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Dr. Pitkin is killing its patient restaurants

“First, do no harm, the next is to do good”

Primum est enim non nocere, proximum prodesse.

Hippocrates’ corpus began a conversation two millennia ago regarding the ethos of medicine. From “Of the Epidemics”: “Practice two things in your dealings with disease: either help or do not harm the patient.”



I repeatedly heard this growing up, as my father was a renowned head and neck surgeon.

Our board of health’s decision to shutter restaurants needs to be reconsidered in this context. When benefits clearly outweigh harms or vice versa, the appropriate action is obvious. When they are closely balanced, “first, do no harm” must be the ethical guiding principle. It is precisely this dilemma why the patient, family and loved ones are often consulted as to the appropriate courses of treatment. Similarly, living wills dictate our DNR, life support, etc. … orders.



Our community is the patient. Poor outcomes are a result from overvaluing benefits and discounting harms. All treatments have effects and side effects (every pharmaceutical ad on TV is proof of this). Closing restaurants has discounted the harms and overvalued the benefits, as we have no evidentiary proof of benefit. We think, we feel, but we do not know. We still have more questions than answers.

Since March: 10% of our population has tested positive (1728:17,500); .21% have been hospitalized (38:17,500); 2.2% of our positive cases have been hospitalized (38:1728). Death rate of positive cases is .23% of which two were 90-plus and one was in hospice. (4:1728)

Symptom evaluation, diagnoses, treatment options, course of treatment, and prognosis. Sometimes we need to rinse and repeat until we arrive at the right diagnosis, etc.

Symptom: high incidence rate (not an overrun health care system). Diagnosis: high rate of COVID-19 community spread. Treatment: Physical distancing, face coverings, capacity restrictions, and now, vaccinations. Primary cause: household spread, both member to member and informal gathering.

What we do know: Of the restaurant workforce, 1% has tested positive. Not one case from a customer has yet to trace back to indoor dining. Larger population areas suggest the rate of indoor dining spread is 1.4% of all cases. Closing indoor dining will promote household spread.

“We have to do something” is the mantra from our county. Imagine your physician knowing the major problem but choosing to ignore it because they don’t have the toolkit or will to address it, and instead keep giving you one ineffective pill after another in an effort to “do something.” Please stop, the side effects are killing us!

We are human, our nature is to care, we make mistakes, we are fallible, our propensity is to act, and we must exercise the humility to adjust and remedy. The patient must be given a voice in their treatment. Reconvene and choose to reopen restaurants. Choose to do no harm.

Jimmy Yeager

Aspen

 


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