At this point, everyone has heard that hand-washing, wearing a mask, and keeping 6 feet apart help curb the spread of the coronavirus. While many are not doing these things, many are, and it’s those of you who are following the guidelines that I want to talk to.
I understand pandemic fatigue. Driving home from St. Louis to West Frankfort every year for Thanksgiving and loading up my plate with brown foods, sparing only a sliver for anything green, is one of my favorite times of the year. And don’t get me started on my grandma’s pumpkin chiffon pie. Knowing Thanksgiving is canceled this year hurts. But I’d rather miss everyone this year than get together next year with an empty seat at the table.
The image of an empty seat due to someone dying from COVID-19 may seem hyperbolic, but when you work where I work, you can’t ignore that very real possibility. When you see the lines on the graphs of the St. Louis region’s COVID-19 data going up and up, and when you’re told the region is within weeks of running out of intensive care beds, ventilators, doctors and nurses, you get a pit in your stomach. And these shortages aren’t just because cases are going up in St. Louis. They are being driven in large part by increasing cases in rural Missouri and Illinois, including Southern Illinois, where severely ill COVID-19 patients must be transferred to St. Louis-area hospitals.
At the time of writing, Southern Illinois (Region 5), had a rolling seven-day average test positivity rate — meaning the percent of all coronavirus tests performed that actually come back positive — of 14%. St. Louis had a positivity rate of 18.6%. This may seem reasonable. St. Louis has more people and has always had more cases. But for perspective, in mid-June, St. Louis was at 11.3% while Southern Illinois was at a mere 1.4%. That means since mid-June, Southern Illinois’ percent positivity rate increased by a factor of 10 while St. Louis’ only increased by a factor of 1.6. There’s no other way to interpret those numbers — Southern Illinois has a runaway train on its hands.
And this is a problem for all of us because car crashes and heart attacks are still happening as they always have. The only thing that’s changed is now when you come to St. Louis for those head injuries or stents, there aren’t enough beds, ventilators, or doctors to treat you because those resources are being used for COVID-19.
This is usually where the messaging about the importance of masks and social distancing comes in, but we’re past that. Now the call is for Southern Illinoisans to do their part to talk to each other about that runaway train. I can tell you the numbers, but (most of) you don’t know me, and have no reason to trust me. Trust is the foundation of any meaningful conversation. If you look around your network, I bet there’s someone who trusts you and who is also planning a Thanksgiving gathering, hanging out with friends, not wearing their mask in public, or doing some other action that could accidentally kill someone. If you know that person, it’s your responsibility to talk to them. If you are a business leader, community leader, religious leader, or just someone seen as a source of sound advice — it’s your responsibility to speak up.
It may be a hard, uncomfortable, awkward conversation. But here’s what I want you to know — you will be more effective than you think. Decades of scientific research tells us that the most effective messengers are those who have mutual respect with the receiver. Next year, without a doubt, there will be empty seats at the Thanksgiving table. Will you be able to say you truly did all you could to help your community? Did you speak up when it was your voice needed most?
Beth Prusaczyk, PhD, is faculty at Washington University School of Medicine in St. Louis, where she studies health care delivery and quality. She is originally from West Frankfort and focuses her research on rural health disparities.
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