Have been attending on inpatient service @BrighamWomens @DanaFarber this month, and on a #COVID19 "Special Pathogen Team" this past week. Amazing camaraderie and esprit de corps, really proud of these places & people. A few quick #medtwitter observations:
1) A LOT of patients present with signs & symptoms that *could be* COVID-19: regular febrile neutropenia, other respiratory illnesses, fever after a transfusion, vague symptoms in people who have lymphopenia because they just had a transplant or are on lymphodepleting chemo, etc.
I don't think I've seen much discussion of resource use for ruling out COVID / so many common COVID mimics. COVID teams are metaphorical N95 masks for the hospital: filtering & allowing patients who prove COVID negative to pass through to other teams, keeping those who "rule in"
2) A @dunkindonuts Munchkin' box is the perfect size for keeping a (non-metaphorical) N95 mask in. Plus you get to feel good about eating delicious munchkins - helping the cause, so to speak. 😀 
3) There is real value in working with the same nurses with whom one has built a healthy relationship over years of caring for patients together. When so much else seems upside down, seeing familiar faces helps. They are also the ones spending most time in rooms - Much Respect.
4) #ScrubEx machines have a better user interface than several electronic medical records I've worked with! And are more conversational: "Please wait; I am finding you what you asked for." They also seem to never get stuck, unlike vending machines for candy bars & Doritos...
5) @BrighamWomens must have the best house officers in the world. These guys are thoughtful, curious, and hard-working - and are just Getting It Done in an unprecedented time. Many have been pulled from outpatient or elective rotations. Grumbling? None at all.
6) Disparities are real, not that a reminder was needed. Viruses are no respecter of social status, but there are a disproportionate number of 1st generation immigrants and folks from poorer neighborhoods presenting to us with real COVID. I've never used so many interpreters...
7) Has there ever been a time in recent history when so many prominent people are saying so many ignorant things? Wish a few TV talking heads, celebrity doctors and DC insiders could come on rounds with us and see the reality... Grrr
8) Finding rehab facilities/nursing homes for patients post-inpatient stay is hard in the best of times. Doing so in the early COVID era is well nigh impossible. Care coordinators / Social workers are underappreciated heroes.
9) Finally, many oncology drugs have names that are impossible to say without creating a cloud of respiratory droplets, so we'll probably be wearing masks in heme-onc clinics indefinitely. Tagraxofusp? Eprenetapopt? 😀 Now off to rounds... @marklewismd
