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In Tennessee, Dr. Rafael Paez says understanding coronavirus initially was 'like flying blind'

"There were a lot of unknowns, and there are still a lot of unknowns," said the fellow in pulmonology and critical care.
Image: Dr. Rafael Paez.
Dr. Rafael Paez.Daiana Ruiz / for NBC News

The coronavirus pandemic has provided a training experience like none other for Dr. Rafael Paez.

COVID-19 cases began popping up in the middle of his first year at Vanderbilt University Medical Center, where Paez is a clinical fellow specializing in pulmonary and critical care.

Helping care for critically ill patients was challenging at first because of the lack of information about the coronavirus. It was "almost like flying blind," Paez said.

"It was a new disease, and we knew very little about it," he said. The unusual circumstances led doctors to use observational data, meaning information based on the results of a few patients, from other areas that had already been hit hard by COVID-19.

"You didn't have hard data to guide your management. You had some principles based on similar disease processes, but there were a lot of unknowns, and there are still a lot of unknowns," he said.

Full coverage of the coronavirus outbreak

But in just a few months, doctors have gone from using anecdotal experience to having evidence of how things work.

"Some of it is not necessarily 100 percent conclusive, but this is definitely much better information than what we had back then," said Paez.

The same has happened with understanding how the virus spreads. "Now we do social distancing and masking. Those are the kinds of things that we were not necessarily doing when the virus hit, because we learned as time went by," he said.

A large volume of medical literature on coronavirus is now published daily, and physicians like Paez are working to keep up with the findings. "It's great, because it means society has really invested in trying to find a way to take care of the disease."

One of the most difficult aspects for health care workers has been the emotional toll. Caring for very ill patients is "emotionally taxing," Paez said. "The patients are really sick, and many of the patients don't make it, so it's hard."

Born and raised in Cuba, Paez completed military service, required for all male citizens, and then began studying engineering. It was a field his parents, his aunts and his uncle had gone into.

But not seeing a future for himself there and wanting more freedom, he left Cuba in 2006 and settled in West Palm Beach, Florida, where he completed his undergraduate degree.

Paez already had an eye on studying medicine. Before leaving Cuba, he met a surgeon who had performed a lifesaving operation on a child.

The exchange between the surgeon and the child's family "changed my entire career and everything after that," Paez said.

It inspired him to take a phlebotomy class in college, which he enjoyed. After he graduated, he attended Florida International University's medical school in Miami. He completed his residency at Brigham and Women's Hospital in Boston, one of Harvard Medical School's teaching hospitals.

At Vanderbilt, apart from his recent work treating coronavirus patients, Paez is working with a medical professor on lung cancer research.

"I really love medicine," he said.

When he is not working, Paez spends time with his wife, getting ready for a big milestone: They are expecting their first child.

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