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Sunday Rounds again. No Rest for the Weary.

Sunday rounds again. No rest for the weary. ER is full and people are lined up with positive tests. On the more optimistic side, this isn’t exactly like last year when we were running scared, we were running out of PPE, and people were dying left and right. 1. We know how to take care of COVID-19 patients much better now. We have dexamethasone, remdesivir, and tocilizumab. We know how to use high flow nasal oxygen to keep people off the ventilators. I haven’t had a single COVID-19 death since January, and I’ve had some really sick patients including doctors who were in the ICU. I’d rather not have so many though and so prevention is still the best for everyone.
2. We are able to detect variants and keep track of them. The surge last July was supercharged by the D614G mutation and it was months before we confirmed this. Now we can track all the variants and do enhanced contact tracing. If we keep the proportion of variants low, we can keep this under control.
3. We know what works – faceshield and mask combination is more than 90% effective IF used properly. We also know eating together if you aren’t from the same household is a MAJOR source of spread. The recent PGH outbreak was partially from this, and I’ve had two outbreaks in my lab before even after I had banned eating together. Almost every single outbreak can be traced to lax adherence or to someone who already had symptoms and decided not to isolate. I hope this time we follow meticulously our health protocols or this is never going to end.
I’m vaccinated but its just the first dose and its been only two weeks. There may already be some partial protection but I’m still gearing up same as before I was vaccinated. I’m a bit less scared for myself since I am less likely to get severe disease, but I am still scared for ALL my patients.
I know its been a long year, but this is far from over. Please continue to use your armor – mask, face shield and physical distance. There is hope and we do know that all pandemics end. We just have to hold on for a bit longer. Thank you and stay safe.

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