COVID-19: Physicians share insights on how to flatten the curve

By John Murphy, MDLinx
Published April 3, 2020

Key Takeaways

The vast majority of physicians support extreme containment measures to deal with the extreme threat of COVID-19, according to a new MDLinx survey.

Far fewer doctors surveyed—about 1 in 5 (19%)—characterize the viral disease as “‘somewhat of a threat,” while 2% of doctors are unsure what to call it. And just under 2% say it’s “not at all a threat.” 

It’s not clear what that last tiny group is thinking. (Perhaps they chose the wrong answer by accident?) In any event, the nation’s top doc for immunology pulls no punches in characterizing COVID-19 as an extreme threat. 

“We’re going to have millions of cases,” Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Disease, told CNN. He also estimated that the nation will see roughly 100,000 to 200,000 deaths from the disease. 

MDLinx surveyed physicians by email to ask about the threat of COVID-19; 690 physicians responded. 

How to flatten the curve

Slowing the number of infections to prevent totally overwhelming the healthcare system (aka “flattening the curve”) involves a number of measures that must be done simultaneously. When asked what’s needed to flatten the curve in the United States, the following percentages of physicians approved these measures (more than one answer was permitted): 

  • 67% - Social distancing 

  • 71% - Quarantine for those not sick or infected 

  • 83% - Isolation for those sick or infected 

When asked what additional measures should be taken, physicians suggested a number of ideas: 

  • “Tracking/isolation of people who have either tested positive or have been exposed to/come into contact with someone who tested positive.”

  • “Extreme hygiene; use disposable gloves when touching objects touched by others (eg, handles of shopping carts, food at grocery shops).”

  • “Mass testing, including people who are asymptomatic who have had known contact/exposure to someone who tested positive for coronavirus.”

  • “Masks in public, for everyone!”

  • “Washing hands for 20 seconds.”

  • “Population-wide large doses of vitamin D and transfer factor.”

  • “Enforced closure of gathering places.”

  • “Moratorium on all non-immigration visas and closing down of US borders.”

  • “Increase the amount of personal protective equipment available to healthcare providers to decrease transmission and spread within the hospital.”

  • “Shutdown of all nonessential services nationwide.”

  • “Install protective dividers between [store] personnel and customers.”

  • “Exercise, sunshine, water (6-8 glasses/day), prayer.”

Lock it down

On March 24, the entire nation of India began a 3-week lockdown to prevent a deluge of infections, just about 3 weeks after the first wave of cases began there. Meanwhile, the United States has implemented no such national measure, even though the outbreak here started at least a week earlier than in India. And, for some areas and industries in the United States, it’s still business as usual. Domestic air travel continues, for example, as do national train and bus lines, albeit on reduced schedules and limited availability. 

However, about three-quarters of all states have instituted lockdowns, which include stay-at-home orders, closing schools and non-essential businesses, and mandatory social distancing when outside. But, to what extent should US states shut down? Physicians are largely in favor of a national lockdown, like those executed in other nations affected by the pandemic--even ones where the outbreak is not as drastic as the United States. Here’s how far physicians think we should take restrictions: 

  • 70% - Nationwide

  • 18% - State-by-state 

  • 10% - COVID-19 “hot zones” (eg, New York City, Seattle)

  • 2% - Unsure

Currently, a group of physicians and other healthcare providers who are working on the front lines of the COVID-19 crisis have started a petition to President Trump and government leaders to enact a nationwide quarantine. 

“Such quarantines have been implemented in several other countries around the world experiencing this crisis,” wrote the petition’s organizers. “The evidence shows that without access to widespread COVID-19 testing, a national quarantine is the best way to slow the spread of the disease.”

So far, the petition has more than 300,000 signatures toward a goal of 500,000.

How long will it last? 

How long will the lockdowns last? When can we stop “social distancing”? And when will toilet paper return to the shelves at the supermarket? 

We asked physicians when they thought social distancing restrictions could be lifted and we’d return to life as normal. Here’s what they said: 

  • 9% - Less than 1 month

  • 44% - 1-3 months

  • 34% - 3-6 months

  • 8% - 6-9 months

  • 3% - 1 year

  • 3% - More than 1 year

Governor of New York Andrew Cuomo estimated that, as bad as the situation is in the Empire State right now, it’s only going to get worse throughout the month. He predicted that the apex of the crisis in New York won’t arrive until the end of April. 

“This is not a short-term situation,” he said earlier, on March 22. “It is going to be 4 months, 6 months, 9 months.” 

European response

If you want to know how COVID-19 will affect America, look to Italy, health experts have said. Along those lines, M3 Global Research has been conducting ongoing weekly surveys of physicians and patients in Italy, France, Germany, Spain, the United Kingdom, and other European nations, as well as the United States. This week, nearly 4,800 healthcare practitioners (HCPs) and more than 900 patients responded.

As the number of cases has risen rapidly in the nations surveyed, the perceived threat level of COVID-19 has also increased—54% of HCPs consider it a severe threat compared with 51% in last week’s survey. Notably, patients’ perception of the threat level jumped 10% since last week, from 43% to 53%. In the United Kingdom, HCPs’ perceived threat level leapfrogged by 18%, from 51% to 69%, as a lockdown was ordered throughout the British Isles.

Confidence in governments’ preparedness continues to wane, dropping slightly in most nations compared with last week. HCPs’ confidence in the French government's plans has fallen from 77% to 64%, while patient confidence there plunged from 83% to 49%. For the first time, Italian HCPs’ confidence in their government has decreased, consistent with the high death rate.

Support for the majority of containment measures continues to grow, with 72% of HCPs in all nations now backing the closing of businesses and schools compared with 33% 2 weeks ago. Quarantines are now supported by 82% of HCPs. In addition, 81% of all HCP respondents agree with canceling public events, and 76% now approve of suspending international travel.

Access the full survey results from M3 Global Research here.

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