Infectious Disease

Infectious disease physicians and clinicians writing on KevinMD about outbreaks, antimicrobial resistance, vaccines, and the ongoing challenge of preventing and treating infection. Contributors include the physicians who treat infectious disease and the public health physicians who track it. For a maintained record of what physicians have said about vaccines and vaccine refusal since 2004, see Vaccines: what physicians say, in their own words. For what clinicians wrote during the COVID-19 pandemic as it happened, see COVID-19: what physicians wrote as it happened.

Enduring the pandemic: How to support your friend on the frontlines

Jesse O'Shea, MD

Conditions and Diseases

May 12, 2020

Troubled by the volume of patients dying before they could even be taken out of ambulances, a New York emergency physician recently ended her own life.

Are we all just vital statistics, waiting to be calculated? COVID-19 has infected and killed more than 56,000 Americans. We must remember that every single one of these deaths is a loved one—a son or daughter, a father or mother, a husband or wife, a …

My professional life battling an RNA virus

Lawrence Hurwitz, MD

Conditions and Diseases

May 12, 2020

I feel like I am reliving a bad dream. The race to find a treatment and/or cure to SARS-CoV-2 is reminiscent of decades of practicing gastroenterology while hepatitis C roamed the hospital wards as a death sentence for many. I found myself recently recalling a patient whose story ends with science finding a cure.

As I peered around the ICU curtain, I could see a motionless ill man. I …

An orthopedic surgeon goes to the COVID frontlines

Nicole M. Montero Lopez, MD

Physician

May 12, 2020

I am an orthopedic surgeon in New Jersey and recently started a new practice. Less than a week after starting, news of COVID-19 arriving in NYC was everywhere. My family, my hospital system, and the rest of the country was trying to get a handle on this virus when my daughter spiked a fever that weekend. I spent an hour calling DOH at 5 a.m. trying to figure out if …

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A vaccine alone will not be enough to recover from the impact of COVID-19: Emotional antibodies against it are needed as well

Jay Wong

Conditions and Diseases

May 12, 2020

I was seven years old when I first got my heart broken. I was swiftly rebuffed by my second-grade crush, Brett who, upon getting gently pecked on the cheek by me one afternoon following recess, grimaced and began aggressively wiping off the invisible remnants of the kiss with the palms of both his hands, swiping vigorously up and down his cheek while shouting in utter disgust, “ew!” in front of …

Comparing the preparedness of hurricanes to pandemics

Sarah C. Smith, DO

Conditions and Diseases

May 11, 2020

As I stand in line at a Tampa Lowe’s today in the middle of a global pandemic, I cannot help but note the vast differences in people’s behavior around me. There is a complete dichotomy in the ways in which individuals are responding to COVID-19. Some customers who err on the side of safety are sitting in their cars waiting for curbside pickup. Others are carefully social distancing as they …

Emergency psychiatry during COVID-19

Ruchi Vikas, DO

Conditions and Diseases

May 11, 2020

The reaction to the COVID-19 pandemic in the comprehensive psychiatric emergency program (CPEP) began insidiously, with an initial sense of unease. Patients are brought into CPEP when they pose a danger to themselves or others. Often they are brought by police, but occasionally they come on their own or with concerned family members. CPEP is a locked unit, separated via locked double doors that require a valid ID badge to …

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Emergency psychiatry during COVID-19

What do you want from health care after COVID?

Rosalind Kaplan, MD

Physician

May 11, 2020

In the last six weeks or so, the practice of medicine has been turned topsy-turvy by the COVID pandemic. Those weeks seem like an eternity. We have been so consumed with testing and treatment coronavirus, flattening the curve, and figuring out how to wear a mask without having our glasses fog up, that it’s hard to remember health care before COVID.

But let’s try, just for a minute. Let’s try to …

A psychiatrist crashes into telemedicine during the pandemic

Allie Thomas-Fannin, MD

Conditions and Diseases

May 11, 2020

As far as psychiatrists go, I admit I’m odd, even in a field known for its quirks. I’m fast-talking, irreverent, and most patients tell me I’m not what they expected, but they come back.

I’m not for everyone, and that’s OK. I love my field but didn’t always feel the field loved me.

At a conference workshop, as a PGY-III, in a room of 40 other psychiatrists, mostly attendings, the leader pulled …

Everyone agrees nurses are heroes. Why aren’t we treating them that way?

Inge Garrison, RN

Conditions and Diseases

May 11, 2020

It’s been said that history doesn’t repeat, but it does often rhyme. And as we’re learning during COVID-19, lessons from the past can be a guide to help us navigate a modern pandemic — if we listen to the rhythm of history.

For a little more than two years in the middle of the 19th century, Great Britain, France, the Ottoman Empire, and Sardinia fought the Russian Empire for …

How social distancing affects vulnerable nursing home residents

Palak Patel

Conditions and Diseases

May 11, 2020

On a cold evening in early March, my grandpa and I queued outside a nursing home in rural California. He pulled an insulated lunchbox, filled with hot chai and pureed rotis, to his chest and sighed. There are at least eight families in front of us, and if we don’t move fast, my grandma will fall asleep before she’s had dinner.

Twenty minutes later, we’ve reached the threshold: a nurse takes …

Stop calling health care workers heroes and do something to help them

Deborah Edberg, MD

Physician

May 11, 2020

The narrative that paints health care workers as “heroes” makes me uncomfortable. I may not have a right to an opinion as I am third-string back up not currently working in an overwhelmed ER or ICU. I also feel uneasy about the sea of gratitude and cheers of support, though I know they are uplifting to the people on the receiving end.

Yet, while watching these stories of appreciation, resilience, and …

We must protect the most precious scarce resource required for the next phase of the pandemic

Jessica Turnbull, MD

Physician

May 10, 2020

“Good news! You have antibodies, so you’re immune to COVID-19.” How relieved would we be to hear that? I could move throughout my place of work, or my grocery store, with added security. I would muse about a vetted cohort of immune providers to care for patients with COVID-19. PPE could be conserved so that it could be plentiful for the providers who volunteered themselves to remain in the fray …

Should we stress about stress? Protecting ourselves during the pandemic.

Reut Gruber, PhD

Conditions and Diseases

May 10, 2020

COVID-19 has exposed us to a wide variety of different stressors. In the short term, our stress response is useful as it helps us respond quickly and effectively. But when the stress lasts longer, we have to identify and acknowledge the “downside” risks.

We should not stress about stress but protect ourselves against it.

Intense, prolonged stress has a negative impact on our immune system. Stress increases the …

After COVID-19, there’s no turning back from a digital clinical workforce

Muthu Alagappan, MD

Physician

May 10, 2020

Novel coronavirus (COVID-19) has challenged our health care industry in profound and irreversible ways, creating massive pressure that has exposed system-wide inefficiencies and inequalities. It has also fundamentally shifted the way first responders, health care providers, hospitals, health systems, and even the federal government are using digital health technologies.

The current pressure test that our industry, economy, and global community is withstanding has forced health organizations—both large and small—to rapidly adapt, …

The hidden wounds of COVID-19

Andrew Trotter, MD, MPH

Physician

May 10, 2020

By the time we started to have a significant number of COVID-19 patients in our hospital, I was working as the attending on the inpatient infectious disease service. Along with the rest of my infectious disease colleagues, we had all been tracking the evolving COVID-19 statistics and mounting predictions that we would eventually become inundated with COVID-19 cases. We were in that “waiting for it” phase. Although it gave us …

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The hidden wounds of COVID-19

Responding to medical students’ concerns and anxieties during these unprecedented times

Kali Chiriboga

Medical Education

May 9, 2020

Everyone is in the same situation across the country in these unprecedented times.

What a statement. A statement that every medical student has undoubtedly heard in utter multitude during these times of virtual medical curricula in place of clinical curricula — of canceled steps, levels, CKs, PE, and CS. It has no doubt been challenging on everyone, with some feeling stripped of their opportunity to help and serve their mentors and …

My living will during COVID-19

Gayle E. Woodson, MD

Conditions and Diseases

May 9, 2020

I am not afraid of being dead. Our four grown children are thriving, each in their own way making the world better. If I am wrong in my faith that Jesus is preparing a wonderful place for me, I will never know it.

I do dread the process of dying, and COVID-19 would be an awful way to go. Most people have mild symptoms, but mortality skyrockets above the age of …

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My living will during COVID-19

A reasoned response to the PPE debacle

Robert Frolichstein, MD

Conditions and Diseases

May 9, 2020

The lack of adequate supplies of PPE is deplorable, inconceivable. This has been made abundantly clear through both social media and traditional media. Post after post on various social media outlets have exposed the appalling shortages and, at times, blame and attack those that are obliged to provide us the PPE. Those posts, in part, have spurned movements among nonmedical personnel to donate and make masks. Heartwarming, and it feels …

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A reasoned response to the PPE debacle

How to liberate doctors from EMRs

Erin Palm, MD, MBA

Health Technology

May 9, 2020

We talk a lot in critical care medicine about liberating patients from ventilators. Vents are getting a lot of deserved attention for saving lives in the COVID-19 era. But the machine has downsides that get worse the longer the patient needs it.

Because we’re obsessed with taking great care of our patients, we in ICU medicine obsess about ventilator liberation. There are thousands of publications on the topic. Vent weaning protocols …

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How to liberate doctors from EMRs

Infectious Disease

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