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Jonathan J. Miner: Protecting others during a pandemic

(Trent Nelson | The Salt Lake Tribune) Magdelena Litwinczuk, one of a group of ICU nurses from Northwell Health who will support ICU teams at Intermountain Healthcare in Utah, at a news conference in Murray on Tuesday, Aug. 4, 2020. Last April, Intermountain deployed two COVID-19 Response Teams totaling 100 caregivers to assist New York City-area hospitals during that state’s major surge of COVID-19 cases. Those hospitals planned to return the favor when their surge subsided, which it now has.

When I was a kid, my dad would often recite a poem called “Home” at family home evening. Tears would well up in his eyes whenever he would read the lines: “You’ve got to weep to make it home. You’ve got to sit and sigh, and watch beside a loved one’s bed, and know that Death is nigh.”

Last week, a nurse came to my office to tell me that I had an urgent phone call. It was the daughter of a patient telling me that her dad was on the ventilator and dying from COVID-19. She asked: “What can you do to save him? What would you do if this were your dad?”

Those words hit me especially hard because three years ago, it was my dad on the ventilator.

It was early 2017. I took the first flight home to Utah when I heard that Dad was sick. When I arrived, I ran to the ICU to find him on the ventilator. A quick look at the ventilator settings and medications made it clear that he would be very lucky to survive the day.

When I had cared for ventilated patients in the past, I would often squeeze their hands to communicate and provide comfort. Squeezing my dad’s hand was different though. This was personal. I promised myself that I’d never forget that feeling, and that I’d always take care of my patients as if they were my own family.

I told my patient’s daughter about my dad’s critical illness, which he somehow survived despite extensive lung injury. I told her how I knew what they felt, and that I’d do everything possible for her dad.

I sometimes ask medical students if they can recognize the disease in this photo,

(Photo courtesy Centers for Disease Control) This image was captured in 1973, in the country of Bangladesh, and depicts a closer view of this child’s face, as she was being held by her father. This girl who’d been infected with smallpox, displayed a classic, though severe maculopapular rash over her entire body.

but they usually can’t identify smallpox since it was eradicated decades ago.

The COVID-19 pandemic is a window into our past. Old cemeteries are full of graves of parents and children, who died prematurely from infections that are preventable today. My great-grandmother died at 40 from tuberculosis. My uncle died at age 7 from an infection that today would have been prevented. My grandparents carried that grief throughout their lives.

Before the advent of vaccines and public health measures, at least one in six children died. Now, infant mortality in Utah is around 1 in 250. Consider the children’s lives that have been saved by public health measures including immunizations. Many of those children grew up to become our own family members and friends. And many who don’t take vaccines survive thanks to others who do take vaccines.

The HIV epidemic hit America hard in the 1980s, but the monthly death rate from COVID-19 is even more staggering.

Consider:

  • Over the last 40 years, AIDS has taken the lives of 700,000 Americans.

  • In the last nine months, at least 230,000 Americans have died from COVID-19, with no end in sight.

In the 1980s, life expectancy for AIDS patients was about 1 year. At the height of that epidemic, Barbara and George H.W. Bush met with AIDS patients. They empathetically listened and respected the patients as well as the experts, including Dr. Tony Fauci. Thanks in part to their support, HIV is now treatable.

Empathy + science = survival.

Mothers and family members are immunized against pertussis to protect newborn babies, who are too young to take the vaccine. Public health is partly about science, but it’s also about average people feeling enough empathy to protect the vulnerable among us.

Coronaviruses are winter viruses, and we are in for a devastating winter if we don’t protect each other. Scientifically proven, preventative measures like masking and avoiding large gatherings are minor sacrifices that have major benefits in terms of the lives that we can save, especially since a vaccine won’t be widely available until sometime next year.

Doing the right thing during the pandemic is a manifestation of our empathy, and happens naturally when we remember that numbers and statistics represent people who deserve a chance to live.

Jonathan Miner, M.D.

Jonathan J. Miner, M.D., Ph.D., is assistant professor of medicine, molecular microbiology and pathology and immunology at Washington University School of Medicine. He is a native Utahn, a Brigham Young University Gordon B. Hinckley scholar and winner of the Ann Palmenberg Award from the American Society for Virology.