WARNING: As an ER doc in a rural hospital, I’m seeing the number of #COVID19 cases here *rise* as we start to plateau in NYC, Detroit, etc. Though @realdonaldtrump anticipates fewer new cases in so-called hot spots, I’m more concerned than ever. Here’s why: (1/11)

Rural hospitals run in a resource-limited environment on a daily basis. While we have most of the equipment we need, what we lack most is personnel. We frequently use traveling RNs to fill our needs, and many doctors travel from at least an hour away. (2/11)

At night we have one doctor, often me, in the whole hospital & one respiratory therapist. Normally, we manage just fine with the occasional night that feels like it will never end due to volume and acuity. But a surge in #COVID19 cases could reach crisis mode very quickly. (3/11)

We have a small number of ventilators but with a single respiratory therapist, the question is: who will manage them all at once, in addition to other duties? With 2 dozen inpatient beds, who will care for patients when we double or triple the number of admitted patients? (4/11)

And with telemedicine fulfilling our after-hours hospitalist needs, how do I manage an ER while responding to crises on the floor? Under normal circumstances it’s quite doable, but when we hit our expected peak in 4-8 weeks? I worry we’ll be stretched too thin. (5/11)

Rigid social distancing measures have thus far kept our case load from getting out of hand. These policies are precisely why we’re seeing a slowdown in new cases in major urban areas that have been hardest hit. But this slowdown is proof of efficacy... not cause to relax. (6/11)

Understandably, weary Americans are now looking to state & national leaders for guidance on when (and how) we can reopen our communities & get people back to work. We need more #COVID19 tests ASAP. (7/11)

I hear the stress in the voices of my patients as they describe recent job losses for them and their families. It’s painful to know that many millions have lost health insurance and are scrambling to figure out how they will pay for insulin and heart medications. (8/11)

And it’s painful to hear our President reject this scientific truth: in order to safely open up our country, we must aggressively #TestAndTrace and isolate patients with #coronavirus, both symptomatic & asymptomatic. This is the urgent, imperative path forward. (9/11)

The President must utilize the Defense Production Act to ensure the availability of tests, reagents, swabs, and new #antibody tests to determine who is safe to re-enter society. Doctors and nurses want our neighbors to head back to work, but we want them to do so safely. (10/11)

We doctors have taken an oath to care for the members of our communities. We can’t do it if an avoidable surge of very sick patients overwhelms our ability to do the job we love. Help us help you. #StayHomeStaySafe until we have the data from tests to get you back out there. /END