Coronavirus straight talk – the letter that should be sent to every American

Tom Frieden, M.D.,

In May of 1988, I was working as a medical resident in New York City. AIDS was front and center for the hundreds of patients we cared for and for whom we could do so little, and for ourselves, fearing needle sticks as we drew blood dozens of times a day.

I remember vividly standing in my small apartment and reading a letter from Surgeon General C. Everett Koop. It wasn’t an exclusive letter – quite the opposite. Every household in America received one, along with a pamphlet produced by the Centers for Disease Control (CDC).

The letter was controversial. ”Some of the issues involved in this brochure may not be things you are used to discussing openly,” Koop wrote. “I can easily understand that. But now you must discuss them. We all must know about AIDS. Read this brochure and talk about it with those you love.”

I hope we all receive a letter soon from Dr. Jerome Adams, today’s able surgeon general. Just as Dr. Koop spoke plainly about the risks of the AIDS pandemic, we need plain speaking about the risks of today’s pandemic, COVID-19. Here’s what a letter might say:

Today, we are facing a threat to our health unlike any we have faced before. We are at war with a virus. It is a war we can win. But we need every one of you to help, now. Here are some things you need to know, and do:

  • Thankfully, about 99 out of 100 people who get COVID-19 will recover, although it may take many weeks.
  • This is a dangerous virus, and everyone in our country is affected by it. Many will become ill, some only mildly, but often with a painful, exhausting infection in our lungs and viral pneumonia. Some of us, and some of our loved ones, will die. Sadly, it’s going to get worse before it gets better.
  • Health care workers and first responders are our most precious resource. Check by phone or online before you go in for care if you’re sick — many health centers and hospitals have separate, safer entrances. If you do go for care, cover your mouth when traveling to and within health facilities. Health care workers must come first – including for treatment and a vaccine, and, if there are shortages, for face masks. That way, health staff will be there for us when we need them.
  • There are some things all of us must do now. And, whatever happens, we must continue to do these things. These include:
  1. Wash your hands often. Before you eat or drink or touch your face if your hands may be contaminated. After you touch anything that may be contaminated.
  2. Cover your cough and sneeze with a tissue that you throw out, or with the crook of your elbow. Then wash your hands.
  3. Don’t go out if you’re sick. If you have cough or fever and need to get health care, wear a surgical mask, bandana, scarf or other piece of clothing over your mouth.
  4. For the foreseeable future, stop shaking hands.
  • If you’re over 60 or have a health condition such as heart disease, lung disease or diabetes, stay home. There’s a virus out there, and you’re at a much higher risk of dying from it. And that’s not just a terrible tragedy for you and your family – it will take up health care resources that may be scarce.
  • Your personal health is your choice, but the health of others is not. You may feel healthy, but if you get infected you can pass the virus to others who are more vulnerable. You owe it to them not to get infected so you won’t infect them. And you owe it to all of us to do your part in stopping the spread of this virus.
  • Physical distancing is important. Crowds amplify the spread of the virus. For the time being, stay six feet away from just about everyone.
  • Take care of your emotional wellness. Be physically active. Enjoy nature. Connect with friends, family and others – by phone, video or other safe ways. Remember that, bad as this is, it will pass, and we will be stronger.
  • The virus spreads from people who are infected and from contaminated surfaces. That’s why it’s so important that people who are infected are physically isolated, why we must improve how we clean our hands, and why we must sanitize frequently touched surfaces such as doorknobs.
  • We hope and wish there will be an effective treatment and a vaccine against this virus. As of today, there is no scientific evidence that any medicine works, and a vaccine is likely to be many months or even years away.
  • We are all in this together. That means supporting your local health department and checking cdc.gov for the latest information and recommendations. And supporting protection against microbes around the globe, because, bad as this pandemic is, there will be others in our lifetimes. Future pandemics are inevitable. What’s not inevitable is that we will be underprepared.

This letter should include something every U.S. household needs: a digital thermometer. This will help people with a fever to physically isolate themselves sooner and help calm concerns of those who feel feverish but don’t have an elevated temperature.

Everyone should take their temperature when they feel sick, and twice a day if they’ve been exposed to the virus. We are stronger together even if for a while we are physically distant.

That would be immediately useful mail – thanks for the thermometer – that we would remember vividly more than 30 years from now.

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