USA TODAY International Edition

Don’t give in to COVID fatigue

ICUs are still full, and patients are struggling

- Dr. Thomas K. Lew Dr. Thomas K. Lew is an assistant clinical professor of medicine at the Stanford University School of Medicine and an attending physician of Hospital Medicine at Stanford Health Care – ValleyCare. All opinions are his own.

After nearly a year of treating very ill, hospitaliz­ed patients with COVID- 19, I received a letter from a patient I had cared for in March.

The previously healthy 35- year- old profession­al had spent a month on the ventilator, and his muscles had atrophied so much that he had lost the ability to walk. Ten months later, he wrote to say he has finally fully recovered and can run miles. I was heartened to hear how far he had come.

Unlike my patient though, as a nation we are still finding our footing with this pandemic. We have made a great deal of progress in understand­ing the virus and are now armed with proven therapeuti­cs and vaccines.

In many ways, however, the worst aspects of the pandemic have not changed: My hospital wards are still filled with patients struggling to breathe, intensive care units are full, and after more than 424,000 deaths, we are still fighting the perception that this virus is not lethal.

The death toll is on track to pass a half million in February, which is impossible to fathom. At nearly 4,000 deaths per day, that’s the magnitude of a Sep. 11 attack spread across the nation. Per day.

Spend an afternoon in the hospital, and the numbers start to become entirely believable. Hospitals across the nation have dedicated COVID- 19 units, and even then, more space is needed.

Every day I go to work, I have a growing census of patients, young and old, who are struggling to breathe even on incredible amounts of oxygen. Some recover, some are destined for weeks on the ventilator, and some die. Even those who recover are left worse for the wear with persistent fatigue, posttrauma­tic stress disorder and asthmalike conditions.

Dwindling ICU beds

Rather than ramp down with the end of 2020, cases and deaths from COVID- 19 reached all- time highs. We have easily surpassed the 25 million mark for infected persons. More troubling, we are again entering a phase of dwindling ICU beds, staffing and resources.

Many areas, including large cities like Los Angeles, are in a state of emergency where oxygen has become a precious resource and is rationed only to those with the best chances of survival.

Not only is this dangerous to those infected with the coronaviru­s, but it is also life threatenin­g to anyone else who becomes sick or injured.

Suffering a heart attack or even getting into a car accident becomes that much more hazardous when the health care system is strained.

Even doctors and nurses are becoming in short supply. After nearly a year of this, health care workers are getting tired. Burnout rates are high, with some states unable to find enough nurses.

With all the hard work being done, it is incredibly discouragi­ng to see our fellow citizens ignoring our recommenda­tions and realities. More than 8 million people traveled by air in the United States in the last week of 2020, which increased transmissi­on of the coronaviru­s and led to the spikes of cases we are seeing.

This past week, I personally treated several patients who traveled for the holidays and have not been able to return as they and their families suffer from COVID- 19. And now California has lifted its curfew and stay- at- home orders, which will tempt many people to resume a more normal routine.

I get it. Just as health workers are tired, the public is also fatigued from relentless COVID precaution­s. But this is not the time to let up.

Vaccines are now a reality, and though the national rollout has been chaotic and confusing, the shot will eventually be available to you. When it is, please take it.

Precaution­s still necessary

The vaccines are safe and tested, and provide significant protection from the virus and its new variants. There are mild side effects of fatigue, body aches and fevers that many experience, especially with the second shot, but they’re nothing compared with the actual symptoms of COVID- 19.

In addition, you will protect the community by reducing your chances of needing hospitaliz­ation, which frees up medical resources. This is what will lead to a sustained # flattenedcur­ve.

Do not give in to COVID fatigue. Continue to wear masks and socially distance. Until most of us are vaccinated, the chances of viral transmissi­on, hospitaliz­ation and death remain high for everyone, not just the vulnerable. Because the vaccines are not 100% and take time to reach peak efficacy, these precaution­s will still be necessary.

The idea that you could go back to a normal life five minutes after getting vaccinated is unrealisti­c and dangerous. More likely, we will see some return to normalcy in the second half of the year.

It has been a long road, and will continue to be difficult for the time being. But like my patient who learned to walk again, we will recover. We just need to resist COVID fatigue, stay motivated, listen to public health experts and continue to move forward like my patient did — one step at a time.

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Dr. Thomas K. Lew

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