April 18, 2020 - 9:00 pm
I’ve become increasingly concerned regarding the basis for the various actions taken by Gov. Steve Sisolak during this medical state of emergency.
The initial actions of closing schools and nonessential businesses to achieve social distancing were clearly necessary in response to model projections that indicated a potential number of cases that would overwhelm our medical capability and result in unnecessary deaths. Unfortunately, those seem to be the last decisions made on the basis of data. Subsequent decisions seem more of a knee-jerk response rather than common-sense or considered decisions based on data and medical input.
For instance, the governor’s decision to restrict the use of hydroxychloroquine came at a time when the FDA had approved the drug for off label use in treating COVID-19. It deprived patients who were taking the drug for approved reasons. More importantly, it prompted physicians seeing patients in their offices suspected of having COVID-19 to admit these patients to the hospital rather than use HCQ when appropriate and continue to treat and follow them as outpatients. This leads to an inefficient utilization of hospital beds that were in short supply.
Press releases stated that the decision was based on the “concern” of the state pharmacy board that there might be hoarding of the drug. Other states imposed no such restrictions, and there was no hoarding. So where is the data that shows Nevada physicians are less responsible than those practicing in other states?
The decision on April 8 to ratchet up the restrictions on activities and businesses because “people are dying” was reportedly in reaction to pictures the governor viewed showing golfers not maintaining his mandated social distancing. Yet on that date, actual deaths and COVID-19 cases in Nevada (and in the United States in general) were far less than those projected when the governor initiated measures to create social distancing. Additionally, on the same date, Nevada reached its peak medical resource utilization and began having a surplus of resources.
In other words, since April 8, Nevada has had more capability to treat COVID-19 than needed. So why — when the goals of the initial directives regarding social distancing had been met (despite people participating in outdoor activities such as picnics, tennis, basketball and golf) — increase the burden on Nevadans by restricting their outdoor social outlets and activities? Because the data doesn’t indicate a basis for the action, what is the basis? Was it a reaction to the large number of deaths reported the days prior when Nevada reached its peak deaths per day?
Given the long incubation period of COVID-19 and the expected lengthy treatment of the people who ultimately succumbed, virtually all of the people dying at that point would have been infected prior to the beginning of the social distancing measures on March 17. So those deaths are not a result of improper social distancing and are not a justification for imposing additional restrictions. Indeed, all the data shows that the sacrifices that Nevadans have endured since March 17 have been working very well despite them engaging in outdoor recreational activities that don’t strictly adhere to social distancing mandates.
One final point. During the 2017-18 flu season, when the current governor was a Clark County commissioner, 80,000 people died in the United States from common flu. For Clark County, the proportional number would be approximately 533 deaths. The current projected total COVID-19 deaths for the entire state of Nevada through August is 254 with no deaths after early May. So more than twice as many people died in Clark County during one flu season when the governor was a county commissioner, and there was no interruption of the business and activities of the citizens of the county, state or country. I would venture a guess that you could probably find a picture of then-Commissioner Sisolak on the golf course.
Dr. David A. DiOrio, a general surgery specialist, writes from Las Vegas.