On May 11th, 2023, the COVID emergency will officially end after three years.  As such, it is warranted to reflect upon this time and the lessons that have been learned from this period as there will certainly be another pandemic in our lifetime.  With apologies to David Letterman and CBS Orchestra, here is the Bream Medical Trop 10 List of lessons from the pandemic.


10) Nurses are master negotiators

– Nurses used the pandemic to leverage their income.  Nurses realized that operating a doctor’s office, hospitals, etc., was impossible without them.  When the staffing crisis occurred, they (unlike doctors) took advantage of the supply and demand advantage and ended up with temporary huge pay increases, sign on bonuses, and other financial compensation as a reward for their hard work and perseverance during the pandemic. 


9) The American health care system failed its stress test

– Not just America, but the world failed its stress test.  When care was needed most, there were no ICU beds and an Emergency Medicine boarding crisis ensued, families were not allowed to see their loved ones who were dying, among other massive issues with equipment, supply chains, and other issues. 


8) Rushing is not always the best policy

– Many of the therapies that had accelerated development during the pandemic ended up causing side effects or ended up being not as effective as originally thought.  While the need to get vaccines and therapies out was paramount, one must reconsider retrospectively if going through more traditional processes would have been a better strategy.


7) Medical publications are significantly compromised

– During the pandemic, it became readily apparent that the most prominent medical journals are rife with bias and influence. The funding of these journals, usually from medical alphabet organizations, often exposes this bias and why it occurs.  Additionally, it was revealed that these journals accepted articles with significant flaws that were readily apparent. Which leads us directly to…


6) Most doctors/medical professionals are journal illiterate

– Instead of critical thinking and reading articles for themselves, most policy was driven by the media during the pandemic and topline data from Big Pharmaceutical companies without questioning the data.  Medical professionals should have been able to dissect the data from these papers which showed that most of these trials had significant limitations and flawed interpretations of data.  However, once a topline article was generated by press release, it was accepted by most healthcare professionals with an unquestioning attitude.  Only in the pandemic have we practiced press release medicine.  The usual standard is publication of data before adoption of such practices.


5) Telemedicine has a positive impact on medicine

– With the COVID emergency, telemedicine started to figure prominently in healthcare.  It seems to have gone rather well as it is convenient for patients, provides access to care – especially mental health – in remote areas, and eliminates office visits for minor acute needs, which frees up more space for medically complex patients.  In my opinion, the restrictions are telemedicine that were lifted for COVID emergency care should remain permanent.


4) Public health “experts” were often wrong and don’t practice medicine

– It is hard to track all the things public health experts got wrong during the pandemic at this point.  Certainly, COVID-19 was a novel virus, and in the beginning, no one knew exactly what the right answers were.  However, the “experts” ensured that the basic questions surrounding COVID, which would have made huge practical differences in the lives of people were not addressed.  Had the “experts” in the government even run the most basic of studies on COVID-19, the controversies surrounding the virus would have been avoided.  However, when there is no definitive answer, misinformation and politics were left to fill the void.  This is often exacerbated because people who are labeled “experts” often have no clinical experience (Rochelle Walensky is a prime example) and make policy decisions that have real-world implications while not understanding how the real-world functions. 


3) Modern medicine remains poor at treating viruses and post-viral illness

– One of the major flaws of modern medicine is that it is not effective in treating viruses.  COVID showed us that an acute infection can have long-lasting effects.  This is not a new phenomenon, but the sheer number of COVID cases with severe manifestations left many people afflicted with long COVID.  Since, literature has linked several viruses to conditions such as MS, type 1 diabetes, and there is likely a viral link to other poorly understood syndromes such as ME/CFS, POTS, MCAS, and multiple other chronic illnesses.  While I have been privileged to be a co-author of multiple cutting-edge papers on long COVID and help thousands of people, most patients have been less fortunate and have toiled through the medical system with significant suffering.


2) The FDA and CDC need a significant overhaul

– I don’t think there is a lot more to say here other than the CDC guidance has been convoluted to say the least and the decisions made by the FDA have been questionable.


1) Everyone loses when medicine and politics are mixed

– Medicine remains a sacred covenant between the provider and the patient.  When politics are mixed into this relationship, nothing good comes of it.

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