March 18, 2020

Going Viral

Before I started medical school in 1986, I worked for a while as a waitress in Austin, Texas. That was back in Austin’s glory days. My fellow wait units, as we called each other, bonded over many things, becoming friends. We camped and hiked, and talked and shared books and stories. As I was leaving Austin to start school, David said “You are leaving to become more important and do great things, you will forget me after you leave, because I am nothing”, heartbreaking to hear. By the time I returned to visit a year later, he was dying of AIDS. The restaurant and his friends had an around the clock schedule to care for him. I reminded him of what he had said a year before. His response was “I learned that I do matter and my friends love me, I would not say that any more, one blessing of this awful thing”. I never forgot him. And that was my first journey into the world of viruses.

After I returned from working for the Indian Health Service in Arizona on the Hopi and Navajo reservations, I took a job at a community clinic in 1996, specifically to help with AIDS patients. Working during that time was heartbreaking, but also exhilarating. The breakthroughs that were happening in knowledge and treatment literally brought people back from the edge. In the beginning the treatments were brutal with multiple pills and dosing times daily and massive side effects, but people were living and no longer dying. Ten years later, a combination pill was approved that was one pill once a day. That was massive progress at the time. That scientific effort made a difference. Recent data is showing that people with HIV have a life expectancy the same as non infected people, if they are on medication.

And now the Coronavirus is here and we have jumped to Warp Speed. The virus is suspected to have its first infection in November of 2019, and now here we are at more than 219,000 world cases today, March 18, 2020. The virus itself is viral, spreading in exponential ways across the world. Lives are at stake, and people want to help.

But along with the warp speed of the spread of coronavirus, the warp speed of science increased to gain understanding of the virus, identify it, find its genome, design possible vaccines, try treatments, try to understand why some people get sicker than others. Everyday there is new data, and at the same time, new theories. Four months is warp speed, compared to the HIV research that took years. Everyone feels the pressure. The virus itself is viral, spreading in exponential ways across the world. Lives are at stake, and, the good news is people want to help.

These hypotheses, as well as rumors and false reports, can go viral too. Sometimes the reporting is ahead of the data which goes viral before it is ready. Sometimes helpful, but often dangerous. As I felt during my time as the On Call COVID expert today, we all need to slow down a bit and check our sources. Doctors, nurses, patients, family members. Lives depend on it.

More tomorrow. Goodnight. My brain is a bit fried.

Wash your hands.

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.