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.

Should physicians shy away from accepting their mortalities?

Aakanksha Asija, MD

Conditions and Diseases

April 2, 2020

In between snippets of conversation exchanged with my husband about how the first day of remote learning went for our 9 year old and whether the latest nanny was likely to quit given health risks associated with working in a two-physician frontline worker household in the context of COVID-19, we also discuss some potentially dangerous scenarios. The discussion is quite mundane, between what we are having for dinner and how …

Are Boston hospitals prioritizing money over the safety of their employees and patients?

Anonymous

Conditions and Diseases

April 2, 2020

Growing evidence suggests that the novel COVID-19 virus can be aerosolized. To adequately protect employees, providers require not just “droplet,” but “airborne” precautions and the appropriate healthcare worker personal protective equipment (PPE).

Appropriate PPE mandates an N95 mask. News reports for weeks have described hospitals working without the necessary protection for health care providers.

This is the case in Boston-area hospitals, which are running short on these masks. One of the city’s …

We are not being too alarmist about COVID-19

Christopher J. D. Patton, CRNA

Conditions and Diseases

April 2, 2020

I’ve been reading a lot of posts expressing disappointment with the way that COVID-19 has been covered in the media and worry about the economic consequences of prolonged social distancing. This is long, and you might not care, but here’s my perspective as a former ICU nurse that witnessed many deaths, a nurse anesthetist who is dealing with both the administrative headaches that go with dealing with this disaster and …

Giving birth during the COVID-19 pandemic: an obstetric anesthesiologist’s perspective

Maria Sheikh, MD, MPH

Conditions and Diseases

April 2, 2020

“It’s a strange time to be having a baby,” my patient said as she sat alone in her labor room. The state order to shelter-in-place in California had left her family with few options as her husband had to stay home to take care of their toddler. She is one of many pregnant women who do not have the choice to even consider a home birth due to her congenital …

Try social loving instead of social distancing

Jay Wong

Conditions and Diseases

April 2, 2020

Social distancing.

It is a mantra that seemed to have been plucked straight out of obscurity for those who had never heard of it before just as the coronavirus pandemic dug its ugly claws into the fabric of American life. And since then, it has been perfusing our cultural ether for the last several weeks—aggressively occupying the webpages across the internet, leaping onto the headlines of newspapers, and frequently serving as …

How are we doing? The short answer is that we’re OK. The real answer is much longer.

Jill Jaimes, MD

Conditions and Diseases

April 2, 2020

My friends ask me how I’m doing. The short answer is always, “We’re OK.” But the real answer is much longer.

I feel a lot of anxiety these days. It’s always there, sometimes with more intensity than others. But a constant, ever-present, lurking beneath our routine.

Like everyone else, sheltering in place is a component of it. There are the combined aspects of keeping my four children entertained, keeping them from fighting, …

The hospital doesn’t care: Physicians must advocate for themselves

Anonymous

Conditions and Diseases

April 2, 2020

On Doctors’ Day, my hospital celebrated our work by giving us each a pair of cheap headphones, and also announced the death of an attending. Though the personal risk to each of us was highlighted by the recent death, the administration did not give hazard pay, or PPE comparable to other countries’, or even a guaranteed supply of isolation gowns. Just headphones a different color than the ones they gave …

The fragile economics of America’s emergency departments

Jesse Pines, MD and Arjun Venkatesh, MD

Conditions and Diseases

April 2, 2020

On the front lines, America’s emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19. Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our …

The testing cavalry for COVID-19 is coming

Jack Jeng, MD, MBA and Davis Liu, MD

Conditions and Diseases

April 2, 2020

Testing for novel coronavirus is still a serious issue in the U.S. due to a lack of lab capacity, test reagents, nasal swabs, and even personal protective equipment for health care workers. Due to these shortages, the CDC is recommending that COVID-19 testing should not be performed on patients without symptoms and instead be prioritized for: 1. hospitalized patients and symptomatic health care workers, 2. patients at highest risk for …

The ethics of prescribing during a pandemic

Nanette Elster, JD, MPH

Conditions and Diseases

April 2, 2020

In times of disaster, marginalized groups often become even further marginalized. Both those of lower socioeconomic status and those with disabilities often are left out of emergency planning, as is evidenced by the current COVID-19 pandemic. From access to testing to ability to acquire needed goods and services to triage policies being adopted from community to community, those with lower SES or …

Immunity passports: How to eventually climb out of the COVID-19 pandemic

David M. Mitchell, MD, PhD

Conditions and Diseases

April 2, 2020

During the influenza epidemic of 1918-1920, my great-grandfather, Ralph Norton Mitchell, was in the military. He helped stack the corpses of those who had died from the infection. I shudder to think about what type of personal protective equipment he used. However, his survival reminds me of a feature of all epidemics–some individuals have or develop immunity, and those who have immunity can “do the work.”

Currently, we are …

In these dark times of a pandemic, look to history for hope

Edwin Leap, MD

Conditions and Diseases

April 1, 2020

This is a frightening time. The coronavirus is called “novel” because it is new, and what is new is often terrifying.

We don’t know enough about our new microscopic enemy. Scientists, clinicians, and policymakers are all working tirelessly with limited data and learning along the way. Consider that many diseases that we regularly face have been observed, reported, studied, and treated for decades; some for centuries (although with less success than now). Novel coronavirus …

What COVID-19 taught this physician about money

James Turner, MD

Conditions and Diseases

April 1, 2020

COVID has taught me many things in and outside of medicine. Most importantly, it has taught me that the medical field is a family. There is nothing that drives a family together like a crisis. For those of us on the front lines, I’m raising a pint of the finest for you! That “front line” not only includes the doctors, nurses, and staff caring for patients sick with COVID. It …

What has changed for emergency physicians? Not much.

Anonymous

Conditions and Diseases

April 1, 2020

“You are a hero! “

“Thank you for all you are doing!”

It is overwhelming and tremendous; it is touching and heartwarming; it is genuine and sincere. The outpouring of support and love for health care workers and first responders has been a bright light in the dark days of the coronavirus. But I have been forced to wonder: What has really changed? OK, before you get outraged by that statement, hear …

The angst and guilt of an older physician

Eliot Nierman, MD

Conditions and Diseases

April 1, 2020

I am writing this a bit selfishly as part of personal catharsis, and it has been helpful serving that purpose and helping me better understand what I am experiencing. If, however, some of it strikes a meaningful chord or you have some critique or suggestions, then, of course, I am delighted to hear from you.

While we all are under stress, I have been feeling angst I …

Fighting COVID-19: Don’t let health care workers become collateral damage

Crystal Wong, MD, Suzan Song, MD, PhD, MPH, and Sara Kerley, MD

Conditions and Diseases

April 1, 2020

Last week’s death of the first nurse to die from COVID-19 in New York City infuriated health care colleagues who blamed his death on lack of protective gear. Across the U.S., health care workers are scrambling to design makeshift personal protective equipment, also known as PPE. Nurses are resorting to wearing Hefty trash bags because they have run out of gowns. …

Will COVID-19 stop the devaluation of physicians?

Mark Lopatin, MD

Conditions and Diseases

April 1, 2020

About a year ago, I wrote about how physicians are being devalued. More recently, I posted on my Facebook page how, in the current time of need, physicians are suddenly being valued more. I noted how in the midst of the COVID-19 pandemic, the powers that be are turning to the same physicians to lead us out of the crisis. I alluded to compromises being contemplated …

If social distancing isn’t hard for you, you’re doing it wrong

Amy Garlove, MD

Conditions and Diseases

April 1, 2020

I am not a germaphobe. I have never wiped a grocery cart handle before now. I don’t wear a mask during flu season in my office. I love for my kids to play in the dirt, and I welcome the daily exposures they have in our house, school, and life. I have the utmost respect for the immune system and the amazing job it does every single day, battling more …

Fear and love in the time of a pandemic

Rabia Jalal, MD

Conditions and Diseases

April 1, 2020

Coronavirus, COVID-19, social distancing, quarantine, flatten the curve, wash your hands, do not touch your face: These are not terms that I am reading out of any of my of medical school books, these are terms that have become a reality for every household in the world, irrespective of nationality, socioeconomic status, gender, creed, etc.

I write this article not as a physician, but as a person full of fear and …

Read more…

Fear and love in the time of a pandemic

COVID-19 and the toll on health care workers’ mental health

Amira Athanasios, MD

Conditions and Diseases

April 1, 2020

It is well known that physicians are more likely to screen positive for depression and have higher rates of suicide than their counterparts in the general population. But how is this fact exacerbated by the global pandemic of fear, anxiety, and mounting death tolls known as COVID-19?

For starters, health care workers are at the front lines of the emerging disaster, having to set aside their own …