30 Dec 2020
A colleague in trouble: healthcare professionals in the eye of the hurricane
Javier Escaned reflects on 2020 and the COVID-19 sanitary crisis
The COVID-19 crisis heralds a new set of rules; perhaps for the first time, we anticipate that the near future will be different than we can imagine. Like so many times in the past, healthcare professionals and scientists will continue being in the eye of the hurricane.
"All we know is still infinitely less than all that remains unknown"
~ William Harvey
A history of quarantine
I learned that an English physician was forced into quarantine while traveling in Italy.
This happened in Treviso, a city well known to him, only 50 km away from the university in which he had trained at as a fellow some 20 years before. Not being ill, and holding a health certificate that was issued for his travel, he considered that the fact that he was stopped and put into quarantine was “an unjust affront”, but his complains were ignored both by local officials and doctors, fitted with peculiar bird-like masks that were part of their personal protection equipment against the epidemic.
Apart from this small detail, the incident might well have happened yesterday but, as a matter of fact, it occurred in 1636. The name of the physician was William Harvey, today acknowledged as the person who discovered the circulation of blood; and the episode took place during the epidemic of bubonic plague afflicting Europe at that time.
Experiencing the outbreak of disease
Like Harvey, many doctors have experienced the outbreak of disease. In 1981, when I was a medical student, an unknown pneumonic syndrome with high mortality (later identified as having a toxic cause) spread without control over Spain, affecting 20,000 people. Eleven years later, when I was an interventional cardiology fellow in Rotterdam (The Netherlands), an outbreak of polio disease quickly became a nationwide medical emergency and generated major concern among all of us working at medical centers.
Of course, the two events mentioned above pale in comparison with the ongoing SARS-CoV-2 pandemic. This time it all happened too quickly. Our hospitals became overwhelmed to the point that scheduled diagnostic studies and interventions had to be postponed, any available room could be transformed into an improvised ICU, and the staff had to be redeployed to dedicated premises to treat COVID-19 patients. Suddenly, there was only one disease, and very soon we found ourselves in the previously unimaginable scenario of a social lockdown.
Acknowledging the social importance of healthcare workers
There was sudden acknowledgement of the social importance of carers. Solidarity bloomed, people spontaneously started to applause healthcare workers from their windows - a tribute first happening in Madrid before spreading to the rest of the world. We all have examples of how the current pandemic brought out the best of many people. Yet, on top of our clinical duties we had to face the social and personal consequences of the pandemic: loss of life, suffering; uncertainty, fear, conspiracy theories born of a shattered reality; misleading messages sent by political leaders; sense of dejection before failed promises of a new normal soon to come. In the quest for meaning, many thought of the COVID pandemic as a battle. Metaphors based on the military ramped up in the media while, in truth, there was no enemy but bare life.
Sound scientific principles needed more than ever
Amidst all this disorientation, a compass is needed. As many others, I feel that reason, science and humanism, three key pillars of the spirit of Enlightenment, are more needed than ever. And it is becoming clear now that, like Harvey, those who committed their lives to medical research, accepting in many occasions precarious working conditions and not worrying about the low social prestige attached to science, those who patiently learned the language of life, are the ones who are now leading mankind out of this nightmare: compassion can be written using the genetic code. We also learned that, in turbulent times, adhering to sound scientific principles, to proper reporting and peer reviewing of scientific results is needed more than ever to make solid progress and not to generate confusion.
The COVID-19 crisis heralds a new set of rules; perhaps for the first time, we anticipate that the near future will be different than we can imagine. Whatever comes, the troubles experienced by Harvey four centuries ago, and by all of us over the last months, serve as a reminder that our task as healthcare professionals and scientists, in situations like the ones described, will continue keeping us in the eye of the hurricane.
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