How to work in context of illness

[meow1985]

I need a bit of moral support. During the holidays I managed to have a Covid exposure and contract a respiratory illness. I am vaccinated and boosted. Whether it is really Covid or not, the jury is still out. I’m waiting on the PCR test. I can work from home. In fact I do at baseline part of the time. The symptoms vary from mild to moderate to barely there, but enough to bother me and make me feel like managing a tough patient interaction is more than I can handle. I keep questioning whether the symptoms could be clouding my thinking or memory, and it’s hard to tell. I have to go back tomorrow and have a couple unstable, tough patients that day. The concerns of is this Covid and what if I get long Covid or neuro Covid or something are also weighing on me. Overall I feel overextended.

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[Mass Effect]

I need a bit of moral support. During the holidays I managed to have a Covid exposure and contract a respiratory illness. I am vaccinated and boosted. Whether it is really Covid or not, the jury is still out. I’m waiting on the PCR test. I can work from home. In fact I do at baseline part of the time. The symptoms vary from mild to moderate to barely there, but enough to bother me and make me feel like managing a tough patient interaction is more than I can handle. I keep questioning whether the symptoms could be clouding my thinking or memory, and it’s hard to tell. I have to go back tomorrow and have a couple unstable, tough patients that day. The concerns of is this Covid and what if I get long Covid or neuro Covid or something are also weighing on me. Overall I feel overextended.

What do you mean you have to go back? You mean work from home? I wouldn't go back in person if you don't even have the PCR test back yet?

Aside from that, sounds like you're at baseline psychologically. Just do the best you can.

 

[meow1985]

What do you mean you have to go back? You mean work from home? I wouldn't go back in person if you don't even have the PCR test back yet?

Aside from that, sounds like you're at baseline psychologically. Just do the best you can.

I mean I am scheduled to work tomorrow, which I can do from home.

 

[Mass Effect]

I mean I am scheduled to work tomorrow, which I can do from home.

It sounds to me like you're at baseline.

 

[meow1985]

It sounds to me like you're at baseline.

My mental baseline plus a physical issue and worries about long Covid all seem to be putting me outside of my tolerability zone.

 

[soporific]

My mental baseline plus a physical issue and worries about long Covid all seem to be putting me outside of my tolerability zone.

If you feel you are outside of your tolerability zone, you can take a sick day. Do you have disability insurance? If so that should help with the worries of long COVID.

 

[birchswing]

I'll just do Column A which is the good things:
You're double-vaccinated.
You're boosted.
You were able to get a PCR test.
You can and get to work from home.

That's better than like 99% of the world.

When column B comes up, just think of something from Column A.

And if you consider the possibility that everyone will at some point contract Covid, sort of like EBV (blast that EBV), you are probably at the maximal point of protection for contracting it--being doubly vaccinated and boosted--your infection with it would be the mildest possible. Which, while I don't have the data, I would assume probably portends the least likelihood of long Covid, etc.

 

[meow1985]

If you feel you are outside of your tolerability zone, you can take a sick day. Do you have disability insurance? If so that should help with the worries of long COVID.

I do, it’s part of my workplace benefits package. Also, it’s long Covid, not forever Covid, I believe.

Sick day is an option, but my particularly unstable patients need me, and it probably would just increase the avoidance cycle.

 

[Monocles]

OP when's the last time you took vacation man?

 

[meow1985]

OP when's the last time you took vacation man?

Just did, over the holidays! My first day back is supposed to be tomorrow and I’m not ready for it. Got Covid symptoms on New Year’s Eve. Stupid omicron. I did not even go anywhere or do much of anything, just saw some vaccinated family who visited from out of town. Family drama and worries about Covid and worries about a few patients. Had to fight myself not to open the EMR until yesterday. That was my vacation, lol.

PS: got my PCR result back since making this post, it’s Covid.

 

[Mass Effect]

Which, while I don't have the data, I would assume probably portends the least likelihood of long Covid, etc.

Not to add to the OP's anxiety, but as this is a medical forum, I must point out the above is incorrect.

 

[meow1985]

Not to add to the OP's anxiety, but as this is a medical forum, I must point out the above is incorrect.

In my anxious researching, I’ve already become aware of this fact. The data on the risk of long Covid is actually variable and flawed, but it is not necessarily lower with mild disease, and vaccination reduces it by a factor or about 2.

 

[birchswing]

Not to add to the OP's anxiety, but as this is a medical forum, I must point out the above is incorrect.

Yeah, I looked that up after I posted it, but then decided was better not to correct myself in this case. At least for me--it's good someone posted it.

Sorry you got Covid @meow1985 . I feel like everyone has worked so hard not to get it, and this time around it's just omnipresent and there might not be any avoiding it. And even if you were to get long Covid, which I don't expect, the good news is that unlike many other illnesses, this one has the weight of the world in investigating treatments right now. I mentioned EBV for example. That--well it's probably controversial to get into EBV--but suffice it to say, the long term effects from *this* virus will be more investigated than any other in this history of humanity probably which will probably result in more treatments. Again, not that I would expect you would need them.

I hope you feel better soon.

 

[wolfvgang22]

If you feel overwhelmed and ill, take a sick day. The patients survived before you met them and they would survive if the metaphorical bus hit you tomorrow. Take care of yourself.

 

[Monocles]

Just did, over the holidays! My first day back is supposed to be tomorrow and I’m not ready for it. Got Covid symptoms on New Year’s Eve. Stupid omicron. I did not even go anywhere or do much of anything, just saw some vaccinated family who visited from out of town. Family drama and worries about Covid and worries about a few patients. Had to fight myself not to open the EMR until yesterday. That was my vacation, lol.

PS: got my PCR result back since making this post, it’s Covid.

Why not take the whole week off and recover instead worrying about your illness and your patients' illness? Surely your patients will survive one week without you?

 

[FlowRate]

Not to add to the OP's anxiety, but as this is a medical forum, I must point out the above is incorrect.

I do not stay abreast of the latest covid literature. Was looking into long covid more and came across this AMA article from October stating that it is protective:

What doctors wish patients knew about long COVID

Even mild SARS-CoV-2 infection can lead to long COVID. And with the transmissibility of the Omicron variant, patients may be concerned about the condition.

www.ama-assn.org

Is there newer research or was the doctor they quoted just wrong?

 

[Mass Effect]

I do not stay abreast of the latest covid literature. Was looking into long covid more and came across this AMA article from October stating that it is protective:

What doctors wish patients knew about long COVID

Even mild SARS-CoV-2 infection can lead to long COVID. And with the transmissibility of the Omicron variant, patients may be concerned about the condition.

www.ama-assn.org

Is there newer research or was the doctor they quoted just wrong?

You mean that the vaccine is protective against long Covid? I think the doctor is wrong based on more recent articles and my own experience. I don't think we have a definitive answer yet in the literature, but these and anecdotal data suggest the opposite what the doctor quoted said.

Do vaccines protect against long COVID? What the data say

Vaccines reduce the risk of developing COVID-19 — but studies disagree on their protective effect against long COVID.

www.nature.com

Long COVID risk no lower with breakthrough infection; COVID-19 survival improves for European cancer patients

The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

www.reuters.com

 

[FlowRate]

You mean that the vaccine is protective against long Covid? I think the doctor is wrong based on more recent articles and my own experience. I don't think we have a definitive answer yet in the literature, but these and anecdotal data suggest the opposite what the doctor quoted said.

Do vaccines protect against long COVID? What the data say

Vaccines reduce the risk of developing COVID-19 — but studies disagree on their protective effect against long COVID.

www.nature.com

Long COVID risk no lower with breakthrough infection; COVID-19 survival improves for European cancer patients

The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

www.reuters.com

Seems like there are a lot of both terminology and methodology issues around this. Vaccines are protective against covid and hence protective against long covid. But if you are vaccinated and do get covid then, depending on which study you look at and how they define long covid, you're either partially protected or not protected. The first study from that second link's definition for long covid was a bunch of mental health symptoms that it feels like everyone has been having since the pandemic started, covid or otherwise.

 

[WisNeuro]

Seems like there are a lot of both terminology and methodology issues around this. Vaccines are protective against covid and hence protective against long covid. But if you are vaccinated and do get covid then, depending on which study you look at and how they define long covid, you're either partially protected or not protected. The first study from that second link's definition for long covid was a bunch of mental health symptoms that it feels like everyone has been having since the pandemic started, covid or otherwise.

Yeah, early lit in this area is going to be confounded by shared environmental effects, particularly in studies without well-differentiated control groups. And, most studies I have seen are using subjective self-report, usually retrospective. There are some studies and groups looking at the possible objective neuropsychological effects, including a group at the U of Minnesota, but the research is still pretty new, which make sense given the timeline.

 

[Mass Effect]

Seems like there are a lot of both terminology and methodology issues around this. Vaccines are protective against covid and hence protective against long covid. But if you are vaccinated and do get covid then, depending on which study you look at and how they define long covid, you're either partially protected or not protected. The first study from that second link's definition for long covid was a bunch of mental health symptoms that it feels like everyone has been having since the pandemic started, covid or otherwise.

The research definitely isn't solid in this area and the definition of long Covid needs to be solidified too, but the thing we know for sure is that being vaccinated doesn't mean you won't have long Covid symptoms.

 

[Old&InTheWay]

Long COVID is going to be the new CTE.

 

[clausewitz2]

Nobody here can tell you with the degree of certainty you are looking for that you won't miss something important working with a patient tomorrow that leads to a disastrous outcome that you would have caught without COVID.

And nobody can tell you with the certainty you are looking for that your unstable patient won't kill themselves in a way that could have been prevented by you seeing them tomorrow.

I'm still sorry you got COVID and I hope you do start feeling better soon.

 

[hallowmann]

I mean doctors work with chronic illness all the time. It's ultimately up to them to decide whether they are "bad enough" to warrant a sick day. That said, if you're thinking about it, it may be in both your and your patient's best interests to just take a sick day. It will aid in showing you that the world did not crumble with your one day absence and that the majority if not all of your patients survived.

Take care of yourself and don't worry about long COVID until you're at least out of the window of short COVID.