By David Velasquez
Being a medical school student from the Antelope Valley means that I receive many messages from my home community regarding Coronavirus Disease 2019 (COVID19).
Some are of concern, but others are of skepticism and blame. People in the latter group find it difficult to accept the severity of COVID19 when they are healthy and living in the Antelope Valley, which has only two reported COVID19 cases* and is over 60 miles away from Greater Los Angeles where most Southern California cases are concentrated. But these are not reasons to neglect preventative health measures and relegate the importance of public health information. In fact, living in the Antelope Valley as a healthy person should urge us to respond immediately.
Young people often present without symptoms when infected with COVID19, although new data shows that nearly 40% of patients sick enough to be hospitalized in the United States were between the ages 20 and 54. Having no symptoms means that this population can silently transmit the virus–each person with COVID19 is predicted to infect about 3 people, with some reportedly infecting many more. This is particularly concerning in the Antelope Valley where our loved ones might be sicker and further from our health care system.
People living in more isolated places, like the outskirts of the Antelope Valley, are likely at higher risk for mortality during pandemics. When the 1918 Spanish flu occurred, people in rural communities were much more likely to die from the disease. Today, the risk faced by this community could be worse because of the prevalence of chronic health conditions. Diabetes and high blood pressure are more common in adults living in rural communities than those living in urban centers. Chronic lung disease in this population is also nearly double the percentage in large metropolitan areas.
In the Antelope Valley as a whole, about 1 in 7 adults have diabetes while a whopping 1 in 3 have reportedly been diagnosed with high blood pressure. These numbers are alarming in general, but are even more so today since people with one chronic health condition have a 79% greater chance of requiring intensive care or a respirator or both, or of dying, when afflicted with COVID19. Those with multiple chronic health conditions are at an even higher risk.
Living in an isolated part of Los Angeles County also means that access to health care is compromised. Even though the majority of Antelope Valley residents are medically insured, over 1 in 6 people do not have a regular source of health care while approximately 25% report difficulty in obtaining needed medical care. In the setting of a COVID19 community outbreak, access to care will only worsen. Estimation models predict that in moderate case scenarios in which 40% of the adult population in the Los Angeles region contracts the disease over 12 months, hospitals will need to expand capacity. In worst case scenarios, Los Angeles County will need four times the amount of current hospital beds.
Antelope Valley Hospital, even before the pandemic, had already expressed concerns over their chronically overcrowded emergency department and is planning to expand its facilities. Palmdale Regional Medical Center is similarly budgeting to increase their number of beds to meet community needs. In general, access to care for people in the Antelope Valley would worsen with a COVID19 outbreak.
COVID19 spread in the Antelope Valley would prove challenging, but there are immediate steps we can take to prevent unneeded physical and financial harm. First, we should respond with caution, not panic or disbelief. Staying educated on the current situation through the Centers for Disease Control and Prevention COVID19 website and more general resources like this Los Angeles-specific “no-panic” guide is a reasonable start.
Second, and most importantly, we must religiously practice social distancing. Los Angeles County has already provided us with the groundwork by closing schools, gyms, movie theaters, and bars. They have even banned gatherings of 50 or more people. But these efforts are inadequate in isolation. We must also act accordingly to effectively prevent viral spread. This article provides a great framework for individual behavioral practices–in sum, do not host parties, sleepovers, or families and friends at each other’s houses; limit the frequency of going to stores, restaurants, and coffee shops; and if you have are feeling sick, isolate yourself from others and contact your primary care provider or your nearest medical center. Furthermore, maintain at least six feet of separation between you and the people around you. Ignoring such practices increases disease transmission and places innocent bystanders at risk of harm.
Finally, given the challenges of social distancing, it is important to know your rights regarding paid sick leave and to stay up-to-date with the potential government payout expected to provide many Americans with a financial reprieve. Also, be sure to prioritize your mental health by walking outside and remotely staying in touch with your loved ones.
Dismissing public health information and preventative measures runs counter to the social responsibility we must uphold as citizens of the Antelope Valley. We cannot reach the point where doctors are forced to choose who deserves care and who does not, similar to the situation in Italy. The vulnerability of our neighbors requires us to practice social distancing and prepare for the economic and health realities of COVID19. With this approach, we can each stave off unnecessary burdens and help mitigate an ominous future.
About the Author: David Velasquez is a medical student at Harvard and a long-time resident of the Antelope Valley. You can follow him on twitter @davidevelasqu.
*Editor’s note: Since this Op-ed was submitted, Lancaster Mayor R. Rex Parris has announced six confirmed cases of COVID-19 in the Antelope Valley.