It is four o'clock in the morning, the first rays of the sun have not yet peeked through my window. I realize a particular unsuspected consequence of the pandemic, the proverbial Forero's sleep has diminished. Fortunately, it continues to be restful, despite the reduced number of hours I continue to enjoy total rest. I will put into practice an advice offered to my insomniac patients for a long time: use the hours left by insomnia for productive activities. I will take this opportunity to read a couple of articles.
The early morning silence and the cool temperature make it easy to concentrate. The conference in preparation needs my full attention. Come to think of it, another consequence of the pandemic was the increase in academic meetings. I have participated in more academic activities this year than in many years of practice combined.
Suddenly, two episodes of dry cough brought me back to reality. The cough reminds me of the presence of the virus and how vulnerable we are to its attack. The dystopian confrontation of our society with COVID-19 awakens in me such uncertainty and a sense of helplessness that I remain apprehensive, not knowing what to do.
It is very hard for me to be a pessimist; life has taught me that with some intrinsic tools such as effort and discipline we can overcome many difficulties. For a little more than 50 years I have learned to overcome health, economic and work problems successfully, but the pandemic seems to be beyond my strength. One more consequence of the arrival of the virus, I learned to recognize my inner fears.
At times like these, appealing to science is one of my most frequently used alternatives. The problem is that the always effective science takes its time to offer solutions, as it should, among other things. To this day, everything is still in the realm of the experimental and nothing is concrete. Hydroxychloroquine, azithromycin, ivermectin and other "promising" drugs were taken out of the key ring at the drop of a hat. Their theoretical merits did not stand up to the first methodological analyses.
Remdesivir, initially exalted, has gradually lost credibility. The well-known and lapidary refrain, more studies are needed to confirm its efficacy, with which many failed studies are closed, is now read in the most recent guidelines. (1).
Dexamethasone is reserved for severe cases of pulmonary involvement, but it has no place in the usual cases. Tocilizumab and baricitinib, brought from other scenarios known to rheumatologists, also seem to have some therapeutic effect in severe cases, but a treatment scheme with reasonable effectiveness has not been finalized. Finally, hope is placed in vaccines, drugs that still require some time and money for their massive use. I continue to be concerned; science is delayed.
Almost without thinking I closed the magnificent review on the role of the complement in the etiopathogenesis of rheumatic diseases and went in search of calm waters for my boat. I distracted myself by reading "light" scientific data, remarks, music videos, good and bad memes. The columns written by Alberto Palacios and Fernando Neubarth in Global Rheumatology deserve a special mention, they are fantastic, they combine the personal experience with deep messages very well. Anyway, reading and listening to music, about two hours passed quickly, my fears were diluted by Palacios, Neubarth, Lavoe and others.
The one led me to the other, if the readings produced a few hours of tranquility, forgetting for a moment the effects of the pandemic, because we collaborate with those friends who find in reading a source of calm. I decided then in a Google Drive (2) to post "The traps of nostalgia" my first publishing venture. In the blog (3) you will also find a variety of topics that I hope will be of some use.
These days I will dedicate my sleepless hours to write some chronicles of life that perhaps will relax me more by writing them, than you by reading them. But what else can we do? we are in times of the corona-crisis, where everything that serves to look for the lost tranquility, is worth doing...
1. BMJ 2020; 370: m2924 doi: https://doi.org/10.1136/bmj.m2924 (Published 30 July 2020)
2. The Traps of Nostalgia
3. Elias Forero Blog http://eforerocuenta.blogspot.com/