March 30, 2020

In a time of crisis, it is normal to feel fear and uncertainty and a feeling of powerlessness. We in healthcare are not immune to this and, in fact, many of us may be feeling this even more acutely given our front-line roles in the COVID19 pandemic with so much still unknown.

As reports roll in from around the world, with the desperate situations in Iran, Italy and Spain, and now reports from our own country—Seattle, Detroit, and New York City—it is easy to feel dismayed and overwhelmed. And yet, at this moment, we need to acknowledge these feelings while still finding ways to do our daily work, because if not us, who?

I think it is helpful to focus on the many things we can still control. At the individual level, we cannot control whether the state and our health systems and offices can procure additional masks and PPE, but we can control how we use what we currently have given the best current evidence. We can make sure we are following the latest CDC guidance on use of masks and PPE. This will help conserve limited resources to last as long as possible and provide at least some protection as we interact with sick patients.

We can also practice physical distancing and encourage our families, friends, neighbors, anyone we can reach on social media, and anyone else who will listen to do the same. The NHMS worked hard to help support the Governor to come to a decision to issue a ‘stay at home’ order, and we think that this will save lives, along with the earlier steps taken such as closing the schools, bars, and restaurants, but no one is patrolling the streets of New Hampshire making sure everyone follows the rules. We need to tell anyone who will listen that this is the single most important thing that we can do, and this is something that everyone can participate in. As the American Medical Association recently stated in an open letter to the American public, along with the American Hospital Association and the American Nurses Association: “Physicians, nurses and health care workers are staying at work for you. Please stay at home for us.”

And we can do what we do best—we can critically think and problem solve. We can read everything and anything we can find about this pandemic and things that have worked, and not worked, around the world as we try to fight it and save lives. We can review the peer reviewed literature. We can continue to follow the news reports. We can listen to national experts like Dr. Anthony Fauci and Dr. Benjamin Chan right here in the Granite State, and continually consult resources such as the CDC and NH DHHS to keep ourselves up to date as this situation changes seemingly by the hour. We can then apply that learning to our work, as our understanding of how to approach these patients evolves day to day and week to week, and we’ll stay on the cutting edge of current understanding, which will save lives.

It is unacceptable to me that in the United States of America, we have chronically underfunded our public health infrastructure for decades, and that there are places in this country where people will get sick and die due to lack of adequate PPE and equipment such as ventilators. Our current situation, while entirely novel in the experience of anyone born in the past 100 years, is however not new in the sense of modeling and predictions of what a pandemic might look like. It’s too late now to rewrite our recent past, but we are still writing the next chapter of this story, and while there will be tragedy and fear, there will also be ingenuity, bravery, and heroism. 

I don’t know what the next few weeks will look like—have we implemented these measures early enough that we’ll flatten the curve enough not to be overwhelmed? Will Manchester look like a smaller version of New York City in 3-4 weeks? None of us knows. But each of us will continue to control what we can, and your Medical Society will continue to advocate for every physician in this state in every way possible, as we have throughout this crisis. 

Let me know anything, any time, that you can think of that we can do to help.

In health,

John Klunk, MD
NHMS President

Please send comments or questions to john.klunk@nhms.org.