Part of our job as providers in health care is to make recommendations; especially to fill the void when no one is talking. March 13th, a day picked randomly, saw 556 newly diagnosed cases of COVID 19 across the country. May 6th saw 24,506 cases; July 17th, 70,923 cases. As you recall, during the summer, things started to settle down. Masking, hand washing, and distancing was having a positive effect. People were outside where the virus was diluted. September 20th saw 36,356 cases.

Fast forward to December 4, 8 days after Thanksgiving. December 4th saw 229,243 cases. And so far, this is pre-vaccine, with few national recommendations for mitigation. In other words, apart from hand washing, masking, and social distancing, in terms of intervention, nothing much has changed. In fact, with COVID 19 fatigue, many of us have become lax when it comes to protecting ourselves and others. In Pennsylvania, our stay at home order was lifted in early June. At that time, nationally, our daily rate was somewhere in the 18-20,000 range.

In Allegheny County, as of today, 55% of our ICU beds are filled. This means that we still have some capacity to handle a coming surge. But in places like Cambria County, Mifflin County, and Montour County, they have 100% filled ICU beds. They have no capacity to handle surge. Patients will be diverted either en route or after arrival to other facilities. The other issue is that as our hospital’s reach capacity, there will be no availability to assist with heart attacks, strokes, open reduction/internal fixation of bone fractures, etc. The myriad of things that we need when we seek emergent care at hospitals.

There are some things that we can do out of commonsense. We routinely field questions about how to travel safely, “I need a swab before I travel”, “I need to swab what I get back.” One need only look at the map to see that no matter what destination you choose and no matter what starting point you choose, the country, based on the above numbers, is experiencing massive community spread. Increasingly, there is no safe harbor; no place is untouched.

It’s time to reconsider postponing unnecessary travel. Don’t rely on the Department of Defense in air, on ground testing study of transmission; even the authors admit the study had shortcomings. It assumed 1 infected passenger and no movement within the cabin. This is not a reasonable supposition. It’s time to consider postponing congregant behavior with people outside of your bubble. We are well aware that one need only turn on the news to get similar bad news as we’re delivering; it would be nice to have a break from your medical provider giving you more. So, we will not pontificate. But just know that this surge is not happening because other people are ignoring recommendations. The health of our community is how we behave collectively.

It is our recommendation that we all start to consider postponing unnecessary travel, postponing unnecessary get-togethers. Do it for yourself. Do it for your neighbor. Do it for your grandparents. Do it for your community.

We wrote you in the spring. Unfortunately, we find ourselves not in a similar situation but in a worse situation. We quoted Faulkner, “The past is never dead. It’s not even past.” Unfortunately, we’re here again. And the past is looking awfully familiar. But there is good news on the horizon: Eventually warm weather will return, and we will move outdoors again. A vaccine by either Pfizer or Moderna will be available soon. Things are looking up! But please don’t let us collectively let down our guard. Should you be so disposed, we want everyone to be here to get a vaccine when it becomes available.