Tuesday, March 24, 2020
On The Frontline In The War Against COVID-19
Follow him on Twitter here: Craig Spencer MD MPH
Many of you asked what it was like in the ER right now. I want to share a bit with you.
A Day in the Life of an ER Doc - A Brief Dispatch from the #COVID19 Frontline:
Wake up at 6:30am. Priority is making a big pot of coffee for the whole day, because the place by the hospital is closed. The Starbucks too. It's all closed.
On the walk, it feels like Sunday. No one is out. Might be the freezing rain. Or it's early. Regardless, that's good.
Walk in for your 8am shift: Immediately struck by how the calm of the early morning city streets is immediately transformed. The bright fluorescent lights of the ER reflect off everyone's protective goggles. There is a cacophony of coughing. You stop. Mask up. Walk in.
You take signout from the previous team, but nearly every patient is the same, young & old:
Cough, shortness of breath, fever.
They are really worried about one patient. Very short of breath, on the maximum amount of oxygen we can give, but still breathing fast.
You immediately assess this patient. It's clear what this is, and what needs to happen. You have a long and honest discussion with the patient and family over the phone. It's best to put her on life support now, before things get much worse. You're getting set up for that, but...
You're notified of another really sick patient coming in. You rush over. They're also extremely sick, vomiting. They need to be put on life support as well. You bring them back. Two patients, in rooms right next to each other, both getting a breathing tube. It's not even 10am yet
For the rest of your shift, nearly every hour, you get paged:
Stat notification: Very sick patient, short of breath, fever. Oxygen 88%.
Stat notification: Low blood pressure, short of breath, low oxygen.
Stat notification: Low oxygen, can't breath. Fever.
Sometime in the afternoon you recognize you haven't drank any water. You're afraid to take off the mask. It's the only thing that protects you. Surely you can last a little longer - in West Africa during Ebola, you spent hours in a hot suit without water. One more patient...
By late afternoon, you need to eat. Restaurant across the street is closed. Right, everything is closed. But thankfully the hospital cafeteria is open. You grab something, wash your hands (twice), cautiously take off your mask, & eat as fast as you can. Go back. Mask up. Walk in.
Nearly everyone you see today is the same. We assume everyone is #COVIDー19. We wear gowns, goggles, and masks at every encounter. All day. It's the only way to be safe. Where did all the heart attacks and appendicitis patients go? Its all COVID.
When your shift ends, you sign out to the oncoming team. It's all #COVIDー19. Over the past week, we've all learned the signs - low oxygen, lymphopenia, elevated D-dimer.
You share concerns of friends throughout the city without PPE. Hospitals running out of ventilators.
Before you leave, you wipe EVERYTHING down. Your phone. Your badge. Your wallet. Your coffee mug. All of it. Drown it in bleach. Everything in a bag. Take no chances.
Sure you got it all??? Wipe is down again. Can't be too careful.
You walk out and take off your mask. You feel naked and exposed. It's still raining, but you want to walk home. Feels safer than the subway or bus, plus you need to decompress.
The streets are empty. This feels nothing like what is happening inside. Maybe people don't know???
You get home. You strip in the hallway (it's ok, your neighbors know what you do). Everything in a bag. Your wife tries to keep your toddler away, but she hasn't seen you in days, so it's really hard. Run to the shower. Rinse it all away. Never happier. Time for family.
You reflect on the fact that it's really hard to understand how bad this is - and how bad its going to be - if all you see are empty streets.
Hospitals are nearing capacity. We are running out of ventilators. Ambulance sirens don't stop.
Everyone we see today was infected a week ago, or more. The numbers will undoubtedly skyrocket overnight, as they have every night the past few days. More will come to the ER. More will be stat notifications. More will be put on a ventilator.
We were too late to stop this virus. Full stop. But we can slow it's spread. The virus can't infect those it never meets. Stay inside. Social distancing is the only thing that will save us now. I don't care as much about the economic impact as I do about our ability to save lives
You might hear people saying it isn't real. It is.
You might hear people saying it isn't bad. It is.
You might hear people saying it can't take you down. It can.
I survived Ebola. I fear #COVIDー19.
Do your part. Stay home. Stay safe.
And every day I'll come to work for you
You can follow him on Twitter here: Craig Spencer MD MPH.
Note: This thread is related to #Coronavirus #COVID19
Follow the World Health Organization's instructions to reduce your risk of infection:
1/ Frequently clean hands by using alcohol-based hand rub or soap and water.
2/ When coughing and sneezing cover mouth and nose with flexed elbow or tissue - throw issue away immediately and wash hands.
3/ Avoid close contact with anyone that has fever and cough.
Craig Spencer MD MPH@Craig_A_SpencerDirector of Global Health in Emergency Medicine @ColumbiaMed/@NYPhospital and Faculty in Forced Migration & Health @ColumbiaMSPH | @MSF_USA BoD |#Ebola survivorMar. 24, 2020
Posted by CT Bob at 3/24/2020 01:20:00 PM