So, as we all know, these are uncertain and scary times. I have been radio-silent on most social media platforms because, as you have seen all over the news, healthcare is under siege from COVID-19. Hours are long, brain power is dwindling, and emotionally, we are burning out from stress. There are a lot of questions, fears, uncertainties, and sadly constant streams of misinformation floating around the world. This post is the first of many to help educate regarding COVID-19. I want to preface this by stating that any opinion in this post are mine and they are my own individual remarks based on my personal, professional opinion, current data, and personal views on the situation. None of this should be taken as formal advice and you should always seek the care of your own primary care provider.

At the first sign of infection overseas in Wuhan, things seemed far removed. We were living our lives, uninterrupted, without a care in the world. I was traveling for work visiting practices with colleagues, training new providers, and life was status quo. As I read more and more about reports of this SARS-CoV-2 (coronavirus), my ears perked up. I wasn’t too fearful but I knew there was potential for a possible pandemic. In medicine, we always fear contagion X, a disease which would one day spread across the world and cause a massive pandemic straining our already over-burdened healthcare system. After all, our world is growing increasingly smaller with millions of people traveling around the globe at any minute by planes, trains, boats, and cars. My usual commute to work consists of squeezing my way into a crowded subway car (the T here in Boston), grabbing railings, touching door handles, twice daily at minimum. If a disease was going to spread, it would spread quickly, especially in large metropolitan areas like Boston or New York.

Reports started flooding in from Iran, Italy, and various parts of Asia. This is when worry began to set in. Cases started to rise, Europe was becoming overtaken with the disease. Friends and family over in Italy started reporting the grim scenes in the hospitals. My heart sank…I knew it wasn’t going to be good. Our first cases made it here to the US and those of us in the medical field knew it would start spreading. Early case studies from overseas claimed that this respiratory illness was highly contagious which only favored the elderly, frail, or patients who had pre-existing conditions placing them at increased risk of complications. Sadly, our government was ill-equipped and uninformed with limited resources and delayed what should have been a comprehensive, early intervention overseas when the first cases were reported (a topic for another day). Soon, cases exploded in Washington state as well as New York. The government banned travel from overseas and social distancing became a term that was never used before but is now the only term we know (other than random handwashing memes, Tiger King, or Facebook posts about Zoom meetings or homeschooling).

We have since learned that this disease is affecting any age and proving fatal to even those who are healthy, young, and without risk factors for complications. Quickly, the public learned what PPE stood for, how important ventilators were, and who performs essential jobs. Hospitals became overrun with critically ill patients while the world came to a screeching halt. Soon we realized that the government dropped the ball and did not have any PPE for us healthcare workers, we lacked ventilators to meet the projected demands of “surges” across the country, and did not have adequate testing. While helping devise clinical response guidelines and protocols for providers across 48 practices country-wide, I was also providing support and comfort to friends and family who were infected with COVID-19 in and out of the ICU. My friends, family, and colleagues were on the frontlines fighting with limited or makeshift PPE. Hospitals scrambling for supplies, state governments building field hospitals, and the national guard and army corp of engineers came to help fight the great fight. Soon, celebrities, music artists, and athletes were no longer the adulated, but doctors, nurses, truck drivers, grocery clerks, and all other essential employees who are overworked and underpaid became the heroes, walking into the flames with little protection.

Here we are, three months since the first case of COVID-19 in the US, with >700,000 cases country-wide and sadly >41,000 COVID-19 related deaths. Mass graves are being created in NY, PPE/testing supplies are still scarce, and now political divisiveness is running rampant putting the general public in harms way with protestors who are ignorant to the reality of this disease. Here in MA, we are now seeing our cases rise as surge approaches. We are fortunate to have some of the world’s best hospitals, a plethora of healthcare resources, and a governor who has been on top of the situation since the beginning. While testing supplies are scarce across the country, we are ramping up testing here and will start contact tracing which is the most integral aspect of infection control and strongest weapon in the public health arsenal at this time. I remain hopeful in this uncertain time. I am ready to volunteer at our hospitals who need extra providers on my off hours to care for those afflicted by this disease. This will all end…it will. Until a vaccine is created (not for a while unfortunately), this can only be mitigated by home isolation and social distancing measures. We may never go back to normal, but that may be a good thing. Maybe those who had to risk their lives to work will finally get a decent wage, everyone will have access to healthcare, we will see the impact we have had on the environment which has miraculously started to recover in our absence, and we can slow down to appreciate meals together, our own health and that of our loved ones, gathering with our friends, and appreciate what is most important in life.

Now for some facts to help dispel some of the myths floating around social media, mainstream news outlets, and sadly our president.

COVID-19 is the disease caused by the SARS-CoV-2 virus, a type of coronavirus. It is believed to have originated in Wuhan, China as a naturally occurring type of coronavirus (several already exist).
THIS IS NOT THE FLU OR A COMMON COLD, THIS IS A NEW VIRUS THAT CAN BE DEADLY IF NOT TAKEN SERIOUSLY
It is highly transmissible through respiratory droplets which is why proper hand hygiene, avoid touching one’s face, and physical distancing (6+ feet) is crucial to preventing the spread of this disease.
Wash your hands for 20 seconds (sing happy birthday twice) and if using hand sanitizer, ensure it is alcohol based with >60% alcohol content. I do not recommend using gloves because this tends to give a false sense of security and carries a higher risk of contamination. Just wash your hands frequently.
Per CDC recommendations, please wear a mask or appropriate face covering when in public and use strict physical distancing measures when near others in public (6+ feet).
Please avoid protesting or gathering in groups! I understand times are difficult for those with closed businesses, furloughed jobs, or religious beliefs, but the health of the US depends on you staying home, so PLEASE STAY HOME. My colleagues around the country are risking their lives to save those you know and love, so don’t make our jobs more difficult than it already is.
The reason this virus is so dangerous is that you can have it without having symptoms or at least be asymptomatic for at least 2-14 days. Typical symptoms include, cough, mild shortness of breath, fever, body aches, and headache. Some people may complain of conjunctivitis or a possible rash accompanied by abdominal pain, nausea, vomiting, or diarrhea.
When sick, isolate yourself if possible from those in your household until you have been fever free with improved respiratory symptoms for three days after having had symptoms for at least 7 days since they first appeared.
It is ok to continue your ACE inhibitor or ARB medications if already prescribed (such as lisinopril, enalapril, losartan, or valsartan).
There is NO cure or approved treatment of COVID-19 at this time. Current evidence (while not strong) suggests that Hydroxychloroquine (with or without azithromycin) is not an effective treatment despite the president or Dr. Oz’s claims.
There are poorly respected celebrity “professionals” who claim there are other things that cause more death than coronavirus such as swimming pools. While the numbers may be true, there is a sobering truth they don’t take into account. Their total YEARLY death rates are only slightly higher than the current death toll of COVID-19 which has only been in the past 7 weeks, not per year. Also, you won’t drown or get injured if your neighbor uses their pool whereas your neighbor could potentially infect and harm you from COVID-19.
I beg those of you in states whose governors are not taking this seriously and opening prematurely despite not following scientific guidelines for reopening the economy, STAY HOME. Places where they are protesting, churches still holding services, and areas of public recreation that have reopened such as the beaches of Jacksonville are seeing a significant spike in cases.
Testing is still scarce in most of the country. While capacity (ability to process the tests) exists, the supplies for testing remain low (swabs, reagents, tubes) etc. Those who are on the front lines know that testing is still insufficient despite the claims by the government.
While it hurts me to say this, I myself have been a victim of this. If you see someone wearing scrubs or a hospital/medical insignia on a jacket or vest, please do not given them a dirty look, yell at them, or harass them. Yes, it has happened to myself and some family/friends. People are risking their lives to take care of your loved ones, friends, and neighbors. Be appreciative. We understand infection control better than anyone, don’t worry, we do everything we can to prevent the spread of disease. Some of us have not seen our family since the beginning, so please respect what we are going through as well.
Last but not least, be kind. Give to those who need, smile at those who aren’t, and respect those who are essential and cannot isolate.

The sun always shines bright behind the darkest of storms, and that is no different today. I wish every one of you nothing but health, hope, and a helping hand. Stay safe, stay home!