Healthcare Leaders of America: Test All Healthcare Workers For Coronavirus

To The Healthcare Leaders And Executives of The United States of America:

On Sunday, December 7th, 1941, America awakened to having been “suddenly and deliberately attacked” by the Empire of Japan on the Hawaiian island of Oahu. What did our great nation do in response to this infamous attack on our sovereign soil? And when a small but menancing cadre of religious fanatics plotted a diabolical attack upon our nation on the morning of September 11th, 2001, what did we do?

The answer is this - we attacked. In the first instance, the United States of America declared war on that same empire and on the nation of Germany the very next day. We sent troops to theaters of war in Europe, Northern Africa, and the Pacific. Only 132 days after the bombing of Pearl Harbor, we let the Emperor of Japan know that “you have to bring butt to kick butt” by bombing Tokyo, Japan’s capital. In the case of 9/11 and Al Qaeda, not 30 days passed before American and the United Kingdom had boots on the ground in Afghanistan, taking the fight to the Taliban and Al Queda, disrupting their hotbeds and retreats for terrorism.

Now you can argue the wisdom of those actions, but what you cannot argue are these two unassailable facts: first of all, the Allies defeated Japan unconditionally in World War II, and two, no one has run a jetliner into an American skyscraper or government installation since 9/11.

Ladies and gentlemen, America is – as it was at the end of 1941 and the fall of 2001 - at war. The enemy is not visible to the naked eye. It is loyal to no nation or flag. But this enemy, consistent with satan's prime directives to "rob, kill, and destroy," is mindlessly robbing us of our health, killing our economy, and destroying our very way of life – no less so than an army of soldiers with rifles. Despite this common knowledge and understanding, I look nonplussed and with horror at some of the decisions that federal and local government actors, as well as executive healthcare leaders have made since the SARS-CoV-2 invaded the American corpus. But none of these decisions have disturbed me more than the mass inaction in moving to test healthcare workers – both symptomatic and asymptomatic – for SARS-CoV-2, the causative organism for Corona Virus 2019, or COVID-19.

I respect that I don’t know all of the controlling rules, regulations, policies, and costs – both foreknown and hidden – of policies both enacted and passed over. I also respect that many of you making these decisions are physicians, nurses, PA’s, and lab workers yourselves. You literally have or have had “skin in the game.” Some of you are veterans and reservists and have fought in a conventional war. Some of you have attended our nation’s military academies. Many of you have masters and doctorates in the realm of healthcare management and administration. You are neither ignorant nor stupid. And you are not a monolithic mass of avaricious bean-counters and profit mongers. But you know enough about public health to know that the 18 million health care workers in America exposed to the 332 million American citizens on a regular basis represent the best opportunity for coronavirus to serve as a “weapon of mass destruction” as we interface with the US populace unaware of our own infection status. You know that health care workers remove the “non” from “primum non nocere” (“first, do no harm”) when asymptomatic and undiagnosed workers interact with their often vulnerable patient population. You are no doubt aware of the Iceland study showing 50% of SARS-CoV-2 positive people have no COVID-19 symptoms. Finally, you know in law what a “tort” is.

You know that a tort claim can be filed in court when a person or entity has a duty to effect or prevent a certain occurrence, breaches that duty, and causes injury. This means that, just as a health-care facility has a duty to test to ensure that their employees are free of tuberculosis – a disease that killed a mere 515 Americans in all of 2017 – how much more so must healthcare entities ensure that their staffs are free of a disease that has killed over 3,000 Americans in a little over 30 days! The duty for health care entities to test is real; failure to test is a breach of that duty, and the damage done will be in the thousands of healthcare worker’s lives lost and the lives of the men and women they will infect. Many of these cases of negligence may prove largely indefensible in a court of law. But again, you know this better than I.

So what then is the force that is keeping our corporate and executive healthcare leaders from broadly testing their employees and workers? I believe that force is fear; the same force that President Franklin D. Roosevelt warned us about at his first Presidential Inauguration address when he said that “the only thing we have to fear is fear itself.” Perhaps you fear the costs of testing your people. Perhaps you fear not meeting workforce supply demands if too many people test positive. Perhaps you're afraid of not having tests available for the clinically ill and hospitalized. I don’t know. But the costs of workers spreading the coronavirus instead of treating people for it, the cost to our healthcare system of sick workers not showing up to work now and the dead ones not showing up to work ever, and the value of stopping the spread of COVID-19 by asymptomatic carriers versus the diminished value of testing seriously ill patients with strong evidence of SARS-CoV-2 that you would treat for COVID-19 anyway demands that we overcome fear.

World War II claimed the lives of 50 million people worldwide – 400,000 were American. But by attacking the German, Italian, and Japanese Axis regimes, the world was delivered from tyranny. About 3,000 people died on 9/11, but when America and its allies went on the offensive, many planned attacks on American soil were abandoned or aborted. In contrast, every single solitary American combatant that retreated to the Alamo fort in San Antonio, Texas was killed.

Defense may win Super Bowls, but it loses wars – and our nation is most certainly at war, this time with a submicroscopic organism that has not only killed and wounded human beings, but has brought the financial markets of the world to their knees. It is time to go "on the offensive" and "seek and destroy" this virus - to seek it aggressively and relentlessly from the nasal passages of the American health care worker and destroy it through isolation and quarantine. The most dangerous and insidious enemy of our lives is literally right under our noses, yet we stubbornly refuse to pursue it. And so our inaction begs the question of who will be the next emergency room physician to die? Which ICU nurse? What hospital front desk receptionist? What dietary employee? What janitor in the ER? What phlebotomist will be buried in a week or two? Which one of your secretaries will we funeralize two weeks to the day after she accompanies you on a tour through the ER for the local politicians and the media? And after you attend her funeral, will you attend her 77 year-old mother's funeral who lived in her house with her fireman husband and kids? And after that, will you go to the homegoing of her husband’s battalion commander at the fire department when coronavirus passes through your secretary's husband and kills his boss? Will you also go to the three little old ladies’ funerals after the commander’s wife infects them at the nursing home where she works? When will it end? But importantly, when will you do your essential part to end it?

What is clear is that, in the next few months, healthcare executives will be on the move. They can spend the next 30 to 60 days pursuing SARS-CoV-2 or they can spend it attending funerals; funerals that will, in the post-mortem examination of this pandemic, be found could have been avoided if only we knew who was infected and who wasn’t – especially among our healthcare workers. In many ways, doctors, insofar as this particular disease is concerned, are not “the doctors” at all – the healthcare executives are. They hold the keys to diagnosis, which guides treatment. If the diagnostic tools aren’t made available (the tests), then doctors can't fully do their jobs of detecting illness to guide treatment. And not only are they sheep for slaughter; they are asymptomatic “goats,” leading their unsuspecting patients "to the slaughter" as they potentially expose them to the virus unawares.

Revelation 21:8 is an interesting bit of Scripture. It lists every sort of individual who will be in line for the lake of fire in Hell – “…the unbelieving, the vile, the murderers, the sexually immoral, those who practice magic arts, the idolaters and all liars..” But is says that the very first one in line will be the coward.

Fear and cowardice are like soiled underwear. If we are honest, it is something that we have all experienced. But it is never something that is acceptable. We can't let any fear guide our war on Corona. Prudence? Yes. Caution? Yes. Reason? Yes - but not fear.

My grandfather was a Renaissance man and a boxer. His motto was, “when in doubt – attack!” We are in doubt – in doubt about who is well, who is sick, and if they are sick, we are in doubt as to why. And so, we must attack. Let us save lives and kill this virus with aggressive testing of the brave cadre of Americans who represent simultaneously the best hope for treatment and the greatest threat for viral exposure - the health care workers. Let us starve it of the food it craves the most – the lung and blood meal from the next person it moves to. Help us to help you destroy the novel coronavirus and end the COVID-19 worldwide pandemic. Test as many as you can and test us now, while we are not sick and before we make anybody that way – not because our lives are more important, but because our patient’s lives are too important to allow us en masse to kill them.

Respectfully Submitted,

Darryl L. Fortson, M.D.

Las Vegas, Nevada