TWO YEARS OF COVID: MEETING THE MANY CHALLENGES Michael Schrader, MD, PhD (Dr. Schrader’s remarks at the SFMMS Gala were especially well-received, outlining our multifaceted response in a time of crisis. We asked if we could share them here - The Editors) One in 400 Americans have d i e d o f Cov i d - 1 9 . We a re nearing the milestone of 1 million American deaths which is almost certainly an undercount. But a recent model has projected that 2 million Americans were saved from Covid deaths by our efforts. People ask me if I could ever have imagined the Covid pandemic. Of course, I reply. We have seen pandemics and near misses. Polio, AIDS, Zika, Ebola, West Nile, SARS, MERS, Swine flu. Before that, smallpox, 1918 flu, Bubonic plague, cholera. It has happened before. It will happen again. It is still happening. I came to San Francisco as a medical student and then an intern and resident during the AIDS epidemic. I was drawn to the AIDS crisis because I thought it was the most important health issue of the time. As a 4th year medical student I went to Africa for 2 months to witness the care of AIDS there. I learned HIV care in Ward 5A and Ward 86 of SFGH and later in Floor 5 North A at Mt Zion. We were fighting an impossible battle with no defined end. And somehow it ended with protease inhibitors, a pharmacological revolution. Those were tough times: an end stage AIDS patient was an incredible time and emotional investment, and a learning experience. AIDS patients were vilified and discriminated against and feared. I can’t describe what it’s like to work on the cusp of life and death of young patients. But we lived this: succeeded and failed and lived the drama of life and death every day. I would like to think we were better for the experience but no doubt it changed many of us forever. I trained as a physician scientist and when I finished my residency I briefly flirted with becoming an AIDS researcher. Ultimately being a clinician is what I enjoy most. George Santayana said: “Those who cannot remember the past are condemned to repeat it.” It’s actually the same deal for those who do remember the past but at least it gives us some perspective. We first heard about Covid-19 a little over two years ago. Another SARS coronavirus initially identified in Wuhan, China. Wuhan was locked down. And we waited for whatever would come next. Waited for that inevitable ill wind to blow it ashore. There was an outbreak on a Princess cruise ship and 10
SAN FRANCISCO MARIN MEDICINE APRIL/MAY/JUNE 2022
the passengers were stranded offshore waiting. Governor Newsom formulated a plan to offload them into quarantine in the east bay. He called the CMA and they called SFMMS for some white-coats to stand behind him during his press conference. This was a successful containment operation but it was too late to stop the tide. It was already here. Next Covid was seemingly everywhere, sweeping through our nursing homes and infecting our front line physicians. We navigated the quickly changing recommendations to attempt to slow the spread and avoid overwhelming critical care. Dr Ameena Ahmed had SFMMS commission a graphic video explaining the rationale for slowing the spread. Dr Grant Colfax and Mayor Breed declared a city and county lockdown ahead of other municipalities. Dr Matt Willis organized the Covid response in Marin and was an early victim of Covid himself. He recorded and published his personal account of illness. Our frontline physicians in the ED, hospitalists, critical care and infectious disease were among the first to face Covid. Covid tests were in short supply and difficult to obtain. SFMMS provided information and guidance about availability. Physicians were rapidly running short of PPE. The SFMMS secured a supply of K95 masks from China. Longtime member Dr Sandra Hernández facilitated a major grant to fund them. They are still being doled out from Steve Heilig’s garage. CMA distributed millions of dollars of PPE through county medical societies. SFMMS members loaded boxes into cars at AT&T ballpark for both member and nonmember physicians. Then-President Donald Trump gave destructive wrong advice about hydroxychloroquine and bleach. People died from following his wrongheaded nonsense. We debunked this misinformation as fast as he could spew it. We reached out to media. We educated our patients. Then Trump tried to change Covid into a racial epithet calling it the Kung flu. There was an upsurge of anti-Asian and Pacific Islander hatred fueled by this careless and cruel language. Dr Joe Woo organized a press conference at Chinese Hospital where many prominent politicians and several SFMMS members spoke out including Dr Woo, Dr Beth Griffiths and Dr Brian Grady. WWW.SFMMS.ORG
