No matter what a government, institution, or company does in response to coronavirus, there will be criticism. Even the best of decisions will draw second-guessing and doubt. At the beginning of this pandemic, with limited information and increasing urgency, these entities had to decide whether and when to start work-from-home, cancellation of elective surgeries, shelter-in-place orders, and economic relief bills. All of this is unprecedented. And all these decisions have such unforeseeable downstream impact that no matter what is decided, someone will be hurt. I am glad that, by and large, public health remains the primary motivating factor, though at the expense of economic uncertainty, social fragmentation, and societal disruption. I am sure when the dust settles, key stakeholders will be scrutinized for how they responded, but I personally have a lot of respect for them. Making necessary decisions without knowing all the consequences is a harrowing experience. Fortunately, in medicine and anesthesia and critical care, we operate with a good deal of data, experience, and expert consultation. Although there is uncertainty, I am able to mitigate it with nuanced, individualized clinical decisions and timely feedback to let me adjust. Even that is stressful enough. I cannot fathom what it's like to make decisions for something as big as the airline industry or public health department or preparation of a hospital system. Few people have the experience, foresight, and guts to do that. 

I suppose this is all to say that I really respect what has been done. I know there were failings, some egregious, and I don't want to apologize for those. But, for example, when the Bay Area issued its shelter-in-place order and continued to extend it at the expense of our economic prosperity, I don't protest too much. We saw a flattened curve of cases, allowing our hospitals breathing room, and for that I am grateful. I am sure if the orders came later or were less stringent or were lifted earlier, there would be other consequences.

I often say in this blog that this is all unprecedented, and I believe it is. But it means that we should draw crucial experience from it. We must learn from all the challenges, mistakes, and failings that we've made at small and grand scales in response to this pandemic. I am sure this will not be the last world-wide public health crisis we face. And I hope next time, our decision-making will be more nuanced, more refined, and more successful.