Erik Anderson, MD, is an emergency and addiction medicine physician at Highland Hospital, the county hospital in Oakland, California, where he works in the addiction medicine clinic weekly. Additionally, he works at San Leandro Hospital, a community hospital in Alameda County.

BT: We are now a year into the pandemic. Tell me about the moment when the pandemic became real for you.

EA: I remember seeing the news reports about the coronavirus in China and how it was spreading to nearby countries. I thought it would be like SARS-CoV-1 and we would see what happens. I thought there’s no way that this would become a pandemic. I don’t think it was even on my radar that this would change our lives as we know it. It felt real to me when I started seeing the news in Italy of emergency docs giving reports of how overwhelming it was, the devastation, and how unbelievably out-of-a-movie things were there. I thought to myself, “Well, this is happening now. People need to get ready.” It felt like, from that point on, it was full steam ahead.

BT: Do you remember the first patient you saw with COVID-19?

Dr. Erik Anderson talks with an ED patient.

EA: There were two patients that I remember when we first started testing people. It was midnight on an overnight shift when a woman came in with mild upper respiratory symptoms. She said, “There was a COVID-19 outbreak at my school.” Now, this was well before there were actually COVID outbreaks or clusters in our area. I thought to myself, “Oh my gosh. How did I not know about this? This is crazy.” I remember donning all the gear for the first time and looking at an instruction sheet on how to enter her room. In the end, we couldn’t even order a COVID test for her because at the time, we needed the Public Health Department’s approval. They weren’t convinced that there was a true outbreak there. So I had to go back in there and tell this poor, scared woman, “Sorry, the Public Health Department is not letting me order this test.” I remember that patient so clearly—just as clearly as the next patient I saw with coronavirus, who was a low-acuity, young, healthy patient with flu-like symptoms that ultimately went home and did fine. I remember, at the time, there was this whole thing with contact tracing when you see a COVID patient, and the hospital would track you down to tell you about a patient that you saw weeks ago who tested positive for COVID.

BT: Besides testing, were there any other obstacles you faced early in the pandemic when caring for COVID-19 patients?

EA: There was always so much discussion about who had enough testing and PPE for the weeks ahead. Working at a safety-net hospital always begged the question, Do we have enough of the resources that other places had? Early on, it was clear that big academic medical centers had more access to testing, and we had to figure out how to partner with these centers to help with our testing. So much of it felt unfair. We were caring for a very vulnerable patient population, and it didn’t feel like we had the same level of support as some of the places that had more resources. Things have not been equitable throughout the entire pandemic, and it has disproportionately impacted different health systems, communities, and patient populations. Whether it be testing or access to monoclonal antibodies, one of the biggest takeaways for me is how inequitably COVID hit various communities and health systems along the way.