The pandemic is a lie. I will not wear someone else’s fear. This is all fake news. It is remarkable to see these statements littered across the news and social media. Individuals with a fairly decent level of understanding and intelligence pandering to these ideas just go to show how strong anti-science culture has become. We forget so quickly how it started, forget those who comforted us in times of uncertainty, and those who heeded the call when so many didn’t.
On January 19, 2020, a 35-year-old would test positive for the novel coronavirus in Snohomish County, Washington. Shortly thereafter, Seattle would become the first U.S. epicenter, Wuhan, China would go into lockdown, and the WHO would declare a global health emergency. By early February, the hysteria would start to set in, while local spread would be confirmed in California, Oregon, and New York. Social media would start increasing speculative reporting, and this invisible enemy would be given a new name, COVID-19. On February 5, the death toll would pass that of the SARS pandemic of 2003. Even still, it wasn’t until mid-February when it became real for me. My colleagues from California to New York began reporting their experiences, and I knew it would only be a matter of time before the virus landed on our doorstep. I did what I always do in times of uncertainty: immerse myself in the science and search for an answer. Much to my dismay, the reports being published were anecdotal at best, and most were not yet peer-reviewed.
By late February, the stress and arguments about who should take responsibility began to boil over. Then there was the increase in fear among health care exposure rates, conflicting case fatality reports, the impending disaster in Italy. Frustrations began with the CDC on the flip-flopping in guidelines; was it airborne or droplet, how long did it survive on surfaces, what should we use to treat it, and mostly why couldn’t we test more or everyone? That was probably the worst part, the unknown. Today we forget that the CDC only lifted restrictions on testing on March 3, 2020.
We became tired of the complaining, the fear, and misinformation, so we decided to pen a guideline for our hospital. The first draft was sent for review on March 14, 2020. At this time, there were 153,523 cases worldwide, 5,789 confirmed deaths, and the president had declared a national emergency.
Within two weeks, we had a patient transport plan, admission criteria, treatment algorithms, surge plans, ventilator back-up plans, COVID-19 specific cardiac resuscitation plan, cohorted units, orders placed on protective equipment, and EMR power plans up and ready to go. For the next month, we would meet two to three times daily. By March 17, COVID 19 had spread to all 50 states, and by the 20th, New York had become the outbreak epicenter in the US.
Georgia went on lockdown April 3. Throughout March and April, the world seemed to trust us as the scientific community to lead them through this crisis.
By April, we saw our algorithms were working, and we had some of the best outcomes in the state. Our teams were acting fast and stabilizing our patients even faster. We had specialized teams that functioned like a symphony. There were no vacations. Every intensivist was always available if needed. We developed a camaraderie that will translate to life-long friendships. People were adhering to the guidelines by staying home. Businesses had shut down, the spread was contained, and we could see the light at the end of the proverbial tunnel.
Then on April 24, 2020, with 892 deaths and 22,147 infected in GA, the lockdown restrictions were eased in our state. We were one of the last to close but the first to reopen. We knew the world needed to open; we just didn’t know our world would open like this.
I remember wondering why we couldn’t mandate masks, contact tracing, and social distancing when we reopened. Suddenly, the virus became political.
While the world argued with experts, we were working hard to make a finite resource seem infinite. We created units out of hallways, shifted resources, brought in, and trained health care workers. When we ran out of one medication, we made do with alternatives. When we got busy, we choose to increase our risk of exposure over delaying care to our patients. Administrators are quite literally trying to make a dollar out of fifteen cents, wondering how the system will survive. We don’t know how to help the millions that are uninsured, or the millions more that have insurance which covers only a fraction of their medical bills.
When I started writing this, I was upset at a social media comment I read from a friend that read, “This pandemic is a joke, I will not wear a mask because I will not wear their fear.” Now I see that he was afraid and uninformed. People, in general, are still afraid, if not of the virus, then of loneliness, poverty, or even subjugation. When people exhibit these fears, and if their voices are loud, the politicians must bend to their will. If our politicians are afraid and their voices alleviate our fears, then we bend to their will. My point is, it is OK to be afraid. I am a pulmonary and critical care doctor, my wife is a pediatric intensivist, we have a small child, and we are afraid. But to wear a mask is to be brave. To social distance is to be brave. To trust your doctors is to be brave. To those with doubts, know that you are correct in your feeling that the system is broken. I don’t know how to fix it, but I know that it has to be done soon. Help us get through this so we can build a better world: a world built from understanding and not from fear.
Abubakr Chaudhry is a pulmonary and critical care physician.
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