Respirator, face cover, gown, gloves, shoe covers. One would think I was preparing for surgery or a chemical weapon attack. But no, this is me in the clinic about to examine one of my patients. She looks at me suspiciously. “She” is Mrs. Cruz (name and details changed to protect her privacy), a 70-year-old lady whom I have taken care of for years. She has early stages of dementia, but she always has a big smile for me whenever she visits. Now she looks at me with increasing alarm. I belatedly realize the problem — she cannot see my face, and I am scaring her.
The art of medicine is almost as old as civilization itself. Advances in science have increased the reliability of treatments we use to help our patients feel better. The way we deliver care, however, has remained the same. A doctor still needs to examine a patient.
Hospitals are understandably cautious. The number of patients a doctor can see are limited, and all patients are screened for fever and other COVID-19 symptoms before being allowed to proceed to clinic. Doctors have acrylic windows on their desks, and gargantuan filters clean the air. Alcohol and bleach spray are readily on hand, and a stack of PPE gowns is folded neatly nearby in case the doctor needs to examine a patient.
Looking at the United States, where lockdowns were late and far too short, two million cases and over 100,000 deaths show the effect of not taking COVID-19 seriously enough. Places that acted early and comprehensively like Taiwan, Vietnam, and New Zealand, have done well but remain vulnerable. Universal masks, physical distancing, handwashing, and disinfection can substantially decrease the risk of COVID-19 transmission and should be meticulously implemented. The government needs to step up testing and aggressive contact tracing to isolate clusters. We need to keep numbers manageable until better treatment and a vaccine are developed.
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