March 26, 2020 / BY JAMIE DUCHARME
When Dr. Mark Lewis has to tell a cancer patient they’re dying, he tries to do so as compassionately as possible, usually offering a hug or a hand to hold. The thought of doing so by phone, he says, once felt heartbreakingly impersonal. But in the face of the current COVID-19 pandemic, the Salt Lake City-based gastrointestinal oncologist has had to do many things that make his “conscience weigh heavy.” He’s delivered bad news virtually, to limit the possibility of spreading the virus. He’s delayed chemotherapy for patients who—he hopes—can wait, knowing the treatment would wipe out their immune systems at a high-risk time. He’s made the opposite choice for patients with cancer spreading faster than coronavirus. Each time, all he can do is hope he’s gambled well. Welcome to medicine in the age of COVID-19.
The worsening coronavirus epidemic in the U.S. has upended the country’s medical system. It has led to system-wide disruptions that physicians say are necessary for combating the immediate, un-ignorable threat of COVID-19—but that may, by default, force patients who do not have coronavirus to shoulder a heavy burden. Those with chronic conditions will have to fight harder to get the care they need, not only now but also after the outbreak ends, when hospitals are left to deal with backlogs from appointments canceled en masse. Anyone with the misfortune to get into a car accident or have a heart attack during the outbreak will be at the mercy of a strained system. And in this environment, the gulf between people who can and cannot afford to spend the time and money to seek out good care will become ever-more apparent.
As of publication, U.S. hospitals are still operating smoothly for the most part, but obstacles are mounting. Protective gear and supplies are running short. In a health care system in which routine supply and demand leaves only about a third of hospital beds available on a normal day, medical centers are creeping dangerously close to capacity, particularly in hard-hit areas like New York City and King County, Washington. As fears mount and supplies dwindle, “morale is low,” says Dr. Chethan Sathya, an assistant professor of surgery and pediatrics at New York’s Cohen Children’s Hospital. Each day in the hospital, Sathya says, raises the chances of doctors getting sick, and passing the virus on to their families. Ready though they are to serve, that thought is never far from their minds.