Andreas Laupacis is Editor in Chief of CMAJ.
Today my morning scan of regular websites yielded one encouraging piece of information. No new cases of coronavirus in Wuhan. (The city was quarantined on January 23.) There will be light at the end of the tunnel, but the tunnel is long.
President Trump says that hydroxychloroquine-azithromycin should be used in patients with COVID, that these drugs will be “game changers”. Great! Just when we desperately need people to enroll in randomized trials so we rapidly learn what works and what doesn’t, 30% of Americans are going to refuse.
On the other side of the spectrum is the unsubstantiated fear about ibuprofen (Advil), which started after a tweet from the French Minister of Health suggested that ibuprofen use made COVID-19 worse. I am on the email list of the senior citizens’ condo my mom used to live in, and one of the well-meaning residents sent an alarmist email to everyone warning about the dangers of Advil. So, now we have old folks whose various pains have been well controlled on Advil worried that they are at greater risk of dying from COVID! The lesson? Politicians should not tweet unsubstantiated medical information.
Ode to Billy Joe came on my iTunes playlist. I love that song. However, two lines resonated differently today:
There was a virus going ’round; papa caught it, and he died last spring
And now mama doesn’t seem to want to do much of anything
I have become obsessed with the length of my hair. I am may be doing virtual palliative care consults by Zoom. What if we are socially distancing for months? How long will my hair be by then? No way I am letting Karen cut it. I will scare the hell out of a poor patient who was expecting to be talking to a serious doctor and instead finds some old hippie on her computer screen. Maybe I will need to start each consult by apologizing for my hair.
The reality of social distancing is gradually dawning on us. We know that we are exceptionally lucky because we are well-off and Karen and I get along reasonably well. But it is starting to feel daunting. We worry about our extended family, several of whom are nurses, nurse practitioners or doctors. CMAJ is busier than usual, which is a distraction for me. However, Karen’s work as a trainer of standardized patients is shut down. For the last few days she has been amusing herself by doing our taxes, but that’s now done. Neither of us plays an instrument, paints or has a handicraft-type hobby, although Karen is going to start knitting again. The news is now basically only about COVID-19, which is depressing and repetitive. We might have to discipline ourselves to look at news websites or Twitter only twice a day. More than that is a non-informative downer.
At CMAJ we have been receiving many proposals for articles about COVID-19. Our capacity to review and publish is relatively limited, so we are doing our own version of triage, rapidly making decisions about what we encourage and what we don’t. We are doing our best, but will, I am sure, sometimes make the wrong call. We are trying to review, edit and publish the submissions we encourage as quickly as possible. The number of non-COVID-related submissions appears to have remained the same, which, I guess isn’t surprising. Researchers have access to their data as they work at home, and those who are not clinicians may at last have time to finish manuscripts that they previously couldn’t get to.