I treated 20,000 COVID patients and 3 years after the lockdown, here’s how we can do better

Seems just like yesterday. Three years ago, March 2020, our nation was locked down for the first time in over a century.  
 
A horrific move that upended our nation, impacted the education of our youth, crushed our thriving economy and ignited the fire of a mental health crisis along with increased substance abuse, violence and drug overdoses. 

It didn’t work in 1918 to flatten the curve during the Spanish flu, so why was it fallaciously instituted again.  

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After testing, diagnosing and treating thousands of COVID-19 patients on the frontlines of what was once the COVID-19 epicenter of the world, I reflect: What have we done? What have we learned? What did we lose? What wounds have we inflicted upon ourselves and what lessons are worth remembering? 

 
Most importantly, are we prepared for the future? How can the answer be, yes, if we are still without a definitive diagnosis of the origins of COVID-19 and without answers to guide us in development of practical policy and protocol for a pandemic emergency preparedness plan? We may find ourselves in trouble again.  

Knowing is critically fundamental in future pandemic outcomes, especially in an uphill battle with inflation, supply chain disruptions, antibiotic shortages, baby formula shortages, high health care premiums and massive burnout of healthcare professionals.  
 
The mile-long lines of patients and the sudden outbreak of new variants like Omicron leaving us scrounging for solutions is not a chain of events to be repeated.  

Thoughts of the death of my first COVID-19 patient remain with me. I’ll never forget him. He was in his early 60s and an avid runner. He hobbled in with his wife and nearly collapsed in my arms. He could barely walk. He could barely breathe. He was pale, white as a ghost.  

It was his ninth day of being ill. His temperature was 103, his blood pressure tanking and his oxygen level was extremely low – fluttering in the 70s. Normal oxygen is in the high 90s. I had no COVID-19 tests at the time but I did have an X-ray and so I ordered an X-ray of his lungs because I knew covid had a particular appearance – a patchy white like snow on a TV. Normally a lung chest X-ray should be black, except for the bones & heart.  

I immediately inserted an IV to hydrate him and put him on high-flow oxygen. He perked up beautifully.  

However, I knew I couldn’t take him off the oxygen, otherwise he would quickly deteriorate and go into respiratory distress. So, I told him he needed to be hospitalized. He complied. I recall as the medics rolling him down the hall on a stretcher, he turned his head, looked at me and winked, and I nodded and at that point, I thought to myself he would be OK.  

I was wrong. I called the hospital a few days later to check on him. No answer. I called again the next day and his wife answered. I said, “Hello, this is Dr. Nesheiwat. I’m calling to check on your husband. …”  

Most importantly, are we prepared for the future? How can the answer be, yes, if we are still without a definitive diagnosis of the origins of COVID-19 and without answers to guide us in development of practical policy and protocol for a pandemic emergency preparedness plan? 

There was a cold silence. She couldn’t speak and cried on the phone. I immediately knew it was bad news. She told me he had died later the night he was put on a ventilator. I was deeply saddened. I wondered why. He did have a heart condition, however God took him home early as he did with over a million other Americans.  

But looking back, what truly starved Americans of life was the prolonged shutdown and the social distancing. Avoiding family, friends and loved ones was probably one of the most negligent measures forced upon Americans.  
 
Humans, especially our youth, need social connection and interaction with other people. It’s an innate requirement to thrive, to grow, to develop. The use of technology was an insufficient substitute and fueled the mental health crisis among young female teenagers resulting in a spike in emergency visits by more than 50%. Our country is in dire need of mental health resources. Anxiety, depression, PTSD cannot continue to go unaddressed.  
 
Why do you think a prisoner placed in solitary confinement regresses and becomes more mentally unstable? The punishment defies nature. It’s cruel and inhumane. We sentenced America to the same penalty, but no crime was committed.  

Loneliness suppressed the immune system and was a vulturous precursor to death and disease. We exacerbated that with isolation inflicted upon the masses, including many seniors who died alone.  
 
When the opportunity arose to respect the unknown and allow for change, we did not fastidiously oblige. We knew natural immunity implied protection. We knew children should not be masked, that they were the lowest-risk age group. We knew the high-risk cohorts were seniors and those with underlying diseases like diabetes, obesity, heart disease or a weak immune system.  
 
We learned mandates were ineffective and allowing options resulted in greater compliance. How do I know this? Because working the frontlines, having cared for more than 20,000 COVID-19 patients, I saw firsthand that even with the mask mandates and vaccine mandates, Americans continued to contract the virus, spread it and some die from it. But with time, the severity decreased most likely due to population immunity and re-infection along with vaccination. 

For most Americans, the collateral damage was worse than the pandemic. The mandate intentions had deleterious impacts – it reduced our military personnel, we lost good firefighters, police officers, teachers, healthcare providers and even athletes who refused to capitulate to the out-of-date, CDC regulations.  

My take-home message: exist in the present, in your best health possible so that if you are ever in the midst of a health emergency, your body is in maximum shape and better prepared to avert disease or trauma or whatever ailment you may abruptly face.  
 
Keeping in mind, if you have a pre-existing condition, such as hyperglycemia/diabetes, obesity, heart disease or a weak immune system, you are at high risk of complication, no matter your age. This is the case for most disease, i.e., influenza, measles, pneumonia or even fungal infections.  
 
The societal upheavals we faced in the spread of disease took their toll. The threat of additional infectious pathogens emerging is imminent. So now, reset. Prepare. Execute.  
 
We await the declassification of the Department of Energy COVID-19 documents that led the organization to say with “low confidence” that a lab leak was the likely origin.  

I completed Army ROTC in college and one thing they taught us as leaders, if there’s a crisis, to be prepared to train for emergency situations. So if we are faced with a deadly pathogen we are prepared and ready to fight it.  

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Preparation is the key to positive outcomes. Preparation and education further solidify success and preservation of life.  

In the meantime, our CDC, FDA and federal government must engage in continuous surveillance of emerging pathogens and prepare for another outbreak of disease of unknown origin. That would include emergency staff deployment capability, PPE, ability to manufacture accurate tests expeditiously, and effective therapeutic development.  

There can be no more learn-as-you-go or make-the-rules-as-you-go.  

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Nothing is definitive in medicine. Science is fluid. We must prioritize the most vulnerable. Options, not mandates, result in greater compliance, and thus better prognosis.  
 
We are a nation of resilience and strength. We have faced many hardships – 9/11, catastrophic deadly natural disasters, economic crisis and COVID-19. We will continue to thrive and persevere, but let’s alleviate the burden now and soften the impacts of the next global disaster with practicality and a realistic plan rather than a foolish one-size-fits-all solution.