A member of the medical staff at United Memorial Medical Center in Houston, Texas, treats a coronavirus patient on July 28, 2020.
Multiple US states have found a resurgence in coronavirus cases after reopening.
Insider recently spoke to four doctors in Houston, Chicago and south Florida — all of which have recorded high daily coronavirus cases in recent weeks.
All said they are seeing younger patients with less severe symptoms than people they treated at the beginning of the US outbreak in March.
They also blamed the recent rise in cases on a lack of social distancing and mask wearing.
The Florida doctor said his state should have imposed a mask mandate early on in the pandemic, but that it would be too late now. “We’re beyond the point of no return,” he said.
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After much of America started coming out of coronavirus lockdowns in the spring, new hotspots have emerged across the country.
Insider spoke to emergency medicine physicians located in three areas seeing a concerning number of cases — Houston, Chicago and south Florida — to see what the fight against the coronavirus looks like today.
They all noted that the type of patients and severity of their illness have changed over the course of the pandemic. Many also blamed the new rise in cases on the lack of social distancing and mask-wearing in public, and “pandemic fatigue.”
Younger, less sick, patients
All the doctors said that the coronavirus patients they have seen in recent days have less severe symptoms and tend to be younger, compared to the initial surge of cases they saw at the beginning of the pandemic.
Bradley Kutka, an emergency medicine physician at Advocate Good Shepherd Hospital outside Chicago, said he thinks the reason he is seeing younger patients is because they are “more prone to start going back to socializing … as opposed to older people who are being more cautious.”
As of Friday, there are more than 104,000 confirmed cases of the coronavirus in Cook County, where Kutka’s hospital is located.
Signs of herd immunity?
A 33-year-old attending physician at a hospital in southwest Florida said the fact that they’re seeing fewer severe cases could be a sign that herd immunity is starting.
The physician asked that neither he nor his hospital be identified, because he is not authorized to speak to the press, but his identity is known to Insider.
“One of my theories is that there are definitely many people out there who have antibodies,” he said.
“I think we’re starting to develop widespread antibodies which is why we’re seeing less severity.”
An employee at Carmines Ybor Italian restaurant wipes off the bar while awaiting patrons on June 26, 2020 in Tampa, Florida.
The Florida doctor said he worried that the rise in cases was a result of people being tired of lockdowns and getting complacent about public-health measures.
“If you look back at the 1918 flu pandemic, it was the same thing,” he said. “I think history is repeating itself.”
“You go into lockdown, people come back out when they think everything is OK, they let their guard down, and then the virus spreads even more.”
“Part of it too could be increased testing, but I think that there’s definitely a sense of pandemic fatigue and people being done with this,” he said.
Beau Gemignani and Neil Wingkun, two emergency medicine physicians at Houston Methodist in Texas, agreed. Houston is currently home to the fifth-worst outbreak in the US, with a total of 69,000 cases recorded as of Friday.
“Obviously, there’s been a lot of resistance to social distancing and wearing a mask,” Wingkun, 34, said. “I think a lot of people think: ‘Oh this won’t happen to us, I’m keeping my distance.'”
“Before the mask mandate, I don’t think compliance was that great,” he added, referring to Texas’ state-wide face-covering order, which came into effect early July.
Reopening to blame?
Gemignani, 35, also said that Texas’ fast reopening also likely played a part in the surge of new cases.
“I think the problem has a lot to do with not really social distancing and not wearing masks … maybe some people not taking it as seriously as others,” he said.
“We were one of the fastest states to reopen and it was at a time when our cases weren’t necessarily even downtrending, so I think that at least has to play a part.”
However, Gemignani said it was also probably a mistake to send Texas into a complete lockdown in early April when there weren’t as many cases at the time.
“I think we could have probably limited our opening and not progressed so rapidly while we were still seeing increased cases, but I think we can’t ignore that there are pluses and minuses to lockdown,” he said.
However, he added: “I think we went too fast into a complete lockdown and I don’t know whether a lockdown like we had initially is going to be the answer going forward.”
Medical staff wearing full PPE push a stretcher with a deceased patient to a car outside the COVID-19 intensive care unit at the United Memorial Medical Center in Houston, Texas, on June 30, 2020.
Go Nakamura/Getty Images
Too late for a mask mandate
The Florida doctor said he thinks a nationwide face mask mandate would have been helpful to slow the spread of the virus if it was put in place at the beginning of the US outbreak.
Now he thinks it’s too late for such a mandate to help slow the virus in Florida, which saw a huge jump in new cases in June, and whose outbreak has only slightly abated since.
“Unfortunately, we’re beyond the point of no return … Sure, face masks may help, but we’re so far down the road of this pandemic that it’s almost too late to mandate face masks,” he said.
“There needed to be a very simple mandate that wouldn’t have hurt anybody to wear face masks early on,” the Florida doctor said.
Treatment plans improving
The three doctors in Florida and Texas also gave some good news: They are getting better at fighting the virus now, meaning more people are recovering, and quicker.
“Certainly our treatment plans have improved compared to when we first started dealing with this back in March and April. We’re intubating less and using other treatments,” Wingkun said.
“At the beginning of the pandemic, we heard from other countries that said to intubate early, so people were getting put on breathing tubes as soon as their oxygen levels reached a certain point,” Gemignani added. “Now we’ve opened up other options and trying more noninvasive methods.”
While they said their hospitals had come close to reaching capacity, they have been able to find room for every patient so far. (Some others have been less fortunate: Officials at one hospital in Starr County, Texas, said last week they were forming a committee to decide which coronavirus patients were least likely to survive so they could send them home to their families.)
However, Wingkun said he fears that this ongoing surge would continue into the fall — which could put further strain on the healthcare system.
“My worry is that flu season is going to start in a couple months and we’re going to be dealing with this, plus the flu, and all sorts of things,” he said.
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