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’m bombarded with emails of rapidly changing policies to prevent infections and identify COVID-19 patients (in the course of writing this, I’ve already received three more emails), I’m having a hard time finding masks because the nurses are hoarding them in some corner or taking them home, I feel regret for previously telling friends when they asked me that the coronavirus outbreak is likely not to cause this much death, …
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Coronavirus is a crisis. And an opportunity.
Coronavirus disease (COVID-19) has slowly but surely made its way to Middle America, stowing away on well-meaning citizens who have traveled to the coasts or overseas for one reason or another. It has sneakily hitchhiked its way into Creighton University basketball games, pub crawls, and several area Walmarts. A few patients have been seriously ill, but the majority of the physical, intellectual, and emotional time, effort, and energy spent in …
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Coronavirus has slowly but surely made its way to Middle America
What prompted me to write this essay is seeing a chest X-ray of a physician fighting the COVID-19 disease, and it did not look promising. I wish for the speedy recovery of this unknown physician. With the current state of affairs that our country and many others in the world are in, we need to take a pause and think about how we arrived at this place.
Every day the number …
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We don’t have the luxury of losing health care workers at this critical juncture
I have been answering a bunch of questions about this virus. There is a lot of confusion, and there are a few questions that I seem to hear over and over. So, here is a simple primer.
1. Why is personal distance of 6 feet a thing? The measles virus can be spread through the air because it can literally float on the microscopic dust in the air. …
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Coronavirus made simple by your friendly neighborhood emergency physician
Here in the U.S., we slip and slide around the reality of rationing. We like to believe we can have it all, do it all, that there are no bounds. And if you have money in the U.S., that is more or less true. Until now.
Personal protective equipment and test kits for COVID-19 are in short supply. I won’t explore the myriad of reasons of why …
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It’s the R-word again: rationing
As a hospitalist in Minnesota, my colleagues and I are busy preparing for the coming viral storm. It is starting to rain. We read the harrowing front line stories from overwhelmed hospitals in China, Italy, and now here in the U.S., and reach for a sublingual Zofran tablet to calm the nauseous dread.
The smart and intuitive “flatten the curve” graphic has made a strong case to the public for why …
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Hospitals run on much more than doctors and nurses, so spread the love
There’s an intruder in our relationship, and her name is COVID. Every night I come home, and she’s lurking around the corner on an Amazon box, in the crevice of my couch perhaps, or her scent is lingering on my husband’s scrubs. A physician-physician marriage is hard enough, but when put under the microscope of a life-threatening pandemic, well, it is disjointed to say the least.
My husband is an orthopedic …
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I don’t want to risk my life to keep my job
I looked at the door. Standing there, in a paper gown, my hair tucked back into a ponytail, mask, and shield across my face, gloves on, boot covers over my shoes and legs. Behind that door was a woman I had known for years, whose youngest I had delivered, whose children I still cared for. And her father had just died.
Under normal circumstances, as her long time family physician, I …
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Doctors will die. My friends will die.
We are in crisis. Hospitals have become, in addition to repositories for the pandemic, infectious with moral illness.
From an emergency medical physician:
I have been told not to wear a mask in every room, only in rooms of people with infectious symptoms. And we are talking about [just] a surgical mask. I have emails saying this, and they go on to say no outside masks from home unless they are simple …
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Are administrators disciplining doctors who wear masks too often?
We are in the early stages of the COVID-19 pandemic, but it’s already very clear that the infection prevention community in the U.S. has never faced such an enormous challenge. Reflecting back on the past two weeks, we have learned many things that will make us better prepared for the long term. My goal is to keep track of these in this blog. So here we go:
We are far too …
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Infection preventionists are true heroes, and other things we’ve learned so far
I often hear professionals talking about “working at the top of their license” – contributing their highest skills according to their training. To overcome this pandemic, now more than ever, every single one of us will need to work and live at the top of our humanity. Patients, families, nurses, doctors, front desk staff, administrators, lab techs, health plan executives – everyone – must find even small ways to create …
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Living at the top of our humanity: a patient’s plea
I’m a proud member of our hospital’s Jewish All-Star team, which means I work every Christmas. One great thing about working Christmas is the hospital is never full. No one wants to be hospitalized on Christmas. If patients can go home, they do, sometimes even against medical advice. On top of that, there are no elective surgeries, chemotherapy admissions, or surprise calls from clinic. All is calm, if not bright.
Of …
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The hospital census calm before the COVID-19 storm
Health care workers’ lives are not expendable. Yet, we are being asked to battle a microscopic enemy with disgracefully inadequate personal protective equipment (PPE).
We know that using PAPRs (powered air-purifying respirators) would be the best practice when working with highly infectious air-borne diseases. But, PAPRs are uncommon in our institutions, so the guidelines were relaxed. An N95 disposable mask was suggested as the next line of defense even though we …
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We are not expendable. We are not replaceable.
I hope we eventually study the COVID-19 event after a sober period of analysis and reflection as an example of a societal panic attack. This is not Ebola, with a mortality rate of over 50%, or even SARS, with a 10% death rate. We’ve seen this movie before, figuratively and literally.
A new viral disease appears (like the swine flu in 2009), people die, the fear and misinformation spread like wildfire. …
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Our collective struggle to fight COVID-19 coronavirus
In February, I had my first patient ask about my thoughts on the coronavirus. At that time, I was aware of the coronavirus and cautiously optimistic about the situation. My advice to the patient was to have a healthy level of concern about the virus, given the medical communities limited data on the virus. I instructed the patient on proper handwashing techniques since this is an issue, even for many …
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COVID-19: 5 tips for psychiatrists
One week ago, a mere glance at my phone between patients would have sufficiently caught me up on 30 minutes of disconnect from both social and mainstream media. Today, as I closed one virtual appointment and waited for my 9 o’clock follow-up to join me on-line, I was met with 16 texts, 148 WhatsApp messages, and four breaking news alerts from a variety of apps. Yes, I was thinking about …
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A guide for mental wellness while distancing: a psychiatrist’s perspective
In 2009, when more than $35 billion was invested in expanding national electronic health record (EHR) uptake, one of many advantages touted was its value as a tool for managing population health. This promise has failed to materialize due to a chaotic rollout of non-communicating systems. Today, as we confront COVID-19, the coronavirus wreaking international havoc, the need for such a tool is exquisitely evident.
How could …
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Would Medicare for all help us combat COVID-19?
I am a physician, and I am not isolating. Like the Vietnam War defined my parents’ generation and World War 2 defined the generation before that, the COVID-19 pandemic will likely define mine. My father and grandfathers went to battle – I am now called to be a soldier. My small group of orthopaedic trauma surgeons agreed this morning to rotate in and out of hospital shifts every two weeks. …
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I am a physician and I am not isolating emotionally
A few days ago, a good friend revived an email thread that routinely circulated among our social cohort of 17 aspiring doctors during our final two years of medical school. The subject line read: qThurs HH. Translation: happy hour every Thursday.
Back then, the goal of the email was to establish a standing opportunity for any available recipients to vent about 5 am rounds and difficult attendings or to share stories of fascinating cases and …
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Residency training in the time of COVID-19
The summer of 1979 is permanently etched into my memory. I walked into the intensive care unit as a newly minted intern. I walked over to ICU-Bed 1 to be introduced to my first patient, a frail teenaged boy who was tethered to a ventilator.
“He is day 30 with respiratory failure from disseminated coccidioidomycosis,” my internal medicine resident informed me. “He is your responsibility now, and don’t f*** it up.”
An …
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Coronavirus: the human factor in intensive care
