But this wave feels different, Daxon said. One difference: Physicians know more. In March, clinicians focused on finding a “silver bullet” to fight the relentless disease. Now they know some best practices: Administer steroids, if appropriate. Don’t rush to put patients on ventilators. Be judicious with fluids. Put patients in a prone position to take pressure off their lungs. In short, stick with what Daxon called the “bread and butter” of critical care rather than spinning wheels to identify that elusive treatment that may offer a knockout punch.
Unlike in March, doctors have had time to prepare mentally, and the medical community is guarding against the tendency for physician burnout. Daxon said he and his colleagues feel they’re in it together, helping each other more readily with unforeseen schedule changes. And the growing familiarity with the virus comforts him: “Just do the fundamentals [of critical care], do them well, and you’ll do right by the majority of your patients.”
Daxon and a colleague are former military doctors and talked recently about some parallels between their mental state in the service and in confronting COVID-19: “The worst part of the deployment in the military is the week before, where you’re just getting ready and there are all these thoughts about how bad it could be. But once you get into the deployment, you wind up being better than you normally think you are.”
Meanwhile, U.S. health officials remain upbeat about the progress of vaccine research and development. FDA approval for a vaccine could come as early as the end of November. But doses will be limited and distribution strategic. Front-line workers would likely get the first doses, with other critical groups following. Plus, health officials face a staggering task coordinating the logistics surrounding vaccine distribution.
Daxon hesitates to call himself pessimistic about the duration of the pandemic, instead noting the importance of being “realistic.” He thinks we should expect “several months, at best, of just terrible rampage from this virus.” He expects that after a difficult winter and spring, we may again see some relief in summer 2021. But he cautioned that it may be years before society returns to a sense of pre-pandemic normalcy.
He sympathizes with people’s frustrations over pandemic precautions. But, he cautioned, our weariness doesn’t change the virulence of the coronavirus.
“You have an obligation to love your neighbor and serve them, even if you think they’re irrational or overblowing it,” Daxon said. “The little things like wearing a mask don’t cost you much, if anything, but would mean a great deal to other people.”
As it stands, Daxon said, he’s steeling his nerves for a hectic season: “I’m starting a string of night shifts tonight, and I just assume it will be very busy.” Then he checked the hospital census and prepared to get to work.