Opinion | “Like Standing on the Shore and Watching a Tsunami Approach”

Here’s why.

First, we wonder how safe it is to protect yourself only with patients with symptoms. We know that asymptomatic people spread the virus three days before symptoms appear. Currently, my head injury and heart attack patients in Virginia have asymptomatic Covid-19 much less often than patients in New York or California, but that may not be long. The virus will soon become so widespread that we have a high suspicion index for everyone, regardless of whether he has respiratory symptoms or not. We could already be at this point; We just don’t know because there is a lack of tests.

A colleague recently saw a patient as a “headache”. Only when he got close enough to put a stethoscope on her chest did she announce that it was a sinus pressure accompanied by a fever, cough, and contact with a family member who had recently returned from Europe. We need enough PPE to wear a mask everyone Patient regardless of the complaint.

Second, real life in the emergency room is far from being as orderly and clear as the algorithms that our public health officials are developing. As I try to risk stratify patients to know which level of protection to use according to the latest algorithm, I am navigating through inefficient computer systems, answering questions from three different people, and trying to reach the multitude of patients who are on me wait and watch how rescue workers bring more patients through the door. As my colleague found out from his headache patient, patients don’t always tell the whole story when they are tried. In addition, the virus does not always wait for the highest risk interactions such as intubation and suction to take the opportunity to spread. We shouldn’t wait until we intubate or suck to carry N95. In addition, the Covid 19 test is not always completely reliable. Just like the flu test, there will be false negative results.

Third, state-certified emergency doctors are too valuable a resource – only 39,000 of us for the whole country – to play with their health. In small hospitals like mine, groups of doctors are small and staff with limited backup are small. Trust me, with our expertise, to make quick decisions and steer the flow quickly, if you want experienced emergency physicians to protect you at the forefront, not quarantined, sick or dead. Without enough PPE, it’s about it whennot when we go down. Doctors from other specialties will take our place, but they will not have the same skills. The ophthalmologists, orthopedists, or nephrologists who will replace us in the emergency room will do their best, but regardless of our friendly eye, bone, and kidney specialists, they are really the doctors you want to see when you arrive in the emergency room Suspected Coronavirus Infection?

The demoralizing reality I’m facing is that PSA may not come anymore. So I went to my local hardware store last week and bought a face mask. I post on social media with other doctors and nurses on the front line with the hashtag #GetMePPE. It’s crazy to look for medical equipment in a hardware store as a doctor.

In the meantime, I lose sleep because I don’t have a good course of action. Do I use masks with every patient to protect myself from asymptomatic spreading and to run the risk that the masks will go out completely? When the PSA is empty, do I go inside like a fireman storming into a burning building in a speedo and flip-flops? The death of Italian doctors Robert Stella and Marcello Natali, who bravely continued to work without PSA, is a terrible warning.

Will I get to a point where I have to make a decision to save my family or patients? I’m worried about my two teenage sons and parents in my 70s. My family has not signed up to take this risk. To protect them, I set up a decontamination zone in my washroom. When I get home after my shift, I go straight to the washroom, take off my clothes, and leave all the work utensils there before entering the rest of the house and hugging my kids. I cried last night when I made the decision that when it comes to a local situation, my sons will stay with other family members, not with me. There is nothing more difficult for a mother.

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