It's been weeks and we are still locked down at home. That is, if you are not one of the 40% in our society who are considered "essential workers". Many of us are staying put, sitting inside and binge watching TV or taking long lonely walks outside, giving the dog exercise. But what will happen when these restrictions are lifted and we can go about our daily lives? Or will we? As Dr. Fauci said " unless we get this virus under control, a real recovery will not happen". We must stay isolated until we hit that 14d downward trend. 

The refrain is Testing-Tracing-Isolate. Yet Arizona is #46 in state testing, currently 7.6/1,000 tested. Many tests are negative, yet we know that testing has a serious false negative rate. One physician wrote that in a NY hospital ER even people with gun shots, broken bones and diabetic problems showed on lung xray Covid pneumonia. This virus does not make everyone ill.

Harvard researchers recommend that we test 500,000 people per day in the US, yet we have tested so far, in total, just a fraction of our population. We have lost as many people in a few weeks as was lost during the 20 year Vietnam war. So, if Arizona is at the bottom of the testing spectrum, when will we ramp up enough to test the numbers daily needed to manage this crisis? Returning to life as we "know it" any time soon would be "reckless and undisciplined" according to a medical expert.
Doctors, scientists and health professionals should be our guides and our sounding board. They are the only people we should listen to, because they base their decisions on something we must use 100% of the time, science. Science should be our guide and science should be our only reference.

In Santa Cruz California, they found after random testing, there was a 50-85 fold increase in antibodies seen among the well population. That means there is A LOT of undiagnosed and unconfirmed cases walking around without symptoms. We are also learning that those who had illnesses in winter and tested positive for flu or strep could have also had Covid. That might mean this winter you could have Covid-19 and the flu, so get your flu vaccination! Initially we didn't test for the virus if you were positive for something else. We are rethinking this hypothesis.

Arizona must develop a thorough tracing program. Once good testing is in place, contact tracing must be next. Our state must hire an army of tracers working diligently to trace every contact, everywhere. It will be a lot of work but it is the only thing we can do.

We will have a vaccine and treatments one day. A treatment, or multiple approaches to healing will be best. But to be safe, we must do both, treat and vaccinate. When a vaccination is available, Arizona should then mount the biggest public vaccination effort since erradicating small pox and vaccinating for polio. We must vaccinate everyone unless they have a legitimate medical exemption. When we finally develop herd immunity we may then, in a few years, breath a sigh of relief.

The bright spot in this will be opportunities for employment. We will need tracers, vaccination workers and healthcare workers. We need you to train to be a nurse, PA, doctor, tech, CNA, or other healthcare team member. We need you all, now and in the future. Arizona has a severe rural healthcare provider shortage. Arizona has jobs for you, good paying jobs with a bright future and you will always be employed. Your job future is secure.

So as a retired Physician Assistant in Emergency medicine, Workers and Women's Health, I have hope. I have seen it all and believe in the human spirit. I believe we will learn and thrive. But we must be vigilent.

Arizona is not yet ready to reopen. I predict it may take to June or July. Until then we should be careful, mask, sanitize, wash your hands and stay a good distance from those you do not live with. Have hope. We are strong and we will get through this.

Written by Sharon Girard, PA-C emeritus, a candidate for the Arizona State House.