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CHR's COVID-19 Bulletin, May 7, 2020

[This article deals with a continuously evolving situation. It was written by Norbert Gleicher, MD, on May 7, 2020 and published on the same day. For a list of all COVID-19 Bulletins, scroll to the bottom.]

As the country is slowly “reopening” it economy, the President’s COVID-19 Task Forece is redirecting its focus by concentrating on this reopening process and on, as quickly as possible, developing an effective vaccine. These are good news, especially since similar changes are underway in many countries around the world, suggesting that these changes may be a first sign of worldwide normalization and economic recovery.

These developments also reduce the necessity for regular COVID-19 Bulletins from CHR and they, going forward, will undoubtedly decrease in numbers. We will still, though, issue Bulletins when important news must be conveyed.

All of this, of course, does in no way suggest that the COVID-19 pandemic is over. Very much to the contrary, with increasing understanding of the virus there is increasing certainty that, not only is the current episode not over but there is significant risk that sporadic “hotspots” may arise and that in the fall a second major wave of infections may occur. One can only hope that federal and local governments will be better prepared than they were the first time around, should that, indeed, happen.

Better preparation is needed on two distinct levels, conceptional and practical. On the conceptional side, we now much better understand the virulence of COVID-19 and the true severity of disease it causes in different patient populations. In practical terms, we, therefore, understand better the necessary hospital capacity, availability of protective gear for physicians, nurses and other support staff as well as appropriate professional man- and woman-power. We, however, also understand better by now the unintended consequences on national health and economy from a mitigation strategy via economic shutdowns and, therefore, for the first time can really establish models that consider not only the benefits from mitigation but also its risks and other downsides.

It, of course, is always easy to criticize through the retrospectoscope conceptional mistakes that were made in the past in, first, underestimating the virus and then overreacting to the pandemic by shutting down the economy with little regard for unintended medical as well as economic consequences. These kinds of overreaction are not unexpected even from well-meaning “experts” who often only see the benefits of what they know helps in mitigation, but, subconsciously or consciously, overlook the downsides. Not wanting to belabor this issue here further, we recommend that readers of this Bulletin also glance at the lead article in the May issue of CHR’s monthly newsletter, The CHR VOICE.

A health care crisis beyond COVID-19?

In the May 7 issue of The Wall Streeet Journal, (page B1), an article by Sharon Terlep raises concerns about a “non-virus health crisis,” based on a warning by executives from CVS Health Corp which has generated data that apparently demonstrates that, due to the COVID-19 health crisis, the U.S. population appears to delay routine health care. In this context it is important to note that CVS _is not only one of the largest pharmacy chains in the country but also the owner of _Aetna, one of the largest health insurance companies, and is, therefore, well suited to evaluate such data nationwide.

This is, of course, one of those unitended consequences from shutting down the country that proponents of the radical mitigation strategy this nation has been pursuing never seriously considered. If anything, we are surprised by how surprised CVS and the media reacted to above noted findings. After all, shutting down most of the economic engine of this country did not only mean shutting down mom and pop stores on Main Street; the national mitigation strategy also shut down most of routine health care in the country. How can one, therefore, be surprised about an impending “non-virus health crisis,” if one has even only a minimal understanding of the meaning of unintended consequences.

Going forward at CHR

The shut-down, of course, also included most infertility treatments. As also discussed in more detail in this month’s VOICE, fertility clinics, fortunately, have started reopening. Since CHR never closed its doors, we do not have to move through a reopening scenario but, for the foreseeable future, will maintain practice changes that were implemented with start of the COVID-19 pandemic. Maintaining separation and other mitigation procedures at the center is, of course, meant to protect our patients as well as our staff. As CHR by now has demonstrated very successfully over almost two months, one can minimize risks for patients and staff and, yet, continue providing excellent health care unrelated to COVID-19.

And this concept does not only apply to health care. The sooner our government representatives recognize this fact, the quicker the country will return to a “new normal,” significantly different from the “old normal” but, nevertheless, more “normal.”

CHR's COVID-19 Bulletins

Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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