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My Cousin Susan

Susan Arase, August 2019.

By David Yamaguchi, The North American Post

These days, one often reads or hears of deaths. All are sad; those where the deceased was young, died unexpectedly or quickly, and/or was living a life that counted for something are especially so. All of the latter apply to the October passing of my cousin Susan, from cancer. She is the Boston cousin I mentioned in my July 31 column, “A Loop Trip Around Mount Rainier,” which describes a long but fun day-trip we took together last summer. If she was starting to become sick then, it wasn’t obvious across the approximately 16 hours we spent together that day. We drove, we hiked, and we talked during the entire trip, catching up in the way that cousins do who meet only every ten years.

Like most travelers on vacation, Susan only minimally described her work as a nurse for the Boston Public Schools. So on learning of her death, three months after diagnosis, I Googled her, to discern more. There, we find that seven months after our Mount Rainier trip, she found herself on the front lines of COVID-19, trying to help her school system—involving 54,000 students, and 8,600 teachers and staff—grasp what all of us remain up against.

While in hindsight, Susan’s statistics (below) are overly grim—the web today lists 27,571 COVID-19 cases and 1,169 deaths for Suffolk County enclosing Boston (Oct. 25)—what is clear is that she was striving to get people to think about the finite number of hospital beds in greater Boston. Other than moving her web-references to the end, adding clarifying parenthetical content for print readers, and  light editing, I reprint her words in full.   

Please join me in honoring Susan by doing what you can to stay safe from COVID-19 over this winter, so that we can all emerge into a brighter spring.

“From Susan Arase, RN: COVID-19 Request for Assistance [1]

“March 16, 2020

I’m not sure everyone fully appreciates the extreme risk we are facing from COVID-19 so I am going to write a little bit about why this situation is so critical and why I have been working so hard to get others to understand. It is, admittedly, hard for us to grasp the danger when we have not actually seen or personally experienced what is happening in our midst.

We are probably about 10-14 days behind Italy in our trajectory. It is likely that the virus is silently spreading, which we don’t realize, as very few tests have been done in the U.S. overall. And because of the long incubation period, we are discovering confirmed cases only after someone becomes seriously ill and it is all but certain that many others have been exposed. Additionally, the guidelines for when to administer the test are narrow, so that those who should be tested are not being tested.

We know that serious concern is the capacity of our healthcare system to manage a surge in cases. Here are some numbers for Boston: [2]:

1. The population of Greater Boston about 4.9 million

2. Available hospital beds in Eastern Massachusetts = 2,500

3. Available ICU beds = 150

4. Assume 40% will get sick (estimates range from 20 to 60 % of the global population)

= 1.96 million in Greater Boston

5. Assume 20% of those will need hospitalization = 380,000

6. Assume 4% will need the ICU = 76,000

2,500 hospital beds will be available for the 380,000 who need them; only 150 ICU beds will be available when we need 76,000. We have many fewer beds than they have in Italy and we have fewer doctors per capita as well. The discrepancy between beds and need is why it is so important to “flatten the curve” (see below), which we can do by washing our hands diligently (better than hand sanitizer), using hand sanitizer when we can’t, creating social distance, and limiting travel. We are trying to build the capacity of the health care system to care for those who become seriously ill from the virus. We know the elderly and immunocompromised are most at risk[.] But it is NOT said that you or one of your loved ones won’t be one of those who need that hospital or ICU bed no matter how healthy you currently are[.] We want to make sure you get it. Read this article: [3]

This is my recommendation: Do NOT go out more than is essential, for example, grocery stores and pharmacies. You are okay to go outside if you get cabin fever but make sure to create social distance and stick to all the CDC’s recommendations. Do NOT go to the movies, the gym, or your local bookstore. Do not have playdates. Be fanatical about hygiene.

These measures are meant to “flatten the curve,” that is, to increase the capacity of our healthcare system to manage this pandemic. Hopefully, this will also buy scientists time to develop an antiviral medication and immunization as well.

Here is an information sheet from Children’s Hospital about COVID-19 that you are welcome to share with families: [4]

If you develop symptoms of COVID-19, please call your doctor’s office. Keep in mind that most individuals who develop coronavirus will have mild to moderate symptoms and will be caring for themselves at home so please do NOT panic.

—Susan Arase, RN”

[1] Boston Teacher’s Union Member News. https://btu.org/member-news/from-susan-arase-rn-covid-19-request-for-assistance/

[2] https://www.bostonglobe.com/2020/03/13/metro/these-are-crazy-numbers-boston-doctors-warn-that-italy-may-be-preview-coronavirus-outbreak-here/

[3] https://www.nytimes.com/interactive/2020/03/13/world/asia/coronavirus-death-life.html [“Two women fell sick from the coronavirus. One survived.”]

[4] Here Susan refers to a basic “Family information sheet, COVID-19,” Mar. 5, 2020. To see it, click the link from her original article.