July 9, 2020

symptoms and exposure

In early March, I was convinced that the Seattle area was about to explode with infections. I was not the only one who thought that: most medical organizations here thought so too. Detailed plans and contingencies were arranged. The city went into lockdown mode. And I started worrying about having symptoms. Since COVID-19 often starts off silently, we worried that exposures had already happened.

In one of my early posts, March 13, 2020, I wrote about “Second Year Medical Student Disease”. After the first year of med school when we learn how the body works, the second year is spent learning how it falls apart. In that year, our active minds diagnosed multiple diseases in ourselves, based on transitory symptoms. In the early part of March, I was in the throes of Second Year Medical Student Disease: COVID-19 version; imagining every sneeze, clearing of the throat, headache, or cough as an early sign of COVID-19. Eventually, I calmed down and all of my anxiety about my symptoms resolved.

I have been in a relatively calm place since, feeling pretty sheltered and safe. This week felt different. Maybe because I am seeing a full schedule of patients again, maybe because infections are rising, maybe the patients wearing valved masks have left me feeling exposed, or maybe because my regular grounding medical assistant has been out this week. I am not sure, but I have started noticing that I worry more about each little throat tickle, sneeze, or nose sniffle.

I am not really thinking I have been exposed. I am very careful, but I am reminded of the anxiety this unknowing can bring. Probably many of us feel it daily, especially as we see the cases rising in states that are re-opening, shown in this interactive New York Times article about different states. Everyone of us has weird, unexplained feelings in our body that come and go, but it doesn’t mean we have an illness associated with those minor, changing body sensations. But oh, do we worry about those sensations!

This Atlantic article about the confused messages sent by our local and federal governments rings true to me. Humans are actually not very good at risk calculation when things are not clear, and we can get so caught up in moral reasoning and judgement that we lose our empathy. Reading the article helps me see why we are in the confused muddle we are. We cannot blame it solely on polarization, it seems to be part of our human makeup. We did fantastic when the goal was to stay home early in the epidemic. It was simple and we followed the guidelines. It worked beautifully. Now the message is muddled as we are re-opening, so people get mixed messages about what the risks really are. We often tend to underestimate. We also get lost in moral reasoning about acceptable or unacceptable behavior or outcomes, such as deaths. It helps me realize shaming people for their behavior is not particularly helpful. I am hoping that we can get clearer guidance and examples from our leaders to move us beyond. We need to move back into empathy and compassion and away from frustration and judgement.

My last tidbits for the day are links to more information about mask material , how to wear them (so important and often not understood), and Mayo Clinic answers to false claims about COVID-19, such as the rumor that eating garlic will protect you.

Wash your hands cover your nose, and keep safe six.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.theatlantic.com/ideas/archive/2020/07/reopening-psychological-morass/613858/

https://betsybrownmd.substack.com/p/march-13-2020

https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html

https://www.sciencedaily.com/releases/2020/07/200708125350.htm

https://www.kingcounty.gov/depts/health/covid-19/~/media/depts/health/communicable-diseases/documents/c19/face-coverings-dos-and-donts.ashx

https://www.seattletimes.com/life/no-garlic-cant-protect-you-from-covid-19-amid-false-claims-heres-what-the-science-says/