Coronavirus has turned the world upside down, and when you do that, secrets tend to collapse under their own weight.
Medical science is now under the spotlight, and everybody has turned their attention to how health authorities are handling the situation.
For scores of years, even a few centuries, medical science wore a shroud of mystery nobody could unveil unless they went through the painful and laborious process of studying medicine. Since doctors “knew” and patients “obeyed”, medicine started adopting a paternalistic approach and doctors became political authorities in whatever city or town they settled their practice.
In modern times, doctors finally understood they needed to share their knowledge to prevent disease. Now, almost every patient makes their own research and understands a bit about the human body before consulting with the doctor: some are even enthusiastic second-guessers. But still, there were many secrets and dark corners of medicine that remained concealed – until coronavirus came and changed everything.
Yes, COVID-19 is revealing things about medicine you were not supposed to know.
Secret #1. Doctors usually make an educated guess
You want to think that your doctor knows everything and has been trained to take care of your health problems. Actually, experience is very important, and it is the only way to put into practice endless pages and diagrams in medicine books and journals.
Human error is always lurking, and statistical flaws can make things much more difficult.
Very few patient diagnoses are 100% certain, and when they are, they often entail treatments that prove invasive, very uncomfortable, and sometimes associated with risky side effects (think about certain biopsies, for example). Thus, doctors usually need to make educated guesses.
Even protocols and complex diagrams to treat patients can have statistical flaws. This fact would not become evident in most cases, but coronavirus is infecting more people every passing minute, and the total number of cases is enough to make up for any unlikely scenario. In other words, you will see very rare cases even if they appear in 1 for every 10,000 people. With near 5 million cases in the United States alone, there will be 500 rare cases that doctors will not always be prepared to handle. Some of them won’t be even described by current literature.
But making an educated guess and working against statistical flaws is not necessarily a bad thing. Medical science is always evolving to improve the accuracy of tests and provide the best options. Actually, new diagnostic tests and treatments should be compared to what is actually considered the standard of medical care, and will only become available to the public if they are more effective or provide an edge we can use to our advantage
Secret #2. Health professionals are sometimes forced to play God
Choosing between life and death is one of the worst experiences doctors face. Not only patients but also doctors suffer a lot with these types of decisions. It is not easy to stop giving ventilation to one patient that is not likely to survive and give the opportunity to another with better odds. Once again, it is impossible to know for sure the outcome of one patient versus another, but we can use statistics to make an educated guess.
There’s a principle in medicine that some people didn’t know about before coronavirus, called triage. It is basically choosing who is getting medical care first and who will be neglected when there’s a lack of medical devices or facilities. It sounds cold, and it is, because doctors need to put aside their feelings and think logically.
Triage was initially applied in emergency medicine, as in natural disasters when there are plenty of people requiring medical attention and limited personnel and tools. But now it is applied all over the world as coronavirus depletes healthcare resources in one country after the other.
Instead of suffering two deaths, for example, you can have one and cut in half the mortality by applying one principle that sounds simple and sound, but carries an emotional burden doctors will be bearing for hours or days.
Secret #3. Headlines of new medications and vaccines can be misleading
Too often we read announcements like “new vaccine discovered”, or “new treatment discovered for breast cancer”. But there’s a whole process before these treatments and vaccines are made public, and the headlines are usually misleading because they can be interpreted as if they were already available.
With COVID-19, there are several vaccines under research, and some of them show a lot of potential. However, they cannot be released to the public before going through a series of clinical trials. We cannot jump this step, not even with the current pandemic.
Think about it, what if we release a new vaccine without sufficient clinical trials and safety considerations?
That could bring about unexpected side effects; some could be lethal and much more dangerous than the disease we’re trying to eradicate.
So, it’s not a good idea to accelerate the process, and clinical trials need to undergo a series of steps, each one with an increasing number of patients, and more complex methodology to detect adverse events.
With that in mind, we trust that science and numbers will work better than emotional judgements and hasty decisions.
Secret #4. We were not prepared, and we are still incompetent
The darkest secret of medicine unveiled by the current pandemic is that we were not at all prepared for what happened.
Governments were not prepared, health facilities were definitely not prepared, lay people were not prepared, and even health authorities made mistakes along the way.
Even though we had talks and models predicting something like this – they became famous as conspiracy theories, by the way – what we did was not enough to counter the problem.
With the coronavirus pandemic, health professionals realized we have a tendency to look at potential problems and say “this is not going to happen to me” or “not in my lifetime”. We tend to overlook the problem and turn our attention to more pressing matters, until the counter reaches zero and turns into “a more pressing matter”. What if global warming becomes the next neglected problem just because we’re adopting the “not in my lifetime” reasoning?
Medicine has some dirty secrets that you’re not supposed to know about, and some have been revealed by the pandemic. But we are always striving to give the best to our patients, and even if coronavirus released a few secrets of modern medicine, they can be easier to understand and forgive if you understand the background and hear about the other side of the story.