One year ago, on March 14, I worked my first of many COVID shifts as a hospitalist at a large academic teaching institution in Chicago. In the beginning, I think most of us on the front lines felt a strange combination of duty, fear, and exhilaration. There was this novel virus, the world was shutting down because of it, and while the rest of society was stocking up on toilet paper, we were being called to battle. We felt a distinct sense of purpose, yet I don’t think any of us truly knew what we were getting into. People called us “health care heroes” and sent us food and gifts. Family members called and texted to check on us, and we felt prideful to do the work that had to be done. Adrenaline filled our blood vessels, and we rolled up our sleeves. In the beginning, it was still not exactly clear how this new virus spread. We wore masks while seeing COVID patients, but not around each other. The idea of “community spread” was not even on our minds; we still asked patients if they had recently traveled. hand washing was what was hammered into our brains, not mask-wearing. We meticulously wiped down our computer stations and belongings so often that the hospital-grade anti-microbial wipes had to be kept in locked areas. We helped each other don our PPE, and carefully studied videos detailing the doffing process to not contaminate ourselves. We freely changed and threw away our N95s and face shields between each patient, not realizing that those supplies would become precious commodities in a few short weeks. After all, in the beginning, we all thought this “COVID issue” wouldn’t last more than a few weeks, maybe a few months. Most of us, even our most esteemed infectious disease colleagues, would never have surmised that we would be living in this new pandemic reality for the next year or more. In the beginning, we battled perceptions that this was all “fake news” that doctors or the government made up this disease. We tried our best to explain that while yes, it’s the same class of virus that causes the common cold, it is different in a very deadly way. We begged everyone we knew to take this seriously. We pleaded on social media to “flatten the curve.” We fought back tears explaining why hospitalized patients could not have visitors and why they had to die alone. Eventually, the virus became politicized. Mask-wearing became politicized. COVID numbers, hospitalization rates, even death rates became politicized. In between hospital shifts, we fielded loved ones’ questions as best we could, but in the end, it was up to them to either believe us or not. Is this really that big of a deal? Is it really worse than the flu? Do we really have to cancel our upcoming vacation and stay home? Yes, yes, yes. Meanwhile, we went to work every day with persistent fear and anxiety about whether we would have enough PPE and how we would care for patients who had a disease that wasn’t in any textbooks. In the beginning, we gathered in crowded hospital auditoriums before “social distancing” became a thing to learn about the SARS-CoV-2 virus. We poured over emails detailing the constantly and rapidly changing COVID treatment and isolation guidelines and new complications of COVID that were being discovered on an almost daily basis. Give hydroxychloroquine, don’t give steroids. Nevermind – don’t give hydroxychloroquine and give steroids. Try Remdesivir. Tell patients to isolate for 14 days after onset of symptoms. Well, maybe 10 days is OK. Actually, maybe 7 is OK. Wear an N95 and change it between each patient. Actually, wear the same N95 all day. Actually, a plain surgical mask is OK. Now, one year later, while suffering from “COVID fatigue” like most everyone else, frontline health care workers are bleary-eyed from working through surge after surge, holiday after holiday. We still battle conspiracy-theorists and anti-maskers. The initial horror we felt wearing the same mask all day has essentially vanished. We no longer bat an eye at throwing on a face shield to go and see a patient. Adding “COVID” to a patient’s differential diagnosis does not elicit the same angst and panic as it once did. One year later, no one really calls us “health care heroes” anymore, but we still quietly go about our business one patient at a time. One year later, over half a million Americans have died from COVID-19, and society is slowly but surely emerging from under its rock, from the darkness of quarantine – deficient in vitamin D, starved for social interaction, and yearning for human touch. We are tired and scathed but cautiously hopeful and optimistic. That initial sense of exhilaration has been dampened but not extinguished. One year later, we are in so many ways more resilient, stronger, and have a deeper sense of what really matters in life. We have truly surprised ourselves with what we are capable of, as we find ourselves flirting with vaccines on the precipice of a potential “return to normal.” But one year later, what have we learned? What does “normal” even mean? Will this experience fundamentally change how we live our lives, even after the pandemic is over? How we care for our patients? How we operate our hospitals? How we pay for health care? Will anything change at all? That’s for each of us to decide. On this first anniversary of the beginning of the COVID-19 pandemic, I hope we all take a moment to reflect on just how much we have learned, how much we have accomplished, and how far we’ve come in a relatively short amount of time as a health care industry. But I also implore us to think about how much further we can go, how much better we can still become, and how our positive impact on society can be made even deeper. Manya J. Gupta is an internal medicine physician. Source
