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Dr. Frank James: This is the beginning, not the end of the hard part

Dr. Frank James is San Juan County's Medical Officer. He posted the following on his facebook page on December 18, 2021.

Just to be clear. This is the quiet before the storm. Be wise and prudent and dont go out to eat, dont travel for the holidays, love the ones you are with now and have been with all along.

January will be the hardest time in my lifetime. I am 70 now and lived through easy times from a historical perspective. My time in the 'uniformed services' was on Navajo in the Public Health Service. But these will be hard times.

Two years in we think we have suffered, and many have but the coming wave will penetrate deeply into our society. The vaccinated will largely get bad colds and yet will be infectious and the disease will spread more quickly than every and get to the entire population.

If you are not vaccinated and are higher risk you could easily die. Our hospitals are already at or past maximum occupancy, locally running over 100% occupancy more than under. The critical element that is missing are not rooms, beds or supplies but rather personnel. We are short on highly trained people and that is a shortage that can not be imagined away or magically fixed with more money or changes in policy. We will hit a place where we move to 'crisis standards of care'-- which means some people will get care and others will not. Healthcare providers will have to choose between those with COVID and require intubation and those with heart attacks and need immediate surgery.

This is coming at us quickly but sort of in slow motion. Here is some advice:

Do not travel for the holidays. Spend time with those you love at home that you have already been spending time with.

Do not eat out, it seems safe but this disease will sweep through our communities quickly and the fact has not changed that people are most infectious in the 48 hours BEFORE they develop symtoms.

Be prepared to take care of yourself.

Buy a pulse oxemiter now, give them for Christmas presents, if you run below 94 call your doctor if you are below 90 call EMS.

Something as old fashioned as a humidifier, the old fashioned things we used when kids had coughs when they were little, will reduce the rate of pneumonia in kids and adults. In the winter when we heat our homes it dries the air out inside (yes even when it is raining outside) and the moisture in the air keep you lungs and upper airways able to mobilize and cough out the junk that otherwise clogs up your lungs. Ask an otolaryngologist if you dont believe me.

Please be kind. Especially if you are fairly sure you know the Truth and feel obligated to share your insights with others or if you are angry about not getting what you think you need or want. The healthcare folks..... they are exhausted. I see my own staff in tears fairly often these days they have been working hard, exposed to real risk to them (and their families) for 2 YEARS now, and they are literally exhausted. They are going to be a little cranky themselves at some point so be patient with them, they are still showing up and honestly they are even more 'over it' than you could even imagine.

Over the next two weeks we are going to go up a hill that will seem to go on forever. This is the beginning, not the end of the hard part. You are tired of it all, so is everyone else. We want to be over and for things to go back to normal. That is not going to happen until we get over the next 6 weeks. Stop pretending it is over. Stop the parties, the dinners out, the travel... just stop it, now.

If we dont we are going to be in a world of hurt. In San Juan we still have not had any deaths in the county, we have half the infection rates of the second lowest county in the US. We are going to have deaths and our infection rates are going to go up dramatically. It is not about the quality of the public health response this bug is really bad. Less sever perhaps for those immunized we may just get 'a bad cold' but the immune compromised and the elders and most of all the unimmunized, they will be at that time in life when life could end, yes permanently. And they are parents that may not be there to take care of their children, grand parents that may not see the next Christmas, children than may not be in class in 2022. So damn it get vaccinated, wear a mask when you are out of the house (an N95 or KN 95 as they are no longer in short supply - finally!) If you wear cloth one a paper one should be under it.

This will sound odd but Merry Christmas! Going through a pandemic is a disaster but we can get to the other side together and with our humanity and caring intact. We can learn from this what really matters (and it is each other). My mother's sign that hung in our kitchen growing up still hangs in mine. The most important things in life.... aren't things.

Dr. Frank James, San Juan County Health Officer

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