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Massive In-Particular person Medical Conferences and Cognitive Dissonance for ID Docs

dipakhajj by dipakhajj
February 6, 2023
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Dissonance: lack of settlement; inconsistency between the beliefs one holds or between one’s actions and one’s beliefs; a mingling of sounds that strike the ear harshly.

It began shortly after the chaotic, disruptive, and all collectively disagreeable Omicron wave of 2021–22.

It continued by way of the BA.2 and BA.5 surges, and now performs on by way of the swarm of Omicron variants that float throughout us.

It’s the persistent background sound of an ominous minor chord signaling COVID instances to these of us who focus on Infectious Illnesses — by no means going away, waxing and waning in quantity, all summer time lengthy and now into the fall.

That’s one of many two chords taking part in repeatedly and giving us details about take a look at positivity charges, wastewater information, vaccine and treatment-evasive variants, and producing calls from sufferers, colleagues, mates, and relations about having COVID.

Undoubtedly this chord will probably be taking part in louder as winter arrives, together with variants BF.7, BA.2.75.2, BQ.1.1, and who is aware of what else is in retailer. Respiratory viruses, together with SARS-CoV-2, are seasonal, after all.

Taking part in on the identical time is a special chord, in a cheerful main key — most likely C main, no much less. Individuals listening to this chord can all however ignore that there’s loads of COVID on the market. Sniffles once more are allergic reactions, sore throats and coughs no extra ominous than what they had been earlier than the pandemic. Which means, not very.

COVID take a look at for that gentle sore throat? You’ve acquired to be kidding. Masks up for crowded indoor areas? C’mon, that’s so final 12 months.

Colleges, eating places, bars, live shows, huge weddings, locations of worship, gyms, journey — as famous right here beforehand, all again to regular.

Most individuals don’t expertise these two chords, taking part in concurrently. However we do, we ID medical doctors — a scary chord in a single ear, a cheerful one within the different.

The place does that go away us ID medical doctors? With a complete lot of dissonance — the sound of these two chords, main and minor, taking part in collectively. Minor if we’re caring for the immunocompromised and/or older and frail, or main the an infection management workforce on the hospital, or managing tight scientific schedules with individuals dropping out for 7–10 days for COVID, or responding to queries about COVID — the amount of which correlates completely with native wastewater concentrations of SARS-CoV-2.

However it’s a significant chord if we’re making an attempt to be like most “common” individuals, simply eager to get again to a pre-pandemic life.

It’s an applicable time to convey up this battle, as a result of we’re on the eve of our huge skilled assembly, IDWeek — first in-person IDWeek since 2019, which was, in fact, the Earlier than Occasions.

You received’t be shocked that this assembly of ID specialists has strict masking policies, and a vaccine requirement to attend.

You additionally received’t be shocked to listen to that, like the remainder of our species, ID docs can’t socialize if it includes consuming and consuming with out taking off our masks. Determine that half the motivation to attend these conferences (at the very least) is for this type of networking. Or that many people, in our non-ID time, have gone to weddings, events, gyms, eating places, live shows …

Some would possibly name this hypocrisy. The very definition of two-faced — sure, actually! Masked whereas indoors on the assembly, unmasked whereas sharing lunches, drinks and dinners with colleagues we haven’t seen in ages. Hey, what’s it going to be, ID docs?

Others might argue it’s nonetheless rational to require masking on the assembly. As Dr. Priya Nori famous to me throughout a current dialogue on this subject, we’ll be lowering our danger of viral respiratory infections at the very least half the day — and some danger mitigation is healthier than none. This was my view once I shared being invited to a gaggle work assembly that, to my chagrin, appeared to take place in a crowded basement closet. Couldn’t we do higher on air flow than that?

There’s validity to each of those views (hypocrisy vs. danger mitigation), although actually Dr Nori’s is the kinder and extra beneficiant one.

However I’ve one other interpretation. I believe we’re simply confused. And nervous. And drained. And humbled. And, talking for myself, we’re collectively struggling by way of a little bit of PTSD, recalling the final two actually terrible winters, and for these of us from sure city facilities, the nightmarish March–April of 2020.

We will actually hope these days are behind us, that our vaccine and infection-induced immunity continues to attenuate the severity of illness, that our ICUs and ECMO machines will stay unstressed, our elective surgical procedures not postponed.

However we don’t know that. Therefore the dissonance.

And I hear it, and suspect everybody attending IDWeek in Washington DC this week will hear it too.

dipakhajj

dipakhajj

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