Lessons from the Pandemic

Hi everyone, We’ve learned a ton since the start of the pandemic, and today I wanted to share some of the lessons I’ve learned:

1. Be transparent: Don’t hide bad news. For months, we worried about running out of PPE, we didn’t know how high the numbers would rise, and we weren’t sure how to keep everyone safe. But we shared what we knew when we knew it, both the good and the bad, and that was the right call. Transparency builds trust and trust builds confidence, and confidence is indispensable when fighting a pandemic.
2. Prioritize: Mission #1 was to save lives. Sure, masks were uncomfortable, closing businesses caused hardship, and social distancing bred loneliness. But we needed to make these sacrifices to save lives.
3. Protect your team: People can do anything when they feel safe. From day one, we secured PPE, we created humane schedules, and we vaccinated everyone as soon as we could. To care for our patients, we needed to care for our team.
4. Back to basics: Faced with a new, lethal disease, it was tempting to abandon standard practice, even when the evidence was sketchy. But even with COVID, the basics were key: low tidal volume ventilation, judicious sedation, attention to detail, and teamwork saved lives.
5. Not all suffering is visible: When you miss your friends, when your parents get sick, when your wedding gets canceled, and when worry keeps you up at night, you suffer. But suffering can be hard to see, especially behind masks. Assume people are suffering, and treat them compassionately.
6. Follow the data: When the pandemic began, it was tempting to embrace untested hypotheses. Remember when we were advised to stop ACE inhibitors and warned against using ibuprofen? Neither concern panned out. Pandemic or not, remember this principle: hypotheses and evidence are not the same.
7. Beware theatrics: By now we know what stops the spread of virus: masks, social distancing, and good ventilation. We also know what doesn’t work: empty gestures like closing parks and scrubbing fomites. Even now, Connecticut parks are reserved for “solitary recreation” and the New York City Subway still closes every night to disinfect the trains. I’m sure both efforts are driven by the government’s wish to show action, but these useless efforts just distract attention from measures that actually work.
8. Invest in science: It’s been a year of breathtaking discoveries, culminating in vaccines that will save millions of lives. Let’s remember that all this happened because we invested in science.
9. The joy of Zoom: Yes, we miss each other, but in some ways we’ve been more together this year than ever. I’ve been invited (virtually) into patients’ homes, I get to see my VA friends every morning at Report, and I visit my mother every evening on FaceTime. Even when the pandemic ends, we should keep the cameras on.
10. Listen: From day one, residents told us what we needed to know. That’s how we learned PPE distribution was inconsistent, that workrooms were overcrowded, and the rules for wearing N95s were confusing. It’s an essential lesson for leadership: listen to your team.
11. Be a healer: I’ll never forget leaving the MICU at the end of a long day, passing by a resident who was holding the hand of a dying patient. Even as we struggled to save lives, compassion and healing were essential.
12. Small acts of kindness are huge: Children’s signs decorating the MICU, hospital leadership distributing ear protectors, Meals4Healers. We were sustained by countless little kindnesses.
13. Seek reliable information: With Washington in turmoil, we had to rely on other sources of information. Fortunately, there were many, including the COVID Tracking Project, the Johns Hopkins Coronavirus Resource Center, the New York Times, the Yale New Haven Health website, and respected scientists and journalists such as Zeynep Tufekci, Ashish Jha, Anthony Fauci, Ed Yong, James Hamblin, Julia Marcus, and countless members of our own community, too many to mention.
14. Surround yourself with talented, committed people: I can’t imagine a better team than ours. From the nurses, respiratory therapists, and physicians at the bedside, to the researchers and clinical therapeutics team that guided us, to the hospital, school, and department leadership that secured the resources we needed, to all the employees who put themselves in harm’s way to get the job done- we did it well and we did it together.
15. Prepare for the worst, but keep the faith: The pandemic isn’t over. We still have variants to deal with and most of the population remains at risk. But warm weather is coming, millions are getting vaccinated, and the numbers are falling. The end of the pandemic is in sight.

Though we’ve been through a devastating year, we’ve grown stronger, wiser, and more cohesive than ever. As the pandemic starts to fade, let’s acknowledge all that we’ve accomplished and all that we’ve learned. No matter what the future holds, if we’ve learned anything, it’s that we have the talent, the spirit, and the commitment to meet any future challenge that comes our way.

Enjoy your sunny Sunday, everyone.

Mark

PS Thank you for all the birthday wishes, yesterday. It was a good one!

MDS