Elna Schiopu, MD, is a rheumatologist who has been in practice for nearly 15 years. She is affiliated with University of Michigan Hospitals & Health Center and an associate professor of internal medicine/rheumatology at the University of Michigan Medical School, Ann Arbor, Mich.
Dr. Schiopu has experienced the COVID-19 pandemic response from both clinical and research perspectives. She recently discussed her experiences with The Rheumatologist (TR).
TR: What lessons have you learned from the pandemic?
Dr. Schiopu: The question is complex, and this situation is unprecedented. There are several layers around COVID-19 knowledge, starting with the naked data surrounding what happened, such as structure of the virus, its transmission, its mortality, etc. The next layer is the different perspectives [on] interpreting the data—epidemiologist, infectious disease experts, etc. The following layer is the media and the spinning by both traditional and online media in their presentation of the facts. The last—and probably biggest layer—is how do we interpret [the data], and how we adjust to what is happening from a family, physician, immunology perspective.
TR: How did your practice change to meet the demands of the pandemic?
Dr. Schiopu: My feeling was incredible frustration. It’s like when patients bring me a bottle with a supplement, hand it to me and ask if it is safe. The problem is we have very minimal data on what is in it—let alone its safety.
I [have] felt the same through most of the pandemic. Patients are told to ask your doctor, but what do we know? Having no data is almost better than so much contradictory data. As a physician with patients who have family and friends calling us and asking what to do, it was frustrating to say the least.
New patient access became complex because everything was shut down. When patients were sick, there was no hesitation. We were able to convey to our patients the need for them to start immunosuppressive drugs and not wait for the pandemic to end.
What hindered me—and I am beyond furious—was state government interference in our medical practice. There was a time when the governor of Michigan—who does not hold a medical license—banned doctors from prescribing hydroxychloroquine for COVID-19. This [decision] created a lot of hoops for prescribing this medication to non-COVID patients.
In addition, the lengthy, statewide strict lockdowns spread fear and distrust among our patients without seemingly helping in any way with transmission of the virus. At times, I felt advocating for our patients could result in professional backlash, because we still had (have) to keep up the narrative that this virus kills everyone in its path—which we are learning is far from being true.