Science’s COVID-19 reporting is supported by the Heising-Simons Foundation.
Ready or not, the patients were coming. This time last year, physicians around the world prepared, most for the first time in their careers, to treat a new disease—over and over and over again.
“There was a terrible sense of foreboding, like in a movie when the minor key music starts playing,” says Robert Arntfield, a critical care physician at Western University in London, Canada.
In Wuhan, China, the doctors who first encountered the pandemic coronavirus raced to share surprising symptoms and possible treatments with far-flung colleagues.
In Tokyo, ill cruise ship patrons from the Diamond Princess were wheeled into the hospital of the National Center for Global Health and Medicine. Infectious disease physician Norio Ohmagari dusted off the best treatment plan he had: one for the related coronavirus that causes Middle East respiratory syndrome. “Honestly,” he says, “we were not quite sure what we could do.”
In the United Kingdom’s Cynon Valley, a man arrived at a clinic for routine bloodwork, then announced he had a high fever and cough. Shouts went out for a doctor. As primary care physician Chris Butler prepared to assess the patient, “I was dropping my gloves,” he says. “I was pretty nervous.”
Over the harrowing year that followed, clinical evidence on how to treat the pandemic coronavirus poured in—a muddy torrent of hundreds of thousands of papers, preprints, and press releases. Many physicians were torn between waiting for results from large clinical trials, the gold standard of evidence, and offering something, anything, to the gravely ill patients in front of them. “These are smart physicians who are watching people get very sick, watching people die, feeling helpless, and wanting to do whatever they can,” says Lisa Moores, a pulmonary and critical care physician at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.