When the year 2020 began, who would have ever thought that a pandemic would envelop the world with the loss of more than 550,000 lives and unfortunately probably many more to come. At that time, we heard of a virus that had begun to spread in China but the virulence was not yet known. Although there were some who were beginning to worry, for the most part, we thought it was somewhere else. We began the year planning graduations, weddings, summer vacations, and a host of many other happy things. No one could have fathomed what the world was about to face.
The first known case in the United States is thought to have been in the Seattle area in mid-January 2020 who had traveled from Wuhan, China (Holshue et al., 2020). Additional cases were found in the Santa Clara County, CA, in early February. These patients had no known travel history and were believed to have contracted COVID-19 via community spread (Soucheray, 2020). This was long before anyone had the chance to even learn or think about how to protect themselves from developing the virus. Researchers from the Icahn School of Medicine Mount Sinai in New York City found that cases of COVID-19 were most likely in New York City in late January 2020 (Gonzalez-Reiche et al., 2020).
Roll the calendar to July 2020 and we were now very aware of what had occurred in the ensuing months. The closing of almost every school, restaurant, store, entertainment venue, and just about every industry across the country changed the lives of all. Whether you were involved in strict lockdown states or in states that were hopefully cautious to avoid the fate of other states, there was not a newscast, daily government/state update, or special report that did not describe the challenges that healthcare workers and first responders faced. No one can deny the intense situation that was occurring in New York City. I could not help but worry for all of my colleagues who were working in environments that no one could have ever anticipated. Our own NAON members were being called to shift from orthopaedic care to COVID-19 care on COVID floors and COVID intensive care units. Our Past President, Jack Davis, coined the term "Ortho Now Other," which played on a theme from some years earlier when we stated, Ortho Not Other. We have heard countless accounts from NAON members who were frontline caregivers and yes they were and continue to be Healthcare Heroes!
As I read Dr. Elizabeth Carlson's review of the book, And If I Perish: Frontline U.S. Army Nurses in World War II, by Evelyn M. Monahan, Rosemary Neidel-Greenlee, and Alfred A. Knopf (514 pp.), I got caught up on this sentence: "These nurses, 'unarmed and without the benefit of rigorous military training, climbed down ropes and ladders into a land craft that took them, alongside the fighting men, on to the beaches of French North Africa'" (p. 23), I could not help but think of how our NAON nurses, who needed to acquire skills quickly and then who had to forge right in to care for the thousands of patients who required a totally different kind of care. We should be indebted to every healthcare worker.
Now we all need to face the challenges of moving on, yet knowing that COVID-19 is not gone and that it will continue to be something that needs to be managed for many months to come. For orthopaedics, although we continued to provide essential care during those days when there was complete lockdown, we now must move forward and care for orthopaedic patients with a myriad of problems. We must create an environment where patients, families, and caregivers are safe. From patient clinic visits to surgeries in ambulatory surgery centers or hospital settings to rehabilitation settings, continued meticulous care must be put in place to develop and maintain ongoing workflows that protect all. We cannot become fatigued with the processes and workflows that will need to become the new normal.
Nothing will be easy in the next few months. Managing our own personal well-being will be important as the challenge will continue. Self-care must be prioritized. This too will be difficult while trying to find time to manage work, home, children, etc. As we face the new normal, remember that we will adapt and we will succeed during these challenging times. Vigilance will be the key to success. Stay well!
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