key: cord-0884103-7h2k8ugg
authors: Drazner, Mark H.
title: COVID Silver Linings
date: 2022-03-09
journal: J Card Fail
DOI: 10.1016/j.cardfail.2022.02.007
sha: e6893687ec52002f7173a1a4dc7b68a4f5727fee
doc_id: 884103
cord_uid: 7h2k8ugg

nan

The COVID-19 pandemic is the most catastrophic worldwide event in my lifetime. Optimism is hard to maintain when faced with one wave after another. It is as if each variant is a new gladiator entering the arena with intent to destroy us. Delta, Omicron. . . who's next, and when will this end? Yet, even in this darkness, as in all times of tragedy, there are bright spots. Mr. Rogers told us to look for the helpers. I've taken to looking for #BeaconsOfLight. 1 Recently, while reading about the events in the National Basketball Association (NBA), I was struck by the idea that despite the misery of the pandemic, COVID does have silver linings. In the NBA last December, many players were unable to play due to COVID exposure and quarantining, and teams had to sign short-term, 10-day contracts with players who otherwise would not be in the league. Such replacement players benefited financially, receiving more money in those ten days than for an entire season in the developmental league. 2 Equally important, they gained the opportunity to showcase their skills, which might help them gain a season-long contract. Finally, even if it only lasted for 10 days, they achieved their dream of playing in an NBA game. For these replacement players, this opportunity was a silver lining of the pandemic.

Recognizing the silver linings does not minimize the horrific consequences of the pandemic; furthermore, all of us can benefit by having our spirits lifted during this difficult time. I suggest that we should look through this lens for silver linings in health care as well. Most notable has been the remarkable speed at which major medical advances have occurred. Only two years into the pandemic, we have made tremendous strides in therapeutic advances with monoclonal antibodies, oral and intravenous pharmacological therapies, and vaccines that are highly effective and can prevent hospitalization and death. Large randomized clinical trials were successfully completed despite the numerous challenges posed by the pandemic and led to many of these advances. The pace of these accomplishments in such a short period of time, and under such difficult circumstances, is truly breathtaking. Watching the worldwide medical and scientific communities come together successfully to combat this virus is a COVID silver lining.

Another silver lining has been the opportunities created for early-career health professionals. At my home institution, University of Texas Southwestern Medical Center, early in the pandemic, our cardiology fellows established a systematic approach to collecting information from patients with COVID admitted to our hospitals to glean insights that could advance our understanding of this illness and, thereby, improve care. Subsequently, the platform they created was leveraged and used to develop the national American Heart Association COVID-19 CVD Registry. 3 Our cardiology fellows became subjectmatter experts, and the roles of teacher and learner flipped, with those younger in age teaching the faculty. For the fellows, the pandemic created space and opportunity for academic success. For those of us now in the learner role, our silver lining was watching with pride as the next generation emerged, perhaps thrust into the limelight earlier than expected, yet proving they were more than ready to accept the mantle.

The pandemic has also accelerated the adoption of telehealth as a means of delivering care. The HFSA has issued a Scientific Statement on this topic. 4 While much remains unknown about how to conduct an optimal telehealth visit, and whether it may lead to improved or worse outcomes when applied to longitudinal care, several anecdotal observations already are clear. Telehealth has made it easier on our patients to access care, so that a visit can be done from home or work in under one hour, rather than several hours, or longer, spent coming to the medical center. It also has allowed me the privilege of virtually entering the homes of my patients, breaking down the walls between my office and their living spaces. Telehealth also has made it easier for family members to participate in visits. Furthermore, I have enjoyed the challenge of learning how to assess jugular venous pressure via remote estimation over video connection. 5 There are other silver linings of the pandemic. Conversion to the virtual platform has expanded the reach of lectures and conferences to larger audiences at a more affordable cost. The long-term implications on medical education are not yet known, but undoubtedly will be consequential. The widespread adoption of video conferencing also has touched our personal lives. Indeed, my family has had several gatherings, involving four generations of relatives across the United States, to celebrate holidays via Zoom; before the pandemic, such events would have been unlikely to occur. Finally, many have used the forced time at home to develop new skills or acquire pandemic hobbies. It's heartening to hear about and see photos related to these newly acquired culinary and creative talents, often leading to a smile or laughter and moments of brief respite. Such shared experiences rejuvenate our spirits and help maintain our stamina, important attributes that will allow us to emerge victorious in our battle with this wily and relentless foe.

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Fellow-driven project leads to national registry for COVID-19 biomarkers

Virtual visits for care of patients with heart failure in the era of COVID-19: A statement from the Heart Failure Society of America

Feasibility of remote video assessment of jugular venous pressure and implications for telehealth