US medical workers self-isolate amid fears of bringing coronavirus home
Dr Michelle Au is an anesthesiologist and, therefore, expert at quickly and safely putting patients on ventilators. Under normal circumstances, her work is in the operating room.
But in the midst of a respiratory disease outbreak she has a new job, which is both critical and dangerous.
With the coronavirus pandemic bearing down on communities across America, her Georgia hospital – like many others – has canceled all elective surgeries and pulled her on to a specialist airway team.
“Putting in an endotracheal tube is probably one of the highest-risk procedures,” for exposure, Au said. “It is directly accessing the airway where the virus lives. It could become airborne in the period of time the tube is put in,” she said.
And with supplies of personal protective equipment already dwindling, healthcare workers have a new anxiety: am I bringing coronavirus home with me?
“I personally am sleeping in the basement now,” she said. Her two children are under strict instructions to use a different bathroom, and not touch their mother’s things. The family has a do-not-cross-this-point policy for the basement.
“There is a sizable portion of people who have already started self-isolating,” in the medical community,” Au said. “They have started sleeping in separate bedrooms, separate bathrooms.”
She said many health workers believe they will be infected, saying: “It’s not a matter of if, but when.” It “looms larger because of this larger anxiety of [personal protective equipment] running out,” she added.
Under normal circumstances,N-95 personal respirator masks, face shields, eye protection would all be worn by medical professionals before certain procedures involving Covid-19 patients. But with outbreaks all over the world, there is massive demand for such equipment.
The need for supplies is so urgent, unmet and all-consuming, worried healthcare workers have started a new hashtag to lobby government – #GetMePPE.
Under normal circumstances, an N-95 mask would be tossed after one use. Not so now – Au gets one per day, and it is tucked away into a brown paper bag between uses. Hospitals and doctors’ offices are also guarding materials fastidiously. Many are kept under lock and key.
Statistics support the importance of meticulously dealing with the the contagion in medical facilities. In China, 41% of all Covid-19 cases were related to hospital transmission, and healthcare workers are at increased risk of developing the disease, according to recent research in the Journal of the American Medical Association.
Dr Christian Rose, a concerned San Francisco emergency department physician, was forced to move out of his apartment because he feared spreading the disease to his mother-in-law, who suffers from a degenerative lung disease. In a letter published in the New England Journal of Medicine, he described donning a 17-piece personal protective equipment set, removing it in 11 steps, and still wondering whether he would spread it to vulnerable members of his family.
“Once you have an at-risk person at home, you just can’t come home,” said Rose. He and other hospital staff were considering renting an apartment for people who may have been exposed, and did not want to expose family while in quarantine.
“What’s a safe way for us to maybe share a house? Should we get an apartment to give people access at different times?” he said. “If we know two of us are exposed, and we’re both quarantining, we can be together. We’re trying to do some calculus,” he said.
Just one stark example of the possible consequences of shortages is the story of the Italian physician Dr Robert Stella, who died earlier this month after caring for patients in the Varese region of northern Italy without appropriate equipment.
“We have run out of masks, but we don’t stop, we go on,” he told others, according to MedScape. He is now being hailed as a hero by colleagues.
At least two US emergency room doctors are known to be infected with the virus and in critical condition. Dozens more health workers are infected, and frontline workers have reported having difficulty getting tested for coronavirus. A recent survey of nurses found one-third lacked N-95 masks completely.
Federal government response has been confusing. At one point on Wednesday, Donald Trump invoked the Defense Production Act to help provide, “health and medical resources needed to respond to the spread of Covid-19, including personal protective equipment and ventilators.” However, he later said he would only invoke such a clause in a “worst-case scenario”.
While Au is working to help people during the crisis, she is also running for Georgia state senate in district 48. Normally, she likes to keep work and her political life separate.
But in this situation, she said: “There’s no more obvious example of the effect of community health on personal health,” than the coronavirus. “It shows the importance for government to have a science-based healthcare policy.”