“We are alarmed at what appears to be the lack of consideration for the future health of our patients. The downstream health effects of deteriorating a level are being massively under-estimated and under-reported. This is an order of magnitude error,” it states.
In the letter, sent last week, doctors described the lockdown as a “mass casualty incident”.
President Donald J. Trump
The White House1600 Pennsylvania Avenue, NW
Washington, D.C. 20500May 19, 2020
Dear Mr. President:Thousands of physicians in all specialties and from all States would like to expressour gratitude for your leadership. We write to you today to express our alarm over theexponentially growing negative health consequences of the national shutdown.In medical terms, the shutdown was a mass casualty incident.During a mass casualty incident, victims are immediately triaged to black, red,yellow, or green. The first group, triage level black, includes those who require too manyresources to save during a mass crisis. The red group has severe injuries that aresurvivable with treatment, the yellow group has serious injuries that are not immediatelylife threatening, and the green group has minor injuries.The red group receives highest priority. The next priority is to ensure that theother two groups do not deteriorate a level. Decades of research have shown that bystrictly following this algorithm, we save the maximum number of lives.Millions of Americans are already at triage level red. These include 150,000Americans per month who would have had a new cancer detected through routine
screening that hasn’t
happened, millions who have missed routine dental care to fixproblems strongly linked to heart disease/death, and preventable cases of stroke, heartattack, and child abuse. Suicide hotline phone calls have increased 600%.Tens of millions are at triage level yellow. Liquor sales have increased 300-600%,cigarettes sales have increased, rent has gone unpaid, family relationships have becomefrayed, and millions of well-child check-ups have been missed.Hundreds of millions are at triage level green. These are people who currentlyare solvent, but at risk should economic conditions worsen. Poverty and financialuncertainty is closely linked to poor health.A continued shutdown means hundreds of millions of Americans will downgradea level. The following are real examples from our practices.Patient E.S. is a mother with two children whose office job was reduced to part-time and whose husband was furloughed. The father is drinking more, the mother isdepressed and not managing her diabetes well, and the children are barely doing anyschoolwork.Patient A.F. has chronic but previously stable health conditions. Her elective hip
replacement was delayed, which caused her to become nearly sedentary, resulting in apulmonary embolism in April.Patient R.T. is an elderly nursing home patient, who had a small stroke in earlyMarch but was expected to make a nearly complete recovery. Since the shutdown, hehas had no physical or speech therapy, and no visitors. He has lost weight, and isdeteriorating rather than making progress.Patient S.O. is a college freshman who cannot return to normal life, school, andfriendships. He risks depression, alcohol abuse, drug abuse, trauma, and future financialuncertainty.We are alarmed at what appears to be the lack of consideration for the futurehealth of our patients. The downstream health effects of deteriorating a level are beingmassively under-estimated and under-reported. This is an order of magnitude error.It is impossible to overstate the short, medium, and long-term harm
to people’s
health with a continued shutdown. Losing a job is
one of life’s m
ost stressful events, andthe effect on a
person’s
health is not lessened because it also has happened to 30 millionother people. Keeping schools and universities closed is incalculably detrimental forchildren, teenagers, and young adults for decades to come.The millions of casualties of a continued shutdown will be hiding in plain sight,but they will be called alcoholism, homelessness, suicide, heart attack, stroke, or kidneyfailure. In youths it will be called financial instability, unemployment, despair, drugaddiction, unplanned pregnancies, poverty, and abuse.Because the harm is diffuse, there are those who hold that it does not exist. We,the undersigned, know otherwise.Please let us know if we may be of assistance.Respectfully,Simone Gold, M.D., J.D. & >500 physicians (attached)
Simone Gold, M.D., J.D.
Steven Abelowitz, M.D.Marc E. Adams, M.D.Jon Ahrendsen, M.D.Camille A. Alden, Ph.D.Rory Allen, D.O.David W. Allison, M.D.Richard Amerling, M.D.Neel Anand, M.D.Catherine Anderson, D.O., M.B.A.Maria-Lucia Anghel, M.D., M.B.A.Elena Antonelli, M.D.Shahzaib Anwar, M.D.Mario R. Anzaldua, M.D.Robert A. Appel, M.D.Deanna Armstrong, M.D.Patrick James Baggot, M.D.Martin H Bailey, M.D.Scott Barbour, M.D.Ronald M. Barke, M.D., F.A.B.O.Morton W. Barke, M.D., F.O.C.O.G.Jeffrey I. Barke, M.D., N.B.P.A.S.Jeffrey Barke, M.D., N.B.P.A.S.Kurt Barrett, D.O.Bart Barrett, M.D., F.A.B.F.M.James P. Bartels, M.D.Barry L Beaty, D.O.David Behar, M.D.David Bennett, D.O.Linda L. Berkley, M.D.Lawrence W. Biel, M.D., F.A.B.I.M., A.B.I.H.M.Antonio E. Bifero, D.C., M.B.A., D.A.A.I.M.Robyn Bilinski, M.D., M.P.H.Marsha Y. Blakeslee, D.O.Andrew Blankenau, M.D.David Bloom, M.D., N.B.P.A.SKenneth J. Bochenek, M.D., D.A.B.A.William F. Bodenheimer III, M.D.Valerie Bonnett, M.D.Robert C. Bransfield, M.D., DLFAPAKeith Brookenthal, M.D.Stewart Brooks, M.D.Dale R. Broome, M.D.James Broomfield, M.D.Emile Broussard, M.D.Annie Bukacek, M.D.Juliet D. Burry, M.D.Andrew Lennon Buscemi, D.O.Kerrey B. Buser, M.D., F.A.C.S.Paul A. Byrne, M.D.Kelly A. C. Busby, D.O., B.C.O.F.P.Steven A. Campau, M.D.Garlon L. Campbell, Jr., M.D.Douglas J. Campbell, M.D.Sean T. Canale, M.D.Paul Canale, M.D.Enrique J. Canton, M.D., F.A.A.P.David Caponigro, D.D.S.Renee Caputo, M.D.Gabriel Carabulea, M.D.Joyce Carnes, M.D.Wesley Allen Carr Jr., M.D., M.S.John T. Casto, M.D.Roland Chalifoux, Jr. D.O.Kenneth S. Cheng, D.O., N.B.P.A.SBrian Chesnie, M.D., F.A.C.B.M.Janis Chester, M.D.James N. Childs, M.D.R. Lee Chilton III M.D., F.A.C.E.P., F.A.A.E.M.
Paul Church, M.D.Robert Cihak, M.D.David Bruce Clark, M.D.Teryn Clarke, M.D.C. Drew Claudel, M.D., F.A.A.D., F.A.C.M.S.Lynwood Paul Cleaveland, M.D.Mary P. Coday, M.D.Ronald S. Cohen, D.P.M.William R. Cohen, M.D.Stefanie Colavito, M.D.Edward J. Coleman, M.D.Kevin Considine, D.O.Paul Corona, M.D.Sydney Crackower, M.D.Michelle Cretella, M.D.Steven M. Croft, M.D., F.A.A.N.Scott K. Cunningham, M.D.Lawrence Czer, M.D., F.A.C.C., F.A.C.C.P.Scott Glickman, D.O., F.A.C.O.S.
Anthony M. D’Agostino, M.D., F.A.C.P.
Andrew Dale, M.D.Dusan Damjanovic, M.D.James Dancho, D.P.M., F.A.C.F.A.S, F.A.C.P.M.Dennis Daniels, M.D.Boris Darovsky, M.D.Stephen M Davidson, D.O.Matt Davis, M.D.Marianne Dawn, M.D.Richard B. Dawson, M.D.Michael De Luca, M.D.Robert Dean, M.D., Ph.D.James K. DelloRusso, M.D.Anthony F. Dempsey, M.D.Thomas Denley, M.D., F.A.B.I.M.Laurel DeStefano, M.D.Vishva Dev, M.D., D.M., F.A.C.C.Joseph N. DiBello Jr., M.D., F.A.C.S.Robert DiDonato, M.D.William A. Diedrich, M.D., F.C.A.P.Jihn R. Diggs, Jr., M.D.Jeffrey Hall Dobken, M.D., M.P.H.Jane Doe, M.D.William Domb, D.M.D.Larry L. Doss, M.D.Tom Douglas, M.D.Edward Frank Drass, M.D.Glenn W. Drumheller, D.O.Thomas Dumler, M.D.Edward Dupay Jr., D.O.Robert W. DuPriest, Jr., M.D., F.A.C.S.Eric Eck, D.O.Alieta Eck, M.D.Ryan Eggers, M.D., M.A.Michael Eilbert, M.D.E. John Eldridge, M.D.Robert Ellsworth, N.M.D.Edward Elmer, M.D.George B. Elvove, M.D.Kim Erdmann, M.D.Brian Erdmann, M.D.Diego Fallon, M.D.John Fan, M.D.Daniel Farb, M.D.Harold G. Fdelter, Jr M.D.Ronald E. Feldman, M.D.Robert Feldtman, M.D.Jeffrey E. Fernley, D.O., M.S.Fraces Dee Filgas, M.D., D.A.A.P.M.
John R. Fish, M.D.Albert Fisher, M.D.Kenneth Alan Fisher, M.D.Richard G. Fisher, M.D.Michael Fitzgibbons, M.D.Bernadette Flynn, D.O.Edward F. Fogarty, M.D.John Forney, M.D.Patricia L. Foster, M.D.Stuart W. Fraley, M.D.David A. Frank, M.D.William Franklin, M.D.Leonard Friedman, M.D., J.D.Paul Fronapfel, M.D.Gus G.Stratton, M.D.Martin Gallagher, M.D., D.C., FABOIMGary L. Gallo, M.D., J.D.John E. Gambee, M.D.Silvia Garcia, M.D.Hiram L. Garcia, M.D.John M. Garrett, M.D. F.A.C.S.Michele Gasiorowski, M.D.James GentileElaina George, M.D.Sullivan Gerald, M.D.Sophos Geroulis, M.D.Steven Giannotta, M.D.Dan Giurgiu, M.D.Jeffrey Glaser, M.D.James Godchaux, M.D.Vernon L. Goltry, Jr., M.D.Steven R. Goodman, M.D.William S. Graham, Jr., M.D.Robbie Grant, D.O.William Grant, M.D.Karladine Evelyn Graves,M.D.Cesar Guanzon, M.D.Joseph Guarino, M.D., M.P.H., FACOEMRajan Gulati, M.D.Vincent J. Gulfo, M.D.Amit Gupta, D.O, D.A.B.A., D.A.B.P.M.Hugh Hall, M.D.Jason Hall, M.D., F.A.C.S.Bob Hamilton, M.D., F.A.A.P.Laura T. Hammons, M.D.Ralph Harder, M.D.Rich Harover, M.D.Michael J. Harris, M.D.Lyle M. Harrison, M.D.Angelique Hart, M.D.Elizabeth Hawruk, M.D.Adrian J. Heap, M.D., F.A.C.S., F.R.C.S.(C)Steven Hearne, M.D.Richard C. Heckmann, M.D., DABPNSebastian Heersink, M.D.Kristin S. Held, M.D.Carol L. Henricks, M.D.Hector N. Hernandez, M.D., F.A.C.S.Robert E. Herold, M.D.Michael A. Herron, M.DVernon J. Hershberger, M.D.Meir Hershcovitch, M.D.David Hesse, D.P.M.WIlliam Highberger, M.D.Elias Hohlastos, M.D.Sara Gayle Hornberger, D.O.Sylvia Horsely, M.D. F.A.C.O.G.George Hughes, M.D
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