Thanks as always to Dr. Mike Silverman, Chair of the Department of Emergency Medicine at the Virginia Hospital Center in Arlington, for these superb updates!
Friday Night Update from the ER in Arlington, VA
The head of the World Health Organization said this week that “We are not there yet. But the end is in sight.” This an optimistic view that the world is in a good position to end the pandemic thanks to vaccines and treatment options. I know many/most people are acting like it’s over. Even at work this week, I had a conversation with nurses, and we all have relaxed our behavior over the last year and are getting closer to our “normal” lives. We know it’s not over but have much of the fatigue that everyone else has.
The ER numbers certainly support things improving. Two of the last three weeks have had less new cases and we’re seeing a drop in the percent positive rate. We are clearly on a downward trajectory, which is great.
A South African study published in the NEJM this week showed the rapid decline of vaccine protection over time. “The primary two-dose series of Pfizer’s mRNA vaccine, effectiveness against BA.4/5-related hospitalization slipped from 47.4% after 3-4 months…to just 19.3% at 9 months and beyond, and even with a booster dose…vaccine effectiveness against hospitalization from BA.4/5 declined from 68.8% at 1-2 months after the third dose…to 46.8% at 3-4 months.” Fortunately, there’s a new booster, and everyone 12+ is eligible.
Finally, on the topic of who will take care of is in the future…A recent report came out looking at physician burnout. I see these regularly. Emergency physicians are the most burned-out specialty this year. Probably not a surprise but it creates an issue if physicians are leaving the specialty due to early retirement or moving to other ways to provide care (urgent care or telemedicine). In an article published in the Mayo Clinic Proceedings looking at all specialties, “About 63% of physicians surveyed experienced at least one manifestation of burnout in 2021, shooting up from 38% in 2020 and representing the highest amount in a decade of recurring survey findings. The “mean scores for emotional exhaustion and depersonalization were higher in 2021 while satisfaction with work-life balance dropped,”
It’s been a long week so cutting it short tonight and moving on to happy hour and a fire pit. Have a great weekend.
Coronavirus is not quite done with us yet.
Science matters. Get vaccinated (or your booster). Keep a mask handy.
Mike
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