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Diary of a critical care doctor: Preface

  • Sean Bagshaw

On February 27, 2020, I started a journal, not sure where such writings would lead. While I have written many scientific papers and reports, I had never journaled before. This was foremost to build a relative synopsis of the unfolding events of the Coronavirus Disease 2019 (COVID-19) pandemic. However, as time passed, these frequent journal entries also found intent to document and help me navigate and reflect upon my personal observations, my thoughts and my impressions. These writings also reflect my perspectives as a frontline critical care physician, as a scientist and researcher, as a medical leader and importantly, as a son of ageing parents, a husband and a father of small children.

Perhaps such a record of the surreal and life-altering viral plague rapidly consuming our global community would serve as an archive of events to reminisce upon and to further share with my children and perhaps my children’s children. This text is meant to complement my long-hand journal entries and benefits from being written “after the fact” with some hindsight wisdom.

The World Health Organization (WHO) issued their first Situation Report on January 20, 2020, that summarized the events from December 31, 2019 through January 20, 2020 (https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf). This reported described the following:

  • On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China.
  • From 31 December 2019 through 3 January 2020, a total of 44 case-patients with pneumonia of unknown etiology were reported to WHO by the national authorities in China. During this reported period, the causal agent was not identified.
  • On 11 and 12 January 2020, WHO received further detailed information from the National Health Commission China that the outbreak was associated with exposures in the Huanan Seafood Wholesale Market, a live animal and seafood market, in Jianghan District, Wuhan City (Huanan Seafood Wholesale Market – Wikipedia). This market was believed to represent “ground zero” for the ensuing global pandemic. Of the first 41 patients hospitalized with this pneumonia of unknown etiology later confirmed to be due to 2019-nCoV, two-thirds had exposures to the Huanan Seafood Wholesale Market. Unfortunately, from this cluster, numerous healthcare workers (HCW) became secondarily infected, confirming that person-to-person transmission was occurring.
  • The Chinese authorities identified a new type of coronavirus, named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) which was isolated on 7 January 2020.
  • On 12 January 2020, China shared the genetic sequence of the novel coronavirus for countries to use in developing specific diagnostic kits.
  • On 13 January 2020, the Ministry of Public Health, Thailand reported the first imported case of laboratory-confirmed novel coronavirus (2019-nCoV) from Wuhan, China.
  • On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-nCoV from Wuhan, China.
  • On 20 January 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of laboratory-confirmed 2019-nCoV in the Republic of Korea.
  • Situation update: As of 20 January 2020, there were 282 confirmed cases of 2019-nCoV reported from four countries including China (278 cases), Thailand (2 cases), Japan (1 case) and the Republic of Korea (1 case); all cases in Thailand, Japan and Republic of Korea were exported from Wuhan City, China.

Additional Early Milestones:

Symptoms and Maximum Body Temperatures According to Day of Illness and Day of Hospitalization, January 16 to January 30, 2020

Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al.
First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-36.
  • On 27 January, 2020, the first case of the first case of laboratory-confirmed 2019-nCoV was reported in Toronto, Canada in an individual who had returned from Wuhan, China (https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019–ncov.pdf) (COVID-19 pandemic in Canada – Wikipedia)
  • The first description of community transmission of 2019-nCoV occurred in a women in B.C. on 5 March, 2020, who reported not having had any travel or exposure to anyone known to have been infected (Canada confirms first ‘community case’ of COVID-19: Here’s what that means | CTV News). At this time, the leading theories of transmission were via direct contact (i.e., fomites) with infected surfaces or possibly respiratory droplets.
  • On 5 March, 2020, the first case of laboratory-confirmed 2019-nCoV was reported in Calgary, Alberta.

My first journal entry was on 27 February, 2020. [More to follow.]

About the Author

Sean Bagshaw is an intensive care physician at the University of Alberta Hospital and a health researcher at the University of Alberta, in Edmonton. He has borne witness to the events of the global COVID-19 pandemic as a husband, as a father to young children, as a son to ageing parents, and as a member of the frontline team of healthcare professionals caring for people with COVID-19 in the intensive care unit.