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.
“Do you think we should prepare a will?” I vividly remember saying these words to my wife, also a physician, as we drastically saw COVID cases rise in early March 2020. Just months ago, we heard about the novel coronavirus now known as SARS-CoV-2 but did not grasp the world-changing consequences it would have. Living in Western New York, we were not immediately hit with a surge of cases like …
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Life in the emergency department during COVID: a rural physician’s perspective
Artificial intelligence (AI) has proven of value in the COVID-19 pandemic and shows promise for mitigating future health care crises. During the pandemic’s first wave in New York, for example, Mount Sinai Health System used an algorithm to help identify patients ready for discharge. Such systems can help overburdened hospitals manage personnel and the flow …
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Artificial intelligence, COVID-19, and the future of pandemics
Mirroring the national surge of COVID-19 infections, this past week, I received a barrage of requests from patients seeking pre-travel COVID-19 tests. Despite urgent pleas from the CDC not to travel this holiday season, Americans seem hellbent on celebrating Thanksgiving the way we always do; around a table with family and friends. If COVID-19 is our mortal enemy, we are playing right into her hands. We are a stubborn nation …
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Don’t let a negative COVID-19 test ruin your Thanksgiving
Our country seems to be spiraling out of control. The unending political discord post-election continues to divide our citizenry. The Presidential election is over, accept the results, and move on. There are much more serious issues to have our full attention and among them is the war against COVID-19. This deadly contagion has claimed over a quarter of a million lives in the United States and shows no signs of …
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An apology to frontline health care workers
I asked nurses, technicians and secretaries where it was: the iPad for patients who wanted to speak to their loved ones. COVID didn’t allow visitors. A few days into our peak, it was likely this patient had COVID. They were gasping for air, but could still speak, somewhat. I was hoping to save them an intubation. I told them I may need to put them on a ventilator but assured …
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A physician’s COVID role reversal
I was sitting in my kitchen this morning drinking coffee, as is my usual routine on a Saturday. On this particular morning, I was looking at the empty chairs around my dining room table. These antique dark pine Windsor chairs are well-loved and aged with a patina that includes many layers of memories from family gatherings in their previous life.
Acquired in a recent move, this was their first holiday season …
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Empty chairs this holiday season
COVID-19 has propelled the nation into widespread telehealth services to provide consumer-based care, especially for those who access this technology. Equity issues arise when using digital communication because many underserved populations lack access to digital and/or mobile services. Inevitably, this brings up the greater concern of an unintentional exacerbation of disparities because low-income groups face limited access to both computers, mobile services, and the internet. Hence, investing in access to …
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Telehealth in underserved populations needs telecommunication expansion
Finally, 2020 has offered some encouraging news, with Pfizer and Moderna publishing recent results that provide initial evidence of their vaccine’s ability to prevent COVID-19. With the recent promising results from both vaccine trials, it seems like only a matter of time before the FDA approves them. While some hurdles remain before the vaccine’s distribution and availability to the general public, this news is a welcomed relief for many. However, …
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Will anyone take the COVID-19 vaccine when it’s approved?
As of November 2020, there are about 11.5 million confirmed cases of COVID-19 and 2,50,000 deaths from COVID-19 disease in the USA. Conspiracy theories thrive in times of great uncertainty, and the COVID-19 pandemic has proven to be a petri dish for them. Misinformation regarding the usage of masks, vaccine safety, and other pseudoscientific theories are thriving on the internet.
Many doctors, nurses, and other health care …
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Physicians fight from the social media frontlines
Math was never my favorite subject. However, I was lucky to have good teachers who took the time to help me navigate through high school math and graduate with a final A grade. As I struggled with numbers and equations, calculus and fractions, I was told by one particular teacher to remember the five Ps of math: pen, pencil, paper, patience, and practice.
As of writing this, more than 11 million …
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The 5 “P’s” of a pandemic
Have you ever walked into a hospital before shift change in the early morning hours? The lights are dimmer, there is scarce staff walking to their floors, and people are counting the minutes until the new staff comes. Most staff exist in this survival mode to get to the arrival of the new nurses. Sometimes you can even smell the burned coffee sitting on the bottom of the coffee maker. …
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The quiet death of confidence
“As you know, his condition has been worsening dramatically over the past week. He is unable to breathe without the non-rebreather since last night. Today may be a good time for a goodbye visit.” I told the family of my COVID-19 positive patient who was DNR/DNI (Do not resuscitate/do not intubate).
In my second year of residency in obstetrics and gynecology, I thought that the days of caring for a male …
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Using the COVID experience to build durable relationships with my patients
February 24, 1991, and I wait. I wait on the edge of my cot under the pitched canopy of my far-away canvas home; its sides pulsating from the ever-present wind; sand somehow traversing the walls, everything inside airbrushed a pastel tan; outside the surrounding Saudi Arabian desert limitless in all directions. The winds of war have been blowing, and the time has come. There are 10 of us inside the …
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We are again at war with another unseen enemy
As cases of COVID-19 sore around the nation, the days of New York as the epicenter of the pandemic have become a distant memory for this emergency room doctor. Did the government really once send us refrigerated trucks for our dead and a naval ship for our sick? Did we really sit masked, goggled, and wrapped in plastic while sweating out shift after shift surrounded by coughing, gasping coronavirus infected …
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The long months of winter are coming. Will we be ready?
On November 9th, the governor of North Dakota, Doug Burgum, decided to allow hospital workers with COVID-19 to continue to come to work. He required that they be asymptomatic and that they only work on COVID-19 wards with COVID-19 patients. Given at-capacity hospitals and skyrocketing case counts in that state, health care workers (HCW) had asked state leadership to take extraordinary measures to curb disease spread. HCW were (and are) …
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The problem with allowing COVID-positive health care workers to continue working
I rarely post more than pictures on Facebook. In fact, I rarely use Facebook for much of anything anymore. But I need you all to just listen for a second.
I’m scared. For you and for me.
I need you all to take a minute and think of the last time that you interacted in-person with someone who does not live in your home. Did you …
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We are making sacrifices for you. Please make a sacrifice for us.
This question resonates in my mind each day I pass through the prison gatehouse. The gatehouse is a physical barrier and a mental one, separating the outside from the inside, seceding the lives of people who guard and care for inmates from the lives of those within.
Each morning, the gatehouse is abuzz with activity as people file into work. It’s like going through airport security. Every single day. If you …
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How to find joy in prison
