The Invisible Hand — Medical Care during the Pandemic

This first-person narrative explores how the Covid-19 pandemic reshaped clinical decision-making, even for patients without viral infection. The author recounts the case of a 70-year-old man with stable angina who, before the pandemic, would likely have undergone coronary angiography despite guideline-based indications favoring medical management. As fears of exposure to SARS-CoV-2 escalated, the patient and his wife reconsidered and opted for conservative therapy—highlighting how pandemic-era anxiety inadvertently aligned their choices with evidence-based care. The piece draws on ISCHEMIA trial findings and broader clinical principles to underscore the shifting patient–physician risk calculus. It ultimately reflects on how fear, uncertainty, and evolving public health realities influence care delivery in unforeseen ways

This first-person narrative explores how the Covid-19 pandemic reshaped clinical decision-making, even for patients without viral infection. The author recounts the case of a 70-year-old man with stable angina who, before the pandemic, would likely have undergone coronary angiography despite guideline-based indications favoring medical management. As fears of exposure to SARS-CoV-2 escalated, the patient and his wife reconsidered and opted for conservative therapy—highlighting how pandemic-era anxiety inadvertently aligned their choices with evidence-based care. The piece draws on ISCHEMIA trial findings and broader clinical principles to underscore the shifting patient–physician risk calculus. It ultimately reflects on how fear, uncertainty, and evolving public health realities influence care delivery in unforeseen ways