Sunday, December 27, 2020

COVID-19 and Travel, a Doctors Perspective

 I realize that it has been quite a while since I have posted.  Life for me has changed significantly (for the better) and most of my time is now occupied by my 2 young children.  I just wanted to quickly share my thoughts on COVID-19 and how it has effected me both as an avid traveler and as a practicing emergency medicine physician.  My views below are based on my knowledge as a physician and my personal observation; they are not based on fear, emotion or politics.  

While I am at work I feel that I have some sort of control over the situation and I have a routine for reducing the odds of exposure.  I wear an N-95 mask the entire shift and I request that all patients also wear a mask prior to me entering the room.  In this way even if I am treating known COVID positive patients I at least know that I have taken precautions to limit my risk.  Outside of the ER however I do not have the same sense of control.  There are 2 main factors with COVID which will prevent me from flying, staying in hotels, sightseeing (in crowded locales) and partaking in sit down dining for the foreseeable future.  First is the wide spectrum of views that people have on COVID and the fact that a sizable portion of the population significantly underestimates the risks and/or views it as a political issue.  Second, when you go out in public for nonessential reasons the other people you will interact with are statistically more likely to be COVID minimizers or in denial.  These 2 factors go hand in hand when it relates to travel. 

My biggest hesitation about travel, particularly air travel, is that the people you will be in close proximity to are people who are more likely to have a low concern for COVID.  The people who take COVID precautions seriously and give it the respect it deserves are not going to get on a plane.  Your fellow passengers are people who decided that the risk of flying and sitting less than 6 feet away from 8 strangers for an extended period of time was worth it.  These individuals are a self selected group which exhibit more risky behaviors than the overall population.   Their personal risk benefit equation is biased to rationalize the risk that they are taking.  A good proportion of them also likely made similarly risky decisions in their daily lives in the days leading up to the flight.  This self-selected, risk tolerant group is statistically more likely to be COVID positive than the overall population which includes all the people who were too risk adverse to fly.  

There is a fairly large percentage of COVID positive individuals with no symptoms and also a segment of the population who will justify flying while symptomatic by internally convincing themselves it is just a "cold" that is causing their fever and cough.  I have had numerous patients who basically argue with me on performing a COVID test by telling me that their symptoms are due to a "cold" or "smokers cough".  When their test comes back positive they are shocked.  People who are in denial with covid will attribute their symptoms to anything but COVID.   

Because of the above and also because I have personally seen several patients die from COVID while also having patients argue with me about wearing masks I will not be flying anytime soon.  Flying is a personal choice and if you want to fly by all means I am not going to argue with you.  In the end travel is supposed to be enjoyable.  There is no enjoyment to be had if my family and I are doing everything in our control to stay safe while those around us may not take similar precautions.  

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