingly, but don’t overdo it. Check in once or twice a day. Being constantly tuned to the news can do more harm than good. Make sure that it’s more Netflix and a comedy or two than the 24-hour news station.

It’s important to remember that the recommendations public health professionals are promoting regarding COVID-19 are not only about preventing individual illness, but also about protecting the healthcare system to be there for all. We know that while the current situation may be unsettling, we can rely on each other, the lessons we’ve learned and our public health and healthcare professionals and institutions to both persevere and thrive in even the most trying circumstances.

This crisis too shall pass, but there still is much to do.

Resource List:
4. NYSDOH Novel Coronavirus (COVID-19) Hotline: 1-888-364-3065

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