Rally Cycling doctors Kelby Bethards, Kristie Nicholls, and Mark Greve report in from the front lines.
During normal season, Rally Cycling's team doctors wear a lot of different hats. One moment they're treating road rash, the next they're advising via telephone on finding the right allergy medicines in Australia, or flying across the world to be with the team at races in Europe, South America or the Middle East. Now, with racing suspended for the foreseeable future, they are back at their 'day jobs', contending with something they've never seen before.
Rally Cycling team doctors Kelby Bethards, Kristie Nicholls, and Mark Greve have seen their lives changed immeasurably by the pandemic. Their experiences provide a deep insight into the varying effects of the coronavirus in the USA.
Personal letters sent to Greve's hospital in Rhode Island.
Dr. Mark Greve is an ER physician and associate professor of emergency medicine at Brown University in Rhode Island. The virus has changed he and his colleagues' entire mindset.
"It's almost like combat medicine. We're working in a system that you'd normally never have to contemplate and you don't know where the resources are. You can't assume you'll have access to all the things you normally would. And that includes personnel. So as a medical practitioner, you have to be able to operate autonomously.
"We're not so much having to become a jack of all trades, master of none, we're having to become a master of everything."
Dr. Kristie Nicholls has also seen her job change in scope. As a family doctor who was already providing telemedicine services before the pandemic, she has seen the number of states in which she is allowed to work surge, as states with a shortage of expertise relax their telemedicine rules. Officially licensed in four states, she is currently seeing patients from 14, from Alaska to Florida.
"It's confusing because every location is so different; whether they're doing tests or not doing tests, or requiring a lab slip, not requiring a lab slip. In New York, for a while, I don't even know if they are now, but they were not doing any outpatient testing for coronavirus. But in other places, they were trying to test as many people as they could. It's almost impossible to keep up with."
For the team's medical director, Dr. Kelby Bethards, who works in urgent care, treating patients often not-yet-diagnosed with coronavirus adds an extra precariousness to the situation.
"A colleague of mine who works with those who already have a diagnosis said to me 'At least I have a ventilator with a filter between myself and the patient.' For us we don't have that, you have people walking in who maybe don't even know they have it."
And that is to say nothing of the profoundly strange nature of the virus itself.
"I used to work at a medical facility at 9,000 ft and we saw a lot of altitude sickness. Coronavirus is mimicking altitude sickness a lot. But it's infectious, meaning that people aren't necessarily coughing and hacking, and they don't even know or feel like they're short of breath, but their O2 saturations are very low. You'll see these people and you're like, 'This guy's got it for sure, he's got a temperature of 103. He's huffing and puffing 30 times a minute instead of 12 times a minute.' But he doesn't even know he's doing it. It's bizarre."
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