I was quarantined weeks before the Bay Area rolled out the "shelter-in-place" order. My feelings on quarantine might have been more insightful then, before we were all doing it. The county public health department was aggressive in quarantining health care workers who might have been exposed because early in an epidemic, the most important intervention is identifying and isolating contacts. At the time, there were only a handful of patients in the U.S. hospitalized with coronavirus, and it made sense to aggressively close off those clusters. Unfortunately, since then, we have realized the much higher prevalence of disease in the community and the role of community spread in propagating COVID-19.

In any case, dozens of doctors, nurses, respiratory therapists, and staff were quarantined from this one patient. Fortunately, none of us developed symptoms, but it was nerve-racking. We were beginning to appreciate how severe this disease can be. One barrier to this - and the reason why for a while, we had claims that "this is like the flu" - is that coronaviruses are a general category, and the infections these viruses cause range from mild to life-threatening. The vast majority of (regular) coronavirus infections I see are mild, and it takes a real shift in perspective to see how much scarier COVID-19 is. Many of us have never seen Middle East respiratory syndrome (MERS) or SARS. I was still in college when the SARS epidemic happened. It was only during my quarantine period about a month ago that we began appreciating the data from China and realizing the severity of respiratory failure with COVID-19.

I don't usually ruminate, and I'm not a hypochondriac, but there's some degree of anxiety and guilt. Should we have isolated the patient earlier? Did I put my nurses and respiratory therapists at risk? Was there anything that could have clued me in earlier to this patient's diagnosis? When you're stuck in a 1000 sq ft apartment, these thoughts loom large. Time drags her feet.

And yet, for those two weeks, we didn't see any dramatic nationwide movement to prepare for this disease. It was already on U.S. soil, already putting patients in the intensive care unit and health care workers in quarantine, and most places were still doing business as usual. Hindsight is 20/20, and it's always easy to say we could have done more earlier, but I still stand by that sentiment.

By the end of my quarantine period, we were starting to see some mobilization, but the United States, and in particular, health care in this country, is a lumbering inertial beast. I spoke at a company-wide call with thousands of listeners about my experience with COVID and quarantine. Looking back on that just several weeks later, I wonder if I would have said something different knowing where we are now.