I have an ongoing role in Delaware as an Emergency Physician in our largest hospital caring for some of the COVID patients being treated in our state. I also have a role with the State Division of Public Health working on EMS and Hospital Preparedness at our State Health Operations Center.  I know many of you are in areas that have been severely impacted by COVID and all of us have questions about the disease itself and what will follow.  As we continue to address the COVID pandemic, the Commodore and I have been in contact and we wanted to share correspondence with you from earlier today:

Governor Murphy has taken a solid approach in my estimation and his efforts to limit contact are prudent. While there are some indications of progress, we are a LONG way from a solution and resolution of the current events.  I believe most states in the region have established May 15th as a minimum closure date and I don't see any change to expect that would end sooner.  The Philadelphia area was identified as a potential "hot spot" yesterday and this includes Camden (as well as Wilmington) so Southern NJ would be affected.  With ongoing cases in northern portions of the state, a surge in Southern NJ would tax resources and would most likely result in further mandatory closures and extensions of the timeline.  The next 7-10 days will be very telling for the Philadelphia area. 

Your guidance on emails has communicated clear and correct information.  The difficulty here is that everyone is hopeful that a "peak" equals an "end" and unfortunately, the two are far from synonymous.   Areas that are showing excellent public health leadership are expressing cautious plans for slow, deliberate and very gradual resumption of activities.  So far, PA, NY, NJ and DE are aggressively maintaining their policies and I do not expect them to be too hasty to lift restrictions.

·         Limitations on indoor gatherings and crowded outdoor gatherings.

·         Recommendations for those who are vulnerable to avoid risk by continuing their social distancing.

·         This would likely include our older members, those with chronic lung or heart conditions, those who are immune compromised or on chemotherapy or other major medical issues. 

·         Ongoing guidance for people with any illness to avoid social situations, self-isolate from work and monitor for worsening symptom.

·         A recurrent outbreak is a significant concern and will be a limitation before "return to normal".

Earliest resumed activities will likely be outdoors with natural social distancing so beaches, parks, sports activities, etc. may be opened before restaurants, indoor club venues, etc.

I hope this guidance is useful in your planning bearing in mind that this is speculation for what will follow May 15th and makes the presumption that cases, hospitalizations and severity of illness begins to improve in the coming 2 weeks. I'm happy to stay in the loop with all of you and appreciate you contacting me.  Let me know where I else I can be of assistance.

Rob Rosenbaum

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