A rural Iowa doctor's ongoing pandemic experience

Dr. Greg Cohen: "I still see patients who trust me with their diabetes, blood pressure, heart disease, and lives, but believe I am lying to them about COVID."

I am sad. I am frustrated. I am frustrated. I am hopeful. I am resolute, and I am just so tired.

I have written previously about my feelings and experiences as a rural Iowa family physician during the COVID-19 pandemic.

So where are we now? I still go to work every day and see whoever needs to be seen—sick or otherwise—with whatever PPE is available (that has gotten better).

Earlier this summer we were seeing one or two COVID patients every one or two weeks. Now we see multiple cases every day. We have coronavirus patients continuously in the hospital again.

Although fewer than before, we have deaths again. Unlike last winter, when most who died were elderly, patients are now dying in the prime of their lives. Our community (Lucas County) has even seen the death of a pregnant woman.

In early summer, Iowa was reporting about 75 new COVID-19 cases daily, and hospitalizations hit a low point of 46. Now our state is averaging more than 1,000 new daily cases, and more than 500 people infected with the virus are hospitalized. Once again our suburban and urban hospitals and ICUs are near or at capacity.

The U.S. is reporting hundreds of thousands of cases every day, more than 100,000 hospitalized, and nearly 3,000 deaths on September 2. So much of this did not have to be.

To be clear, we could not have stopped this surge from happening. That said, we could have and should have done so much better.

Ongoing misinformation, mistrust, social media, cable tv, news bias, and partisan politics have sabotaged our efforts to fight the worst pandemic in more than 100 years. The greatest, wealthiest, most powerful nation on earth has failed miserably to unite against this ongoing public health disaster. So much of this suffering was and is preventable.

I still encounter patients who believe the pandemic is a hoax. It is not. I still see patients who trust me with their diabetes, blood pressure, heart disease, and lives, but believe I am lying to them about COVID. I am not. I still hear them say, "Wasn't this just the flu?" Or a bio weapon, a government program to control the population, change our DNA, make us into zombies. Some just believe it is over.

The truth is, we have lost hundreds of thousands of Americans who did not have to die.

The truth is, we are on track to lose another 100,000 plus lives.

The truth is, tens of millions have been hospitalized since this began, and tens of millions more have survived but with permanent damage to their health and wellness. Nearly 25 percent of those who get this disease will still have symptoms six months from now, whether their initial illness was mild or severe.

The truth is, thousands of brave, selfless health care workers have died. Many thousands more have been hospitalized, and millions have been harmed by this disease or their experience caring for us. Experts estimate a quarter to a third of all health care workers will leave their profession by the end of the pandemic.

So what can we do?

We need to get vaccinated as soon as possible. While not perfect, vaccination will greatly decrease your risk of contracting the virus, spreading it, and ending up in a hospital or worse. We were all given a gift. We have at least two vaccines that are extremely safe and effective, and enough doses to protect every American.

The rest of the world does not understand the reluctance of so many to get vaccinated against this terrible disease. They would do anything for the opportunity to get vaccinated. We are mired in a surge that is devastating our friends, neighbors, families, communities and health care system. Those who are not vaccinated account for more than 90 percent of those hospitalized and 99 percent of the deaths. The evidence speaks for itself.

Wear a mask in indoor public spaces, or in a crowd with people we don't live, or people not wearing masks. Most masks provide the wearer with about 30 percent protection from contracting this disease. When we all wear masks, we can decrease transmission by about 90 percent. N95 masks do considerably better than cloth masks and are now available to the general public. I have cared for hundreds of patients who were ill with COVID-19, and probably hundreds more who had few if any symptoms, but were still infectious and did not know they had the virus.

Despite my multitude of close contacts, I never got this disease and repeatedly tested negative for the virus and the antibodies. I have to believe I did not get COVID because I wore a mask and required all of my patients to wear one as well.

Stop looking for our health information from social media, cable tv, politicians, and other biased and marginal sources. Look to your doctors and reliable websites like Mayo Clinic or Cleveland Clinic, or the Centers for Disease Control. If possible, read the studies on Pub Med.

Do not ask for or take medicines that have not been studied or approved for treating this disease. I know many who are taking all kinds of supplements and repurposed or veterinary grade medications. I have done extensive reading about those treatments, using reliable medical sources. Most if not all have not been shown to be effective or safe.

I see too many patients who present for care too late and too sick, because they relied on untested remedies and are no longer eligible for treatments shown to decrease severity of illness and risk of hospitalization.

I spend much of my days seeing friends and neighbors and coworkers, sick and well, trying to help them make the best informed choices. It can be exasperating and exhausting, just trying to help one person.

But it is the season of the Jewish High Holy Days. A time for self introspection, forgiveness, and hope. To paraphrase the Talmud, to save a life is to save the world. It is my inspiration in difficult times. I try very hard to save each and every one of the lives that has been entrusted to me.

I am sad. I am frustrated. I am angry. I am resolute. I am tired. I am hopeful. Shana Tova!

Editor's note: "Shana Tova" is Hebrew for "Happy new year." The Jewish holiday of Rosh Hashanah begins on the evening of September 6.

Dr. Greg Cohen has practiced medicine in Chariton since 1994. He was named a Distinguished Fellow by the American College of Osteopathic Family Physicians as well as Physician of the Year by the Iowa Osteopathic Medical Association in 2019.

Top photo of Greg Cohen provided by the author and published with permission.

  • The Denizens of COVID Denial

    Rereading this Bleeding Heartland article disheartens me, beyond the pale. How can a first world society take their civil liberties to a hyper—extreme and deny professionals the opportunity to educate their patients on the merits of an FDA approved vaccine?

    Kudos go out to Dr. Cohen for steadfastly caring for the ill, albeit aware that some chose unfortunately to listen to misinformation and go massless while indoors and not get vaccinated Ours is a first world society with a percentage of the population who chooses to have the shamelessness of misguided juvenile delinquents, following faux experts and religious exemption zealots. How can you complicate prophylactic practices of wearing a mask and getting vaccinated? And yet their masquerading, misguided logic takes civil liberties to an asinine politicized, eclipsed state. This percentage becomes the super spreader by function of their COVID-19 vaccine abstinence. Only in the United States can individuals take it upon themselves to add their self inflicted ignorance to Dr. Cohen’s caseload. Only in the United States can individual liberties and religious exemptions add to the Country’s hospitalizations, long term lingering side effects, and deaths.

    Thank you, Dr. Cohen for doing the awful job of helping people back on their feet, if they are able and getting them back to their own life. But why do we have to perpetually self inflict pain and death upon ourselves, in this process? My tacit response is self explanatory.

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