Doctors Are Dreading the Third Coronavirus Wave – The New York Times

At least we know more now, I offer. This is not false reassurance. We know that masks and distancing, testing and contact tracing, can prevent spread. Though there is no magic bullet for this disease, we know that a simple inexpensive steroid seems to save lives. The data for remdesivir, the antiviral so many families sought so desperately early on, are less clear, but it is likely helpful for some patients particularly early on in their disease course.

Perhaps more important, we have learned what doesnt work. We no longer rush to intubate earlier than we would in other diseases. For those patients who do need intubation, we recognize that meticulous critical care itself the daily drudgery of managing volume status and checking labs and titrating ventilator settings is a lifesaving intervention. Indeed, recent studies have demonstrated a significant drop in mortality among hospitalized patients with the virus. This should give us reason to be hopeful.

But mortality is not the only outcome that matters. We have also learned that infection with the coronavirus can bring with it a host of prolonged, debilitating symptoms now termed long-haul Covid even for those with only mild disease. And the impact of this virus is not isolated to those who are infected. I think of the rest of the patients in the hospital, their long and lonely admissions. I think of the families who struggle with our visitor policies, the pain of having to tell them that their loved one is critically ill but because the patient is not actively dying, the family cant spend the night. To say nothing of the cost to the elderly and isolated. I cared for a man recently who lived alone and had barely left his home in about six months. Only after he died did I realize that our central lines and breathing tube and finally chest compressions might have been the only physical contact he had felt since the spring. The true cost of this pandemic will not be measured in a body count.

So we control what we can. Looking ahead to the possibility of another surge here in the Northeast, as the cold air drives us indoors, we refine our protocols and procedures. We arrange schedules. We make cautious plans to see the people we love. We laugh when we can, even if nothing is actually funny, because that is better than the alternative.

A few days after my overnight shift, I check in on the patient list in the unit. The elderly man has worsened despite our most current therapies, and he is now intubated in the intensive care unit. As I read through his notes, I feel it all rush through me, the anticipation and the dread and the frustration and sadness of avoidable suffering. I close my eyes and I find myself thinking again of those brown bags of personal protective equipment. I hope that we will not need to make room for more.

Daniela J. Lamas is a critical care doctor at Brigham and Womens Hospital in Boston.

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Doctors Are Dreading the Third Coronavirus Wave - The New York Times