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Confronting the COVID-19 Virus: An ER Doctor’s Thoughts

Now that we are in crisis, it’s time to stop listening to every blog and twitter account with an opinion and instead look to those who have the training and expertise to combat the epidemic.
Confronting the COVID-19 Virus: An ER Doctor’s Thoughts
Image: Photo by Kelly Sikkema on Unsplash

When I talk to people about the COVID-19 virus, I try to start with some basic facts to make sure we are beginning from the same foundation. As a doctor, one of my biggest struggles is overcoming a culture of misinformation and a prevailing distrust of traditional sources of expertise.

With the rise of the internet, suddenly everyone believes they are an expert in what is wrong and how to treat it. This often makes my job frustrating, for example, when having to explain that peppermint does not cure a cold.

This belief that we are all experts has become particularly challenging in medicine as patients self-diagnose and treat themselves. It is not uncommon that a patient will argue with experts offering evidence

Now that we are in crisis, it’s time to stop listening to every blog and twitter account with an opinion and instead look to those who have the training and expertise to combat the epidemic.

Let’s start with some basic facts:

  1. COVID-19 has shown similar characteristics to influenza. It is spread from person to person through droplets (sneezing, coughing) and droplets left on surfaces. It also can spread asymptomatically from person to person for several days. In other words, you could have and spread the virus without knowing it. This is why social distancing—even if you don’t have symptoms—is so important.
  2. The virus is different from influenza. We currently do not have a vaccine for it and we don't know its’ true mortality rate. Despite what some misinformed people have said, it is almost certainly much higher than influenza, especially for the elderly and immunocompromised.
  3. The numbers coming out of Italy are alarming. This pandemic has overwhelmed robust hospital systems across the globe, leading to massive understaffing and overworked health care providers, not to mention the challenging ethical considerations of who gets to live and who dies.

Understanding the Panic

Watching the news and talking to family and friends, there is a real sense of panic starting to set in across the globe. Far from dismissing this panic, I very much understand. Panic is real because fear is real and it is this fear that doctors, pastors, and organizational leaders need to address when interacting with people around the coronavirus. Simply telling people to not panic without addressing the underlying fear will do nothing.

So why are people afraid? It’s because of uncertainty. I see patients in the ER who are wondering if they have the disease and if they will die. I hear from my friends and family who are not in health care, wondering if they should freak out and buy all the toilet paper and pasta. I hear from my colleagues as we talk about the implications for our department over the next few months.

This is a time of great uncertainty, and we are all a part of it.

But, while I understand the uncertainty, will still have a role to play.

Media and leaders need to continue to encourage people to stay out of large groups and to help serve their neighbors. Taking pictures of your local grocery store with nothing on the shelves is not helping. Sharing stories of hoarding toilet paper or masks is only inciting others to follow your example.

If we run out of necessary food in grocery store, it is the elderly and sick who couldn’t get out during this immediate rush who will suffer. If we don’t have the medical equipment for hospitals and treatment centers, then it is going to fall on healthcare professionals to care for the sick without necessary precautions.

The more elderly who get sick and need respirators, the more physicians will have to decide who gets one.

Leaders have a direct responsibility to help combat this by discouraging negative behaviors, limiting unnecessary gatherings, and taking this pandemic seriously.

The Medical Response

It is clear now that the response in Canada and the U.S. has not been fast enough. No matter what politicians say, mistakes were made. While we are stepping it up now, this still isn’t fast enough.

Even today, every event and big gathering we continue to hold represents a failure. I understand the impulse: each leader wants to just get through this next night and then decide about future changes. Again, this is a mistake and profoundly unloving. Make the decision now. Your event is not more important than others.

On the ground in hospitals and care centers, we need to understand that the burden of response in an epidemic like this falls on health care workers. In this calm before the storm we are working to be prepared. We’ve stockpiled what we can in PPE (personal protective equipment) and are running simulations throughout our departments on how to deal with cases.

We are likely going to become short staffed and under resourced in the coming weeks, particularly as events close and workers need to stay home with children.

I'm not overly fearful of getting sick and neither are most of my colleagues; we work in this environment every day and know we can be exposed to potentially dangerous pathogens on a daily basis. Like firefighters running into a burning building or police running towards gunshots, doctors and nurses will be entering hospitals across the world knowing that this choice might mean their lives. We need your prayers and support.

What we are concerned for is for those populations we serve and, in particular, the vulnerable among them. We are concerned for the elderly and immunocompromised who can't fight this. We’re scared of having to make the decisions they’re making in Italy—deciding who lives or dies.

Tomorrow I'm still going to work. Doctors, nurses, and other health care providers are still going to work Again, we need your prayer and support.

Our Christian Witness

Being a Christian working in the emergency room has given me many opportunities to share the gospel with my co-workers and patients. The urgency and severity of our work means people are often open to talking about deeply personal issues and hearing about God’s love for them.

Yet this is a rare situation where as a doctor I believe I have something to say to the church.

First, please stop holding services.

We are more than capable of watching services at home, reading our Bibles, and getting on our knees. While this is not ideal and pastors need to think through how to help those who might not have internet access, this is a minor and temporary measure we can take to lead the way on this issue.

The gospel does not depend on your service being held. Instead, your people are looking to you about whether to take this seriously. Instead of holding a service, spend your time strategizing about who needs help in your community and developing a plan to get it to them. Reorient your budgets for bearing the burdens of your people rather than pressing forward with services.

Second, be careful in ascribing to God specific motivations.

It is impossible to know God’s will in the midst of this epidemic and pastors should be extremely cautious in making providential claims. In my experience treating all manners of illness and injury, these claims often come from positions of privilege rather than in the midst of suffering.

Third, think creatively about how to love your neighbor.

Think through how much of that stockpile you amassed in the last week that you can give to your church so they can hand items out to those in need. Ask local organizations how you could volunteer or what they might need that you have just lying around. Isolating yourself and claiming God is in control is not helpful and, more importantly, not honoring to God. This is an opportunity to show others how we as the church love—sacrificially, indiscriminately, and enduringly.

I can’t say what the future holds. I know the church will continue to endure, that the gospel will continue to go out, and that Christ will continue to reign.

My hope at the end of all this is that people said we overreacted. Because overreaction means we won and that we did our part to help save lives.

Dr. Spencer MacDonald is an emergency room physician at Hamilton General Hospital in Hamilton, Ontario.

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Confronting the COVID-19 Virus: An ER Doctor’s Thoughts