Reflections of an Infectious Disease Physician: Where COVID-19 and my Personal World Collide

Dr. Katie Sharff tackles COVID stigma

Dr. Katie Sharff is a practicing infectious disease physician, and a skilled researcher whose papers on myocarditis highlighted the CDC’s own deficiencies. Here she discusses a personal story— how we turned the mundane— respiratory viruses— into something shameful.

Why do humans get respiratory viruses? Despite millions of news stories on COVID19, no one asked the obvious question. Respiratory viruses exist because human beings have to be close to each other. We are a social animal. We have to breathe each others air, and everything wonderful in life happens in proximity. Respiratory viruses exist because being human means being close to one another.

Children have gotten and will get respiratory viruses for as long as we exist. Our knowledge of the immune system is so primitive it would be a mistake to conclude: it would be better to avoid such viruses. The truth is we do not know. It might actually be bad. And yet, here we are with arrogant pundits confident in the unyielding power of humankind to bend the natural world to our will. Arrogant but not wise. Clueless that we don’t even know what is best.

I hope you enjoy this essay as much as I did.

-Vinay Prasad MD

Reflections of an Infectious Disease Physician: Where COVID-19 and my Personal World Collide

Dr. Katie Sharff

My 9-year-old son came home from school today and said, “I had a terrible day at school, nobody would play with me.”

“Why buddy?” I inquired.

“Because of my cough. When I coughed, Sara moved her chair away from mine and made a mean face. My teacher was extra stern and made me wash my hands twice in 5 minutes.”

My son has a viral upper respiratory tract infection, and he has viral-induced asthma. A few days ago, he had a drippy nose and mild congestion but no fevers or fatigue. Although he is vaccinated and has had breakthrough Omicron infection, I did the compulsory COVID-19 home antigen tests which were negative.  He was not sick; he was full of energy. When I dropped him off at school today, he was chasing his friends on the playground. However, throughout the day, he started coughing from his asthma, and now nobody will play with him.

I am an infectious disease physician. My family’s relationship with COVID-19 has been intertwined since February of 2020. Two and half years into the pandemic, it continues.

Our relationship with COVID-19 started on February 25th, 2020. I was volunteering at Forest Hills Elementary School in Oregon. While I was volunteering, the administrative assistant mentioned that the beloved custodian, Mr. C, was sick at a Kaiser Permanente Hospital with pneumonia.

“Will you drop off this get-well poster that the first grade made for him when you go to work tomorrow?” she requested. I gladly obliged.

February 26th, 2020 was a rainy, grey, 40-degree Wednesday in Oregon. It was just like any other February day. I stopped by Mr. C’s room in the ICU to deliver the poster the children had made. I was there on a social visit; he was receiving excellent care from the ICU team with all the appropriate tests and treatments.

As any curious ID physician does, I chatted with the family and started asking questions, lots of questions. Things didn’t add up, it didn’t make sense he was so sick. At that time, COVID-19 was only a disease of far-off places: China, Italy, and cruise ships. You couldn’t test for it unless the patient had a known contact or history of foreign travel. It wasn’t an infection that occurred in elementary schools or office buildings.  It was a disease on our radar but only discussed in theoretical terms.

That night as I was going to bed, I scanned the news headlines. The first case of community transmission of COVID-19 without a known contact had been identified in a patient in California, no details were available. If it occurred in California, why not Oregon? CDC Confirms Possible First Instance of COVID-19 Community Transmission in California

On February 27th I called our local public health officer and implored we check Mr. C for COVID-19.

“It can’t be done, he doesn’t meet CDC criteria for testing.” I was told.

“Well then, please have them change the criteria,” I pushed back.

By 4 pm that day, CDC had updated their testing guidance allowing us to send the appropriate swabs for COVID-19, results would be expected in a week.

On February 28th, I left Oregon for a medical conference in Arizona to meet up with my husband. As my plane landed on the tarmac and I turned on my cell phone, it started buzzing wildly.

“Call me right away, COVID-19 positive…” read the messages.

February 28th, 2020 was a time when COVID-19 was considered under control in the United states. Mr. C was the 2nd case of community transmission without a known contact. (‘An inspiration to all of us,’ says doctor who treated Oregon’s first coronavirus case - oregonlive.com) It would be several more weeks until the country went into lock down and the world shut down.

It was on this day, February 28th that my professional life collided with my personal world. I was placed on 14-day quarantine and told I could not get on an airplane. My husband and I canceled our plans and drove overnight from Arizona back to Oregon. My son’s school shut down for an arbitrary 5 days and a hazmat team came into decontaminate the school. Classes resume at Forest Hill grade school in Lake Oswego | kgw.com  I stayed home for 14 days on quarantine (I did not contract COVID-19 at that time), but I didn’t share my experience with any friends or neighbors. My two children needed to see friends, they needed to be invited on playdates and attend birthday parties. I knew the minute I shared the details of my professional experience; my children would no longer be included.

On March 16th, 2020 Governor Brown declared Executive Order 20-20 and closed schools. Over the next 12 months, the only people that would socialize with my family or children were doctors and their children. Our usual social group was terrified of us, somehow as an infectious disease physician I was considered a vector ready to spread COVID-19 to the community. Non-medical friends regarded me with respect but a bit of trepidation, their fear was palpable. Kids walking down the street were not allowed onto our driveway in case we would transmit COVID-19 to their family. My children suffered because of my profession.

It is now two and a half years later. My kids are at school and they are fortunately thriving. However, our community’s reaction to usual respiratory viruses is forever changed by the impacts of COVID-19. I try to remind friends and patients that respiratory viruses are part of the usual landscape of infections. Our children are blank slates, they have not seen these viruses for the past 2 years and so remain vulnerable to every upper respiratory infection that circulates in our community. However, despite my best efforts, my son’s cough is met with fear, trepidation, and judgmental stares. His friends won’t play with him, his teachers are nervous, the cashier at the grocery stores glares at me from behind her mask.

When will we reframe our thinking and remember that children get colds and upper respiratory infections and that is a normal pattern of life? Once over the acute illness and afebrile, a lingering cough or drippy nose should not keep them out of the classroom and shunned from social activities. The fear of COVID-19 has infiltrated the innocent world of the 4th grade classroom.

I sit here, as a mother and an infectious disease physician, reflecting on how COVID-19 has upended my world, and understanding that my son should be able to go to school tomorrow. However, if his friends won’t play with him and his teachers are nervous, I will keep him home, only to protect him from the ongoing emotional scars that this pandemic continues to deliver. 

*Names have been changed or abbreviated to protect privacy

Katie Sharff, MD is Chief of Infectious Disease at Kaiser Permanente NW in Oregon and Co-Chair of the Kaiser Permanente COVID-19 Vaccine and Medication Safety Committee. She has a professional interest in COVID-19 vaccine related myocarditis and has published two research papers on this topic. (https://doi.org/10.1002/pds.5439; https://doi.org/10.1016/j.amjcard.2022.02.039).  The opinions expressed here are her own and do not reflect the opinions of her employer.