Last night I took a call from a wife of a patient in his 70’s, who had not left his house for weeks, who only visited with his son through his front window, and whose memory had deteriorated seemingly overnight. At 6 PM he did not remember a family FaceTime call he had at 5:30. I sent him to the ER, where he was diagnosed with COVID.
Another careful patient in his 60’s emailed me today saying he had been diagnosed with COVID last week. His symptoms were mild thus far, but he was not yet out of the woods. Another healthy and active senior patient was in the ER on Thursday, 9 days into his illness. We had talked just two days earlier, and we both thought he was on the road to recovery. He wasn’t, as within 48 hours he was short of breath and in decline.
Another patient came in to see my PA four days ago for a routine visit. He had no known exposure and had no symptoms, but he did 24 hours later. My PA, who just recently completed over a year’s worth of breast cancer treatment, was left counting the minutes she was in his presence trying to determine her exposure risk.
On Friday I had a brief interaction with a patient who gave me a Christmas gift. Her son came down with COVID on Saturday, and sure enough, she started having symptoms today. I found myself hoping she had not unwittingly also given me an unwanted present.
These were some of the careful ones. Two weeks ago I met with the director of my grandmother’s assisted living facility to discuss her care. We were masked and about 8 feet apart for the brief meeting, a meeting I would not have had if the director had told me that she had a sick daughter at home. The director was sick the next day and tested positive the day after, forcing me to stay out of the office for a few days, and starting an outbreak in the facility that impacted several residents.
Another patient, who had sick family members at home, nevertheless decided to go and see his eye doctor. For some unexplainable reason he did not see that he was putting doctors and their staff at risk for infection, something that is hard for me to fathom.
In response to the recent explosion, and since as health care workers we are probably just weeks away from being vaccinated against the virus, my PA, office manager and I made the decision today to limit face to face visits to only those urgent visits and essential encounters that have to be done in person. We do not want to infect our families over the holidays and see no reason to needlessly put ourselves at risk when lasting protection is just around the corner.
Not all patients have responded positively to our decision. Some have even expressed anger, accusing us of being selfish. I do not know how selfish we are being, but I do know that we cannot trust that all of our patients will take appropriate precautions or will tell us of possible exposures. Given the overwhelming surge in cases (a dramatic increase relative to the summer peak), we feel the difficult decision has to be made.
But, being the health professionals we are, in addition to full telemedicine schedules one of us is going to be in the office every day. When people truly need us, we will be there for them. We each took an oath, and we both take it seriously. Some risks have to be taken.
Dr. Barrett
PS: Be smart, and be safe. While the case fatality rate is not as high as once feared, this not a harmless disease. The vaccine is here, and all who want it should have access to it by summer. Now is not the time to lose vigilance.
PPS: This is a personal post, not a political one. I am not writing for or against lockdowns, I just want people to be careful. I know many people have no choice but to work (my daughter is a hairstylist and things are very hard for people in her profession) and I am deeply concerned about the tragic emotional and economic consequences suffered by so many.
