My jaw is aching from my fitted N95 mask, along with a headache from the face shield wrapped around my forehead for the last eight hours during my ER shift. I did not take a break to eat, drink, or go to the bathroom as a flurry of patients arrived at nearly the same time to our “hot zone” possible-COVID pod in the emergency department. One had a cardiac arrest and needed to be resuscitated and put on a ventilator, one had sudden onset weakness from a COVID-associated stroke, and one had a fall leading to a traumatic brain bleed – and had been exposed to COVID.
Several other patients with shortness of breath needing evaluation and hospital admission had also recently arrived. “By the numbers” this day, pre-COVID, would not have been considered a busy one in the ER. However, both the mental vigilance and physical burden of patient care in PPE, in an already fast-paced environment, are tremendous.
Several weeks into the order to stay home, everyone is getting restless, my toddler among them, and the weather is more beautiful every week. While many are “over COVID,” the reality is that COVID is far from over for our city.
We must remain vigilant.
Our region was among the earliest affected, and now hardest hit, in the country. However, from both the ER frontline and the overview from Jefferson Health’s Incident Command Center, stay-at-home orders and social distancing efforts since the initial spike in cases here have helped flatten our curve. This mitigation effort means you may currently be fortunate enough to not personally know someone who has gotten very sick or died from COVID. But we do.
We must ensure that the decline in cases we hope to see in the coming weeks does not become the trough before another regional wave of COVID-19.
I saw this too many times during my work in Liberia during the West Africa Ebola epidemic. One seemingly benign dinner gathering or birthday visit is the perfect kindling for these viruses.
The challenge with this coronavirus is that for some there will be no significant symptoms — you will feel fine but may still be a public health risk. For others, it may feel like a cold, a GI bug, or the worst flu of your life. For the unlucky ones, respiratory issues will lead you to meet my colleagues in the ER or ICU. We know the elderly and those with other medical problems are at increased risk for severe illness, but among healthy individuals, it is hard for us to predict exactly who may land on the critical care end of the spectrum.
But physical distancing, wearing masks, hand washing, and reducing movement efforts are working. COVID-19 cannot sicken people it never meets.
Whether currently attempting (and let’s be honest, failing) to have your work meetings via Zoom while homeschooling your 8-year-old, or connecting with family for a meal on FaceTime – these efforts are making a difference to us on the front line.
I once thought the seemingly endless days entirely sealed into a sweaty Tyvek suit while working in a treatment unit during the peak of the Ebola crisis in Liberia would be the biggest challenge of my medical career. One out of two of my patients died day after day, and trying to better understand and manage that disease in a limited-resource setting was an unforgettable trial. However, the scale of COVID-19’s impact on our country, and the inequities it highlights in our city, reveals unprecedented challenges, to which we must rise together.
This pandemic will forever change our world view. But the stay-at-home part? That will be temporary.
Scientific and medical communities the world over are working tirelessly to learn more about this disease, developing improved tests, treatments, and a vaccine. We have started plasma donation and treatment protocols at Jefferson Health in addition to many other trials to evaluate possible treatments.
We need more time.
Until we get numbers down to the level of tracing for each positive case, it is critically important that we follow public health mandates and continue distancing. Patience with resuming normal activities and expanding social circles will continue to save lives.
Your efforts already prevented an earlier surge here. It allowed us time to procure more personal protective equipment and ventilators. We created more ICU capacity at Jefferson hospitals than we could have once imagined. We have endless pandemic response maps, tiered surge plans for staff and space, and layers of on-call teams.
The front lines continue to rely on your good sense and goodwill in these extraordinary times.
Thank you for being part of this team.