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.
Hi Andreas, My solution to the hair thing is to do my consults and follow-ups by phone, With all my patients also social distancing at home , I suspect many are in their pajamas or other comfortable netflix binging out fits, its perhaps better and more comfortable to not see each other,
More seriously, I feel privileged to be allowed into their homes and their lives like never before even if just by phone..
Good comments and reflections, Andreas. We share many of your concerns. I agree about restricting our news consumption to help maintain sanity. In our age group and with my wife immunosuppressed, we’re at higher risk. Moving to a condo seemed like a wise move three years ago, but now it’s somewhat confining. We do get for a long walk each day and look for birds as they begin to migrate through our area. We’re made more use of IT connectivity with FaceTime bedtime stories for our grandkids in Toronto and a FaceTime virtual cocktail party with friends. It’s interesting how our kids are worrying about us. They call frequently, offer to get things for us and urge us to avoid going to grocery stores etc. It’s quite touching and reassuring but somewhat unsettling at the same time. Overall, we’ve coped pretty well and we see our neighbours taking it seriously too. But this is going to be a long haul and perseverance will be challenging. I’m now re-reading The Great Influenza, a good account of the 1918-9 epidemic. This is in some ways a rerun and our weapons are not a whole lot better. Take care.
Good comments that we need. Keep them coming Andreas.
Love your sense of humour in this blog which erin sent me. Hope I can read it daily as it is down to earth and written by a knowledgeable person.