COVID-19 Is A Different World For Our Most Vulnerable Citizens

I have been a physician for almost twenty years. The AIDS pandemic has been the greatest public health calamity of my career. Global Health Observatory data estimates that approximately 32 million people have died from HIV-related illnesses since the disease was formally identified in the early 80s. AIDS had already gained a firm foothold in the United States before the administration of the time publicly mentioned the name. Now, the emergence of viral epidemics such as SARS, H1N1, MERS-CoV, and COVID-19 presents a uniquely deadly threat. It is an unintended outcome that as our society becomes more globally connected, we put ourselves at greater risk for such novel infectious diseases.

Like most concerned citizens, I have listened to the White House COVID-19 Task Force briefings expecting to hear scientific facts, consistency, introspection, and clarity. What I hear, however, is a lack of sensitivity to the needs of the average American. Much time is spent praising each other for a job well done without admission of major system failures.

There remains a preferential testing bias that plays itself out over and over. Persons of privilege who likely do not meet defined CDC testing criteria somehow manage to be tested. The vast majority of Americans are morally responsible and do not wish to take up critical testing resources. They just want to know if they can hug an elderly parent or tuck their child into bed at night without exposing their loved ones to harm.

We continue to live in a state where a sliver of Americans have access to the rights to which we are all entitled. The Task Force refers us to the CDC website for the most up to date information. There is no acknowledgment that this requires a phone or computer, internet access, and a reading comprehension level that is greater than average. This leaves our most vulnerable citizens, such as persons with disabilities, seniors, and those who are homeless at an even greater disadvantage.

As well, we continue to be told that only nonessential procedures will be delayed. I completely support this as an infection control measure. However, we must be sympathetic to the fact that many of these so-called nonessential procedures are, in fact, a lifeline to the person who is affected. For someone with crippling arthritis, joint replacement surgery is essential. For a person battling cancer, transplant surgery is essential. What is lacking in our federal response is basic compassion.

I have come to realize that most of what a physician provides is reassurance. From holding a hand while delivering bad news to instinctively tucking in a shirt tag as someone sits up from the exam table, we are constantly looking after the welfare of our patients. This is the first time in my career that I struggle to provide honest reassurance. To think just weeks ago, we were telling patients that their risk of contracting COVID-19 was exceedingly low. Without the tools upon which doctors normally rely, like evidence-based medicine and readily availability rapid diagnostic testing, we are left feeling humbled and helpless.

We must practice physical distancing but not distance ourselves in other ways. As a society, we have never been more interconnected than we are at this time. It is time for our federal government to provide a decisive and comprehensive plan of action. While we cannot make up for the time that has been lost, we can take measures to ensure that we do not repeat our mistakes.

Rio Dickens is an internal medicine physician.

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