Reason can wrestle and overthrow terror – Euripides

Collecting data and testing evidence takes time, and in that vacuum of time, fear, frustration and a desire to act animates us to abandon reason. Not a day goes by when more anecdotal evidence, hearsay, or outright falsehoods related to COVID19 don’t scream at us across the internet. It’s in these times when we need a backstop against this desire to abandon reason so we can ensure the safety of our patients.

So how do we take care of our patients in a moment of uncertainty? I find It’s helpful to remember a few things:

1. Do no harm. There’s a reason this remains a bedrock principle of our profession. It still applies, even in a pandemic.
2. Lean on what you know. While there’s much still to learn about this virus in particular, there’s a lot we already understand about viruses in general, and we care for patients with similar diseases all the time, just not in this volume.
3. Follow current best practice. Just because we don’t have a miracle drug treatment for COVID19, it doesn’t mean we don’t already know much of what we need to know to care for these patients. Good research exists for example on the best management of ARDS and just because this is a “novel” virus doesn’t mean we should throw the ARDSnet protocol out the window.
4. Trust your ability. Even without a drug treatment we are still very good at taking care of people. Even during this pandemic, many of our sickest patients will walk out of the hospital alive because of our care. Trust in your ability as a clinician.

While we take the time to build evidence and find better solutions, here are some trustworthy & evidence-based resources to help you stay on track and keep in check the desire to act out of fear. I will update these resources regularly. Remember, trust the evidence, and lean on what you know.

• IDSA – Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 Infection
• Assessment of Evidence for COVID-19-Related Treatments
• Oxford COVID19 Evidence Service – CEBM

Watch This Space for Regular Updates