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The Second Wave

October 11, 2020
by Mark David Siegel

Hi everyone,

It looks like the long-expected second wave of coronavirus is here. Numbers are rising in the state and hospital. In recent days, several inpatients turned from negative to positive on repeat testing, so we need to stay vigilant.

Vaccines and game-changing treatments remain a distant hope, months away at best. While we don’t expect a repeat tsunami like the 450 inpatients we had last April, the COVID census will almost certainly rise as the weather cools, so let’s double down on the advice we give our patients and let’s practice what we preach.

Paradoxically, it’s easier to stay safe when the risk is high. I speak as a veteran of the COVID-ICU, where I spent several weeks last Spring. In the COVID-ICU, we had no judgment calls to make. We wore PPE for every patient. In the hallways and workrooms, we wore masks without fail, except for the few seconds we took to sip coffee or bite into pizza. I felt much safer in the COVID-ICU than at Stop & Shop; the COVID-ICU was a safe zone, and to my knowledge, no one got infected there.

The risk rises when we try to judge who’s infected and who’s not, even more so when we grow complacent, like when we forgo PPE during emergencies, when we pull our masks down for long periods, and when we forget the limits of testing. But as a community, we can push back against the wave, so please consider this:

  1. It starts with a trickle: The number of cases rises slowly at first, before taking off. Though the numbers remain low in Connecticut, any case can spawn a superspreading event. Keep your eyes on the published dashboards, for example from the CDC, the COVID Tracking Project, Johns Hopkins, the Worldometer, the New York Times, and the State of Connecticut.
  2. Be Bayesian: Don’t assume a negative test rules out COVID. Even highly accurate tests, like our PCR assays, can miss cases if the viral load is low or the specimen is collected incorrectly. Patients exposed just before admission can turn positive afterwards. If you suspect COVID, don’t let a negative test dissuade you.
  3. When in doubt, assume the worst: This is the intensivist in me talking. If you think a patient may have COVID, assume they do until proven otherwise. When in doubt, wear PPE. It’s better to be too cautious than not cautious enough.
  4. Prepare for the long haul: The pandemic isn’t going away soon, so don’t set yourself up for disappointment. Let’s embrace the new creativity, like combined conferences across campuses, outdoor hikes and meals, and pandemic music videos.
  5. Take control: Though there are no guarantees, it’s in our power to stay safe, especially if we wear masks, follow PPE guidelines, and keep our distance. As we were told at last week’s Town Hall, few if any YNHH employees have gotten infected at work. Let’s keep it that way.
  6. Hold each other accountable: If a co-resident’s mask is down, ask them to pull it up. If a patient’s mask is off, remind them to put it on. If I forget to wear my face shield, tell me. Let’s be role models for each other.
  7. Speak up: We’re not a perfect community, but that’s our goal. We did well during the first wave in large part because residents spoke up, telling us where PPE was running short, seeking clarity in hospital policies, and sharing the challenges they faced on the floors. If you have something to say, speak up.
  8. Support science and public health: A toxic dump of misinformation is spreading on social media, like rumors about the ineffectiveness of masks. It’s our job to spread the truth. Let’s harness the power of our voices. Listen politely to what people tell you and respond just as politely with the facts.
  9. Vote: To defeat the pandemic we need leaders who respect science and empower public health officials to do their jobs. Please do your part and vote on November 3.
  10. Take care of yourselves: Now more than ever, we need to exercise, eat, and sleep. Be kind to others and stay in touch with friends and family. Be gentle with yourself. This is hard, but I know we’ll make it through the pandemic if we take care of ourselves.

Our community is blessed with unlimited talent, strength, and resources. I know we can withstand anything COVID brings our way, so let’s join hands and face the second wave together.

Have a good Sunday, everyone, and take care, Mark

PS For further reading:


PPS Scenes from yesterday’s Program Director’s Hike (thanks to Camilla Powierza)!

Submitted by Mark David Siegel on October 11, 2020