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.

People are ignoring social distancing guidelines. We must get it together.

Cory Michael, MD

Conditions and Diseases

March 31, 2020

I recently received a postcard in the mail titled “President Trump’s Coronavirus Guidelines for America.” The first of these recommendations is to follow the directions of my state and local authorities.

In my community, notable restrictions on commerce have been handed down by my governor, my mayor, and a county judge. This has had a crippling effect on our local economy as we brace for the storm to get worse. For …

The small practice primary care response to COVID-19

Talal Khan, MD

Conditions and Diseases

March 31, 2020

I am scared as I sit down to write about our journey as a small practice as we fight along with the rest of the world against the unthinkable force of nature in the form of a COVID-19 pandemic. My small primary care practice is only two years old. In a time when medical practices are already dying, the financial consequences of social distancing as a response to COVID-19 can …

Being a doctor is not what it used to be

Raviraj Patel, MD

Conditions and Diseases

March 31, 2020

All my life, I’ve been told that I will have job security. No matter what, as a doctor, I will always have a job despite whatever may come. I have chosen one of the most stable and secure jobs that exist. But did I?

Coming from a family of clinicians — seven physicians, two nurses, and one LPN — one would assume that we are safe and secure, for …

A resident physician’s reflections on COVID-19

Poornima Oruganti, MD, MPH

Conditions and Diseases

March 31, 2020

As I change out of my scrubs in the resident lounge bathroom, I am exhausted and numb. I put on sweatpants and a T-shirt, taking care of folding my scrubs to avoid touching the dirty spots. I wipe my phone and keys with an antibacterial and antiviral hospital wipe, and place them into my bag. I hang my white coat on a wall hook in my workroom, my stethoscope in …

In the midst of a global health crisis, USMLE Step 1 needs to be made pass/fail now

Anna Delamerced

Conditions and Diseases

March 31, 2020

Every aspect of life has been affected by COVID-19, including medical education.

Since March 17, medical schools across the nation have suspended clinical rotations, per guidelines from the Association of American Medical Colleges (AAMC). The target end date for this temporary pause was set originally to March 31.

The National Board of Medical Examiners (NBME) followed suit, declaring that Prometric testing centers were closing …

The doctors cry. The world applauds.

Rinki Goswami

Conditions and Diseases

March 31, 2020

Two weeks ago, I wrote to describe our pandemic situation as a labor of love. Now, as a fourth-year medical student – the only word I can find is: fury. I am absolutely furious. I am furious that the country’s leading public health agency, the Centers for Disease Control and Prevention (CDC), has been muzzled and not permitted to speak directly to our people. I am furious that our federal …

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The doctors cry. The world applauds.

We can’t build our way out of the ventilator shortage. But there is a solution.

Deep Ramachandran, MD

Conditions and Diseases

March 31, 2020

“Hey buddy, can you spare some ventilators?”

No, this is not an attempt at dark humor. This is the preamble of numerous calls that are going on across the nation right now. Whether the call is made to a ventilator manufacturer or to other medical centers, hospitals are busy stocking up on the highly technical devices that are anticipated to be in short supply. Here in North Carolina, where …

The inspiring concern and connection between health care workers during the COVID-19 pandemic

Nina Shapiro, MD

Conditions and Diseases

March 31, 2020

The current pandemic of COVID-19 has already brought out the best and the worst in people all over the world. These dark days have also brought out some deep-seeded feelings of fear, anger, selfishness, and, thankfully, selflessness. As a surgeon in a busy tertiary care center, and as a human living in tony Los Angeles, I see the best and the worst in humanity in a matter of minutes each …

Racially equitable decisions in the era of COVID-19

Andrew Spector, MD

Conditions and Diseases

March 31, 2020

Several weeks ago, Americans physicians started receiving reports that our Italian colleagues were being forced to decide which of their patients would receive life-sustaining therapy for COVID-19. Across the United States, American physicians are on the brink of similar devastating choices, if they’re not there already. Some states have started preparing by creating guidelines to help physicians make …

False negative: COVID-19 testing’s catch-22

Dr. Saurabh Jha

Conditions and Diseases

March 31, 2020

In a physician WhatsApp group, a doctor posted he had a fever of 101 degrees Fahrenheit and muscle ache, gently confessing that it felt like his typical “man flu” which heals with rest and scotch. He worried that he had coronavirus. When the reverse transcription-polymerase chain reaction (RT-PCR) for the virus on his nasal swab came back negative, he jubilantly announced his relief.

Like Twitter, in WhatsApp, emotions quickly outstrip facts. …

An emergency physician to President Trump

Matthew S. Kuchinski, MD

Conditions and Diseases

March 30, 2020

I am a practicing emergency medicine physician in Indianapolis, IN. I work in a county hospital whose mission is to serve the underserved. I, like you, was born into a life of privilege with white skin and parents with the means to provide all that was needed and more. My college education was paid for, and I lived a carefree life through college.

I graduated from pharmacy school and entered the …

I am an emergency physician. I risk my life for the future of our world.

Dr. Sara R. Ahronheim

Conditions and Diseases

March 30, 2020

I am a frontline health care worker. I am an emergency physician. I am also a mother to two glorious, growing, miraculous children and wife to a handsome triathlete stay at home dad. Additionally, I am one of three daughters to a pair of still practicing exceptional pediatricians in their late 70s, and sister to two strong, beautiful women. I am also a severe asthmatic only well controlled by puffers …

Lessons from evolution of telemedicine in response to COVID-19

Talal Khan, MD

Conditions and Diseases

March 30, 2020

The COVID-19 pandemic has threatened our physical and mental health and the very fabric of society. Social isolation has devastating consequences on small businesses, but it has also opened doors to remote business opportunities in the virtual world. Medicine has long been ready to launch telemedicine. However, bureaucratic red tape has prevented this from happening in real-time. Archaic regulations have stifled growth. However, necessity is the mother of …

Medical students: It is time to stop being spectators

Adithya Sivakumar, MD

Conditions and Diseases

March 30, 2020

On July 21, 1861, spectators traveled to Manassas, Virginia to witness the first battle of the American Civil War. The rich citizenry of the Union wanted to see how easily the Confederacy would collapse against the Federal Army, giving a quick end to the secessionist slave-owning states. Unfortunately, the Union Army came decidedly unprepared, and the Confederacy won that battle, sending the spectators scurrying, as well as the entire Union …

Physicians and health care workers are expendable pawns in the game of corona roulette

Mia Marietta, MD

Conditions and Diseases

March 30, 2020

When did physicians and other health care workers become expendable pawns? When did they become unwitting participants in corona roulette?

When hospital systems began to mandate that, in spite of known exposure, in spite of even a positive COVID-19 test, physicians (and their colleagues) continue working.

When hospital workers are informed that if they are caught wearing masks when not seeing a confirmed COVID patient, disciplinary action will be taken.”

When physicians receive …

PPE policies must reflect the needs of frontline staff

Anonymous

Conditions and Diseases

March 30, 2020

Physicians are leaders. As leaders, we are focused on how to ensure safety for our coworkers while also acknowledging a need for stewardship of scarce supply of resources, namely, personal protective equipment (PPE).

I have a particular interest in this topic since I am an emergency physician with a high-risk newborn at home (who spent time in the neonatal ICU just a …

Words of courage for medical students and residents

Deborah Edberg, MD

Conditions and Diseases

March 30, 2020

About 15 years ago, I spent a few weeks at a small community hospital in Zambia, helping to staff the primary care clinic and attend some of the rounds on the small inpatient units there. The inpatient pediatrics unit was full of young children suffering from malaria or measles, often both. One particularly stark evening, a young couple walked in with an infant wrapped in a scarf carried softly on …

After the pandemic, telemedicine will be here to stay

Subha Varahan, MD

Conditions and Diseases

March 30, 2020

Due to the COVID-19 pandemic, many physicians, physician assistants, nurse practitioners, and other health care providers (HCPs) transitioned their clinical practice to telemedicine in the last few weeks. As recommendations from the Centers for Disease Control (CDC) cautioned that older adults, 65 years or older, were at a higher risk for illness with the virus, the Centers for Medicare & Medicaid Services (CMS) “broadened access to telehealth services so that …

Medical students are living life one day at a time during the pandemic

Anna Delamerced

Conditions and Diseases

March 30, 2020

My friends’ weddings have been postponed, even my own cousin’s.

Step 1 exam dates have been moved, much to the shock of many students I know. My brother’s third-year rotations have also been delayed, and the curriculum has unexpectedly changed from the original schedules he and his classmates had.

My fourth-year friends’ Match Days and trips to celebrate with loved ones have been canceled.

This spring, I was going to visit my grandparents …

The world is a scary place right now, and that’s OK

Justin Sterett, MD

Conditions and Diseases

March 30, 2020

As a society, we are faced with levels of uncertainty that are unprecedented for our times. This tension and fear doesn’t discriminate and permeates every corner of the globe.

People might compare the magnitude of this pandemic to events like 9/11 or Hurricane Katrina, but that misses a key element. The disasters we have lived through in our lifetimes up until now were, of course, tragic and devastating in their own …

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