Confessions of a non-clinical ID physician during COVID-19 times


After 20 years of working at a hospital, I was ready to try something new. I had provided primary and specialty care to adults living with HIV or viral hepatitis for two decades, taught scores of students, residents, and fellows, successfully led our hepatitis program, conducted clinical research in the areas of HIV, disparities, HCV and aging, and for the last two years, I was senior director of HIV services a health system.

As I looked ahead to my 50th birthday, I was itching for a change, new and exciting challenges, and then the perfect opportunity came along.  In December 2019, I accepted a position at a pharmaceutical company as a regional medical director to start April 1, 2020.

When I signed the contract, COVID-19 was a viral illness in China. It wasn’t even called COVID-19 then, it was still the “Wuhan virus.” Fast forward to my last clinic day in March, we were already in full preparation mode and had tested a few travelers for COVID though didn’t have any confirmed positives yet.

I was crushed that I was leaving the frontlines just when things were about to hit. I was excited about my new position, but I felt guilty.  I felt like I had deserted my colleagues. I felt like I walked away from the greatest challenge of our time. The bond of a shared struggle is lifelong, and my colleagues were my sisters and brothers. The feelings of guilt came in waves, and my family tried to understand and support me. I cried a few times, had many sleepless nights, and had intense anxiety thinking about my colleagues and friends getting infected. I had all these emotions as I started training and was learning new and exciting things at my new job.

I knew I was privileged to be away from the high-risk hospital environment. I knew I was privileged to be safe on lockdown with my daughters. I knew I was privileged to be protected from the chaos, unknowns, and deaths in the hospital, I knew I was privileged to have an exciting new job, and that made me feel so guilty.

Over time I realized that I could do my part as an ID physician by keeping people out of the hospitals. I could do this by prevention education and sharing complex data with non-medical audiences. I shared information and discussed data on different platforms.  I spoke as an invited ID expert at both the Chicago mayor’s and Illinois governor’s COVID briefings. I recorded three COVID podcasts and responded to tons of IMs, texts, and emails from friends and acquaintances across the world about COVID.

By late April 2020, I had signed up and got my volunteer badge to help with telehealth calls and was ready to do inpatient work or help with testing if we ever got to where New York City was. Fortunately, Illinois was able to flatten the curve, and our cases continue to decrease. We are still in this pandemic with a projected second wave in the fall, but I am confident that Illinoisans will continue to do our best.

I accepted that I could continue to be part of initiatives to support frontline workers, keep up with emerging literature, donate to hospital meal trains, and continue to privately and publicly support my colleagues. I will always promote the incredible clinical and research work being done daily by the amazing CCH team.

I finally embraced the fact that I will always be an infectious diseases physician even if not on frontlines anymore. I can and will continue to add value to the lives of others in my new role as I support my colleagues in the frontlines.

Below are the things I have done and will continue to do. These have helped me move from a place of guilt to a place of accepting that with change comes growth.

1. Continue to provide credible information to our communities and the general public through social media outlets, blogs, podcasts, media interviews, community spaces.

2. Model good behaviors of social distancing, hand hygiene, and mask use. Have your family be ambassadors too. Lead by example.

3. Volunteer your time to speak when opportunities arise that increase community awareness. No information shared is wasted, and even reaching one person could save the lives of many.

4. Review the vast and rapidly emerging literature on COVID and send full-text articles, summaries, links, updates to your colleagues on the frontlines who are immersed in taking care of patients.

5. Support your colleagues privately by sending them encouraging messages, ordering meals, being a listening ear to vent to or a shoulder to cry on. You understand their frustrations and struggles.

6. Promote the work your colleagues are doing on the frontlines and the sacrifices they are making every day.

7. Seek funding for and donate PPEs to the hospitals and hard-hit communities. By equipping the public with masks and sanitizers, you help flatten the curve.

8. Speak up and advocate for your colleagues in places where you can. Advocate for PPEs, mental health support, childcare support and in other ways needed

9. Sign up or continue to do telehealth services for primary care or mental health /therapy visits. By keeping people healthy at home, you are doing your part during this pandemic.

10. Identify ways in your non-clinical practices to eliminate the racial disparities in many health outcomes we have seen for decades and now see with COVID-19

As a Nigerian-American infectious disease physician and regional medical director, my commitment to medical education and addressing racial disparities in health outcomes is unwavering. It’s time to show my dedication, passion, and the commitment to excellence that governs all that I do.

Toyin M. Falusi is an infectious disease physician.

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