If you’re reading this, you’ve survived 2020. Congratulations!—although it probably doesn’t feel like there’s much success to revel in at the moment. Indeed, this has been a year of hardship for everyone in some form and certainly, for many, it still may feel like there’s no end in sight. And it doesn’t seem like much cause for celebration to have dodged a bullet when you’re still staring down the barrel of a loaded gun. However, any glass that is half empty is also half full and I think it can prove instructive, if not therapeutic, to remind ourselves of just how far we’ve come this year.

In keeping with tradition, rather than looking forward for any prospect of a “return to normalcy,” allow me to take this time at year’s end to reflect a bit on some of the positives that have come from the last 12 months.

I assumed the role of Editor-in-Chief of JUCM at the beginning of 2020 and never could’ve dreamed of the plots twists which would unfold over just 12 months. It was, in fact, in the same month that I took over at the Journal, that the first case of COVID-19 was diagnosed in the U.S. Then, less than 2 months later, COVID-19 was declared a pandemic. Since then, we have been battered by no less than three “waves” of COVID case surges—each heartbreakingly arriving just when the prospect of reprieve seemed within reach. As I write, we are facing renewed austerity measures and shutdowns throughout the city of Chicago and nation, and, indeed, throughout the world.

 While the road ahead seems long (and likely is), I’m amazed when I look in the rearview mirror at just how far we’ve come this year in medicine and in the specialty of UC specifically. Just 10 months ago, we had no understanding of how the novel coronavirus was spread, how to prevent it, how to test for it, and how to treat the more serious complications of it. I can clearly recall the early days of the pandemic, when we’d run a flu swab and call it COVID if the influenza test was negative, but “seemed like the flu.” Now, who among us couldn’t rightfully claim to be a de facto COVID-ologist? By comparison, it took over 20 years after the first case of HIV before we had any clinical test to detect infection.

We’re undoubtedly fortunate that this pandemic arrived in an era of more advanced technology. This allowed for the sequencing of the SARS-CoV-2 genome within weeks of its discovery. Additionally, through various online communities, we have been able to communicate the findings from our clinical experiences with affected patients instantly and throughout the world. In pre-COVID times, clinical studies often took many years from planning to publication. The former pace of scientific progress seems positively glacial compared with what researchers tackling the pandemic have accomplished thus far: going from 0 to over 64,000 hits in a PubMed search for “COVID.”

I’m proud to report JUCM’s contribution on this front as well. Prior to 2020, there had been only a handful of original research studies published in the Journal. However, in this trying time, our fellow members of the UC community felt an obligation to share critical findings they had learned while caring for the massive numbers of COVID-19 patients who presented to UC centers around greater New York City. We also recognized the relevance and timeliness of these findings and worked closely with the authors to expedite several COVID-related original research publications. At the time of release, these studies were the largest examinations of chest x-ray findings in COVID patients ever published and subsequently have been cited by other investigators hundreds of times.

The UC community at-large has also risen to the challenge. As volumes plummeted during the spring months, many UC centers pivoted quickly and adopted novel telehealth platforms that allowed them to continue to deliver timely and convenient care to millions of sick patients and the “worried well” alike. This allowed many patients to stay home when seeking in-person care was unnecessary, which certainly mitigated the spread of infections—an undeniable service to public health.

In many communities, UC centers have functioned as primary sites for much of the COVID testing as well. Despite many uncertainties and hurdles in obtaining reliable PPE and testing supplies, we have not been deterred. Rather, we have lived up to our stated mission of providing convenience of access and have accommodated, and continue to serve, patients with COVID-related concerns in dramatic quantities every day.

And, while it is true that we haven’t yet found the ideal antiviral or a safe and effective vaccine, our progress is hopeful. Since the pandemic began in March, we have gone from gasping for breath to treading water to confidently swimming the backstroke. All the while, I have been constantly amazed by the ingenuity and perseverance I’ve seen in the UC community as we’ve supported the nation and world through this impossibly difficult moment.

There remains a long road ahead for us, but I am sure we are up to the challenge. And with a new year comes revived energy—the phenomenon behavioral psychologists refer to as the “fresh start effect.” After seeing all we’ve done over the last 9 months, combined with the full head of steam we will undoubtedly bring to 2021, I can’t wait to see what we will accomplish together over the next 12 months.

Happy New Year,

Joshua W. Russell, MD, MSc, FAAEM, FACEP
Editor-in-Chief, JUCM, The Journal of Urgent Care Medicine
Email: [email protected] • Twitter: @UCPracticeTips

Don’t Forget about the Road Behind

Joshua Russell, MD, MSc, FAAEM, FACEP

Quality and Provider Education, Legacy - GoHealth Urgent Care, is affiliated with the University of Chicago Medical Center in Vancouver, WA, and is Editor-in-Chief of JUCM.
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