Finding hope in the COVID-19 pandemic

I am a 41-year old physician in the Phoenix metropolitan area. In the course of several unforgettable weeks in March 2020, my life, like every American’s, had been drastically flipped on its head. While I feel fortunate to be able to continue to have employment and a source of income, I cannot deny there is a daily palpable sense that my profession puts me at a great risk for exposure to this potentially deadly virus. My commute to and from work, which was once consumed by thoughts of the procedures of the day, is now crowded with worries about my patients, empathy for the struggles of small businesses that I drive by and once took for granted, and concern for the health of my elderly parents. With the passage of time, I am even worried and frustrated about how a prolonged financial crisis may impact my own career. All of these fears much be all-to-familiar to the readers of this blog.

Yet, despite these innumerable overwhelming negative sentiments, I am beginning to wonder whether this great cataclysm we are dealing with provides us as a nation with inimitable lessons that we should not let pass.

For the first time in my ten years practicing medicine as a radiologist, I am awestruck by the global displays of support and appreciation for the health care workers who are at the front lines of battling this scourge. Whether by rooftop paroxysms of cheering in countries like India, Italy, and Israel or glowing posts of support on social media, or military fly-over salutes, there is effervescent gratitude for the tireless work of medical professionals. These scenes are unparalleled in my 15-year career in medicine.   While I do not feel that shows of support are in any way peremptory, they are nonetheless gratifying. In a society that has for decades had an embroidered glorification of athletes and entertainers, it is inspiring for a chance to finally witness an appreciation for the heroes in our midst– health care workers, grocery stockers, deliver personnel, truck drivers — those so-called “essential workers” without which our way of living would collapse.

When I speak with provider colleagues across the nation, there is a surprising growing sense of community amongst hospital workers and administrators, the proverbial “we are all in this together.” While initially in the outbreak, there were anecdotal reports of hospital administrators restricting the provision of personal protective equipment (PPE), I have personally experienced, to the contrary, those on the administrative side actively communicating with and being attuned to the needs of medical staff.  I respect the desire to square safety for employees with the conservation of essential resources such as PPE. Daily personalized emails by hospital chiefs to their employees, conveying a tone of understanding and appreciation, seem to be fostering closer ties and a sense of appreciation between hospital administration and staff physicians, nurses, etc.  I hope these ties will carry over in the post-pandemic world.

When the crisis ends, we are undoubtedly going to experience a recalibration and prioritization of our critical medical device and pharmaceutical supply chains— this is a positive thing. This pandemic has exposed a crucial flaw in our over-reliance on out-sourcing for essential goods such as personal protective equipment and medications, which has left us vulnerable and exposed. I could never fathom that a basic commodity such as the face mask I wear when entering a patient’s room might be limited by export capacity from another nation. This is not to say that we should refrain from sharing with other nations or in-turn receive aid, or working together in the global community to combat disease that does not recognize borders. But we must also be prudent in how we allocate essential medical resources so that we are never again left susceptible to the whims of other nations who may not be capable or willing to help us.

A lot will be learned from this pandemic on how we can expedite scientific processes for disease treatment and modify the delivery of health care to adapt to sudden-onset emergencies. Our ability to detect, address, and begin to combat this virus in 3 months since it first rose to the global conscience five months ago stands in stark contrast to our years of delay and denial when the AIDS epidemic spread in plain sight in the early 1980s.  For as much as we criticize our politicians and public health officials, we have blown away any previous timelines in dealing with emerging infectious diseases in terms of accelerated identification of the pathogen, enacting lockdowns to stop its spread, and exploring therapeutic options. The world will learn from our dealings with COVID-19 what worked and what didn’t. We will worth with scientists in the global community to develop future treatments and vaccines to emerging diseases as efficiently and safely as possible in record fashion. Hospitals will learn from their “disaster protocols” in this pandemic, constructing hybrid suites or floors that can easily convert from elective care suites into ICU rooms or infectious-disease floors.  Centers will employ health care professionals with diverse skill sets to adapt to a crisis situation, and tedious credentialing processes will be expedited to increase capacity with a pool of “backup” physicians and nurses, etc.

While it’s hard to see an end in sight in the midst of this darkness, our long-term outlook as a nation is hopeful. We must embrace this pandemic as a learning experience, a message to change some of our values and methods. On March 30, photographers caught the emotive passage of the USNS Comfort by the Statue of Liberty in New York Harbor — “Give me your tired, your poor, your huddled masses yearning to breathe” — a reminder of the mettle of our nation and our historic ability to overcome and learn from these trials. We must rise to this call.

Lavi Nissim is an interventional radiologist and co-founder, SocialRounds.

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