While on a hike with the dogs the other day, practicing my social distancing, I heard something that I have not heard in a while; the sound of a commercial jet in the air. I stood and stared at it for a bit. To my surprise, I saw two other contrails in the distance. It has been weeks since I have seen or heard a commercial jet in the air; something that I always took for granted since they were always there—like toilet paper. Never did I ever think that there would be a day when I would not see a jet in the sky or toilet paper on the shelves; not just for a day, but for weeks!!
A World at War
The world is currently at war with the Covid 19 virus. While none of us truly know when this war will end, we can expect that it will have a significant impact on our future. “Necessity is the mother of invention” and war-time is a great spawning ground for both new inventions and advances in existing technology. Following World War II, innovation shaped a post war world. The jet engine, pressurized aircraft cabins, and the use of radar ushered in modern air travel; making the world a smaller place. Synthetic rubber replaced natural rubber and made for more durable tires for vehicles and aircraft. This led to faster cars, heavier industrial equipment, long haul trucks, and larger, more capable aircraft. Penicillin was the first antibiotic ever introduced. The introduction of newer and more powerful antibiotics revolutionized the treatment of infections and was the gateway to modern medicine. Helicopters became another effective method for air travel. The later development of the jet turbine engine made helicopters faster and more capability of lifting larger payloads vertically. Finally, the V2 rocket set the stage for humans to go to space. Imagine what the world would be like without satellite communication and navigation. It also set the stage for modern space travel and exploration. However, some post World War II inventions have experienced their fair share of controversy. For example, plastics have been considered both a scientific wonder and an environmental disaster. Nuclear energy and nuclear weapons could also be considered a blessing and a curse.
The Impact of Communication Technology
Many have compared this pandemic to other events such as the Spanish Flu in 1918, the AIDs crisis in the 1980’s or H1NI in 2009. In all of the many comparisons, I would like to focus on one in particular; our ability to communicate. Take a moment to think of how communication has changed from the Spanish Flu in 1918 until now. Communication is not a new invention. Scientists estimate that humans first began to communicate as far back as 2 million years ago. While many animals communicate with each other, our communication ability is unmatched. Over the years, we have continued to expand our abilities to communicate and interact on so many levels. Prior to Covid 19, we already had in place a litany of news channels covering the spectrum of every opinion; conservative, liberal, and all those in between. In addition to that, we had Facebook, Instagram, Twitter, Zoom, Snapchat and many more. If that is not enough, there is on line video gaming, on line gambling, on line shopping, grocery and food delivery, on line social forums and chat rooms. We are now communicating more efficiently and effectively than we ever have in the past. Our ability to communicate has given us an amazing technological advantage during this pandemic. For the first time, we, as a species, have been communicating on a global level both as societies and individuals. National and local leaders have been able to spread the word concerning this pandemic in order to take effective measures to slow the spread. Doctors and scientists from all over the globe have been able to connect in an effort to formulate methods for testing and treatment. Our many other forms of communication have allowed people to stay mentally and psychologically connected while maintaining physical separation; the only known way to slow the spread of the virus. Most importantly, human beings have now become so interconnected that we have been able to speak with one voice and shut down the entire world economy for the sole purpose of containing this virus and limiting its effect on the world population. These are things that we have never been able to do prior to this pandemic. It truly speaks to how powerful our communications capabilities have become in unifying the world.
Communication and Healthcare
Long after this pandemic end, it is likely that the many advances in communication will continue to shape just about every business and industry to include healthcare. There is no longer a question that we are facing an unprecedented shortage of physicians in this United States and the World. But, in addition to a shortage, we are also facing issues of access to care, inconvenient hours, and uneven distribution. For example, larger cities may have adequate numbers of both primary care physicians and specialists; however, moderate sized cities and towns as well as rural areas lack sufficient primary and specialty care coverage. Advances in communication will likely be used to make up for these deficits. Carson Tahoe Regional Medical Center already uses telehealth services to fill needed positions such as neurology. Neurologists from the University of Utah are available using Telehealth in order to provide real time guidance to the Emergency Room physicians for patients suspected of having a stroke. Telemedicine has been available to patients prior to Covid 19, but it was slow, cumbersome, and restricted. Now, Telemedicine has been opened up widely and many of the physicians’ offices are using it to connect to patients. At Carson Surgical Group, we are employing Telemedicine in order to give our patients access to care, while still being able to maintain social distancing during this difficult time. We are also using telemedicine to communicate with specialists at UC Davis concerning difficult cases and complex surgical issues that may need a higher level of care. We can evaluate patients here, communicate the findings about patients to specialists at UC Davis, send imaging studies for their review, and create a treatment plan. This helps limit patient travel and facilitates patient care for those cases that are beyond the capabilities of our hospital. For patients who do not speak English, telemedicine translation services allow physicians and nurses to communicate with the patient in their language. No longer do we need translators on site. Translation can be done remotely, similar to skype or zoom. Remote meetings, online forums, electronic educational opportunities, instructional videos, and telesurgery have all come on line and are helping surgeons bring new technology and advanced treatments to their local areas. This also helps patients avoid long distance travel to a tertiary care facility in order to get care in a location that is far from family, friends, and emotional support. We can only expect that our communication capabilities will continue to become an ever increasing, integral part of patient care in the years to follow Covid 19.
Communication and the Future
While we do not know exactly when this will end, we know that it will. Maybe we will know that it is over when we start seeing commercial jets in the air and toilet paper on the shelves again. We also know that this will change our world in many ways, one of which is how we communicate. Physicians and their patients will benefit from these advances in communication because it will allow us to bring more advanced technology and treatment options to local and regional communities even in a situation where we have less primary and specialty care physicians. Obviously, there will be some controversy as our communication continues to evolve. As with plastics and nuclear power, our advances in communication must be temporized by the fact that we are a social species. We need one on one, face to face interaction. We cannot simply isolate ourselves and rely on cyber connections and computer screens to interact. Let’s face it, even in this age of advance healthcare communications, imaging systems and artificial intelligence, nothing beats an “old-fashioned” history and physical exam. There is also the issue of communication overload. We have so much information coming to us from so many different angles that we will need to find a way to filter it, organize it, and fact check it. Still, Covid 19 has clearly demonstrated the importance of communication if we are to survive as a species. The world will recover, but our communications will never be the same.
Dr. Kevin D Halow MD MBA FACS