'Courage alone won't be enough': Advice from an emergency physician who fought Ebola

As the coronavirus pandemic intensifies in the U.S. and across the world, healthcare providers must get enough rest, remember to eat and know that "courage alone won't be enough," an emergency physician wrote in an article for STAT.

Adam Levine, MD, an associate professor of emergency medicine and director the Center for Human Rights and Humanitarian Studies and division of global emergency medicine at Brown University in Providence, R.I., wrote the piece, providing advice to healthcare workers on the front lines of the pandemic based on his experiences in West Africa fighting the Ebola epidemic in 2014.

Dr. Levine went to Liberia in the summer of 2014 to aid the emergency response to Ebola and to help establish an Ebola treatment center in Bong County, Liberia.

Though the fear he initially felt when he left for Liberia dissipated, it never completely went away, he said. But Dr. Levine, writes, "Courage is not the absence of fear — it is doing what you know you must, even when you are terrified."

He also writes that courage is not the only attribute needed to get through the coronavirus pandemic. Healthcare workers will have to be vigilant about taking care of themselves and each other, he said.

This means healthcare workers must make sure to protect their health and take care to put on and take off protective equipment correctly, while making sure their team does the same.

"You are a precious and limited resource, and you must act the part," he writes.

Dr. Levine also discussed the difficult decisions physicians must make when rationing care.

"You may be surprised to learn that rationing is rarely very rational," he wrote. "Your hospital or department of health or professional society may have developed guidelines, yet you will find them difficult to apply to the unique circumstances of the patient in front of you."

These difficult situations also mean that healthcare workers must be aware of their implicit biases and make sure they are not getting in the way of their decision-making.

Dr. Levine concludes his article by reminding healthcare workers that "this too shall pass." He recounts a story from Liberia where a truck pulled into the treatment center parking lot with a banner on the windshield that read "no condition is permanent."

More articles on integration and physician issues:
Nearly half of surveyed primary care practices say they don't have capacity for COVID-19 testing
Physicians take drastic measures to protect families from coronavirus
Primary care recruitment: How 3 organizations are moving the needle

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