I started taking care of COVID-19 patients in late March. Before the pandemic, I rounded on my hospitalized patients with my entire mega-team of fellows, residents, medical students, and advanced practice providers. We would troop in and out of each patient’s room so that I could guide the clinical care for the day. Now, we have changed how we round to reduce the number of people in patients’ rooms. We have changed, just like everything else has changed, because of the coronavirus pandemic.
On my first day rounding on COVID-19 patients, a patient of mine was admitted with end-stage heart failure and a mechanical heart pump that was keeping her alive. She came in short of breath, so she had been tested for COVID-19 and was found to be negative. So, in I went, without a mask and all the fancy accoutrement we have come to label as “personal protective equipment.” After all, her test was negative. Thankfully, I remembered our new rules on rounding and had most of my team wait outside. I leaned over her to listen to her heart and lungs, and she coughed while my face was inches from hers. Two days later, she had worsening shortness of breath and required a breathing tube and a ventilator to stay alive. This time, her COVID-19 test was positive.
That same day, I saw another patient with a transplanted organ who had also been “ruled out for COVID” as we say, meaning that she had had a negative COVID-19 test. This time, I was wearing a simple face mask, as had become the latest recommended policy for any of us working in the hospital. Shortly after I saw her, she too had trouble breathing and ended up on a ventilator. Learning from our earlier experience, we tested her again for COVID-19, and this time it was positive.
Two exposures later, I had a little bit of anxiety (would I too now contract COVID-19 and end up on a ventilator like my patients?) and a lot more perspective on the insecurity of this moment. We are learning something new every hour, every day about how the virus spreads, about how reliable the tests are, about the treatments we can use. The bottom line, of course, is that everyone, everywhere can get exposed to the novel coronavirus (SARS-CoV-2) in big ways and small, either by standing inches away from a COVID-19 patient or by the accidental close contact sneeze in the grocery store. Hence, social distancing.
Over a week after my first exposure, I started coughing and had a sore throat. As a recent arrival to Atlanta, I wondered, could this just be pollen allergies? Because of my exposures and since I care for some of the sicker immunosuppressed patients in the hospital, I could not take that chance. I went to get tested for COVID-19.
When shelter in place first began, I heard the residents of Midtown Atlanta, my neighborhood, come out on their balconies every night at 8 p.m. to cheer, sing, and bang pots and pans in support of front line workers. I smiled from my own balcony window every evening when I heard the noise. At first, I did not make much more of it.
Following my exposures, I had an outpouring of support from my colleagues, friends, and family. In a now-virtual community, everyone came together to make sure I was okay both physically and emotionally. Gratitude only begins to describe the emotion I felt with every text, call, video chat, balcony cheer, and donation made to local hospitals.
If there is anything I have learned from being on the frontlines, it is that we as Americans can come together as we never have before in most of our lifetimes. We can be there for each other and zoom with one another and holler from one balcony to the next. In this moment of free-fall, perhaps that is the most important lesson that endures. Every socially distanced cheer and virtual hug aggregates to real social cohesion. Supporting one another is always our strongest asset.
By the way, my test was negative.
Lakshmi Sridharan, M.D., is an advanced heart failure and transplant cardiologist and an assistant professor of medicine at Emory University. She shares experiences like this one on her podcast, This COVID Life. The views expressed here are solely her own.
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