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4 24 20 Letter from a scottsdale Doctor to Gov. Ducey:Letter 

Dear Governor Ducey,

I am a family physician practicing in Scottsdale, Arizona.  While other physicians and I recognize the immense pressures and responsibilities you have in this COVID19 situation, we feel that some of your current policies need to be reconsidered.

Medical experts in the fields of epidemiology and virology are determining our country's response to COVID19 with the sole purpose of minimizing COVID19 infections and deaths.  While their research is essential, our country must keep this pandemic in perspective.  In fact, relatively few Americans will die from COVID19, and yet our misguided efforts to save lives are straining our economy, ruining millions of lives, and causing immeasurable harm for the sake of an effectively small impact on our nation's health.

The United States population is 331 million; approximately 2.8 million Americans die annually.  More than 1.2 million die from heart disease and cancer alone; another 500,000 die from fatal accidents, chronic lung disease, and cerebrovascular disease (based on 2017 CDC data).  Most experts agree that the COVID19 death rate will decline as more testing is available and will likely end up at <1%; most of those deaths will be in older patients with a shortened life expectancy due to pre-existing chronic disease.  More than 80% of cases have been categorized as mild, and the vast majority of people who become infected will fully recover and help provide us with "herd immunity."

I am frustrated to see dozens of obese shopper�s don masks and gloves to "protect" their health while they fill their carts with the soda, chips, frozen pizza and processed foods that are far more deadly than the virus.  Why do our public health discussions not address these "pandemics" which are far more widespread and take many more lives?  Your citizens are following social distancing guidelines put forth by the CDC, but they ignore the abundance of other CDC guidelines regarding exercise, maintaining a healthy weight, cancer screenings, and routine child and adult vaccinations that are proven to prevent disease.  Your current policies are so narrowly focused on COVID19 that they neglect the health risks that will kill far more of your citizens.  When you post your COVID19 statistics, consider also posting the number of deaths due to chronic disease, accidents and suicides that have occurred during the same time period.  That will give people a better perspective, and maybe even help them identify and reduce their greater risks.

Bankrupting our local businesses and shutting in our citizens are not improving their health, only diminishing our resources.  My colleague outside of Denver informed me that her hospital is losing $1 million per day and it is having to furlough medical staff.  I know the hospital group I am affiliated with here in Scottsdale is well below census because the pandemic model thus far has been grossly inaccurate.  But in the meantime, you have forced closure of all fitness and recreation facilities despite multiple medical studies demonstrating moderate exercise, as well as socialization, improves immune function and promotes longevity.  You have restricted dentists and periodontists to treat only emergent cases, when in fact there is a proven correlation between oral health and cardiovascular disease. Coronaviruses are here to stay; maybe instead of saving Americans from the pandemic, you should focus your efforts on making them healthy enough to survive it.

Policymakers insist we need to take these extreme measures to protect the vulnerable.  But what definition of "vulnerable" are you using?  Are you including your citizens who are vulnerable to poverty, substance abuse, neglect, mental illness, domestic violence, child and elder abuse, and suicide?  Are you aware that our millennials are expected to have a shorter life expectancy than their parents due to substance abuse and mental illness?  COVID19 targets the old and sick, but isolation and loneliness kill indiscriminately.  We are embarking on a time when overdoses, assaults, murders, and suicides due to this forced media recession may far outnumber the deaths caused by the virus.  Sadly, the U.S. suffers nearly 50,000 suicides annually, a number which will surely increase given the recent unemployment and isolation that has been imposed upon us.  My husband was widowed during our last economic recession when an out-of-work architect attempted suicide by running his SUV into his late wife's sedan.  My stepson's colleague committed suicide last week, and I personally know of two other suicides in the past two weeks (please note that the two suspected COVID cases I treated during the same timeframe have fully recovered).  Daily I am treating patients for pandemic-related anxiety and depression, and no doubt I will soon lose some of those to suicide and substance abuse as well.  Would your citizens choose this trade off?  I am not sure, but at the very least, educate them as to these realties and let them decide which �vulnerable� population they opt to save.

Finally, in addition to practicing medicine, I am a small business owner who owns a solo private practice.  I am infuriated by the disregard for Arizona small businesses and the government's usurpation of control at every level, particularly when I am educated enough to know that COVID19 comprises only a small portion of our overall health crisis. 

Furthermore, Arizona is not New York or San Francisco.  We are not a vertical city; we do not have their population densities nor their homeless populations.  While the benefits of closures in those cities may outweigh the financial losses and economic/social hardships, blanket policies to close Arizona and similar states clearly do not.  You are applying irrelevant models to your citizens and gravely harming the majority in the process.  I urge you to examine local studies and statistics to make wise, relevant policies for our state.

 What policies would I recommend?  Evaluate each county individually.  Keep the hospitals below census but do not bankrupt them.  Discourage unnecessary travel.  Advise older patients with pre-existing conditions and patients who are immunocompromised to be cautious and stay home.  Incentivize biomedical companies to develop more efficient testing methods and pharmaceutical therapies.  Increase production and the discriminatory use of personal protective equipment for our medical providers.  Educate the public on basic hand washing and hygiene.  Tackle the homeless epidemic where disease runs rampant.

 In the meantime, open up businesses, open up the cities!  Educate your citizens on how to best fight this virus, how to optimize their immune systems and resiliency, and then allow them to resume their normal lives.  Implement policies to help optimize the health- physical, emotional, and economic- of your citizens so that they do not fear COVID19, but instead are strong enough to overcome it. You have your citizens� attention like never before, now use this opportunity to get them healthy so that they can survive not only this pandemic, but also the ones that will undoubtedly follow.

Respectfully, Jennifer Fontius, MD

Dr. Jennifer Jane Fontius

Family medicine

7450 E Pinnacle Peak Rd Ste 156, Scottsdale, AZ 85255


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