Healthcare News first published this article, “Much Ado About Covid,” on August 4, 2020.
“I fear those big words which make us so unhappy.” — James Augustine Aloysius Joyce
The Age Of The Pandemic
Once upon a time severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the 2019 novel coronavirus, a pandemic commonly known as COVID-19 or simply COVID. Considered to be of zoonotic origin, COVID is closely related to bat coronaviruses, pangolin coronaviruses and SARS-CoV, although the full extent of the pandemic’s epidemiology may take years to unfold. Nearing the fifth-month since the World Health Organization declared COVID-19 a pandemic, the medical community, the media and the masses continue to debate the efficacy of social distancing, masks and the mortality rate while the general structure of modern civilization as it existed in late February 2020 continues to crumble.
Notwithstanding the dispute over the pandemic’s origin and the threat it may or may not cause to humans, the world has shown some resiliency during a global “shutdown” of unprecedented and epic proportion. While certain open issues remain to be decided and may only find resolution through the Supreme Court and/or civil unrest, this article focuses on the minutia of COVID, and specifically what to do when respiratory secretions collected using a nasopharyngeal swab combine with reverse transcription polymerase chain reaction testing and possibly even computed tomography imaging of the chest to conclude a patient is sick.
What To Do About COVID?
Treatment protocol for those who test positive for COVID-19 remains as transparent as the need for Carrousel in Logan’s Run, a problem exacerbated exponentially if hospitalization is required. Stripped of practically anything patient-friendly, clothing for those clinicians working within the hospital-institution post-COVID makes a fashion statement resembling the likes of biosafety level four. Gone are friends and family, all of whom must be relegated to remote locations, accessible only through technology.
Do not expect anything that may resemble special attention by the hospital staff, a necessary measure designed to minimize possible infection and protect first responders. Indeed, about the only thing certain when it comes to COVID-19 is that death in a hospital must be lonely and terrifying, the psychological effect from which could possibly pour over into the healthy and not-as-sick (undiagnosed and/or newly diagnosed). Should this unlikely event occur the impact on society would be profound and possibly even unconscious, manifesting itself in subtle ways that would not be noticeable at all, expect perhaps for that fifth dentist who does not recommend sugarless gum to patients who chew gum.
What If It Was Me?
The pandemic sheds paralytic fear, which in turn attacks the human spirit, hoping to send humanity into the depths of its own personal prison. For me, COVID-19 hit practically overnight, depriving me of any meaningful opportunity to prepare for its arrival. COVID was difficult to mistake. Like pornography, I just knew it when I saw it, presenting in the form of a cough, a fever, and an iPhone snooze button I never knew existed. Even with enough education to respect the virus, a lifetime of training still forced me to finish up a telephone conference before attending to my own personal pandemic. Flush with and from symptoms, I hardly noticed the discomfort caused by the nasopharyngeal specimen collector (according to the Centers for Disease Control and Prevention, the “[s]wab should reach depth equal to distance from nostrils to outer opening of the ear”).
I spent the hour between test and result contemplating the two children I may never see again, and at which hospital I would spend my final days. Upon confirming the diagnosis of COVID-19, however, I remembered that I still only had a fever, a cough and fatigue. Nevertheless, fever and fatigue ruled the day, and by late afternoon I was deep in the Netflix abyss, overwhelmed and amazed at the number of options from which I could choose. General pain from a persistent cough prevailed over the fever that slightly broke the next morning, but upon awakening Day Two my conviction was firm that my immediate future did not include a hospital bed. By Day Three, thanks in part to Gatorade and “Warrior Nun,” Season One, my physical symptoms began to subside almost as quickly as they first appeared. The end appeared to be near, at least when it came to COVID-19. Or so I thought.
Fear And Loathing In COVID
Modern medicine has learned much about the pandemic in just a few short months, including the ways in which COVID-19 may attack scores of organs in the human body and not just the network of organs and tissues which make up the respiratory system. Some recent studies focus on patients with neurological challenges, their associated health burden and the possible social and economic costs as a result. Distracted in part by society and the war it now wages against “the mask”, science is not yet ready to make any long-term conclusions about the pandemic. The tale of COVID-19 does not end with ventilator or vaccine, and the number of actual lives claimed by COVID-19 may be just a small part of the plot.
Somewhere in the wake of COVID-19’s body count is mental health, still just as hard to identify as it is to treat. COVID-19 survivors, as well as those who manage to avoid the pandemic altogether, may ultimately end up with Rorschach and Prozac just like the other 270-plus million individuals world-wide who suffer from depression. As little as society knows about COVID-19, there has yet to be a statement that the pandemic is fun. The general lethargy experienced from any novel, hostile virus, the quarantine/isolation due to COVID-19 and the varying degrees of cognitive impairment that linger long after contagion ends all exist within concentric circles. This is a gray zone for our gray matter, and inside the eye of the pandemic, separating out each part of this equation is challenging and frustrating. Most of the United States either had it, has it, or is concerned about getting it. One day medicine will identify exactly what “it” is.