What is it About Covid That Makes it Worse

He was doing OK at first. He was not in distress and looked quite comfortable. Then, all of the sudden, things changed.

He became so much worse: he couldn’t breathe. He was restless. He became increasingly agitated.

Then, his heart just stopped. We called a CODE BLUE. We started CPR, and I placed a breathing tube into his lungs. His heart came back, but it was not to last.

I placed him on every medicine I had to try to help his heart beat more forcefully. Nothing was working. When I did an ultrasound of the heart, it was barely beating — even though he was on rocket fuel for the heart. In spite of everything we were doing, we could not save him. He died within hours of coming to the ICU.

It was sad, and I really felt for the family at the bedside. At the same time, I didn’t have the same feeling I had when I took care of a Covid patient who suffered the same fate. I’ve faced death so many times in the ICU. But with Covid it was different, and I’ve figured out why.

Fear.

I didn’t have the fear and dread that I had taking care of Covid patients. You see, I wasn’t scared of catching cardiogenic shock from the patient. I am not scared of catching diabetic ketoacidosis. I am not scared, even, to catch someone’s septic shock, even though it is possible to catch some infections like C. difficile or tuberculosis.

I am scared of catching SARS CoV-2. I am deathly scared of getting Covid and then bringing it home to my family. This disease is so horrific and so new, and we still don’t know what are the long-term effects from this disease. This unknown, this uncertainty, leads to a great amount of fear. And that fear permeates everything when caring for patients who are suffering from Covid-19.

Never before have we had a disease like Covid-19. Sure, we’ve had influenza, and even very bad influenza pandemics like H1N1. We have never had something as bad as Covid-19; something as horrific as Covid-19; something as deadly as Covid-19.

And it’s “transmitted through the air,” as someone famously said recently. It’s so contagious, and that fact adds to the menace of the disease. And when you have dozens of these patients at the same time — all on ventilators, all super sick — the fear and dread can be overwhelming. It was overwhelming.

Yes, we had PPE, and I was and still am extremely grateful for it. The PPE works, too. And we have some treatments now that seem to be effective for Covid. Still, it’s hard to shake the fear, especially when you see firsthand what horror this disease can cause on its victims.

On the one hand, a little bit of fear can be productive. It ensures vigilance: vigilance for hand washing, vigilance for wearing PPE, vigilance for making sure I don’t catch or transit this disease to others.

On the other hand, too much fear can be paralyzing, and I must also be vigilant against letting the very natural fear I have of Covid-19 from taking over. While several thousand of my healthcare colleagues have indeed gotten Covid, and some have even died, the vast majority of us in healthcare have remained safe from this disease. And I thank God for that.

I’ve faced death many times over as a critical care physician, but I’ve never been as affected as I have been with Covid-19. Fear has a lot to do with that. Going forward, I must remain vigilant: vigilant against catching this disease, and also vigilant against letting my fear get the best of me.