Practicing medicine in the time of COVID-19: One physician’s experience

One million Americans. 6.3 million people worldwide. What do these numbers represent? One million Americans have died from COVID or COVID related conditions. The larger number is the worldwide number of COVID deaths as reported by the Johns Hopkins Coronavirus Resource Center. Epidemiologists and biostatisticians would argue these numbers underestimate the true number of deaths, and I would agree.

Millions of people gone — all ages, all backgrounds. Family members, friends, coworkers, your local mailman or the cashier at the gas station down the street.

And let’s not forget about the people now living with ‘long COVID’ symptoms that may include lingering fatigue, respiratory distress, newly diagnosed heart disease, and neurological problems such as memory loss or impaired thinking.

And yet, millions of people behave as if the pandemic is over. States and municipalities have returned to ‘normal’ by lifting mask mandates and relaxing the concept of social distancing or limiting crowd size, especially in indoor venues. A judge in Florida ruled that the FAA did not have the authority to require masking on flights. I call these examples of politicians, judges, and bureaucrats practicing medicine without a license.

Full disclosure: I was never on the front lines of treating anyone with COVID-19. My specialty is occupational medicine, but that did not allow me to bury my head in the sand and pretend that COVID does not exist.

In fact, the opposite took place. I made it my mission to read every article, log in to webinars, and listen to podcasts from the big brains at the National Institutes of Health and the Centers of Disease Control and Prevention. I devoured articles about COVID in The New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA). As a physician, whether the question came from medical colleagues, patients, family members, or friends, I wanted to be prepared to answer any and all COVID-related questions that came my way.

Q&A

What did you discover?

The amount of misinformation and disinformation floating around the community was beyond belief. Facebook postings are rarely, if ever, a good source of medical information.

Can you provide examples of what your patients were telling you?

I was amazed that some people truly did not believe in COVID. According to their ‘research’, COVID was a ‘hoax’ perpetrated by the government as a form of population control. I would also ask patients to specify the names of specific websites where they got their data, and to this day, no one has ever been able to provide this information.

Others believed the Chinese unleashed COVID-19 as a form of germ warfare as the Chinese communist party wanted world domination.

I have to say, these beliefs in these bizarre theories crossed all educational, occupational, and socio-economic backgrounds. Remember, even a certain occupant of the oval office suggested that COVID-19 infections could be treated by drinking bleach, shining a light into the body, or taking Ivermectin, which is used to treat animals infected with parasites. To clarify further, Ivermectin can be used in people, but only to treat certain parasitic worms and very specific skin diseases.

Across the country, there were many episodes of Americans behaving badly when asked to wear masks in public places such as stores, airplanes, and restaurants. Did you personally experience this?

In general, there were reports that hospital based workers and staff in outpatient clinics were subject to verbal abuse — and in some cases, physical abuse — by both patients and family members regarding mask wearing.

Yes, in my work environment, there were incidents where patients who refused to wear a mask were asked to leave the clinic. Honestly, I was dismayed to read reports that store clerks, restaurant waitstaff, and even flight crews were being physically attacked just for trying to keep us all safe. I am not sure if other countries reported these types of problems but it does make Americans look bad.

Switching gears, I recently read that only 68% of Americans have been fully vaccinated. Any thoughts on how to get those numbers higher?

Now, that is a question best asked of our social scientists. I have divided the population into three groups. The first group are the ones who totally embraced the idea of getting vaccinated and are now fully vaccinated. The second group probably received initial vaccinations and have no desire to get boosters.

Now let’s talk about the third group. I call them the hardcore anti-vaxxers. From my own clinical experience, this group believes that the vaccines contain microchips for governmental tracking or they have been convinced that the mRNA vaccines can change your DNA. Others express a concern that the vaccines will cause cancer or organ failure in the future. Again, in my experience, this group cannot be convinced that COVID vaccines can decrease the risk of severe illness and even death if infected.

Any final thoughts?

We have to talk about the effect of COVID-19 on People of Color. Black and Brown people were disproportionately affected by COVID infections. Many workers in this group did not have jobs that could be done remotely. Think about our store clerks, factory workers, and employees of nursing homes. Workers in urban areas may ride buses and subways, increasing their risk of exposure. In some households, multiple generations may live together in houses and apartments, and the ability to separate sick people from healthy people may not be possible. And again, there has been resistance to COVID vaccinations and mask wearing. These factors combined increased COVID morbidity (illness) and mortality (death) in this particular demographic.

Sadly, COVID-19 is not going away anytime soon. Fortunately, there are now two antiviral medications to treat mild-to-moderate acute infections. Vaccine manufacturers Pfizer and BioNTech are working on producing a new vaccine that will offer greater protection from Omicron BA.1/BA.5 variants. I am going to encourage as many people as possible to get these vaccinations when they are available for the general public.

Denise Algood, MD, MPH

Dr. Algood is board certified in occupational medicine and preventive medicine. She recently retired after 30 years in medicine and can now devote her free time to creating art. Some of her abstract pieces are currently on display at Moonshot Brewery in Kennewick.