COMMENTARY

Reflections From the Bench During the COVID-19 Crisis

Monisha Arya, MD, MPH

Disclosures

April 16, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

I am an academic infectious diseases physician, currently working from home. I will be called for my assigned clinical duty on the ID service at our publicly funded county hospital at the end of April. Until then, I sit on the bench on the sidelines.

I check Twitter regularly to read what my colleagues in healthcare are posting. I am grateful for the insightful and clinically useful knowledge about COVID-19 that is rapidly being shared by our colleagues on the frontlines. Soon I become emotionally overwhelmed by the harrowing tweets and images showing healthcare professionals without adequate personal protective equipment and the increasing updates of them dying on the frontlines. I become gripped with anxiety...and fear. I tell myself to channel my worry and energy in other ways, away from Twitter.

I read the daily reports from our county public health department and learn that we have only a smattering of cases locally; I suspect that this may be due to a shortage of SARS-CoV-2 test kits. I read manuscripts about COVID-19 being released daily in our academic medical journals. Although fever and cough are being publicized on the 24-hour news cycle, I learn from the published Chinese experience that fever is not a universal symptom and that diarrhea is reported by some patients. I attend near-daily COVID-19 Zoom meetings led by healthcare leaders in my institutions and am thankful for their leadership in making very tough decisions for COVID-19 protocols in the context of limited data and finite resources.

Sometimes I am taking notes, sometimes I am wiping away tears. Through all of this, I anxiously sit—or pace in my apartment—and wonder how I can help my brave and selfless colleagues who are on the frontlines today.

I remember that my ID colleague is scheduled for her clinical duty in early April and that her husband has leukemia. I know she should not be caring for patients with the highly infectious COVID-19 lest she get infected and bring that risk to her husband. I contact my boss with my concern and I volunteer to take her place on the ID service at our county hospital. A new schedule arrives soon after, and though I see that I am not taking her place, her name is no longer on the clinical schedule—and I am at peace for her and her family.

I send a text message to my colleague in pulmonary medicine who is currently rounding on critically ill patients in the intensive care unit. I tell her that my prayers are with her and the whole team, and I thank them all for putting their own lives on the line to dutifully and compassionately care for our sickest patients with COVID-19.

I remember that my internal medicine colleague received chemotherapy for cancer 2 years ago. I wonder, With the limited data we have, should she not be on the frontlines caring for patients with a highly infectious disease? There are no national or local guidelines addressing past cancer history as a definitive risk factor for contracting COVID-19 in high-exposure settings. I call her on a Saturday afternoon to discuss my concern; 3 days later, she tells me that she has filed for a medical exemption and thanks me for reaching out to her.

I "break into" (okay, I have the spare key) the house of my closest friend and ID colleague while she is at the hospital, and I sneakily fill her refrigerator with fresh groceries and set a dining table with fresh flowers. She is working 16-hour days serving patients at the bedside, attending daily meetings in her role on our institution's COVID-19 incident command center, and leading COVID-19 webinars for her colleagues in Latin America. With her long workdays at the hospital and our county's stay-at-home orders, when will she have time—or the energy—to go to an open grocery store or be available for a home delivery? I leave her a card to thank her for being my #IDHero and to express my prayers for her ongoing health and strength (and some sleep).

Because of my other professional role as a medical writer, I spend my days and late nights frenetically writing COVID-19–related content to help my clients, colleagues, and health department communicate meaningful, clear, and actionable messages during this pandemic.

Finally, I send my family my wishes for my own healthcare:

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As an avid college basketball fan, I was saddened when the annual NCAA March Madness basketball tournament was (appropriately) canceled. I soon recognized that we are all in a new version of "March madness." I am an anxious person. But on April 27, when I am called from the bench to serve my profession and my patients, I will proudly join my teammates to help them win this game for our community. We are all in this together.

Monisha Arya, MD, MPH, is an infectious disease physician in the Harris Health System in Houston, Texas. She has published extensively in both academic journals and popular press, including Health Promotion Practice, JAIDS, and American Journal of Public Health. Her medical writing for general audiences has been featured on Medscape, Houston Chronicle, Boston Baystate Banner, Star Local Media, and other media outlets.

Follow Monisha Arya on Twitter: @AryaCampaigns

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