EDITOR’S MESSAGE
The Medical Association of Georgia 1849 The Exchange, Suite 200 Atlanta, Georgia 30339 800.282.0224 www.mag.org MAG’s Mission To enhance patient care and the health of the public by advancing the art and science of medicine and by representing physicians and patients in the policy-making process. Editor Stanley W. Sherman, M.D. Executive Director Donald J. Palmisano Jr. Publisher PubMan, Inc. Richard Goldman, rgoldman@pubman.net 770.855.3608 Editorial Board Sara Acree, M.D. John S. Antalis, M.D. Mark G. Hanly, M.D. John S. Harvey, M.D. Frank McDonald, M.D. Mark E. Murphy, M.D. Barry D. Silverman, M.D. Michael Zoller, M.D. MAG Executive Committee Andrew B. Reisman, M.D., President Lisa Perry-Gilkes, M.D., President-elect Rutledge Forney, M.D., Immediate Past President Thekkepat G. Sekhar, M.D., First Vice President James L. Smith Jr., M.D., Second Vice President Frederick C. Flandry, M.D., Chair, Board of Directors Steven M. Huffman, M.D., Vice Chair, Board of Directors Edmund R. Donoghue Jr., M.D., Speaker James W. Barber, M.D., Vice Speaker Debi D. Dalton, M.D., Secretary Thomas Emerson, M.D., Treasurer S. William Clark III, M.D., Chair, AMA Delegation W. Scott Bohlke, M.D., Chair, Council on Legislation Advertising PubMan, Inc. Brian Botkin, bbotkin@pubman.net 678.643.7250 Subscriptions Members $40 per year or non-members $60 per year. Foreign $200 per year (U.S. currency only). The Journal of the Medical Association of Georgia (ISSN 0025-7028) is the quarterly journal of the Medical Association of Georgia, 1849 The Exchange, Suite 200, Atlanta, Georgia 30339. Periodicals postage paid at Atlanta, Georgia, and additional mailing offices. The articles published in the Journal of the Medical Association of Georgia represent the opinions of the authors and do not necessarily reflect the official policy of the Medical Association of Georgia. Publication of an advertisement is not to be considered an endorsement or approval by MAG of the product or service involved. Postmaster Send address changes to the Journal of the Medical Association of Georgia,1849 The Exchange, Suite 200, Atlanta, Georgia 30339. Established in 1911, the Journal of the Medical Association of Georgia is owned and published by the Medical Association of Georgia. © 2017.
The COVID-19 pandemic
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Stanley W. Sherman, M.D.
s I began to write my editorial, I had just read an article that noted that more than 6,700 people in Georgia have died from COVID-19, including two physicians. One was a 74-year-old family doctor who had helped his old and frail cancer patient who had the virus out to his car in early March, before the widespread use of PPE. Should no good deed go unpunished? The article also reported the death of 98 health care workers in Georgia. Clearly our commitment to our profession and to help our fellow man has not bestowed immunity on us to prevent infection and death – and yet you heroes do your job every day. It certainly makes it easy to devote this issue of the Journal to you.
Spending more time at home during the quarantine, I went through some old files and found that at a 2005 MAG meeting we were given a booklet entitled ‘Personal Preparedness Planning Kit For Georgia’s Healthcare Worker’” from the Georgia Department of Human Resources. This kit – developed after September 11, 2001 – primarily dealt with bioterrorism, but it also addressed a pandemic flu plan. As best as I can tell, the only difference in the two is that bioterrorism is intentionally caused while a pandemic is not. The suspect pandemic organisms were influenzas then; now if you go to the CDC websites noted in the kit, you will be directed to the COVID-19 website. Interestingly, a very valuable section in the booklet was on coping with the emotional effects of a disaster – for us, our families, friends, and patients. The booklet listed such emotional responses as trouble concentrating, forgetfulness, numbness, depression, anxiety, grief, anger, and guilt. The physical symptoms listed were nausea, rapid heart rate, headaches, trouble sleeping or nightmares, and the increased use of alcohol, tobacco, and drugs. It encourages people to talk about their feelings, find healthy ways to relax, take frequent breaks, avoid working long shifts if possible, and seek professional counseling if necessary. It also discusses tips for helping children cope, including encouraging them to talk about the pandemic, allowing them to feel upset or cry, letting them know that their feelings are normal, reassuring them that it is not their fault, and protecting them from repeated exposure to the events they may see on television. Unfortunately, patients are beginning to experience what has been described as “quarantine fatigue.” Instead of complying with the CDC guidelines, they forget masks or remove them in the physician’s office, and they seek more social contact despite the increasing number of cases. CDC’s recommendations for dealing with this are the following: advise only going to trusted Internet sites such as CDC. gov, avoiding constant exposure to the news, focusing on diet , exercise and sleep, and staying connected with loved ones – and when doing so, keeping each other accountable in maintaining infection precautions. Personally, an effective vaccine cannot come soon enough! Our feature article is a Q & A with some fellow members who represent those of us on the front line, those consulting, and those in administration during this pandemic. I hope you will appreciate both the differences and agreements in their views as much as I did. Our ethics article challenges us to deal our patient’s
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