NC: A MORE REASONABLE RESPONSE IS NEEDED: "We have never, in nearly 25 years each of practicing medicine, dealt with communicable disease in this way."

Via Rep. Larry G. Pittman

I have been very concerned about how COVID 19 has been handled in my community and our State. Therefore, we wanted to share with you and the NC Legislature what my experiences have been that have alarmed me.

First of all, I would like to introduce my credentials to you. I am a pediatrician of 27 years’ experience. My husband is a Family doctor that has been practicing medicine for 28. He was trained in the military and I in a civilian setting. We both have owned our Clinic which is in Burlington, NC for the past 20 years. We were trained at a time when data and medical knowledge were of utmost importance. Some of the physicians that instructed us and molded us are now legends in medicine. We both take our vocations very seriously. In fact, our profession is a lifelong ministry. Our Clinic has about 5,000 patients that we care for. We have a staff of 15 full time employees plus 4 doctors. We consider ourselves more than just our young patients' doctors. We are physicians and friends of the families as well. I have served on many educational and medical societies, Boards and committees. My husband has as well. We are balanced and try to do our best to have an evenhanded, thoughtful approach to medicine and decision making.

 I began to be concerned about how the Novel Coronavirus was being dealt with when our Alamance Health department offered no updates. We have often experienced epidemics and public health concerns over communicable diseases. We received communications informing us of new cases, the trends and how the disease was being handled from a public health setting. With that information Dave and I could make decisions on how to approach the possibility of the disease affecting our patients. We have only received one fax from our health department four weeks ago regarding the impending COVID -19 pandemic. We have not received any updates on cases, locations, contacts, nor treatment plan. This information would be paramount to slowing the spread of the disease. NC DHHS had a teleconference several weeks ago. Little time nor information was shared about identifying, diagnosing and treating CoronaVirus. Instead most of the time was spent on the importance of telemedicine as a modality to see patients and keep our practices functioning.
We have had 3 patients that we considered suspicious for Corona virus infection. When we requested testing on them, we were unable to do so. On two of them the lab or the institution threw the specimen away as invalid but did not inform us until well after the patient was well. Both families remained under quarantine for 2 weeks but were not informed that their specimens had been discarded. The third patient with chest pain, fever, shortness of breath and a severe cough was sent to the ER. No tests were performed on him and he was sent home.

We received a total of three Coronavirus tests from LabCorp four weeks ago. We asked for more but were refused. We therefore considered that only if our patients did not improve when we treated for other conditions that we would consider a patient suspicious for COVID-19 infection. Since all our patients did well 2-3 days out, we had no need to test, thankfully. We, of course, quarantined. This quarantine was without a real endpoint since we did not have testing to confirm our presumption. This is a great burden to the family since they cannot work nor gather food and supplies during that time.

We have never, in nearly 25 years each of practicing medicine, dealt with communicable disease in this way. We have always been presented data, cases, possible contacts, treatment modalities and a plan of action. Furthermore, we can access the number of cases in a community based on the disease incidence among our patients. We have no cases to report thus far. Our Clinic of 5000 patients and the county population of 169,000 denotes the County incidence to be approximately less than 3% of the population. In fact, today’s count of 73 positive cases yields an incidence of 0.04% in Alamance County of detected cases. This is clearly not a pandemic nor an epidemic infectious disease by any definition. Even if we were to use the more severely COVID stricken County which is Mecklenburg that has 993 identified cases, this yields only 0.09% of the population.

In the past weeks I have seen the incidence of mental health issues, anxiety, poor health, and poor nutrition affect my patients far beyond what the novel Corona Virus has done. The outcome of our management of the disease has and will continue to cause more health issues than the illness itself. Who will be responsible for the ill effects that our patients and community suffers because of this management? What will it cost us in dollars and in lives? I do not have the answer for such a question but present the responsibility and solution to North Carolina legislators and Governor Cooper.
My husband and I ask that we cease to manage the novel Corona Virus in this unscientific and harmful approach as soon as possible. Many of us in the medical community in North Carolina can assist the State Legislators and Governor Cooper to solve the question of containing the spread of COVID while allowing the community to recommence their normal lives once again. We are in contact with several physicians that can offer an evenhanded, knowledgeable, and unemotional approach to this most important task.

We hope that we have appealed to you as leaders, professionals and fellow citizens of the great State of North Carolina and our beautiful United States. Our State motto is Esse Quam Videri. May we live up to this phrase indeed. To BE rather than to SEEM in our freedoms and rights.

Most sincerely,

 Rosemary Stein MD
 David Stein MD
 International Family Clinic
Burlington, NC