Four days ago, I woke up with a scratchy throat, congestion, body aches and fatigue. This is certainly not the first time I’ve experienced these symptoms, but it is the first time I’ve reported them in my 18 years of being a physician.

Khama Ennis

I work in an emergency room, and I spend at least nine hours each day staring down the hellscape that is about to occupy much of this country if we don’t act fast — and perhaps even if we do. Health-care providers are notoriously bad at following our own medical advice, and I am no exception. This time, though, I reported my symptoms, because it might have been a mild case of covid-19.

Sucking it up and going to work without reporting meant possibly spreading a virus that could put my patients, colleagues and their families at risk of exposure to a life-threatening illness. The hospital told me to come in for testing, which involved one of my fellow physicians and a nurse putting on N95 masks, face shields, gowns and gloves before meeting me in the cold parking lot while I waited in my car for a swab that went 3 centimeters deep into the back of my nose. Then I went home to wait for the results.

After four days in the backlog at the Department of Public Health, I finally got the result: It was negative. This time.

Deciding to report my symptoms meant asking colleagues to use a set of personal protective equipment – which is asking a lot. The N95 masks that they used are a precious commodity right now, so much so that our hospital’s new policy is to reuse masks for an entire shift unless they get soiled. A protocol has been created so that we all know how to clean the mask so it can be used again. Until last week, that would have been a violation of federal guidelines, and the regulators that issue hospital accreditations would have issued a citation. The new federal guidance says bandannas might be okay in a pinch.

For now, the health-care workers at my hospital have enough masks to handle the number of patients we are seeing. We think we are a week or two behind the cities that are already crippled by a lack of adequate supplies, like New York and Seattle. It is just a matter of time before we have an influx of local patients who are currently infected but not yet displaying symptoms. I’m already scared about it. Friends in the community have dropped off their leftover masks from DIY projects. I’ll bring them to the hospital now that I have been cleared to return. We are accepting donations in anticipation of future shortages.

Advertisement

Patients in emergency departments are usually in the middle of one of the worst days in their memory, even when there isn’t a pandemic. Decorum isn’t always top of mind, and I’ve had people cough and sneeze in my face more times than I care to recall. If I don’t have a mask and eye protection when a patient fighting the coronavirus coughs on me, I’ll have to decide whether it’s safe for me to see my children, whose elementary school is on its second week closed. Even before this started, I took a shower after every shift and before I touched anyone or anything in my home. Now I’ll be taking a shower before I leave the hospital to make sure I don’t inadvertently bring the virus into my car.

I am lucky to have children who are healthy and would probably be asymptomatic or recover quickly even if they become ill. Their father, my ex-husband, is healthy, too, but covid-19 seems to strike men more severely than women. If the kids go to their week with him as silent vectors because of me, is it fair to put him at risk? If my test result had come back positive, then it would already have been too late, and we’d just have to see how it played out. Now we’ll have to decide every week. Meanwhile, my father, who’s 72, is one year out from a heart and kidney transplant, so we will clearly not be seeing my parents for quite some time.

This pandemic is beyond humbling and terrifying for everyone I know. None of us have ever seen anything like it. In emergency medicine, we have always had a very simple social contract with our patients: Do whatever you want to yourself – smoke, drink, overdose on drugs – and we’ll take care of you. But now what we all do in the community has an impact far beyond ourselves.

Please, let’s all act like it. Stay at home if you can. Have your book club meeting as a group video chat. If you’ve stocked up on protective equipment that nurses and doctors need, contact to your local hospital to see if they can use it. Do what you can – even if it means doing nothing at all. It’s not too much to ask when so many lives are on the line.

Khama Ennis is an emergency physician and the chief of emergency medicine at Cooley Dickinson Hospital in Northampton, Massachusetts.

Copy the Story Link

Only subscribers are eligible to post comments. Please subscribe or login first for digital access. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.

filed under: