Challenges in the Pandemic: A Multidisciplinary Approach

Review by L Flood
Middlesborough, UK

We have seen countless journal articles (the Preface records at least 90,000), often contradictory, relating to the COVID-19 pandemic. I am however impressed that anyone could write and publish a book in the obviously limited time allowed. The result is a marvellous resource for anyone in clinical practice. At the time of reviewing it is only marketed in India, but I am assured that an international release is imminent and certainly this is “time sensitive”.

One of the editors is an otolaryngologist, Christopher de Souza, from Mumbai, India, the author or editor of 38 textbooks to date. Here, he co-authors a chapter on tracheostomy in the pandemic. Fortunately the trend away from invasive ventilation did reduce demand for the procedure. There is an interesting review of the literature considering safety measures for operators, ideal timing and the effect on outcomes. The authors favour percutaneous tracheostomy and there is a nicely illustrated step by step guide to the procedure.

In this multi-author text there is also so much more of general interest. The content is remarkably topical, describing the progress of the disease and therapy at least up to the late summer of 2021. A series of chapters covers the manifestations of the disease in the cardiovascular, pulmonary, renal and gastro-intestinal systems and does so in a style that is very readable and “user friendly”. I found the neurological and cutaneous manifestations a real eye-opener and am grateful for my personal current vaccination status after reading them all. The successes and false hopes of pharmacotherapy rate two chapters. Indeed, at risk of just listing chapter heading, titles such as “Emergency Medicine”, “Anesthesia”, “Telemedicine” give a flavour of just how comprehensive is this book.

A favourite (and, to be honest, that surprised me) was “Palliative Care during COVID-19”. This is a remarkable piece of writing, starting with the widespread failure of doctors to see “the big picture”, to break bad news and to avoid prolonging the dying process inappropriately. The four case reports are moving and show the challenge of dealing with carers convinced the pandemic is a hoax, or those who rely on a divine miracle, or those simply in denial. I could re-read that chapter.

It has been a remarkable achievement by the editors, the authors and the publishers to produce a book of this quality in that time frame. Even if the pandemic abates tomorrow, there will always be the threat of the Omega strain that turns us into The Walking Dead, or of whatever virus fate inflicts upon us. The generic messages here will continue to be of great value and I really do like the cover illustration. That is the spirit needed.