Physicians, nurses, residents, and students writing on KevinMD during and after the COVID-19 pandemic, most of it in real time between March 2020 and 2022: the first weeks and the shortages, the surge, redeployment, schools and masks, the vaccine's arrival and the people who refused it, and what the years did to the people who worked through them. This archive is a primary record of what clinicians wrote as it happened, and more of it was written anonymously than any other subject on the site. For that record organized as a timeline, with the disagreements recorded as physicians made them, see COVID-19: what physicians wrote as it happened. For what physicians said about burnout in those years and since, see Physician burnout: what physicians say, in their own words.
I recently read an opinion by a physician regarding the decision as to which COVID patient would receive care and which would not when hospitals became too full to care for every patient. He suggested that no one need be denied care if some structural changes were made in health care delivery. Given the expected post-Christmas/New Year tsunami of new cases; and limited supplies, equipment, and staff, it is doubtful …
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The ethics of rationing care during COVID
A recent conversation among a group of physicians gave me a fair amount of distress and discomfort.
The topic was an unproven treatment for COVID-19. The discomfort was the disinformation — in my opinion — being shared. The distress was that the discussion likely reflected what some doctors are actually doing for the treatment of patients infected with the coronavirus. Evidence was left at the doorstep.
As I reflected on the conversation, …
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Why won’t unproven COVID treatments go away?
As a physician epidemiologist and former public health official, I’m constantly struck by the sheer amount of disinformation that spreads related to COVID-19. I’ll routinely encounter myths about how masks actually cause viral spread. Or I’ll be told that drinking alcohol or raw, unpasteurized milk combats the virus or that putting hot pepper in food wards off viral illnesses. Meanwhile, conspiracy theories about 5G networks …
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Knowledge is power: Why science and health literacy matters
Recently, I started suspecting that RT-PCR testing was not foolproof at ruling out COVID disease after seeing a fair number of patients with typical signs and symptoms but a negative PCR. I have encountered some patients hospitalized with typical COVID pattern pneumonia, thromboembolism with multiple negative PCR tests. Some of these folks even had exposure history and the signature hallmarks unique to this virus, like multiple peripheral opacities on CT …
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Why COVID PCR tests aren’t as accurate as you think
It’s a Friday in January 1997. Another two-week block of nights behind me, 75 hours a week with a weekend off in between. However, working 5 p.m. to 8 a.m. means waking at 4 p.m. to dress, grab 15 hours-worth of food, drive 20 minutes to the parking deck, and run 10 minutes to the reading room by 5 p.m.
As a second-year resident, working alone covering all radiology services for …
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Long-term sequelae of a life in medicine
I am an internist in private practice in a community west of Milwaukee, and my commitment as a physician is to keep my patients and community safe and healthy. Throughout the pandemic, I have worked hard to learn everything I can about COVID-19, have helped my patients stay healthy, greatly reduced rates of COVID spread through preventive education, and cared for my patients who have become COVID positive, keeping them …
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I feel more alone than ever before
The COVID-19 vaccine has failed.
I don’t mean that the vaccine itself doesn’t work—far from it. I mean the ineffective way such an important lifesaving, pandemic-ending vaccine is being rolled out. The slovenly effort is putting the lives of millions of Americans at risk. At the vaccine’s current injection rates, or even if they got it to 1 million a day, it’ll still take a year before all Americans are fully …
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The failure of COVID-19 vaccine distribution confirms government incompetence
Given the COVID-19 pandemic’s ongoing course, it is important to prioritize offering our still limited vaccine supply to individuals with the highest risk of exposure to, and negative outcomes from infection with the virus. While each state is allocating their initial vaccines somewhat differently, for the most part, staff working in hospitals and nursing homes have been given priority. Hopefully, with few exceptions, the initial doses have gone to those …
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Correctional facilities are not prioritized for COVID vaccines
If 2020 was the year of the coronavirus pandemic, 2021 has got to be the year of vaccinations. The miracle of modern science, generous funding, and expedited research have led to us having at least three available vaccines to fight against the COVID-19 pandemic. Pfizer/ BioNtech, Moderna, and most recently, AstraZeneca have produced vaccines that are up to 94 to 95 percent effective at preventing SARS-CoV-2 virus infections or reducing …
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#ThisIsOurShot to end the pandemic
COVID-19 has turned the world on its head. A major problem we have faced since the beginning is that it had already been spreading like wildfire for a few months since the end of 2019 — before most of the world realized that it was time to take action against this respiratory virus. We’ve therefore been on the back foot from the very start.
Research has estimated …
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The blunt truth on why stopping COVID is impossible
Health care has been hanging by a thread for some time — in our community and across the nation. The COVID-19 pandemic exposed weaknesses inherent in an underfunded public health system, a monopolized hospital, and a fractured medical supply chain.
At the beginning of this pandemic, I wrote, “Our lives will not be saved by the government. And lives will not be saved by elected officials or large institutions. Lives will …
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Is there hope for COVID with home visits?
The coronavirus pandemic posed unprecedented challenges and forced a shift towards an accelerated digital transformation. The COVID-19 public health emergency focused attention on timely dissemination and reporting of research findings, resulting in the rapid growth of preprint platforms. Preprint servers like medRxiv, bioRxiv, ChemRxiv, arXiv, and ResearchSquare received attention for sharing preliminary research during the COVID-19 pandemic. Preprint servers facilitate rapid dissemination, seek the establishment of priority, and solicit feedback …
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Be careful when using preprint servers for medical research reports
As if COVID-19 weren’t bad enough during the pandemic, another public health crisis – substance use disorder (SUD) – has gone from bad to worse, while access to behavioral health services is shrinking.
As of September, more than half (52%) of community behavioral health organizations have seen an increase in demand for services, and half of those that offer SUD services saw their demand jump in the previous three months. At …
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The COVID-19 vaccine won’t solve major substance use disorder treatment gaps
I have never felt so alone. I was lying in bed with severe abdominal pain. Pain I never had before. Well, at least not for a reason.
As I lay there, I kept thinking, what if I die while I wait until morning. It was the middle of the night. I had not felt well since earlier the week before with a severe diarrheal illness. One that only babies have with …
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Alone in the hospital in the midst of a global pandemic
After nine months of death, despair, and fear, the one-two victory of Pfizer and Moderna’s COVID-19 vaccine approvals is a major turning point for everyone in health care. Social media timelines suddenly sprang to life with vaccine selfies as besieged health care workers got their first doses. It is truly a turning point in this relentless pandemic, and it finally feels like we can imagine the end of this nightmare.
But …
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Medical students deserve the COVID vaccine in the first phase of distribution
I read somewhere that 30 percent of nurses were reluctant to get the COVID vaccine, but I didn’t think I would know any of that 30 percent. I was at work the other night when I realized that I was wrong. Newly vaccinated, I was talking to some of my nurses about their vaccine experiences. Several of us commiserated about our sore arms. I asked one of my nurses what …
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In case you need a reason to get the COVID vaccine, here are 12
On Friday evenings, my family usually listens to my husband DJ music in the basement, streaming online on Twitch, and dancing along. During one of these nights, I went upstairs to check on my two girls and remembered to check online for my routine COVID-19 screen results that I’d done the day before.
Since the beginning of the pandemic and when our clinic received COVID PCR swab tests, I’d been doing …
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The week I tested positive for COVID, the vaccine arrived: a family doctor’s perspective
Governor Cuomo showed New York and the world the importance of leadership and communication during a crisis. Ignoring this standard makes the information void surrounding the COVID vaccine roll-out even more upsetting. I represent 150 dedicated pediatric clinicians and over 300 committed nurses, medical assistants, medical receptionists, and support staff who are incredibly disheartened by the lack of information about COVID vaccine for non-hospital front-line workers. My pediatric colleagues share …
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Health care workers who are forgotten on the frontlines
“How can we, as physicians, convince Black patients to take the COVID-19 vaccine?” my residency interviewer asked me, a Black fourth-year Johns Hopkins medical student.
I paused. I couldn’t help but wonder if the interviewer had asked all of the other applicants this question, or just me, the sole Black applicant interviewing amongst eight other colleagues. Nevertheless, I entered the field of medicine with the hopes of promoting health equity in …
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How can physicians convince Black patients to take the COVID-19 vaccine?
