COVID Fatigue

Are you as tired of this pandemic as I am? The mask wearing, all day long; dressing in scrubs every morning; doing my temperature check and symptom screen; sanitizing my hands over and over and over again till my skin is dry, rough and raw-I am getting tired of all these things.  I am tired of looking at other countries who have a unified, cohesive approach and are doing so much better than we are.  For goodness sakes there are more cases of COVID-19 in the White House than in the WHOLE country of Taiwan!  I am tired of disinformation, of conspiracy theories and the constant barrage of bickering.  Lately, I am getting tired of seeing 4-5 new patients a day come down with the disease, almost all of which are over 70 years old.  

These are the patients that I worry about the most.  Almost all of them have gotten the disease from family members.  As families have tired of the precautions, the kids and young adults have expanded their circles which fueled the case numbers through late summer and early fall.  Very few of them have gotten critically ill but here is the catch-they all have grandparents.  What we are seeing now is the maturation of this whole process.  Through most of the pandemic, I would only see a few patients in the respiratory clinic who had COVID and were ill. Most, though, were well but needed to be reassured.  The last two weeks has been decidedly different.  Three to four of the patients would already be diagnosed with COVID but were getting worse and needed further evaluation.  Of the remaining, most would have been exposed to someone with a known case of the disease.  Last week, for the first time, I sent a patient to the Emergency Room with shortness of breath, horrible sounding lungs and an oxygen saturation in the low 70's (normal above 90%). 

That night I experienced another form of COVID-19 fatigue-I was simply exhausted.  Caring for such patients takes an emotional toll.  I had a bit of a headache and was feeling a bit achey when I went to bed.  As I slept, I dreamt of being exposed to White House Staffers. They were literally chasing me!  I woke at 1:00 AM convinced that I had come down with the disease. Panicking, I slipped out of bed and went to the other room to be away from my wife.  I was able to calm down and get back to sleep (after terrifying my poor wife) and in the morning, instead of calling my partners to have them cover for me and go in and get tested, I realized that I was fine. I had no fever, no headache.  There was no cough, loss of taste/smell. I just needed some rest.  Certainly, I must be stressing out about this in my subconscious more than I realize when fully awake.  

St. Louis Area Hospitalizations

I understand that the vast majority of people who contract the virus have mild disease and do just fine.  I have literally ridden the tires off of my bike this summer and am in as a good of shape as I have ever been. My chance of severe disease is quite low.  That said, I am not willing to voluntarily take that chance. Hospitalizations in our area, which have been stagnant for many months are on the rise again. Deaths will surely follow.  A man in Nevada who had the virus in April was infected four months later. Analysis showed that the genetic composition of the earlier virus was distinct from the latter.  SARS CoV2 has already started to mutate.  This does not bode well for a successful vaccine. That said, there is a tremendous amount of research being done on this virus by very smart people.  Lessons learned now will not only be of use against COVID, but will transform our ability to fight other diseases as well. This pandemic will pass but it will take some time. 

Now is not the time to let COVID fatigue lower our defenses.  We must stay vigilant and do the simple things that will keep transmission down.  Masks are effective. Social distancing works.  Avoiding enclosed spaces with lots of other people is crucial. We must take the most care around those at higher risk.  They are not an "acceptable casualty" in this war on health.  You and I must keep forging ahead, fatigued or not.